NHS cash wasted by keeping `fit' elderly in hospital

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Medical Editor

Large sums of National Health Service money are being wasted on "fit" elderly patients who cannot be discharged from hospital because of delays in assessing them for their needs when they return to the community, doctors at the British Medical Association annual meeting were told yesterday.

A BMA survey published yesterday shows that four out of five UK geriatricians report "bed blocking" in their wards for an average of 17 "extra, unnecessary" days. The average stay for an elderly person is 25 days at a cost of pounds 100 a day. The 17 days is additional to this stay.

The meeting unanimously condemned inadequate funding and said management arrangements were inadequate to cope with transfers to the community. It called on the Government to reappraise the Care in the Community Act and to produce fresh guidelines on dealing with long-stay patients.

Dr Nigel Rowell, a GP from Middlesbrough, accused the Government of "asset- stripping the elderly" by making them pay for care in their twilight years. "Fear of long-term illness and the financial repercussions are causing enormous grief among the elderly even before they fall ill," he said. "You can judge a nation on how it cares for its sick, elderly and infirm. Making them pay in their twilight years, in poor health, after a lifetime of service and paying taxes is hardly the hallmark of a civilised society. This cynical privatisation has begun with the most vulnerable."

Dr Arnold Elliott, chairman of the BMA's community care committee, said the survey revealed that the implementation of community care had been "both a terrible tragedy and a terrible waste".

The survey from the BMA's health policy and economic research unit revealed that 44 per cent of the geriatricians and psychiatrists interviewed said there had been a deterioration of services since the Act came into force, and 24 per cent said they felt there had been no effect.

Three-quarters of the psychiatrists said they did not feel that community supervision registers, a key part of government policy for dealing with mentally ill patients, would improve the management of the care of the patients involved.

"Doctors dealing with the elderly are saying quite clearly that patients are spending longer than they need to in hospitals because three-quarters of hospitals have no local arrangements for discharging the patients into NHS-funded beds," Dr Elliott said.

There were wide regional variations. In the Northern and Yorkshire region 58.8 per cent of the geriatricians and psychiatrists said the position had deteriorated over the past two years, while in Wales only 25 per cent thought it had done so. In the North and South Thames regions, about half of consultants believed the services had got worse for the elderly and the mentally ill.