Elderly to get cash help to stay at home

Older people are to receive cash payments to fund care in their own homes under a government drive to reduce the numbers of medically fit patients stuck in hospital.

The health secretary, Alan Milburn, today announced that elderly people preparing to leave hospital will be given hundreds of pounds each to prevent widespread "bedblocking".

The NHS has persistent problems with bedblocking, also known as delayed discharge, which happens when a patient cannot leave hospital because no community care package has been arranged for them.

More than 5,000 patients aged over 75 in general hospital beds had their discharge delayed in the third quarter of 2001-02.

The cash payments will come out of the extra ?2.4bn for social services over a three-year period starting in 2003-04 announced by the chancellor, Gordon Brown, in the Budget.

Mr Milburn told MPs: "Every older person assessed as being in need of care, whether for rehabilitation after a hip operation or for a bit of help with household chores, will be given the choice of receiving a service or receiving a cash payment to purchase care for themselves that better suits their individual needs."

Since February 2000, councils have been able to offer people over 65 money to pay for their care, as well as providing care services, but few have done so.

But the health secretary said it would now be mandatory for all local authorities to offer this as an option to the elderly, where it is relevant to do so.

The cash payments could be used to pay for a care assistant or for the installation of equipment, such as ramps and stairlifts, so they can stay in their own homes.

Mr Milburn also confirmed that local authorities will be made responsible for the costs of bedblocking, and have to pay the NHS's costs if they fail to arrange community care for elderly patients.

Other measures unveiled by the health secretary include doubling the carers grant to ?185m by 2006, to enable more carers to take short breaks; additional funding to provide free home adaptations; faster assessments of care needs; and more very sheltered housing.

The Commons health select committee is due to publish a report on bedblocking tomorrow, and the national audit office is also carrying out an inquiry into the issue.

The problem is largely blamed on the crisis in the care home sector. A report by analysts Laing and Buisson published last week found that more than 13,000 residential care places for elderly people were lost in the UK last year.

Paul Burstow, Liberal Democrat spokesman for older people, warned that unless the crisis was resolved the government would not be able to deliver its plans.

"With care homes closing and cash-strapped councils rationing access to home care, handing the cash over to older people to buy their own care won't increase choice," he said.

"Unless the government is prepared to pay a decent rate for care, choice will remain a pipe dream for thousands of elderly people.

"Putting the cash to buy care in the hands of older people will only make a difference if it ensures access to dedicated high quality care."

Mr Burstow said that the DoH's own figures showed that every day, 579 older people's discharge was delayed because their choice of care was not available.

Over the past five years the number of care home beds has fallen by 63,000 and 109,900 fewer people receive care in their own homes, he added.

Dr Liam Fox, the shadow health secretary, said Mr Milburn's statement was a "reannouncement" designed to distract from tomorrow's health select committee report.

"Trying to bribe elderly patients out of hospital is a typically cynical New Labour approach to a serious structural problem," he said.

"Even if funding is available, reduced capacity in the community means there is nothing to buy.

"Under this government the number of people receiving domiciliary care from either the independent sector or their local authority has fallen by almost 80,000 since 1997."