Doctors fear that the virtual disappearance of NHS elderly care beds over the past decade combined with a gradual tightening of social security rules has pitched many frail elderly people and their relatives into a middle-class poverty trap.
Strict limits on the amount of state support for care in private residential or nursing homes has led to the widespread 'bed-blocking' by elderly patients on acute NHS wards. Increasingly, hospitals are unable to discharge such patients because there is nowhere else for them to go. Relatives insist they can neither care for them at home nor meet the bills for private nursing home care.
Dr Alisdair Riddell, chairman of the BMA's community care working party, said yesterday there was 'no doubt' that the phenomenon of granny-dumping had spread from the US to Britain. The association hopes to shed light on the extent of the problem as part of a survey this autumn of 1,000 family doctors and hospital consultants on bed-blocking.
Already consultants in some parts of the country were having to turn a blind eye to Department of Health guidance barring doctors from allowing financial difficulties of patients and their relatives to influence decisions about the timing of discharge.
As a result, more seriously ill people are having to wait longer for a hospital bed. Under present rules, no one with an annual income or assets of pounds 8,000 or more is entitled to state support for places in private residential or nursing homes that can cost up to pounds 300 a week. 'The current limits are completely unrealistic - pounds 8,000 is a relatively little amount these days,' Dr Riddell said.
Dr Mac Armstrong, a member of the community care committee and chairman of the BMA's Scottish council, said a middle-class poverty trap was clearly emerging as a result of Government policy to target state support at the poorest: growing numbers of people who were above qualifying levels for state support, but were by no means rich, were experiencing financial hardship.
'The burden is falling increasingly on the very people who have funded the welfare state all their lives and thought it would provide for their basic needs from cradle to grave. Now they face the prospect of having their homes and pensions sequestered to pay for long-term care.'
Doctors debating community care at the BMA conference in Torquay repeatedly highlighted growing gaps in social service provision. Many applauded the principles underpinning the Government's community care policies, but accused ministers of not providing the necessary resources.
James Walsh, a GP and social services committee chairman of West Sussex council, said budgets for home helps and district nurses were failing to meet needs. 'Community care is becoming a synonym for cheap care.'