The nightmare of older people left to languish in hospital when
they had no need to be there could not have been allowed to
continue. That was never in any doubt. But doubts certainly do
remain about the government’s solution of fines for those social
services departments deemed guilty of causing delayed discharges
from hospital. They have not been allayed by the recently completed
three-month trial period of “shadow” fines.
Any system of care in the community that respects the dignity of
older people must have some regard for choice. Yet the government’s
obsession with targets is likely to put this at risk and not for
the first time. Fines will be levied on social services departments
that fail to arrange care packages within two days of notification
by the hospital, the most likely result being that older people
will be sent wherever there happens to be a place available rather
than where they would choose to go.
Now that departments are liable to pay the fines for real, the
pressure is on. It could be argued that they should have done much
more to promote intermediate care as an alternative to hospital.
But, having made another stick with which to beat social services,
the government may well find that the main casualties are the very
people it was designed to help – service users.