INEDUCABLE CHILDREN

HC Deb 04 July 1951 vol 489 cc2451-62

10.2 p.m.

Mr. Redmayne

I was discussing the question of the allocation of vacancies to hospitals and institutions and saying that the regional boards deal with things and the local authorities with people and places. Without elaborating that point further, having rather lost my thread of it, I would say that it seems there is a case for closer integration between authorities and hospital boards, and even possibly for giving back to local health authorities, not necessarily the control of their own institutions, but at least some control of the allocation of vacancies in the institutions which were originally fostered by their enterprise and initiative.

Another point I wish to make in regard to local health authorities is that they have lost, at least under this form of administration, any power to make monetary grants to assist parents who are able and willing to pay something towards the treatment of their ineducable children in such private homes as exist. Admittedly they are not very great in number. By the same token, the power to give monetary assistance could be applied to parents willing to band together to provide something which would be an equivalent of an occupational centre where that might be convenient and possible. I feel that if there was power to grant monetary assistance by local authorities it might help at least to reduce some of the weight of the problem.

I wish to ask some questions about the size of this problem and the numbers involved. If my figures are right there are some 7,000 children already in institutions and some 3,500 dealt with in occupational centres. I think I am right in saying that some 14,000 are simply under supervision at home. I should like to know how many children are awaiting admission to hospitals. I do not believe that information has been given; I certainly cannot find it. Certain inquiries have been made from regional hospital boards with at least an interesting result. I am going to quote figures, not in any way as a criticism of regional hospital boards, but to bulid up a picture of how big is the problem.

In the following regions these are the figures which have been obtained: Sheffield 430, Manchester 390, Leeds 210, South-West Metropolitan 390, North-West Metropolitan 350, North-East Metropolitan 226, Newcastle 212, Liverpool 118, East Anglian 68, a total of nearly 2,500. Add to that a number of regions which for various reasons, no doubt very good, were unable to give that information, and it would appear that the number of children awaiting admission to hospitals must be well over 3,000. Again I stress that that is no criticism of the hospital boards. My figures may well vary in date and exact content, but they are so far as I know correct. How many, according to the Minister, are waiting?

How many more children, and this is important, are suitable for admission to hospital but are simply not counted as waiting because the position is so hopeless? That might produce a very interesting answer. Thirdly, how far is this waiting list for hospital treatment matched by a similar waiting list for occupational centres? So much for those questions.

There is also the question of the whole problem of how many ineducable children there are in this country. I ask the Parliamentary Secretary to confirm whether more than 3,000 children every year are being declared ineducable and are being put under the care of the Ministry of Health. The total number of those who have been so handed to the health authority in the last 11 years is 35,000. Therefore, arising out of that 11 years, there are 35,000 children today between the ages of 5 and 16 who are involved in this problem which is the responsibility of the Ministry.

That total is probably larger because in occupational centres and hospitals there are children under five and over 16—if one calls those of that age children. Therefore, although by the figures which I gave earlier as to where these children are, I can account for over 24,000, there are over 35,000 in the country. I should like to know whether where the balance of those children for whom I have not accounted are and also whether that is in fact the size of the problem that the Minister has to tackle.

We must know these figures without any question, and until they are publicly known—I am not speaking now of the people who do such valiant work in this problem but the general public—people simply cannot realise what the problem is. I hope that the Parliamentary Secretary will tell us what progress has been made and what progress is planned to deal with this problem.

I ask and hope specifically that there will be a complete review of it, not only the responsibility of the Ministry of Health, that is in relation to the ineducable children, but also the steps taken in the broad sense, including all backward children. The parents of these children say, "Our children cannot be educated but we are entitled to our share of the general expenditure on education. What do you intend to do in compensation?" That is a fair question. Are these ineducable children getting a fair share of the money spent on education? They are cut off from the Ministry of Education, they are dealt with by the Ministry of Health. Do they get a fair proportion of the expenditure? That question should be answered. Without a review of the problem as a whole it cannot be answered.

