Grandmother with cancer wins cancellation of care charges debt

A grandmother with cancer was pursued by Tower Hamlets council for £2,600 care charges arrears. Her debt was written off after our battle lasting over nine months, with various twists and turns.  Several times, WinVisible quickly had to write to the council asking them to hold off debt recovery, on occasions when she felt too ill to deal with them herself. Ms X is a woman of colour, and we don’t know whether racism was also a factor in how she was treated.

She says:

A MASSIVE ‘thank you’ to all the WinVisible team for supporting me to fight the council in order to relieve me of a large outstanding debt of care charges. WinVisible has also helped to support me around my care plan issues, after the council decided to unethically put care charges in front of my care package. In a case of the council prioritising MONEY before human need as per usual, and acting out of spite by way of penalising me by trying to cut down my care package, because of an outstanding amount owed in care charges. With no consideration that I am registered disabled, dealing with cancer and [kinship carer of] two minors, in need of more hours because of a change in circumstances.

Throughout, WinVisible has been beyond supportive, they worked together and very close with me, helping to assist me in every way, never giving up, they became my extended support network, and stood up for me where all other organisations failed.

WinVisible are passionate and understand the daily struggle of disabled people.  And fight tirelessly for their rights and voices to be heard and their needs met.

Without WinVisible I would not have won my case against the council, I cannot thank the team enough for all their help — thank you again WinVisible Family x

Ms X is one of several disabled women across different boroughs WinVisible supported to successfully challenge the level of their homecare charges, and getting arrears written off as unaffordable.  Some women secured refunds of charges already paid, as well as big reductions and even nil charge or nil contribution ongoing.

What happened and what we did

In November 2022, Ms X told us:

The Income and Enforcement Team of Tower Hamlets is pursuing me for care charges of £2,605.59 which I am unable to pay. Neither can I afford ongoing charges of £97/month in the cost of living crisis.

She received a letter with a deadline to start paying, stating that otherwise they could start court action for debt recovery.  She had the worry of possible enforced deductions from her benefits for the charges debts.  She related that the stress of the council chasing her for the arrears, had triggered a secondary cancer. 

When homecare bills started to come in, Ms X was unable to deal with them.  Her health was terrible, and she had developed a secondary cancer.  She was in family court proceedings which were very stressful and which continued for a year and a half, when she took on the care of two grandchildren.  In this situation, she felt unable to pay attention to paperwork from the council.  And though something was vaguely mentioned during her needs assessment about charges, which she said she couldn’t afford, she wasn’t properly informed ahead of time.  Instead the bills arrived, and she didn’t believe they applied to her.   But usually, councils start charging before any financial assessment is done, and the burden is put on disabled people to challenge unaffordable charges.

When the debt problems started, she went to the local advocacy service, but became dissatisfied as they didn’t strongly challenge the charges.  Later, they dropped her case when their contract to provide advocacy ended.  This was at a crucial time when she was threatened with court.

The deadline given by the council was imminent, so we helped Ms X to write to the director of Adult Social Care (copying in her MP), explaining why she couldn’t afford charges and detailing her disability expenses (December 2022).  She needs a special diet and had to buy different-sized clothes as her size fluctuates under chemotherapy.  A big expense was cabs to do the school run, as her Taxicard allowance of trips was not enough and Taxicard is notoriously unreliable.  Since taking on the children, she had higher household expenses generally, for their heating, food and other needs.

She wrote:

The stress of daily chemotherapy, plus dealing with threats from my local authority, is placing my health under ever-increasing strain.  This is all the more astonishing given the immense amount of money I am saving them by my unpaid care work, which I hope will be reimbursed.  May I remind you that the council is legally obliged to support a disabled carer.  WinVisible has informed me that under the Care Act section 12 the Council has a duty to assess the needs of the family, not only the disabled adult.

We also helped Ms X to resist a reduction in her homecare hours and wrongful pressure to accept this.  The staff member doing her reassessment suggested that if she agreed to fewer hours, the care charges could be waived. This is unlawful as support must be based on need, not ability to pay.  Ms X commented, How can my needs be properly assessed if they are influenced by a debt which I don’t owe. 

