Lords undone (unjust) fine

As debate continues about its own future, the House of Lords has
shown once more that it can be an important restraint on the
government’s zeal for change. By voting to delay the introduction
of bed-blocking fines for a year, the Lords have done social
services departments and health trusts a big favour. Of course,
ministers immediately announced that they would override the
decision, but then had to compromise by delaying the fines until
October instead of introducing them in April as originally planned.

The postponement will give health and social services a welcome
breathing space to agree on the arrangements. But it is doubtful
whether it will be time enough. The National Audit Office report
published last week reveals the scale of the problem with 4,000
people older than 75 unable to be discharged on any given day
because there is nowhere for them to go.

Inadequate co-operation between health and social services, at
which the fines are principally targeted, is only a small part of
the picture. The shortage of places in care homes and the need to
develop an infrastructure capable of supporting intermediate care
are much more significant factors. The fines will be an unnecessary
distraction as local agencies struggle to take this important work
forward.