Pensioners must beware putting all their eggs in one basket

It leaves the victims and their relatives in a state of fear and

shock, especially when the muggers are people they had come to trust.

And, believe it or not there are people, particularly in the south of

England, who did trust the Government, who accepted its assurances and

left it in charge of the country.

Now, having been taken in by a glib yarn about the need to close down

Victorian institutions and transfer senile patients to modern community

care schemes, they have discovered their pensions are missing.

There are now signs that this racket is starting to operate in

Scotland, so be warned. It works like this: If you have dementia and are

being cared for in an NHS hospital, it is free.

Many of these hospitals are past their sell-by date, so you are

offered a scheme whereby they are shut down and the patients transferred

into the community. Greater Glasgow Health Board is embarking on such a

plan, shedding 1500 psychiatric-sector beds between now and the year

2000.

The catch is that if the former NHS patients end up in nursing homes

under the aegis of the social services, it is not quite so free.

Patients are means-tested for income and asset-stripped for savings over

#8000.

The unkindest cut falls where the patient is the holder of an

occupational pension and has a spouse. These people belong to an era,

not yet totally dead, when the men were the breadwinners and the women

kept house.

The pension is widely recognised as a joint asset, for the benefit of

husband and wife; this is acknowledged in divorce law and in

inheritance, when the wife's share carries on after the husband has

died.

Not so in the living death of Alzheimer's and other forms of dementia

if the husband is in a nursing home; the entire pension is up for grabs,

leaving his wife with nothing but income support to keep herself in the

family home.

The home itself will be safe as long as she can hang on in there; but

if she sells up to move somewhere more modest, the asset-strippers will

be back.

In Glasgow's Mental Health Strategy the term ''community supported

accommodation'' describes residential care for mentally ill people which

is not provided on an NHS in-patient basis, at a level suitable for

patients requiring long-term but less intensive care than is provided in

a hospital setting.

''Subject to joint assessment (including discussion with the GP) it is

anticipated that the majority of patients requiring this form of care

would be discharged from continuing NHS specialist care,'' says the

strategy.

That assessment will be the key. In six years' time the balance will

have swung completely. There will be 360 health service continuing care

beds instead of the 1597 we have now; the 334 community supported places

will have swelled to 1275, expected to take on a range of dependency.

Many of them will be purchased from the private sector in partnership

arrangements of the type already in force, and the health board assures

us that where someone is assessed as needing NHS care they will get it

as before.

But it seems inevitable that fewer people who would have been an NHS

responsibility in the past will remain so. The elderly population in

Glasgow is expected to have fallen (against the Scottish trend) by more

than 7% by 2002, but the reduction in spending from the strategy will be

more than 11%. The other side of the coin is that social work

departments, who have to make the system work, are not being given

enough cash to do so.

Care in the community, a concept that has wide support on its own

merits, was not supposed to be a cheap option; it now appears to be a

vehicle for the Government to disengage still further from public

provision for those in need.

As for those still in a position to prepare for the future, the smart

move is into separate his and hers pension schemes instead of putting

all your eggs in one basket.

Of course there is no reason why those with the means should not

contribute towards their own care. If they are old and in a decline from

which they will never recover, it is fair to say the rainy day they were

saving for has arrived.

I am also ambivalent about the plight of old ladies living in houses

far too big for their needs when so many families with young children

are stuck in slums, high flats, or bed-and-breakfast accommodation.

And you could be brutally egalitarian about it and argue that these

are people who were luckier than the rest in being able to afford to

make future pension provision when they were younger, and that a drastic

redistribution of their assets is necessary to spread the growing burden

of caring for the old.

All of these things are true, up to a point. Brutal egalitarianism,

however, is supposed to have disappeared with the Berlin Wall; it is

certainly not the manifesto on which this Government was elected.

But then, the Government also told us the health service was safe in

its hands.