Community care minister Stephen Ladyman says he is “very confident”
that councils doing a “reasonable job” of managing residential care
will make a “profit” out of the delayed discharge fines system.
Speaking exclusively to Community Care, Ladyman said the
£50m the government had allocated to councils to invest in
nursing home and domiciliary care services would enable councils
that worked with the NHS “in the way they ought to” to have no
trouble avoiding fines.
“Those local authorities that do a reasonable job will pay less in
fines than they will get in grant,” said Ladyman. “If they decide
to drag their heels then the money they receive will go back to
health to pay for doing the job that ought to have been done by the
The fines system will be introduced in shadow form from 1 October,
before money begins changing hands on 1 January 2004. If a person
who has been assessed as being ready for discharge from hospital is
not found a bed within three working days the council is liable for
a £100 daily fine (£120 in London).
Ladyman said the government is looking at solutions to overcome
local capacity problems, including developing a model to calculate
the cost of care home places and the price councils should pay home
He warned that private providers needed to be realistic about the
price they charged for beds and said that some councils were
considering setting up their own homes again.
Meanwhile, Ladyman has admitted that a clash of cultures can act as
an obstacle to closer working between social services and health
authorities, following the decision last week by Barking and
Dagenham Council to withdraw Julia Ross from her joint role of
social services director and chief executive of the local primary
care trust because of a row over whether she should be sacked by
Ladyman said: “There are different cultures and we want to find out
what makes it work and what makes it fail. There are obstacles and
in some places they are more serious than others.”
– For a full version of the Stephen Ladyman interview see 25
September’s issue of Community Care.