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The core founding principle of the NHS is that it should provide health care irrespective of ability to pay, from the cradle to the grave. This principle has been eroded by the gradual redefinition of much health care as social care which is then means tested and charged for.
It is important that older or disabled people who need care should receive high quality care in their own home or in residential care homes or nursing homes.
Unlike healthcare which is free, social care is means tested and charges are applied. This is done through the local authority which also provides some of the care, along with the private sector.

This leads to many problems, the most serious of which is affordability for those who have to pay charges, but also a battle between health and social care agencies about what is health and what is social care in order to decide who should pay. In practice it is very difficult to distinguish between a healthcare need and a personal social care need. Attempts to make this distinction has led to an undignified, often cruel, bureaucratic and costly process of assessment for eligibility for NHS funded health care.

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