County councillors have been criticised for holding back home care to save money while Oxfordshire's cash-strapped hospitals are forced to pay for patients blocking beds.
Labour members are angry there was a £1m underspend in Oxfordshire County Council's £74m older people's budget while NHS managers have spent a similar amount in four months tackling a huge increase in delayed discharges.
Social services officers admitted there was a problem with bed-blocking, but said surplus money had been spent on vital services for children and people with learning disabilities.
Hospital patients are labelled as delayed discharges when they have completed their hospital treatment but cannot be released until alternative care at home, in a nursing home or community hospital has been organised.
Barbara Gatehouse, Labour spokesman on social and community services, said the Tory-run council's latest financial monitoring report showed £931,000 was left in the 2005-6 kitty for the provision of care for the elderly, including home support.
The report added: "Actions taken to control expenditure in 2005-6 have, in some cases, impacted on delayed transfers of care, affecting the ability of hospitals in Oxfordshire to meet their accident and emergency targets.
"Additionally, there has been an effect on access to home support and other care provision for clients in some areas of the county, and on other performance targets."
Mrs Gatehouse said that as well as impacting on the Oxford Radcliffe Hospitals NHS Trust, the move also prevented the council from meeting its own service agreement targets which meant it forfeited 72 per cent of a £1m incentive reward.
She said: "The Tories have made a great fuss about setting up a reserve fund to deal with the effects of problems in the NHS, but in fact they're causing such problems by underspending on social services and letting the NHS bear the cost.
"I know we have deficits in other areas, which are being offset by the home care budget, but my argument is that we can't afford to take it out of there.
"It's having a direct effect on the hospitals because they're have to provide care for people in hospital who don't really need to be there."
Last month, the Oxford Mail revealed Oxfordshire's NHS faced an £82m deficit at the end of the 2006-7 financial year without major savings plans.
The ORH, responsible for Oxford's John Radcliffe Hospital, Churchill Hospital and Radcliffe Infirmary, and The Horton, Banbury, has been asked to tackle £35m of the predicted debt, and has warned it may have to cut staff as a result.
Meanwhile, finance director Chris Hurst said delayed discharges had increased from 50 to more than 100 a day since December, costing about £1m and impacting on its waiting time targets.
Non-executive ORH board member Caroline Langridge said: "One hundred delayed discharges is equivalent to half the beds at the Horton. It's a significant number.
"To be carrying 40-50 would be realistic, but at the moment we have more than 120. We should be getting into the public domain just how much it's costing us. We'd never discharge these patients, but people need to know how much harder it makes our targets."
Charles Waddicor, Oxfordshire County Council's social and community services director, said: "Delayed transfers of care are a problem for the NHS and county council.
"The most significant reasons for this are patients waiting for other forms of NHS care, people remaining in hospital beds while deciding where they'd like to go for further care, and the lack of capacity among some of the council's private providers of residential nursing care and home support services.
"The county council is working to alleviate the lack of capacity in the independent care sector. For instance a development programme with the Orders of St John Care Trust will have created additional beds in nine residential nursing homes by 2008."
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