§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Whitelaw.]
§ 12 midnight.
§ Brigadier Sir Otho Prior-Palmer (Worthing)
I wish to raise the question of delegation of health and welfare functions mentioned in the Local Government Act, 1958, as it affects my constituency. I do not want to waste time with the whole history of this case, save to say that a year ago Worthing Borough Council applied for Ministerial consent to include in a delegation scheme those functions mentioned in paragraphs (f) and (g) of Section 46 (1). Recently the Minister gave his decision against the Borough of Worthing. Incidentally, it took him a whole year to reach this decision. Does it really take all that time to go into a matter such as this? The mills of the Civil Service do indeed grind slowly.
I was then approached by the Worthing Borough Council and asked whether I would table certain Questions. I was so incensed at the Minister's decision that I decided on stronger action. I decided that first of all I would see the Minister personally, if he would see me, in order to try to make him change his mind, and secondly, if that failed, that I would raise this matter on the Adjournment so that a full discussion could be had and specific questions which I did not table could be answered more fully.
I had a long talk with the Minister. I put the case as strongly as I possibly could, and I added many things, which I have not time to mention in this speech, relevant to the whole question of the Government's attitude towards the old people and people living on fixed incomes. I can assure the House that I did not pull my punches. As a result of that meeting with the Minister, he promised to have a look at the whole thing again. It is not an easy matter after a whole year's discussion to get a Minister even to say that he will look at the thing again, and I was very grateful to him for having done so, but I want to say quite emphatically that it was always my intention to do this and, if that failed, it was my intention to raise the matter on the Adjournment, and that 202 I am not bowing to any pressure of any sort from anybody in doing this tonight.
I wrote two letters to this effect to my council, one stating that I was going to see the Minister in an attempt to make him change his mind, and the second saying that I was going to raise the matter on the Adjournment. For some reason the council was not informed of my second letter. Had it been so informed I dare say some of the criticism to which I was subjected might have been avoided.
However, the case is a very simple one. There is a crying need for accommodation for old people in Worthing: a crying need. This need has not been met adequately. Here I should like to pay a tribute to the work of the Council of Social Service in Worthing for what it has done in this direction. The Act states that there must be exceptional circumstances before consent can be given. I propose to try to show that those exceptional circumstances do in fact exist.
Firstly, the population of Worthing is 74,000, well above 60,000, the statutory limit. Secondly, in ten years the county council has not built one single home for old people under Part III of the National Assistance Act, despite continual and urgent representations. True, seven places have been built or adapted outside the borough in various outlying country districts and villages for old people, but when people reach this age they dislike being uprooted and sent into remote areas. Preston and Lancing have been cited, I believe, as what the county council has done. I can assure the House that that does not alleviate the situation in the slightest degree. Lancing is three or four miles outside the borough, but the old people I am talking of have all their roots, all their ties, and have spent the whole of their lives, inside Worthing, and they dislike intensely the idea of being moved outside of Worthing.
Thirdly, and this is the main point, the average in England and Wales of people over pensionable age is 13.7 per cent. The average in Worthing is 29.6 per cent., or more than double. That is why I said that there is a crying need for old people's homes in Worthing.
I do not know whether my hon. Friend the Parliamentary Secretary to the 203 Ministry of Health realises the plight of some of these old people. I wonder whether she knows how many have been found dead in their beds, sometimes after being there for days before being discovered, because there had been nobody to care for them. There is serious need for this sort of accommodation in Worthing, and if these circumstances are not exceptional, then what in the name of reason are?
I am not in the least concerned with any other aspect of this matter. To what extent it may have an effect on the future county borough status of Worthing cuts no ice at all with me. I am anxious only to see that this growing need is met. It is not conducive of confidence if Ministers in speeches inside and outside the House promise greater freedom to the local authorities and then by administrative action withhold it. I refer in particular to the speech of my right hon. Friend the Minister of Housing and Local Government at Edinburgh in 1957. It may be that the trouble arises by virtue of the fact that a Minister introduces a Bill and then a totally different Minister in another Ministry has to administer part of the Act and does not feel bound by his colleague's promises.
As to the specific questions which I was invited to table—if that is the right expression—we know now that eleven district councils made similar applications and that only two were granted these functions. One was in Wales. The other was the town of Luton, but as that town is to become a county borough that does not cut much ice. That is one question which I am answering on my hon. Friend's behalf. The other question, to which I should like to have an answer, is: how many applications are still to be dealt with in respect of large towns? I have also the 100-dollar question to which I hope my hon. Friend will be able to give a perfectly clear answer, not only for our sake but for the sake of her Minister and herself, so that money and time shall not be wasted on applications such as this. I ask her to make clear what are the exceptional circumstances which the Act and the Minister demand before consent can be given. I believe that it is my hon. Friend's duty to the other boroughs as well as my own to give that answer clearly and concisely.
