"Care in the Community": Report (Hansard, 19 July 1988)

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, as I told the House on 18th May, we shall bring forward our own proposals in due course.

§ The Countess of Mar
My Lords, I thank the Minister for that Answer which does not unduly surprise me. Did the noble Lord read the second leader in The Times yesterday which put more clearly and precisely the points that I should like to have made but shall not now make? Can he impress upon his honourable and right honourable friends in another place the importance of a quick decision on the report because of the problems of elderly people being forced into residential accommodation and patients being discharged from psychiatric hospitals with no proper care provided?

§ Lord Skelmersdale
My Lords, yes, I read the second leader in The Times yesterday: it contained detailed comments on some of the proposals in the report. It would not be productive for me to speculate in that area. The report concerns not only the machinery of government but also the relationship 1200 between government departments. Therefore it is inevitable that a government response will need detailed consideration and time. However, a response will evolve in due course.
I do not regard the length of time taken by the Government to decide on their preferred route forward as implying any downgrading of community care or lack of urgency. In the meantime much can be done by local authorities and health departments.

Lord Winstanley
My Lords, does the Minister recall that in an earlier answer he gave to the House at the end of a debate he said that the Griffiths Report, together with certain other reports, would be examined in the course of the National Health Service review? Does the Minister accept that by then it will be too late and that certain action is essential here and now; namely, to ensure that provision for care in the community is in place before certain patients are discharged from hospital into the community?

§ Lord Skelmersdale
My Lords, that was what I meant. Authorities should be pressing ahead with the development of the services already planned rather than postponing developments pending national action. While it is not necessary to have the i's dotted and the t's crossed in respect of both considerations, clearly it is necessary for them to be in parallel.

§ Lord Allen of Abbeydale
My Lords, this is not the only report which urges a clear national framework for community care. Is the Minister aware that the slowness of the Government in acting in this context, coupled with the provisions of the Local Government Finance Bill as it reached this House, which will have the effect of driving many of the poor and disabled out of the community into residential care, raise doubts about whether the Government still believe in the policy of care in the community?

§ Lord Skelmersdale
My Lords, no. I do not believe that that conclusion can be drawn. Care in the community means more than merely keeping people in their own homes, as the noble Lord well knows. Where considered appropriate there is provision within the care in the community policy for residential homes and hostels of various kinds.

§ Lord Campbell of Alloway
My Lords, can my noble friend say to what extent the Government's response is inhibited by the acute shortage of nurses?

§ Lord Skelmersdale
My Lords, that has no bearing on the matter. Sir Roy Griffiths was asked to report on suggestions for improving the situation within current resources, and he did so.

§ Lord Carter
My Lords, is the Minister aware that because of pressures on their budgets a number of health authorities are underfunding community care in order to balance their books? Can he say what plans the Government have to deal with that serious problem?

§ Lord Skelmersdale
My Lords, I am interested to hear what the noble Lord says. However, we in central government have no evidence of that allegation. If the noble Lord can produce the evidence I shall willingly look at it.

§ Baroness Masham of Ilton
My Lords, with the problem of the extreme shortage of nurses, will the Government extend work permits to those people coming from European countries such as Portugal who wish to be care attendants and who can do that job very well for severely disabled people who wish to live in the community?

§ Lord Skelmersdale
My Lords, the noble Baroness has asked a very precise and detailed question. I should like to consider the matter and write to her.

§ Lord Ennals
My Lords, is the Minister surprised that five months after the report was presented to the Secretary of State, some people who are deeply concerned with community care are not satisfied with an "in due course" response? Does he also accept that Sir Roy Griffiths has spoken of the urgency of the Government's response? Bearing in mind what he said about local authorities, how can he expect local authorities to plan community services for the elderly, mentally sick and handicapped, and physically handicapped, when they have no idea what their future responsibilities will be and when many of them are strapped for funds to do precisely what he says they should do?

§ Lord Skelmersdale
My Lords, I said earlier that both local authorities and district health authorities should get on with the plans which they have already formulated. Whenever the result of the Government's consideration on the report of Sir Roy Griffiths appears, I do not see that that makes any difference to that aspect. Nor should it be suggested that Sir Roy's report is being shelved because it acknowledges the need for further work in the absence of an obviously perfect solution. The framework which Sir Roy has offered needs to be studied before decisions can be reached on the best way forward, but that does not preclude current action.

§ Lady Kinloss
My Lords, can the Minister say how many patients are likely to be transferred from hospital into the community in the next five years, and what provision of care in the community there will be?

§ Lord Skelmersdale
My Lords, not without notice, I am afraid.

§ Lord Cledwyn of Penrhos
My Lords, the noble Lord specifically said in one of his replies that there was far more that local authorities could now do to help to resolve the problem. Will he explain to the House what they can do if they do not have the resources to do anything more?

§ Lord Skelmersdale
My Lords, I said that there is room for progress within the existing arrangements 1202 while we consider the way ahead. Authorities should be pressing ahead with the development of the services already planned rather than postponing development pending national action. I have already made that point.