Budget reaction from social care sector

The social care sector has welcomed a 6 per cent increase in
spending announced in the Budget, but is concerned about proposals
for penalties for delayed hospital discharges, writes
David Brown.

Chancellor Gordon Brown said social care would receive an
additional £3.2 billion over the three years from 2003-04.

Much of the extra cash would be spent on increased care home
fees, with local authorities facing penalties if they were
responsible for delays in hospital discharges, health secretary
Alan Milburn insisted.

Milburn also announced plans for a single registration and
inspection body for social care, replacing the Social Services
Inspectorate, and the three-week-old National Care Standards
Commission.

Tony Hunter, chairperson of the Association of Directors of
Social Services standards and performance committee, said: “We have
got to welcome the headline figures of cash increases in real
terms.

“However the real issue for us is how far the money will address
the deep-seated financial issues not only in services for the
elderly, but for children and people with learning
disabilities.”

Local authorities have surpassed the government’s targets
for reducing delayed discharges, but face problems because of the
financial difficulties experienced by private sector care homes,
said Hunter.

“The success to date lies in joint working with our health
colleagues and applying a punitive approach at this time is
perverse,” he added.

“No one wants to defend bad practice but the reasons for delayed
discharges are complicated and a financial penalty is not going to
help.”

Unison also welcomed the extra cash, but said local authorities
needed time to rebuild care home capacity before penalties for
delayed discharges were considered.

Unison’s national social services officer Owen Davies
warned that the proposals “invite the potential for cost shifting
between the NHS and social services departments unless genuine
partnerships are developed”.

But NHS chief executive Nigel Crisp said the Budget offered the
reforms the sector had been asking for, including decentralisation
and new ways of strengthening partnerships with the social
services.

Rabbi Julia Neuberger, chief executive of the King’s Fund,
said penalties for delayed discharge could lead to a reduction in
user choice over their care package.

Carers UK said it was concerned that the delayed discharge
penalties could further increase the rates of patients forced to
leave hospital too early.

Between 1998-99 and 2000-01 readmission rates doubled to 43 per
cent, and almost half of carers believed that patients had been
discharged too early, said a spokesperson for Carers UK.