Dental care, sight tests and prescriptions are no longer automatically free for people with severe impairments


We are delighted to have Jeanne Carlin as our guest blogger this month. Jeanne has been a parent carer for her daughter, Erica for the past 32 years. Erica has profound and multiple impairments as well as complex health needs. Jeanne is retired social worker, writer and campaigner for children and adults with complex health needs. Her books include ‘Include me’ and ‘Dignity and inclusion’ published by the Council for Disabled Children. Jeanne is also a member of the PMLD Link editorial group and at a recent meeting highlighted a change in benefits that affect people on continuing health care, which we felt needed to be brought to the attention of others. This is what Jeanne has to say:

We have recently discovered that dental care, sight tests and prescriptions are no longer automatically free for those people with the most severe impairments under the new benefit system. My daughter, Erica who has multiple impairments, complex health needs and is now 100% funded by Continuing Health Care funding – is no longer automatically entitled to free dental care.  Erica, like so many others has been moved from Income Support to Employment Support Allowance (ESA).


We received a letter from the NHS dental services in Darlington stating that she had been to the dentist in December 2013 and her dental care had to be paid by her.  We provided them with information about her benefits and then after a few weeks received a second letter stating that she was not eligible for free dental care and if she did not pay £18 she would be taken to court.


I found this information so unbelievable that I then phoned to discover the following: there are 2 types of ESA – one is ‘income-related’; and the other is ‘contribution-related’. Only those people on income-related ESA now automatically receive free dental care, free eye tests and free prescriptions. As Erica is one of the most severely disabled people in our community I cannot understand this type of ruling.  Following an hour on the phone to various people in the Job Centre Plus service we were then told that we could complete an HC1 form and apply for free care.


The 18 page form arrived, I completed that and we now have a certificate (HC2) which entitles Erica to free care for one year.  A new form needs to be completed one month before the expiry date each year to continue this entitlement. I now need to remember each year to apply for what was once an automatic entitlement.


I like so many other family carers take Erica to the dentist and without thinking tick the box stating that she receives ESA. Erica was picked up on a spot check – and I wonder how many other carers have made the same assumption that I made.  Erica was entitled automatically to free dental care when she received Income Support, so a change in benefit should not remove this entitlement.  However it does.

I took the matter up with my MP who wrote to the Department and Health.  This is the explanation which they have given:


‘However, people receiving contribution-based Jobseeker’s Allowance or contribution-based Employment and Support Allowance on their own and not paid with the income-assessed element, do not automatically get help towards health costs.  This is because these two contributory benefits are not income-related and many people receiving them have other resources, and may also have capital. People may therefore need to make a claim under the NHS Low Income Scheme so that their entitlement may be calculated in the same way as that of anyone else on a low income. The amount of help available is based on a comparison between a person’s income and requirements at the time the claim is received.’


We will need to reapply in March 2015.  When we do this we will request that as my daughter’s income and capital will remain the same that a certificate is granted for as long as she remains on ESA.  This will save us reapplying every year – I am not hopeful that they will be flexible enough to see the sense in this request – so watch this space.

Visit Jeanne's blog Sandwich Carer