A TOP surgeon claims it would be cheaper to send bed blocking patients to a luxury hotel than keep them at the Royal Bolton Hospital.

Tony Banks says patients are enjoying an "expensive bed and breakfast", blocking £300-a-day hospital beds because they have nowhere to go.

Mr Banks, vice-chairman of the Royal College of Surgeons, said the beds were desperately needed for people waiting for operations.

Latest figures show that 74 patients were awaiting to be discharged from hospital. Of these, 34 had been in hospital for longer than the locally agreed target of 14 working days.

Thirty one of the 34 were unable to get into a nursing home or return home because funding from either Bolton, Wigan or Salford social services was not available.

This means 42 per cent of beds were blocked because social services could not find patients somewhere to go. Royal Bolton Hospital managers say that the problem is also a national one. A spokesman said: "The problem in Bolton is the question of not having sufficient resources and capacity to care and support everyone who needs it, whether that is in hospital, in a nursing or residential home, or in their own town."

Some patients can wait as long as a month to find somewhere to go -- costing the hospital £9,000 per patient. Mr Banks drew the shock comparison while answering a barrage of criticism of the hospital from BEN readers.

"An acute hospital bed costs £300 a day, but these are filled with elderly patients who are not being found somewhere to go because social services are not shouldering the burden. It would be cheaper to put them up in a top hotel. We have a large number of patients in all specialities who are enjoying an expensive bed and breakfast because of a lack of social services back-up."

London's The Ritz hotel charges £205 per person per night -- proving a cheaper alternative to the daily "rate" for beds at the Royal Bolton Hospital. Mr Banks claims that more nursing and care homes should be reopened in Bolton to free up beds and ease the trust's financial and bed-blocking burdens.

The Wigan and Bolton Health Authority says Bolton is down by five nursing homes. It says some nursing homes in Bolton are opting out from nursing care by registering as rest or care homes. As reported in the BEN, the Registered Nursing Home Association has predicted another major crisis for Bolton this winter as more nursing homes struggle to survive due to funding difficulties.

Mr Banks claims this is putting pressure on hospital beds, with local social services not giving back-up. The surgeon has bitterly attacked those who blame the hospital for its one-star Government league table rating.

He said: "Staff should not be run down. They are doing an excellent job and the administration staff are excellent. They are the good guys who have not played by the government game -- and have now got their fingers burnt with the one-star rating.

"The hospital is a victim of its own success. We are being swamped with trauma patients. This is getting worse since the closure of Fairfield Hospital's accident and emergency department. Now there is nothing between us and the M66. If you fall and break your leg in Bury, it is quicker to come to Bolton."

The consultant orthopaedic surgeon said staff were working flat out but many nurses, especially those who treated the elderly, were leaving to take up jobs in "easier" hospitals. The Government has announced that it is to give £433,000 to fund extra nursing home beds to free up beds in the Royal Bolton Hospital, but Mr Banks says Bolton has seen a cut in the number of care homes over the last five years.

"We have lost three care homes in Edgworth alone. There should be a resurrection of the large number of nursing homes and rest homes which were shut down as a result of government policy.

"We are now seeing the effect of that policy, with large numbers of elderly patients occupying acute high tech beds, which are of course very expensive to run."

Mr Banks claims throwing money at the problem to solve the vicious cycle of bed blocking will not work without improvements to the infra-structure. Instead of an average of 280 orthopaedic patients a year, Mr Banks is now dealing with 360. He claims he is not being funded for the extra demand.

He said: "The staff that are here are being flogged to death. The workload is too great. It is a vicious circle with orthopeadic nurses being forced to look after medical patients.

"Someone, somewhere has to decide what has to go to cover for other areas."

Cllr Cliff Morris, Executive member for Bolton Council's social services, said: "I am very surprised to be told of these remarks and will want to discuss the difficulties being experienced by the hospital trust with the chief executive, John Brunt."

A Bolton Council spokesman said the number of allocated residential care beds had risen by 30 over the past five years -- and was set to rise by another 24 to help the hospital cope with winter pressures.

The spokesman said: "We have been working jointly over a number of years to ensure that delayed discharges at the hospital are kept to a minimum. We fund significantly more beds now than five years ago with an increase in community services also."

A Bolton Hospitals Trust spokesman said: "We keep in close contact with social services and are working with them to find solutions to a wider problem."