Public Release: 

New act will restrict patient choice

Choice and responsiveness for older people in the 'patient centred' NHS BMJ Volume 327, pp 4-5


Chronically sick and older people may not be able to choose where they are treated when new community care regulations come into force in January 2004, warn researchers in this week's BMJ.

Under the Community Care (Delayed Discharge) Act, local authorities will be fined by the NHS for failing to arrange social care services for patients who remain in hospital longer than necessary.

From 2006, new financial arrangements will also mean that hospitals make a loss by continuing to care for any patient who stays longer than the "average length of stay."

These measures could see the chronically sick and older patients being forced into accommodation which is inappropriate and does not serve their needs, write Allyson Pollock and David Rowland of University College London.

The effect of these measures is also likely to undermine the rights of patients to choose their care home, they add. Patients exercising their right to choose currently accounts for 8% of all delayed discharges. Choice for older patients is thus now presented as an obstacle to the efficient functioning of the system.

The health secretary, Dr John Reid, has stated that his government "will empower patients by giving them genuine individual choices about where, when, how, and by whom they are treated." It seems that he does not have in mind the frail, elderly and people with long term illness, they conclude.


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