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 Friday, 19 April, 2002, 12:26 GMT 13:26 UK
Bed-blocking fines prompt anger
Nurses
Bed-blocking is a major problem in hospitals
Local government leaders and social care bodies have reacted angrily to plans to make councils pay if there are delays in discharging elderly people from hospitals.

As part of his wide ranging statement on reform of the NHS, the Health Secretary Alan Milburn said local councils would be given responsibility for making sure beds were not blocked because of a lack of social care.

But the Local Government Association (GLA) says this is perverse and unhelpful, while social care bodies say the plans are "badly misguided".

It's not going to bring any benefit to elderly people

Sheila Scott
NCHA
The criticism comes as the government has been forced to defend its decision to raise national insurance contributions to spend an extra 40bn on the NHS.

Mr Milburn said he wanted to bridge the gap between health and social care as part of the reform programme for the NHS.

And he gave councils the responsibility to use a 6% rise in funding for personal social services to make sure older people leave hospital when their treatment is completed.

If they reduce bed-blocking they can free up extra resources, but if bed-blocking goes up councils will incur the costs of keeping older people in hospital unnecessarily.

The LGA said it was perverse and unhelpful to make local authorities pay and called for urgent talks with ministers.

Brian Briscoe, LGA chief executive, said local authorities were spending 1bn more than the government had provided on social care.

He said: "We need to work closely with the government not in a system in which we are threatened with penalties, but in a system where we can work together in order to make sure that people are properly cared for."

Morbid game

Sheila Scott, head of the National Care Homes Association (NCHA), said fining local authorities would not help those already short of funds.

"If you don't give local authorities enough money to fund long-term care, and then they don't have the money to take people from hospital, and then you fine them, you just keep making the situation worse, and worse, and worse."

She said she could see why the idea of moving patients out of hospital was attractive - it costs around 1,000 to keep a patient in hospital for a week, compared to around 300 for a care home.

"It sounds quite clever, but it's not going to bring any benefit to elderly people."

Jonathan Ellis, of the charity Help the Aged called the policy "badly misguided".

The NHS and social services departments will now be forced into playing a morbid game of pass the parcel with the frailest people in our society

Paul Burstow
Lib Dem MP
He said: "This system will drive a wedge between the fields of medical and social care by shifting all responsibility onto already over-stretched local authorities.

"Moreover, the additional 6% of expenditure promised to local authorities, ostensibly to boost services to older people, is already more than offset by the existing overspend on those services."

Dr Ian Bogle, chairman of the British Medical Association, said: "It is a good idea to provide incentives to local councils to speed up the discharge of patients who are well enough to leave hospital.

"But I would not want to see relationships between doctors and social workers, hospitals and councils becoming fraught due to the threat of financial penalties."

Michael Leadbetter, president of the Association of Directors of Social Services, said: "We have a lot of questions about how this so-called incentive scheme will work.

'Danger'

"The devil is really in the detail."

He said the 6% increase for social services was welcome, but not as much as was really needed.

But Health Minister Jacqui Smith said the government had allocated substantial funds to social care and was committed to improving services.

She told BBC Radio 4: "In order to provide the sort of support for older people that we want to see for them we need to make sure more money is invested. There is considerably more going into social care."

Paul Burstow MP, Liberal Democrat spokesman on older people, said of the plans: "The NHS and social services departments will now be forced into playing a morbid game of pass the parcel with the frailest people in our society.

"There is a real danger that elderly people will be bundled out of hospital into care homes miles away from their families and friends as cash-strapped social services departments try to avoid paying penalties."

Shadow Health Secretary Dr Liam Fox said: "Council tax payers are being forced to foot the bill for the government's incompetent management of the care homes sector."


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18 Apr 02 | Politics
18 Apr 02 | Health
17 Apr 02 | Health
17 Apr 02 | Health
18 Apr 02 | Health
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