NHS Hospital Beds (Hansard, 14 February 2002)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the department has no involvement with this matter. The countryside development unit of Harper Adams University College for agriculture commissioned a feasibility study into the use of rural bed-and-breakfast establishments for the recuperation of patients who do not need to be in hospital for their care. I understand that the college has not embarked on any discussions with NHS bodies in the area.

§ Baroness Gardner of Parkes
My Lords, I am afraid that the Minister's Answer disconcerts me even more than the newspaper article did. That article said: The aim is to fill spare holiday accommodation during traditionally quiet periods". 1185 The Member of Parliament who represents the area where the first pilot study scheme is to take place said: it will help the bed and breakfast sector in rural Britain which has had such a tough year with the foot-and-mouth outbreak". I am worried that the patients and their health interests may not be the prime concern. I understand that bed-and-breakfast accommodation means the provision of bed and breakfast. How can anyone recover with just bed and breakfast? It must turn into the virtual equivalent of a care home providing at least full care. Very often, people who are discharged from hospital require follow-up visits from physiotherapists or others and even their relatives need to be able to visit. It is essential that the National Health Service becomes involved if the scheme is meant to represent intermediate care.

§ Lord Hunt of Kings Heath
My Lords, my experience is that bed-and-breakfast establishments in Shropshire are splendid and of course one would want to encourage members of the public to use them. However, that is not the intent of the National Health Service or the Department of Health. As I have said, this was purely a speculative study by a local college, carried out without any discussion or agreement with the National Health Service. The chairman of the BMA's community care committee said that about the only case that he could imagine in which it might work would be a young man who had perhaps broken a leg and needed somewhere to recuperate after leaving hospital. Otherwise, he said, it is a complete non-runner.

§ Lord Hoyle
My Lords, first I declare an interest as the unpaid chairman of the ExtraCare Charitable Trust retirement village appeal in Warrington. Has my noble friend visited one of those admirable villages? If riot, will he do so? The standard of life of their inhabitants means that there is less pressure and less need for them to have NHS beds. Will he also examine whether any ways can be found to enable ExtraCare to build more of those wonderful villages?

§ Lord Hunt of Kings Heath
My Lords, it is a dangerous precedent to accept visits offered in that way, but, seeing as the offer comes from my noble friend, I shall be very interested in visiting the proposed village community in Warrington. I am aware of the extraordinarily good work that such villages do. Experience shows that people who live in such communities make fewer pressure demands on the National Health Service because of the care and support that they already receive. It is one of the many ways in which we can provide effective care and support to older people.

§ Baroness Noakes
My Lords, is the Minister aware that in her evidence to the Health Committee yesterday, the Chief Inspector of the Social Services Inspectorate expressed serious concerns about the possible use of bed-and-breakfast accommodation, as proposed in the report? Will he assure the House that no such arrangements will be allowed to proceed without the chief inspector's agreement?

§ Lord Hunt of Kings Heath
My Lords, it is for local authorities and local NHS authorities to decide where intermediate care or care for people who are seeking discharge from hospital ought to be provided. I think that I have already made it clear that I find it very unlikely indeed that the bed-and-breakfast proposal could be a serious runner.

§ Baroness Thomas of Walliswood
My Lords, this is a matter of grave concern to us all. The Minister did not answer my question about how many patients were involved when I asked him on 28th January. Will he at least agree that the number of patients delayed last year was roughly equivalent in days lost to the number of cancelled operations in the same year? Is the Minister encouraging other acute hospitals to follow the example of Birmingham City Hospital, which is reducing the delay in the discharge of patients by planning that discharge from the moment the patient arrives in hospital, or the good example of the East Sussex living at home programme, which removes patients from hospital and rehabilitates them for independent living?

§ Lord Hunt of Kings Heath
My Lords, I certainly agree with the noble Baroness that the City Hospital in Birmingham is an excellent hospital that has much to teach others. I have made it clear that the proposal in question came from a rural agricultural college, which was seeking to help the rural economy in Shropshire. The National Health Service and the Department of Health have had no discussions with the college and taken no part in the feasibility study. I cannot make myself clearer on that.
According to the latest figures, which relate to September, 6 per cent of acute beds in the health service are being used by patients who ought to be out of the hospital. However, the action that is being taken and the extra money that was put in this winter to help local authorities provide better support and care in the community are having an effect. It is also worth pointing out that delayed discharges for patients over 75 have steadily dropped since 1997. The figure of 15.7 per cent in September 1997 has dropped to 12 per cent. We know that we have much further to go, but I believe that health and local authorities are working well together to deal with the issue.