Lastly, I would say that I realise that it is very easy to clamour for public expenditure. Of course, given the right economic conditions, a great deal could be done to solve this problem. At the same time I would say that it will never be solved by this or any other Government unless the attempt to solve it starts off on the right foot. I believe very strongly that the right way to start off is to regard it as one problem, the whole' problem of the backward child.

I know that from the Parliamentary Secretary we shall get sympathy, some account of progress and certain figures. But I hope also we shall get an indication that the whole of this matter is to be the subject of study by the Government as to how these really appalling numbers can be reduced.

10.10 p.m.

Mrs. Braddock (Liverpool, Exchange)

I am pleased to take part in this debate, because Liverpool has a very particular problem of its own. I should like to ask what progress has been made by the regional hospital boards in supplying the necessary institutional accommodation for children who are considered to be ineducable, and who are handed over to the Ministry of Health or the regional hospital boards to be provided with accommodation?

At the council proceedings in Liverpool we always have some statement of the situation, and I was appalled to discover that at the moment there are 70, children in the highest grade of mental deficiency, all of whom have been indicted in the courts, and who are actually still at home awaiting accommodation in an institution. This is a very human problem. The parents of these children are very reluctant to make a song about it, because of the personal aspect of these cases. I could quote a number of cases where these children are completely out of hand and are in families where there are younger children. The parents dare not leave the children in case some physical harm comes to the younger children.

Supposing anything does happen, who will take the responsibility? The parent cannot do so. They are only maintaining the children until those responsible have taken the necessary action to find the type of accommodation required by the children. I have been responsible for having conferences with the local authority and the regional hospital board, and while there is a lot of sympathy we are getting nothing done at all. No urgent effort is being made by the appropriate authority to take the responsibility for these children. I am always concerned and am scared about the situation in Liverpool, knowing the cases there, many of them individually.

They are, as the Minister knows, in certain categories—and on 31st May there were 70 in the highest category in Liverpool—the most dangerous mentally defective children incapable of being educated, all of whom had been indicted of some offence. These 70 had been waiting for months for some sort of accommodation. In class 2, there are 14; in class 1 seven, and in the lowest class, where perhaps the parents could manage with a bit of extra supervision by the mental welfare authorities, there are two.

I inquired of the medical officer of health and found that during the last month the total number of vacancies allocated in Liverpool was six. So we are in a position of having about 80 children who are at home and their parents are, in desperate circumstances, trying to control them. I do not believe the regional hospital boards are paying sufficient attention to this matter.

I think that the Ministry of Health should get some definite indication as to the size and classification of the problem. I do not consider there is sufficient classification, because there must be similar circumstances in other cities besides Liverpool. It is a problem we are facing at this moment and the Ministry of Health should give some direction to the regional hospital boards.

It is anti-social that children who are in this condition through no fault of their own should be the responsibility of the parents and cause worry, misery, trouble and upset in their homes, when the local authority have handed the responsibility to the Ministry of Health. The Ministry of Health ought to insist on a complete national review of the situation. Where there are cases of the highest degree of urgency, some immediate and special steps should be taken to relieve the parents of the difficult responsibility of trying to control these children.

10.15 p.m.

Mr. Shepherd (Cheadle)

I support the remarks already addressed to the House. I have been interested in this problem for some time. Last month I took a deputation of hon. Members from both sides of the House to see the Minister of Health, and there we discussed the problem at large. I want to stress the fact that there is the most urgent need for emergency accommodation. Unless one has had experience of the effect that these children have in their homes, one cannot visualise the amount of human misery that is caused. I am convinced that, by and large, both the administrative bodies, the people responsible such as the regional hospital boards, and the public should share this problem. It is an unpleasant one to which many people do not want to face up, but we must face up to it. We must take desperate measures.

