§ 9. Mrs. Knightasked the Secretary of State for Social Services what steps he is taking to overcome the problem of elderly persons who should be in geriatric units or old persons' homes who are occupying instead acute beds in hospitals.
§ Sir George YoungI am concerned that all elderly hospital patients should receive the care most appropriate to their needs, and that scarce resources should not be wasted by unnecessarily prolonged stays in any type of bed. The recently published White Paper on elderly people, "Growing Older", stresses that all hospital departments concerned need to develop admission and treatment procedures geared to as early a discharge as home circumstances and community support permit.
§ Mrs. KnightAs hospital bed occupancy now costs about £100 a day, would it not be cheaper to build more old people's homes? Is my hon. Friend aware that, for every elderly person occupying an acute hospital bed, solely because he has nowhere else to go, someone is 7 being denied treatment or surgery? It is two years since I asked the same question. Nothing was done then and I hope that my hon. Friend will do better.
§ Sir George YoungI will do my best to satisfy my hon. Friend. The economics that she has outlined are correct. Care in the community is cheaper than care in hospital and is what many elderly people want. For that reason we have developed joint funding, which enables the transfer of NHS money to social service departments to enable that transfer to take place. Two-fifths of the total expenditure on joint funding has been devoted to services for elderly people.
§ Mr. Mike ThomasIs not the Minister's reply either naive or cynical? He knows that the provisions in his White Paper provide no funds to carry out what the Government are imposing on local authorities. Is he aware that cuts are being made in residential provision, and money spent on day centres, transport to day centres, home helps, telephones and aids and adaptations? Is he not aware that in those circumstances it is cynical and misleading for him to suggest that it is likely that more geriatric patients will be moved from acute beds in hospitals to beds in residential or community care?
§ Sir George YoungThe hon. Gentleman is misinformed. Local authorities have maintained spending on personal social services. Current spending in 1979–80 on personal services was 4.4 per cent. higher in real terms than in 1978–79. Present indications are that spending in 1980–81 will be at about the same level.
§ Mr. Alfred MorrisOn comparative costs, what is the average cost now of placing an elderly person in a welfare home or in an acute bed in a hospital ward? Is the Minister aware that the Secretary of State for the Environment's harrying of local authorities that are trying to improve community care will mean that more and more elderly people will find themselves in more expensive hospital care? How can he possibly justify such a crackpot policy?
§ Sir George YoungI have given the right hon. Gentleman the figures about the growth in spending on personal social services.
§ Mr. Alfred MorrisOn a point of order, Mr. Speaker. I asked the Minister——
§ Mr. SpeakerOrder. The Minister is answering.
§ Sir George YoungThat problem has been raised by many hon. Members. The National Health Service is developing a programme of building nursing homes to overcome the problem that has been identified of transition of responsibility from hospital to social service departments.
§ Mr. Alfred MorrisWill the Minister tell me what is the average cost of placing an elderly person in a welfare home and the average cost of placing the same person in an acute bed in a hospital ward? That is the question I asked?
§ Sir George YoungIf the right hon Gentleman will table that question, I will give him accurate figures. I said earlier that the economics were as expressed by my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight)—namely, that the costs of treatment in the community are less than the costs of treatment in an acute hospital.
§ Mr. WardWill my hon. Friend take this opportunity to praise those who work in geriatric units on behalf of the community? In spite of what has been said, they do a good job in difficult and distressing circumstances. Is he aware that many of those workers are young people and the good community job they do is not always recognised?
§ Sir George YoungI endorse what my hon. Friend has said. Going round hospitals, I have noted the active approach being adopted by many geriatricians to the treatment and rehabilitation of elderly hospital patients, as a result of which they can return to the community much earlier than would otherwise be the case.