There are significant regional variations in the cost of care within the UK, whether that is to provide care with or without a nursing component:

Region/Cost per week   Care home   Care home with nursing

East Midlands                £555            £687
East of England             £604            £788
London                          £625            £825
North East                     £515            £591
North West                    £480            £673
Northern Ireland            £476            £656
Scotland                        £596            £743
South East                    £641            £874
South West                   £592            £791
Wales                           £497            £603
West Midlands              £513            £694
Yorkshire                      £489            £655

Source: Laing & Buisson Care of Older People, UK Market Report 2013/14.

The common factor is the cripplingly high cost of care for the individual of limited means. Whether that cost is born by the government, or by an individual or their family, who have perhaps been forced to sell the family home to meet costs, the question of affordability takes on an increasingly keener edge.

A solution, for some people, is to arrange for themselves or their relative to be nursed overseas. In 2011, when first researching this subject, I came across an article in, which told of the experience of Steve Herzfeld: ‘After three years of caring for his increasingly frail mother and father in their Florida retirement home, Steve Herzfeld was exhausted and faced with spending his family’s last resources to put the couple in a cheap nursing home. So he made what he saw as the only sensible decision: He outsourced his parents to India.

Today his 89-year-old mother, Frances, who suffers from advanced Parkinson’s disease, gets daily massages, physical therapy and 24-hour help getting to the bathroom, all for about $15 a day. His father, Ernest, 93, an Alzheimer’s patient, has a full-time personal assistant and a cook who has won him over to a vegetarian diet healthy enough that he no longer needs his cholesterol medication.

Best of all, the plentiful drugs the couple require cost less than 20 percent of what they do at home, and salaries for their six-person staff are so cheap that the pair now bank $1,000 a month of their $3,000 Social Security payment. They aim to use the savings as an emergency fund, or to pay for airline tickets if family members want to visit.

Every time he looks at the bills — less than $2,000 a month for food, rent, utilities, medications, phones and 24-hour staffing — Herzfeld thinks he’s done the right thing for his parents and himself.

“It can be done,” he said. “This is working.”

These financial savings can be put into perspective: In The United States the cost for assisted living in a community will run about $4000-$5,000 a month to say the least, in some cases depending on the community up to $10,000 month.

Savings on the cost of care can also be gained in the Philippines. Individuals and their families can access to read that: ‘Mabuhaii Nursing Home offers unique and high quality nursing for elderly from America, Europe, Australia and Asia … We offer four different nursing service categories which differ in the level of intensity of healthcare provided. Prices differ depending on the house and room … Board and lodging without healthcare (Assisted Living) can be booked at lower alternate prices for those who don’t need care … Meals, laundry, cleaning and caregiving are of the same quality in all three categories and houses. Special requests such as air conditioning, flat screen TV, refrigerator and telephone can also be arranged.

Intensive Care
House Price per Month (USD)
Riao $2,130 to $2,590
Mandu $2,470 to $2,790
Molo $2,630 to $2,970 (c. £1,900)

Two (2) nurses per day or four (4) nurses per week take care of only one single resident in 12-hour shifts. Four (4) professional nurses are assigned for one single resident per week. Our healthcare team comes in on two (2) alternate shifts per day in a 7-day period taking care for only one resident. Our nurses and caregivers work for 12 hours a day, 3 to 4 days a week, so they can provide their services effectively in their full potential.

The 24-hour professional care includes:
catering, cleaning, laundry and room service.
house accommodation with high quality European standards.
massage and a full range of activities with the elderly.
trips, entertainment, etc.

Compared to the high costs of being in congestive nursing facilities in Western countries, where there is a sad reality of less quality care, you will save for up to 70% by staying with us for a sophisticated and heavenly nursing home service.

The cost of Intensive Care is slightly more than that of Standard Care, but it provides 100% more health care intensity.

Standard Care
House Price per Month (USD)
Riao $1,360 to $1,840
Mandu $ 1,690 to $2,020
Molo $1,870 to $2,190 (c. £1,350).
Two (2) registered nurses per day or four (4) nurses per week take care of two residents in 12-hour shifts. Standard Care includes high quality medical and social care

Cheaper care services are also offered in the Philippines: At it is stated: ‘We are strategically located at higher elevation and cooler part of San Juan, and of the entire Metro Manila. Thus, our home is safe from the rain and flood in Manila. We are very close to Carnidal Santos Medical Center.

Two-Bedroom House, One Patient per Room.

Our family-oriented staff consists of a supervising nurse and one caregiver for every elderly. The … services include 24-hour care, regular meals, and laundry. A doctor is on 24-hour on-call for emergcy cases. Visiting hours is between 6pm to 9pm everyday or by appointment.

(We) provide a 24-hr communication channel between the elderl(y) and their families … a secure web camera of the client’s room will be shown … to the concerned family.

The following are the detailed services we provide:
– one supervising nurse and two nursing assistants per elderly
– regular meals and laundry included
– 24-hr on-call to doctor, nearby hospital, and concerned families
– scheduled daily visits for client families
– telephone, email, and chat are allowed channels of communication
– secure web camera access for care supervision

Total cost per month for one elderly patient is PHP 30,000.00 (around USD 721.59). (c. £470).

In giving details of these services, I am not endorsing them. I can say that I have worked with very caring Philippino and indian care staff, and the possibility of care being monitored by a web-cam is a positive indication of good care being provided.

What I believe to be the main ethical issues surrounding overseas care are as follows:

Outsourcing a parent (or disabled child/adult) is not the same as relocating a call centre, at least not to most people. An individual struggling to meet care costs might face an agonising choice of sending themselves overseas – “it will help my family, I will be able to leave them my house”. Most would move ‘heaven and earth’ not to send their mum , dad, son, or daughter abroad. Some would not make such effort.

Will government eventually insist on overseas care? This is the main question for the future. The weasel-speak of divide and rule can be imagined: “In times of austerity it is wrong for the elderly and disabled to be a burden to hard working, apiring families. This government will provide the transport costs to high quality ‘care in the sun’ for all”.

The logic of ‘market forces’ makes this inevitable.

Those in possession of absolute power can lie and make their lies come true.

lenin nightingale 2015


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