I have urged on the Minister of Health that he should lower the standards of the institutions. We must use hutments and buildings of that kind. We must increase the number of occupational centers. It is tragic to think that today the number of occupational centers is lower than it was before the war. We must try to get parents interested in this problem. If we can organize an advisory service to give some instruction to the parents, that will be a great help. I urge that this problem should be treated with urgency. I am convinced that it has not been given sufficient attention by the authorities concerned.

It really is a disgrace to our country that we have thousands and thousands of children who are having a damaging effect upon their brothers and sisters and who are still living in their own homes and making the lives of others a misery. It is time we did something about it. I hope that the Parliamentary Secretary will be able to say that, instead of waiting for the regional hospital boards and depending upon this dual administration, the Ministry intend not only to direct public opinion to the urgent need to do something, but that they intend to do something themselves.

10.19 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop) rose—

Mr. Godfrey Nicholson (Farnham)

May I speak for one minute?

Mr. Blenkinsop

I regret that I cannot give way. I have been left with very little time in which to answer the many questions asked about what is an exceptionally important problem. I was anxious that the hon. Member for Cheadle (Mr. Shepherd) should have the opportunity to say a few words because of the very great interest which he has taken in this matter with many other hon. Members on both sides of the House, and the proposals which he has put forward with other hon. Members.

This serious problem is not new. It has, unhappily, been with us for many years both before and since the war. It is one which has increased in its apparent urgency, because now many cases are coming to light which were cloaked and not known before. It is perhaps one good feature of the position that today parents are not as anxious as they were at one time to cloak what used to be regarded as an element of shame. Although that has meant an added burden upon us, it is one which we should accept and which we should not in any way be anxious to discard or pass on to anyone else.

In this problem of the care of the ineducable child, we do face the general problem of how to provide accommodation for them, both in occupation centres and in more institutional accommodation; but we also come up against the problem of staff. There are empty beds which we would wish to see being used in institutions for children, and, of course, for other mental defectives as well, but we cannot use them at present because of the lack of staff. I want to insist that it is not only a question of additional accommodation, but that it is also one of the need for more staff.

I want to deal in some detail with the points raised by the hon. Member for Rushcliffe (Mr. Redmayne), and I will probably also be mentioning some of the matters raised by my hon. Friend the Member for the Exchange Division of Liverpool (Mrs. Braddock). First, the hon. Member for Rushcliffe asked me whether the Ministry of Education was, in fact, passing over too many cases to the Ministry of Health. Were they setting too high a standard, and were children being regarded as ineducable when they could very well be accepted in special schools were there enough accommodation? I do not believe that to be true at all. There is, in fact, no connection between the problem of the lack of accommodation regarding school places and the decision about the category of the child. It is true that there is a very serious lack of special school accommodation, which is referred to in the latest Report of the Ministry of Education, which stresses the urgent need for much more provision.

I am glad to say that a great deal has been done, and since the end of the war, I understand, another 4,000 places have been provided for the backward child and the sub-normal child. A further 1,000 places are in course of preparation, and they will go some way to help to meet the problem to which the hon. Member referred.

Mr. James Johnson (Rugby)

Would my hon. Friend tell us what is the dividing line between a sub-normal child and an ineducable child?

Mr. Blenkinsop

I cannot spend the rest of the evening discussing the actual categories; it would be an unfair use of the time that remains to me. The decision is taken after medical examination of each case, and the provision of an, opportunity for an appeal to be made to the Minister of Education. Subsequent to the passing of the 1948 Education Act. there has been the opportunity for a further review of the cases at a later period, and cases can come back into the educational field when they are thought to be suitable for ordinary educational treatment. In our view, that means that there is little danger of a child being regarded as ineducable if, in fact, it would be quite possible to deal with the case by special school treatment.

