Emergency trips to hospital by pensioners rise by 25%

Emergency trips to hospital have increased by more than 25% among Scotland’s pensioners, despite the investment of millions of pounds extra in community care, figures have revealed.

The surge has raised serious questions about whether the Scottish Government’s flagship free personal care policy has helped frail elderly people avoid spells on NHS wards.

Liberal Democrat MSP Ross Finnie, who was a cabinet minister when free personal care was introduced, has exposed the issue – saying if funding community care is not keeping people out of hospital “we have got a massive costs problem”.

The bill for providing free personal care – which entitles frail pensioners to help with intimate tasks such as dressing and washing – more than doubled in the first five years. It cost councils £128.8 million in 2003-04 – the first full year of the policy – and £273.7m in 2008-09, an increase of 112.6%.

Mr Finnie said: “There are several aspects to free personal care but one clearly was to try to make it easier for people to remain in their homes and therefore receive their care in the community. One might have thought the NHS would be interested to know if that objective is being met.”

He lodged a parliamentary question on the number of hospital admissions among the over-60s which revealed a 26% increase – from 570,424 in 2000 to 719,677 last year.

The number of over-60s in Scotland has also risen, but less steeply, from 1,008,836 to 1,122,170 – up by 11%.

Mr Finnie said he was dis-appointed by the sharp rise in hospital admissions. He added: “I find it difficult to believe that these figures are still going up at the rate they are going up … In a monetary sense we were looking to be making some kind of saving in hospital care to offset the increase in care in the community. It does not appear to have happened.”

Mr Finnie also asked the Scottish Government for its estimate of the impact of free personal care on hospital attendances, but was told this information was not available. He said: “There is quite a serious piece of work needing to be done to get to the bottom of this. We cannot possibly have a position where we are providing funding and resource to allow more people to be treated in the community and find we are still treating them in hospital.”

A Scottish Government spokeswoman said they are investigating how to measure the impact free personal care has had on hospital admissions.

She added: “We know that the way that care for older people is provided needs to change and that’s why we are currently carrying out Reshaping Care for Older People. The results of an engagement exercise asking Scots how they think care for older people should be provided in the future should be available before the end of the year.”

Lindsay Scott, spokesman for charity Age Scotland, said they were convinced free personal care was effective.

He said: “In a lot of cases it does not stop admissions to hospital for accident and emergency, short-term treatment. However, it stops the long-term hospital stay in a lot of cases.

“The whole issue about ‘bed blocking’ has basically disappeared and that is a result of people being able to get cared for in their home and not in hospital.”

He said lifestyle choices, such as smoking, may be behind the rising requirement for hospital care among pensioners.

However, he added: “We reckon if we concentrate on keeping free personal care working properly it will start to show in a reduction in hospital admissions.”

The future of free personal care has been repeatedly questioned amid the pressure on public-sector spending.

Mr Finnie said that when looking for efficiencies social care needs to be examined as a whole, rather than picking on free personal care in isolation.