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Care wars

18 September 2008 / Nicholas Dobson
Issue: 7337 / Categories: Features , Public
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Who pays—health or social services? asks Nicholas Dobson

True, there was no heavy and sinister hum of slashing light sabres, enhanced by resounding surround sound. But a fiercely civilised battle had nevertheless raged within the Victorian Gothic precincts of a galaxy—really rather nearby. For it had fallen to the Court of Appeal on 6 August 2008 to determine a “who pays for care” dispute between St Helen's Borough Council (the council) and the Manchester Primary Care Trust (PCT). The case report can be found at [2008] EWCA Civ 931, [2008] All ER (D) 58 (Aug) and, as the learned Yoda might have put it, Lord Justice May the leading judgment gave, and in agreement the other members of the court were (Lord Justice Scott Baker and Sir Peter Gibson).

The council was challenging the decision of the PCT taken “upon intensive consideration” that the needs of a woman suffering from disassociative identity disorder (and who had been involved with local authority social services since her birth) were not primarily health care related. The decision was financially significant given that the current annual cost of the relevant

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