204 Someone I know told me that someone else had said that I was afraid to criticise the Government. All I can say about that is that the person's knowledge does not match his loquacity. I do not believe that I have delivered a speech in the House since I have been a Member which has not criticised Government policy in some form or another. As to timorousness, I leave others to judge.
I shall be raising another matter on another occasion and I give my hon. Friend due warning. It is the question of accommodation in Worthing Hospital. It also affects old people. I cannot, and have not the time to, go into that in detail tonight. I say only that at the end of September there were 1,331 people waiting for admission to beds in Worthing Hospital. I believe that the Minister has been very dilatory in attempting to relieve this desperate situation.
The situation of the old and the sick in Worthing demands immediate Government action. I appeal to the Minister, to the hon. Lady and to any other Minister who has power in these matters, to ensure that this situation does not continue any longer.
§ 12.10 a.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)
First, even though he has kept me here until this late hour, may I congratulate my hon. and gallant Friend the Member for Worthing (Sir O. Prior-Palmer) on his pertinacity in pursuing this subject? His constituents should be grateful to him for the endeavours he has made to make their views known.
The background to this matter is that the Local Government Act, 1958, made provision for the delegation, on certain conditions, to county district authorities of health and welfare functions under Section 46 (1) paragraphs (a) to (e) and, subject to further conditions, functions relating to the provision of residential accommodation for the aged and others in need of care, and for the mentally ill, could be provided under the additional paragraphs (f) and (g) with which the hon. and gallant Gentleman is concerned tonight.
Functions under paragraphs (a) and (e) were to be given by means of schemes, 205 which had to be approved by the Minister, by boroughs or urban district councils with a population of 60,000 or more at 30th June, 1957. For rural districts of whatever size and other district councils with a population of less than 60,000 the Act provides that they can apply for Ministerial consent for schemes of delegation of health and welfare functions. Consent is given only if the Minister is satisfied that special circumstances justify it. Any local authority making a delegation scheme regarding the exercise of additional residential functions had to apply for Ministerial consent. This consent would be given after consultation with the county council only if there were exceptional circumstances to justify it.
There were nineteen local authorities in England with a population of 60,000 or more, and one in Wales, automatically entitled to make schemes of delegation of health and welfare functions. Of these, two decided not to make schemes, and eleven of the remaining eighteen applied for Ministerial consent to include in their schemes additional residential functions for old people and the mentally ill. Of these eleven, Worthing Borough was one. All the applications were rejected except those of Luton Borough, with a population of 115,900, and Rhondda Borough with a population of 106,400. The decision to reject all the applications with the exception of those two was made on the assessment that there were no exceptional circumstances. In the other nine cases, therefore, the Minister was precluded under Section 46 (2) of the Act from giving his consent.
The exceptional circumstance held to justify the Minister approving the applications from Luton and Rhondda Boroughs were that in each case the population was over 100,000, and Section 34 of the Act provided that:In so far as the question of the constitution of a new county borough is affected by considerations of population, the Commission and the Minister shall presume that a population of one hundred thousand is sufficient to support the discharge of the functions of a county borough council.As such, of course, it would become a local health and welfare authority and discharge all the functions mentioned in Section 46 (1) of the Act, paragraphs (a) to (g). Irrespective of the number of aged or mentally ill persons in such a town, the population of over 100,000 206 was clearly a strong argument against the rejection of a claim to provide residential accommodation for those categories of persons.
In considering the applications for the additional functions, mentioned in (f) and (g) from towns with a population of less than 100,000 but more than 60,000, the problem was to assess whether in any particular case there were exceptional circumstances and whether the authority would be able to provide an efficient and economical service, without undue administrative and financial strain on the county council services. The Act does not define special circumstances nor exceptional circumstances and although for the former paragraph 13 of the White Paper, Command 161, issued at an earlier date, indicates that the self-contained town at some distance from other towns with a population not far short of 60,000 might be given permission to make a delegation scheme, no indication is given there or elsewhere of what might constitute exceptional circumstances. It is clear that these should at least be circumstances which were not generally applicable to authorities within the population range of 60,000 to 100,000.
The reason why the additional functions of (f) and (g) were not delegated in the same manner as the other health and welfare functions was that experience shows that a large catchment area is necessary for the number of old or mentally ill persons required to provide economically a variety of residential accommodation for different categories of patient. Residential accommodation provided for these purposes by the county council is better planned on a county basis.
Circumstances which the Ministry held to strengthen an application for delegation to a county district council were the existence in the town of enough elderly persons who required this service to enable residential accommodation to be occupied solely by town residents and the availability of additional accommodation for county cases to avoid disruption of the county services. Worthing Borough, with a population of 74,550 at mid-1958 and therefore automatically entitled to make a delegation scheme, applied in 1959 for inclusion of residential functions (f) and (g). My hon. and gallant Friend 207 was a little critical of the fact that the proceedings took a whole year. I would remind him that after the application from the county district, we in turn had to invite them to state reasons why they felt they could provide the (f) and (g) functions and having received their reasons, we had to consult the other interests. If I remember the papers correctly, and I read them several times, that occupied the best part of a year.
