NHS has lost 50,000 places for the elderly

Old people's homes are closing in unprecedented numbers, threatening a crisis in the NHS this winter with elderly patients who cannot be discharged left blocking badly needed hospital beds.

Almost 50,000 places have been lost in homes for the elderly and physically disabled in five years, nearly one in 10 of the total, according to figures issued yesterday. Last year was the fifth in succession in which the number of places fell while the population is ageing. Financial pressures caused by rising staff costs and the refusal of local authorities to increase fees for state-funded residents has driven some homes out of business.

Other homes, especially in the prosperous South-east, have been sold as the property boom boosted demand for large houses and properties suitable for conversion into flats, securing big profits for owners.

Yesterday, William Laing, chief executive of Laing and Buisson, the healthcare consultants who collected the figures, warned that the accelerating decline in places could add pressure on the NHS.

"It is already happening in hot spots. But you cannot expect the Government to take action to correct it. It doesn't want to nor does it have the powers."

The number of places has fallen by 49,700 from its 1996 peak of 575,600. To stop the decline, Mr Laing said fees for state-funded residents would have to rise to match more closely payments by privately funded residents, but this would have to be decided by each local authority.

Fees in nursing homes, private and state, are currently averaging £400 a week.

Earlier this month, Sandy Bruce-Lockhart, Kent County Council's Conservative leader, wrote to Alan Milburn, the Secretary of State for Health, warning him of the difficulties caused by the closure of homes.

He said in his letter the situation was worsening and that it was "becoming impossible" to place people in nursing homes. "I have no need to spell out to you the implications of this both for preventing hospital admission and facilitating hospital discharges."

A survey in England in the first quarter of the year showed that one in eight of the acute hospital beds occupied by a patient over the age of 75 was blocked because of delays in discharging the patient to a nursing or residential home.

Out of 100 English health authorities, 15 had been forced to delay the discharge of more than 20 per cent of their elderly patients.

In Berkshire, out of 440 patients aged over 75 admitted to an acute hospital bed, 181 had their discharge delayed, a rate of more than 40 per cent.

Yesterday's figures from Laing and Buisson show that the South-east saw one of the highest rates of closure of old people's homes last year, with the number of places down 4 per cent compared with a 1.6 per cent fall nationally.

The Association of Directors of Social Services has warned that the pressures on care homes in the South-east are building up, and that the position is posing "difficult questions" for the Government.

Mr Laing said: "The reason for the decline in the South-east is that there are alternative uses for care homes as large houses or for conversion into flats. The owners have more incentive to sell because of high property prices."