Published: 21/11/2002, Volume II2, No. 5832 Page 7

A six-month deadline to introduce cross-charging has come under attack from representatives of NHS and local government management who fear it will create 'adversarial relationships'.

The Community Care (delayed discharges etc) Bill, which proposes fining local authorities if they are responsible for delays discharging patients from hospital, had its first reading in the Commons last Thursday.

It is based on a Swedish model which has led to a reduction in the numbers of patients 'blocking' hospital beds. But that system took two years to develop.

NHS confederation policy manager Janice Miles said: 'In Sweden, they got two years to work it out and the benefit of having it implemented gradually.

We have got six months.

'The real problem is going to be the additional administration and bureaucracy this is going to entail.

From our point of view, we have been given a deadline of April 2003, but we still do not know any details. The bill just set out the broad outline and we were told that the detail would be set out in the regulations.We need to know what they are pretty soon.'

And in a joint response, the NHS Confederation, Local Government Association and Association of Directors of Social Services say the key to tackling delayed discharge 'lies in an incentive regime which spans all local agencies, joint targets and a shared performance-management framework that ensures local co-operation and more integrated care.'

Windsor, Ascot and Maidenhead primary care trust chief executive Philip Burgess said any money accrued from delayed discharge should be ring-fenced and spent on initiatives to keep people out of hospital.