GP: send bed blocking OAPs off to Spain; Ill pensioners will recover

It sounds like a Saga Holiday - elderly travellers arriving in Spain to sup the sangra and bask in the rays of the Costa del Sol. But the influx of sombrero-clad pensioners to our favourite seaside destination could be courtesy of a new NHS venture under discussion.

A GP has called on the government to send pensioners off to Spain to recuperate and suggests that the NHS build its own nursing homes on the Mediterranean coast.

The idea was prompted by the bed-blocking crisis, where elderly patients - despite being fit to leave - are forced to stay in hospital because of a shortage of nursing-home places.

Dr Mustafa Kapasi of Greenock Health Centre has discussed his proposals with members of his local health board and hopes to set up a pilot project to test out his plans.

The doctor, who spends his own holidays in Marbella, says he is always amazed by patients' improvement after a few months in the sun.

He said: "I have a house in Spain and, in October, when I go on holiday, I see people going out there for long-term care on Zimmers. They come back in March or April without a stick."

He tells of one acquaintance who was wheelchair-bound and had severe chest pains. After going to Spain on his doctor's advice, the man recovered to the extent that he could walk round the market and climb up 20 steps.

Dr Kapasi said: "We do not have enough nursing home spaces so why can we not pioneer a scheme where the NHS has nursing homes in Spain? It would cost us less and it would improve people's quality of life. They could be in the swimming pool every couple of days. Joint pains disappear in the sun. If their condition improved as much as I see people improving, they could then be returned to the community."

If building homes proved too expensive, Dr Kapasi said the NHS could rent out hotel rooms that lie empty between the autumn and spring.

He said: "We could ask to use the hotels which are not occupied from October to May. Money has been thrown away by the government on schemes to unblock beds which have not worked. That money would have been better spent opening nursing homes in Spain."

Dr Kapasi said that he has discussed his proposals with the chair of the new unified health board for Argyll and Clyde and that there was enthusiasm for setting up a pilot project.

But health economists last night questioned the affordability of the scheme. Dr Andrew Walker of Glasgow University said there would not really be a saving because the freed-up beds would immediately be filled by patients on waiting lists for operations.

He said: "If you take the number of 'blocked beds' in Scotland and multiply by the average cost per day for a geriatric assessment ward in hospital, the total is #56 million. This is what the 2885 patients blocking beds have cost to date. They have yet to be discharged so the final figure for the cohort will be higher. It is also quite a conservative figure as geriatric assessment has one of the lowest costs per day of all the in-patient specialities.

"However - and it is a very big however - if these patients had been discharged earlier, the NHS would not have saved a penny. It would have freed up bed-days that could have been used to treat other patients. This is the true cost of blocked beds and the true benefit that comes from freeing them up."

He added that, if elderly patients were treated to a free holiday, other patients would also claim that they would benefit from sunshine treatment.

"Where will it end? How about people with depression - a lifetime of Prozac costing about #10,000 or a round-the-world cruise?" he said.

The Spanish venture follows a series of elaborate proposals to tackle the problems of bed-blocking.

Last month, the Sunday Herald revealed that one of Scotland's largest NHS trusts, Lothian University Hospitals Trust, was discussing building its own nursing homes because its hospitals are so full of bed-blockers that hundreds of operations have had to be cancelled.

And last year, Dr Alasdair Shaw - a Blairgowrie GP and chairman of Tayside Area Medical Committee - argued that, if patients or the local authority were presented with a bill for the cost of the patients' care in an NHS hospital, this would focus their mind on finding alternative accommodation. He even pointed out that patients could stay in Gleneagles Hotel for the price of a hospital bed.

The cost of keeping an elderly person in a residential or nursing home is between #344 and #387 a week but the expense of a hospital bed is around #1000 a week.

In the last year, up to 10% of hospital beds in some areas of Scotland have been occupied by bed-blockers. The census of bed- blockers for April this year showed that, of Scotland's 34,000 hospital beds, nearly 6% were blocked by people fit for release.

Catch up:

More pensioners are being forced to stay in hospital despite being fit to leave because of a shortage of nursing home places. Hundreds of operations have been cancelled becuase of the crisis. One GP believes the NHS building nursing homes in Spain is the solution.

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