Stephen Dorrell said patients with conditions such as dementia used to get free care in NHS geriatric hospitals.
But the number of places has fallen by nearly 80% in the UK over the past 20 years - despite the ageing population.
He said this had pushed people into the means-tested social care system where they were often charged for treatment.
In an interview with the BBC, he said the redrawing of the boundaries had been allowed to creep in without proper debate or scrutiny and urged politicians to face up to the issue.
An expert commission has already been set up by the government to look into the issue of social care funding in England.
But Mr Dorrell was speaking about a specific group of patients whom he believes the NHS has turned its back on.
Ignored
As well as dementia patients this includes people such as stroke victims and those with Parkinson's disease who struggle to get the NHS to pay for medical treatment they receive.
Mr Dorrell, who was health secretary towards the end of John Major's time as prime minister, said: "People are being charged for care that they would have got free from the NHS 20 or 30 years ago.
"In effect there has been a change in the definition of what constitutes NHS care and that has happened without proper debate.
"Unfortunately, it has been ignored because both politically and financially it is tricky for politicians to face up to it. But because it has not been done in a planned way there is great unfairness in the system. We see examples of cost shunting and bureaucracy that cause individuals problems.
"I would not want to see a return to the old system of geriatric hospitals - care is much better now - but you have to question whether it is fair that this group of people are being charged in this way?"
Evidence on the changes to the nursing care home and geriatric hospital sectors lend support to his view.
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