The bill is the latest stage in a decade long saga that began in the mid-1990s when the health service started shifting care for deeply dependent patients whose condition could no longer be improved medically but who required continuing nursing as well as social care.

The patients were moved out of free NHS care and on to the social care budget, where they were means tested for the support they received.

Given the level of care such people needed, families and individuals faced bills that in some cases ran to tens of thousands of pounds.

In 2003 Ann Abraham, the health service ombudsman, said that health authorities had “misinterpreted and misapplied” the difficult rules concerning the boundary between health and social care since 1996. The result, she said, had been both “hardship and injustice”.

The health department agreed to review cases and said yesterday that it had so far examined 12,000.

“In about 2,000 cases it was found that the decision not to award NHS funding had been incorrect,” a departmental spokesman said. “The NHS has paid restitution to the affected individuals or their families, totalling £180m to date,” or about £90,000 on average.

A further 1,300 cases remain under review, with the aim of completing them by the end of March. However, the department said that it was not possible to estimate what the final bill would be.

The department said that the ombudsman’s ruling and the review had led to improved processes within the NHS in deciding who continued to get free treatment.

About 40,000 people get continuing care packages at present.

Mervyn Kohler of Help the Aged, the charity, said that while restitution was welcome, for many the payments came too late. Some people had been forced to sell their homes to pay for care.

The whole system for continuing care remained “a terrible mess”, Mr Kohler said. People were forced to navigate a complex system at a time when they were ill-equipped to do so. Many inconsistencies also remained, he said.

This underlined the need for the government’s promised green paper on social care to lead to a radically new funding system that was “easy to understand, accessible and properly funded”.

The Alzheimer’s Society said that thousands of people with that disease received only means-tested assistance.

From:
http://www.ft.com/cms/s/0/422bbd44-d9d8-11dc-bd4d-0000779fd2ac.html