The compulsory removal of elderly people in England and Wales under Section 47 of the National Assistance Act and its 1951 Amendment: a survey of its implementation in England and Wales in 1988 and 1989.

Section 47 of the National Assistance Act 1948 and its 1951 Amendment allow for the compulsory removal from their homes of predominantly elderly people to a place of safety. The Amendment has been in use for over 40 years. Little information is available on the workings of the Acts in England and Wales. For the period 1988 to 1989 inclusive, 771 requests for compulsory removal were received by 148 'proper officers'. We examined referrals and removals under the Acts. During this time 165 people were removed. The majority of referrals were from family practitioners (46%), but social workers also played a role (18%). Of the 165 people who were actually removed from their homes, 41 were removed under Section 47 of the National Assistance Act and 124 under its 1951 Amendment. The outcome of compulsory removal was only known in 126 instances. In 34% of cases the person was transferred to residential care and 24% returned home; 18% of the detainees died during their compulsory admission. The outcome varied significantly between health regions (chi 2 = 72; p < 0.001), with for example apparently high death rates in the North West, Trent and South West regions. For a disturbing 24% of people nothing is known of their fate. A mandatory reporting system to examine the use of this legislation is required.