Council angered over government refusal to help in cost-shunting row

A council locked in dispute with a primary care trust over who should pay for continuing care services is angered by the government’s refusal to take up the issue as a national priority.

Leaders from Brent council met with health minister Lord Hunt and local government and communities minister Phil Woolas last week to air their concerns that Brent teaching primary care trust’s debts are seriously impacting on joint services provided by the council.

Brent council had hoped that ministers would take up the issue as a national priority to prevent NHS debts from impinging on councils. But the 45-minute meeting ended in disappointment.

“My big concern is that I can’t see the ministers taking the situation seriously,” said Paul Lorber, council leader for Brent. “They said it was a local difficulty that needs to be resolved locally.”

Brent Council is contesting bills from the TPCT for an estimated total of £8-12m for last year and this year for continuing care, part of which relates to the costs previously paid by the NHS for long-stay hospital patients who have been transferred to the community. Other councils have also received invoices from the TPCT, according to Lorber.

The TPCT has had to make cuts of £42m and has acknowledged its own governance failings, he said. However, joint health and social care services are suffering as a result, including school nurses and health visitors, speech and language therapy for children and physiotherapy at specialist schools.

Gareth Daniel, chief executive of Brent council, said the dispute over continuing care costs had reached an impasse and was fast approaching the need for litigation.

He added that councils across London were concerned that the Brent situation could become a test case for other PCTs.

“There is a very high level of concern over cost-shunting. The anxiety is if Brent PCT gets away with it similar action might be taken by other PCTs. The boundaries of who pays for health and social care are being re-negotiated by stealth.”

Brent TPCT said (in a previous statement) that it does not believe it has ‘shunted’ costs or responsibility and said it is “keen to continue dialogue with the council to ensure a sensible way forward is reached”.

London Councils will be meeting with Lord Hunt in July to carry on the discussions.