The decline in patient numbers in mental handicap hospitals: how the cost savings should be calculated

The movement of patients out of long stay mental handicap hospitals releases some funds which can go towards the development of community services. This paper considers the size of the possible savings on the basis of leaving the resources available for care unchanged for those who remain in hospital. It is argued that the savings depend on the dependency of those discharged, the existing level of services and the policy of a particular hospital about the use of paramedical staff. This has the implication that each hospital has to be considered individually. The paper goes on to discuss how costs in hospitals should be apportioned, and how potential savings can be identified. On the basis of a study of five hospitals in the Northern Region it emerges that there are few fixed costs, but the discharge of low dependency patients produces savings of approximately 50% of average cost. The results show that this rises as the programme involves the discharge of more dependent patients.