Shadow bed-blocking fines will allow councils time to prepare

Councils will not face fines for delayed discharges from
hospital until 1 January 2004, it was confirmed last week.

Baroness Andrews, the government’s health spokesperson in
the House of Lords, said that while the government intended to
start the process in October, charging under the Community Care
(Delayed Discharges) Bill would not begin until January next
year.

“It means that the NHS and local authorities will have a
three-month period over the winter to prepare for full
implementation during which the charging operates only in shadow
form and no charges for delays will change hands,” she said.

However, social services will need to start preparing for
effective weekend working following the news that Saturdays will
not be exempt from the period in which a person must be discharged
(news, page 10, 27 March). While Sundays and public holidays will
initially be excluded from this period, they could be included as
early as April 2005.

Concessions made by the government last week include excluding
individuals receiving mental health services from the bill’s
remit until further debate by parliament.

Mental health charity Mind said that mental health care should
be treated as a special case as the shortage of aftercare would
leave vulnerable patients “discharged to an uncertain future”.

“Evidence shows that people are particularly vulnerable to
suicide in the weeks following discharge from psychiatric
in-patient care and we feel it is important that they are not sent
out to face the world without proper provision for their needs,”
said Mind chief executive Richard Brook.

Meanwhile, Baroness Barker, liberal democrat health spokesperson
in the Lords, said what had been “a terrible bill” would now be
welcomed by patients, local government and health professionals.
“Regulations will now lay down that patients must be consulted on
whether they want to speak to a social worker about care and that
the consultation must be recorded,” she said.

But she warned that patients and councils must now scrutinise
the working of the legislation to make sure it empowered older
people.