HC Deb 08 June 2004 vol 422 cc136-8
7. Ms Ann Coffey (Stockport) (Lab)

What action he is taking to reduce delayed discharges. [177291]

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)

In January 2004, the Community Care (Delayed Discharges etc.) Act 2003 introduced a financial incentive to avoid delayed discharges. That is supported by the delayed discharges grant. The total number of patients delayed in an acute hospital bed on any one day is now about 2,900—a reduction of nearly 60 per cent. since September 2001.

Ms Coffey

The figures from my local hospital, Stepping Hill, indicate that the policy has been a great success in relation to acute wards. Essentially, that is because it has led to much better co-operation between local health and social services. However, delays in discharge are now occurring in intermediate and rehabilitation beds. Will the Minister consider making delays in discharge from non-acute beds subject to the same financial penalties as delays in discharge from acute beds, so that there is effective local co-operation for all discharges?

Dr. Ladyman

The delayed discharges reimbursement system has been such a huge success and has driven down delayed discharges to such a remarkable extent that, to be frank, it would be madness if we were not looking very closely at the suggestion that we extend it, not only to intermediate care facilities, but to mental health facilities. We have started that work and planning, and we shall make announcements to the House as soon as possible.

Mr. Paul Burstow (Sutton and Cheam) (LD)

Does the Minister agree that in planning hospital discharges, it is important to ensure that the rules governing eligibility for free NHS continuing care are applied consistently and fairly across the country? Why has it taken the Government so long to begin to get to grips with the fact that 28 different sets of rules are applied in entirely different ways, with the result that people are, in effect, subject to a postcode lottery in relation to eligibility for free continuing care—care that should be available to them on the basis of their need, not of their means?

Dr. Ladyman

The hon. Gentleman might at least have started his question by pointing out that he was entirely wrong about the 2003 Act, which is now saving 1.5 million bed nights a year—equivalent to eight district hospitals—and which he is committed to repealing should the electorate ever be foolish enough to put his party into government. He was wrong from the start and he is wrong now. As for NHS continuing care, now before anyone is discharged from hospital they must go through the single assessment process, which includes consideration for NHS continuing care. For the first time, we will know whether anyone is entitled to such care before they are discharged.

Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op)

The legislation is making a real difference to reducing delayed discharges and improving the discharge process in Sheffield. Does my hon. Friend recall that, during debate on the Bill, the Opposition spokesperson referred to it as a "nasty and flawed measure" and the Liberal Democrat spokesperson said that it "put beds before patients"? Is not the truth that the measure puts patients' needs first and only the Labour Government are prepared to take the action that puts patients first?

Dr. Ladyman

My hon. Friend is absolutely right. Every extra day that an older person in particular spends in an acute setting when they no longer need to be there makes it less likely that they will be able to retain their independence and return home, which is where most of them want to be. Conservative party dogma is that ending up in a care home is the inevitable consequence of old age, but we want to maintain people's independence.

Mr. Simon Burns (West Chelmsford) (Con)

If one strips all the spin and gloss from the Minister's words, one can see that the Government are fiddling the figures, basically by categorising more and more beds as intermediate and placing patients in them to meet their political targets. If his policy is working so well, why has the number of people receiving domiciliary care been reduced by 2 per cent. in the past year and by 10 per cent. over the past three years? Surely, more should be done to make sure that patients whose discharge is delayed receive appropriate domiciliary care after hospital, rather than being sidelined in an intermediate ward.

Dr. Ladyman

The hon. Gentleman is another person who was entirely wrong about the Community Care (Delayed Discharges etc.) Act, and has been made to look foolish for preaching doom and gloom. He said that the success of the scheme is entirely due to the roll- out of intermediate care beds, but in the six months since the shadow scheme came into effect we have reduced delayed discharges by another 1,000. How can he tie that purely to intermediate care beds, unless he thinks that we have suddenly magicked up tens of thousands of such beds around the country? The fact of the matter is that he and his party would not match our proposed spending—

Mr. Speaker


Mr. David Watts (St. Helens, North) (Lab)

Does the Minister agree that delays are partly caused by lack of funds in social services departments? Does he also agree that the massive increase in health funding has not been matched by increases in social services funding, and will he look at that problem?

Dr. Ladyman

In fact, since 1997, the average increase in personal social services funding by the Government has been 30 per cent. above the level of inflation. Another 6 per cent real-terms increase is promised for next year, so we are making money available and making sure that it is being used to provide intensive home care. Contrary to what the hon. Member for West Chelmsford (Mr. Burns) said, there has been a 30 per cent. increase in the number of people receiving intensive care at home—people who would otherwise be forced into care homes.

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