The next point which the hon. Gentleman raised, and I am grateful to him for giving me advance notice of some of the points he was going to make, concerned the importance of giving priority for institutional accommodation. There is no doubt that social urgency is one of the most important factors that has to be borne in mind, for the very reason mentioned by my hon. Friend, and, of course, the home conditions are very important. I recently visited several institutions, the medical superintendents of which are very anxious, because they have a very high proportion of admissions of the category of case for which, medically, perhaps, very little can be done, but in which, socially, it is most urgently desirable that the child should be taken away from the home because of the particular circumstances of the case.

I would say here that in most areas it is left to the regional hospital board itself to determine the final priorities of admission. But in many regional hospital board areas they leave it to the institutions to decide upon priorities. The practice varies from area to area. We have a particularly severe problem in Liverpool and in the whole of the area covered by the Liverpool Regional Hospital Board, because of the desperate lack of accommodation in that area. In fact, we have to regard the Manchester and Liverpool Regional Hospital Boards' areas as one area for the purpose of admission. That must inevitably mean, I am afraid, that there is a more urgent need in that area for additional accommodation than, perhaps, anywhere else, although that is not to say there is not urgent need elsewhere.

That is why we have allocated out of national funds special sums for new accommodation in that area, in addition to the ordinary allocations to the regional hospital boards. We have made special provision to start building for the Liverpool Regional Hospital Board area this year, and I hope it will be possible to go forward rapidly with that building in order to ease somewhat their particularly difficult circumstances.

I was asked whether any sub-allocation of vacancies could be made to local authorities. The point was made that some local authorities did better than others in the past, that they were more vigorous and more progressive in this regard, and that it was unfair to them that their foresight should now benefit other areas. But surely we must have regard here not so much to the local authority as to the need of the children and of the home. It is not their fault that the local authority did not make provision in the past. Therefore, I think it right that the regional hospital board, as an authority with a wider purview, should have the determination of priorities. I think it necessary to try to see that the most urgent cases of need are given first attention.

I very well know what desperate tragedy there is in many homes, not only in Liverpool, but in other places. It is a heartrending problem on many occasions when we have to turn down applications, for unhappily the vacancies in all these institutions are so very rare. It is not as though there were a steady number of discharges which would provide early vacancies. In most institutions, very few vacancies occur.

I was also asked whether there should not be a system of grants to private institutions. Of course, regional hospital boards can and do make contracts with private institutions for the provision of extra places. In fact, I understand that for the country as a whole—and this does not apply only to children, but to all cases of mental deficiency—some 1,500 are at present contracted for in private institutions. In the Manchester region there are 245, of which a proportion are children's cases.

I was also asked about numbers. It is true that in the past we have not regarded the defective child's problem as really distinct from the broad problem of mental deficiency n all the age groups of the population. I think it would be quite wrong to suggest that the backward child is within this range. It is quite certain that the mentally defective child is a distinct and separate problem and needs to be treated by a separate autho- rity in a different way from the ordinary backward child. It would be quite wrong to suggest that it should come under any authority dealing with children as one class because there is need for special consideration.

Finally, I want the House to know that we are very much concerned with this problem. I am anxious to get fuller figures and information, which I will communicate to the hon. Gentleman. We have as a Ministry urged regional hospital boards to put a certain definite proportion of their capital allocation, which is, alas, far too small, to this sort of purpose. We have been vigorously following that up with all regional hospital boards. I do not mean to imply by that that regional hospital boards are not anxious to do this work. I am sure they are, but they have too many pressures upon them, and are, unfortunately, unable to do as much as we would all wish. We are ensuring that the boards shall use a definite proportion of their capital allocation for this purpose, and we are setting aside additional sums for urgent cases in certain areas of the country.

I hope the House will gather from what I have said that we are by no means complacent, that we regard the matter as one of the most tragic problems, and that we hope to make a still greater contribution towards solving it in future years.

Question put, and agreed to.

Adjourned accordingly at Twenty-nine Minutes to Eleven o'Clock.