The director of Adult Social Care replied immediately to Ms X’s letter, saying that she would get someone to look into it.  We hoped for a resolution to cut through the bureaucracy.  But instead it was passed to the complaints procedure.  Some time later, the Team Manager replied (extracts):

On review of your case I understand that Y completed a review of your needs on [May 2022] and recommended a reduction in care. Y has confirmed that the proposed reductions were not related to your debt and I apologise for any miscommunication that may have implied that this was the case. I would like to reassure you that an assessment of your care and support needs and any recommendation for an increase or decrease in care cannot be subject or related to arrears on your account. 

Given the delay since the time of the assessment and the concerns you have raised in regard to a deterioration in your health, the proposed reduction [in hours] has been suspended . . .   

In relation to the arrears, I understand that an updated financial assessment took place [July 2022] and you were assessed as nil charge from 1st June 2020. Your account was adjusted to reflect this change and the remaining debt of £2605.59 relates to charges covering the period from March 2018 to 31st May 2020.

I would be grateful if you contact (Team Leader) from the Income and Enforcement Team by no later than 27th January 2023 to discuss payment of the arrears which stand.

Finally, the Team Manager wrote that if Ms X did not accept their response, Ms X would have to take her case to the Ombudsman, since the council had completed their investigation of her complaint.

We were all shocked by this cruel and contradictory response, especially as the council leadership had changed to the Aspire party in the May 2022 local elections, who have brought in several new policies to benefit children, young people and families in the borough.

Together with Ms X, we wrote to the council’s Cabinet member for Adult Social Care, explaining why this was unacceptable and it was inhumane to make her go to the Ombudsman as she was already struggling with admin.  We said:

“Pressing a historic unaffordable debt against Ms X, a kinship carer undergoing strenuous cancer treatment, when she is rated nil contribution, puts Tower Hamlets in a very bad light . . .

“We appreciate that Tower Hamlets has agreed a largely progressive budget including free homecare from April 2024.  However Ms X is still being unfairly penalised, and is facing an increasing cost of living for the children and herself, including the end of the government’s energy subsidy.  

“We note from your budget report page 41 that Tower Hamlets currently raises over £3m from homecare charges and has a “bad debt provision of £0.573m” for waiving charges.

Please cancel Ms X’s historic charges as the continued stress is undermining her health at a very difficult time.”

* * *

We didn’t receive any reply, despite ringing the councillor and outlining the issues in Ms X’s case, which he said he would discuss with the director of ASC.  It seemed as if the council would not reconsider the unfairness of their response, having told us they had “completed their investigation”.

After waiting for a reply, with the debt still hanging over her, Ms X contacted her MP to ask her to follow up with the council.

In August 2023, we were forwarded a letter from the council sent to the MP, which said:

In response to your query received on (date), further consideration has been given to the request from Ms X and her representatives regarding her outstanding debt for adult social care charges. I write to confirm that the Corporate Director for Health, Adults and Community has agreed that the outstanding debt will be written off and therefore, not pursued. (July 2023).

Tower Hamlets, where many residents are low-income, has had a mixed history with homecare charges. One of the last boroughs to start charging, having charges which are not the most harsh, and planning to end charges.  When they bring back free homecare again from April 2024, they become only the second local authority in England, after Hammersmith & Fulham, to do this.

But we are concerned to see in the Financial Strategy report page 41:

There will be some service users with debt at the point the policy is changed – it is recommended that these debts continue to be pursued to ensure an equitable approach to those who have paid their charges.

Heulwen from WinVisible, who helped to support Ms X, comments:

“The debt of £2,600 is an enormous sum for a person struggling to make ends meet and needing to pay for taxis to get her grandchildren to school.  The insensitivity of the council to the stress she was being subjected to, over nine months: a) the threat of court action over a period of 9 months, b) the threat of benefit deductions to repay the debt, surely requires that they should consider compensation.  After all, she developed a life-threatening secondary cancer as a result, and she was already recognised as disabled.

“The council was getting something for nothing.  Without her unpaid care for her grandchildren, the council would have had to fund foster care, or the immense expense of privatised children’s home placements.  The money spent on such placements is apparently not transferrable to a private individual who, it seems, is disqualified due to her kinship with the children.

The need for the intervention of the MP, the fact that councils start charging before a financial assessment (leaving it to the carer to challenge unaffordable charges) and, finally, telling Ms X to go to the Ombudsman, is further evidence of the disregard by public bodies to the situation of unpaid carers, from local authorities to central government.  

The pursuit of care charge debt by Tower Hamlets after April 2024 is described as ‘equitable’.  This is a fiction which will subject other carers to the same stress that Ms. X has had to put up with for so long.”