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Saturday, 1 September, 2001, 14:43 GMT 15:43 UK
The elderly care crisis
Many elderly people require care
A lack of funding by local authorities and central government has lead to a crisis in the residential and nursing homes sector.

Thousands of care homes have been closed, and elderly patients have been stranded in hospital with nowhere to go. BBC social affairs Editor Niall Dickson reports on a serious problem.


Throughout the last year residential and nursing homes have been closing down all over the country - the south of England has been especially hard hit.

The government so far has taken a somewhat relaxed attitude arguing that most elderly people wish to remain in their own homes and that new services to prevent unnecessary admissions should reduce the demand for residential care.

Ministers also point out that there is little they can do if home owners want to cash in on a booming property market.


It is hard to imagine what it must be like to be 98-years-old, and to learn that you must leave the care home where you have lived for past 15 years

Until now the Department of Health's view has been that so long as private homes, the NHS and local government work closely and imaginatively together most problems can be resolved.

Now though, with home owners packing their bags, many social services directors are warning that there simply is not enough money to make the system work and that large numbers of elderly people are suffering as a result.

Kent, the country's largest authority, has lost 22% of its nursing home beds in the last 12 months alone.

In parts of the county it has no beds at all for older people with dementia.

Personal tragedy

The closure of homes represents a personal tragedy for many older people which has largely been ignored - research has shown that moving vulnerable old people shortens their lives.

It is hard to imagine what it must be like to be 98 -years-old, and to learn that you must leave the care home where you have lived for past 15 years.

You are given just a few weeks to say goodbye to the staff and friends who form the backbone of your life.

It is cruel and it is happening every day.

Waiting lists

The other victims are old people struggling on in their own homes but who need more intensive support - in many areas there are now extensive waiting lists for residential and nursing homes.

Hospital patients
Many older people stay in hospital waiting for community care
And then there are those who waiting to be discharged by the NHS.

In Maidstone Hospital they have 70 so-called bed blockers - old people who do not need acute care but who cannot find somewhere in the community to look after them.

For the patients it means unnecessary exposure to infection, and it means being looked after by staff who often have neither the time nor the training to give them the convalescent care, social support or rehabilitation they need.

Funding needed

According to the home owners (predictably) and the social services directors (less predictably) the real answer is a swift injection of cash.

The minimum wage, increased competition for qualified and unqualified staff and tougher care standards have all driven up residential care costs.

Yet they say the level of fees paid to homes which, in effect, are determined by government have not kept pace.

This administration has certainly put more money into social services but of course it has also demanded more.

There is a widespread view that standards of care are not as good as they could be and some in government feel that the private sector cries foul too quickly when changes are demanded.

Others genuinely want to see less reliance on residential care.

Add to all this the fact that social care has never been a top government priority and it is easy to see why no-one is rushing out to save the sector.

Of course the impact on the NHS may force a rethink - the health service is undergoing massive organisational change and pressures are building up.

More blocked beds spells disaster for all the government's hopes of cutting waiting times, and of taking accident and emergency departments out of third world status.

With even tighter regulations for homes on the way, it is hard to see how more closures can be avoided - unless there is some form of rescue package.

Without it expect more unhappiness for the elderly residents and more headaches for ministers.

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The BBC's Karen Allen
"Councils have considerable discretion on the levels of charges that they set"
See also:

10 May 00 | Health
Home care charges 'unfair'
08 Feb 99 | Health
Funds 'to care for the carers'
15 Jul 99 | Health
'Free care' for elderly proposed
11 May 99 | Health
UK criticised over elderly care
04 Nov 99 | Health
Long-term care: A special report
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