Plans to fine social services for the delayed discharge of hospital
patients could begin in October, after the House of Commons
rejected the April 2004 implementation date proposed by the House
of Lords (news, page 8, 20 March).
MPs voted by 330 to 205 to reject delaying the start of the system
by a whole year, with health minister Jacqui Smith saying that the
government had proposed “a sensible delay” of six months.
She said:”The bill is about ensuring that those older people who
are currently not getting the deal that they deserve can get a
better deal. That is why I do not believe that we have anything to
gain from delaying implementation for a whole year.”
She said the bill had resulted in an “unprecedented wave of
activity” around delayed discharge, with local authority and NHS
partners discussing shared problems and finding common
She added: “If implementation were delayed for a full year,
councils would not receive any additional funding in 2003-4.
“If it were delayed for six months, councils could still receive
£50m for the period.”
The money could be invested in the staff or services that councils
needed in order to avoid reimbursement charges when fines are
implemented, Smith said.
MPs also voted by 320 to 178 to reject the House of Lords’
amendment to exclude people receiving mental health services from
the fining system on the grounds that it could be
An amendment intended to place a statutory duty on inspection
bodies to monitor the impact of the bill on patients and carers was
also thrown out by a vote of 308 to 198.
Smith said: “The implication seems to be that health and social
care professionals will irresponsibly discharge patients with
inappropriate care packages, but we do not believe that this will
be the case.”
The MPs also voted to reject amendments to limit the fining system
to a five-year period, to exclude Saturdays, Sundays and public
holidays from the discharge period, and to require a patient’s or
carer’s consent before the NHS can inform social services.