It didn’t take long for the fear of “bed blocking” to be expressed by the NHS. This concern about cuts in social care was not an expression of support for colleagues in social services; it was not a plea for the protection for the NHS to be extended to this part of local government; it was a pre-emptive strike from hospital trusts.
“Don’t blame us when waiting lists increase! It will all be down to social services who tell us they have no money to support older patients who are discharged and sent home!”
No money for home help; no money for day care; no money for rehab.
So elderly patients sit in an expensive, acute hospital bed waiting for someone to die in a residential home as part of social services’ “one-in, one-out” budget control policy.
This is what happens when budgets are cut; agencies retreat to core business and argue about who should pay for what.
Hospital trusts would like to get their hands on the care budget for supporting people discharged from hospital so they do not have to deal with social services. They may yet get their wish - after all, GP commissioning consortia will hold the NHS budgets locally and could well buy these services from hospital trusts, who would be happy to provide if the price was right.
Of course, GP commissioners would complain that the local authority should fund this, but GPs are very pragmatic and would rather pay than have their patients unable to get into hospital because beds were blocked by patients who did not need them.
The NHS would no doubt lobby ministers to transfer the funds from local government and since the coalition government has no love for local authorities they might well be sympathetic.
After all, the adult social care budget is the single biggest budget left in the control of the local government; its removal would be the last nail in the coffin.