The council's case when put to us was based on the high proportion of aged persons in Worthing and the scarcity of accommodation provided by the county council. The council claimed that the percentage of persons of pensionable age was more than double the average for England and Wales, as my hon. and gallant Friend repeated tonight. Pensionable age is not defined, but in fact the percentage of persons of 65 and over was a little different from the figures he has given, in Worthing 24.6 per cent., in West Sussex, including Worthing, 17.2 per cent. and in England and Wales 11.2 per cent. The county council had provided no residential accommodation under Part III of the National Assistance Act in Worthing. The nearest was three miles away in Lancing and it accommodated three men and sixteen women. Other Part III accommodation is available in eight other homes with total accommodation for 284 men and 335 women.
Worthing also stated that there were at least 250 persons in the administrative county on the waiting list for Part III accommodation. Forty of these were residents in Worthing Borough. The Borough had provided accommodation for elderly persons under the Housing Acts. A voluntary organisation, the Worthing Council of Social Service, to which my hon. and gallant Friend paid tribute tonight, had established a home in Worthing for twenty elderly women, another for thirty-one elderly men and women in a higher income group, and was considering a third.
The council cited the work on a scheme for the care and after-care of mentally ill persons, known as the "Worthing Experiment" which is being carried out by the hospital authorities and the Nuffield Trust. Some of this work would devolve on the borough 208 council under the new Mental Health Act if delegation were granted.
The Minister sought the West Sussex County Council's views, as he was bound to do. The county council opposed the delegation of both (f) and (g) functions to Worthing Borough Council and said that within a radius of six miles from the centre of Worthing accommodation had been provided toy the county council for 346 persons, to be increased to 367 persons by enlargement of the existing home at Lancing. Eighty-seven former Worthing residents were included in this number.
The county council had to consider the county as a whole, and it considered that the needs in Worthing Borough were less pressing than in some other parts of the county.
§ Sir O. Prior-Palmer
How could it have considered that? The hon. Lady has given figures, and I gave even higher figures. Worthing has a proportion of old people more than twice the average. How could the county council suggest that other parts of the county had greater need? There is no greater need in the whole country.
§ Miss Pitt
The council pointed out that there was a county home for the blind in Worthing which it was desirable should remain under county control as only one-third of the residents came from Worthing. There are six voluntary homes providing accommodation for about 200 persons in or very near Worthing, and the county council has entered into arrangements with all these homes and is responsible for maintaining fifty of the residents. In addition, privately-run homes registered under the National Assistance Act accommodate 298 persons.
It is also possible that many old people not able to manage satisfactorily in their own homes would prefer, and 209 be more suitable for, flats or rooms provided by Worthing as a housing authority, especially if a warden's services were provided.
Although the county council has specifically drawn the attention of Worthing and other housing authorities in the county to the availability of grant from the county council towards the provision of welfare amenities in buildings specially suited for old people, no application has been made by Worthing. It also pointed out that the "Worthing Experiment" concerns only out-patient treatment and community care whereas function (g) of Section 46 (1) relates to the provision of residential accommodation.
In arriving at our decision in the Ministry it was decided that the high proportion of elderly persons in Worthing was not in itself an exceptional circumstance which would justify delegation. In Worthing many of these persons were well-to-do retired people who did not require accommodation outside their own homes; many more were able financially to make their own arrangements in private homes. There was no way of estimating precisely the number in each category. There was no other factor in the council's case which justified delegation.
Under a delegation scheme the county council remains financially responsible for the cost of the service and therefore, even if delegation had been granted, county council approval would have been necessary for any provision of additional accommodation by the borough council. The county council would not be able to give this approval unless the needs in the county as a whole justified this.
Worthing's assertion that she has a higher proportion of elderly people than the national average is somewhat misleading. There are other towns which have a higher proportion than the national average of 11.2 per cent. Of the ten English authorities with populations of over 60,000 which applied to include the (f) and (g) functions in their schemes, Worthing had the highest proportion though Hove, its near neighbour, and Poole also had a high proportion. From the information available to the Minister, it seemed that the problems of Worthing, Hove and Poole were very comparable.
210 All these applications were rejected, with the exception of that by Luton Borough. After the rejection of Worthing's application, my hon. and gallant Friend came to see the Minister, as he has said tonight, in December, 1959, and he wrote twice to my right hon. and learned Friend to make the views of the authority known. The Minister, in turn, wrote to him on 8th January of this year saying that he had reconsidered the matter and pointing out the need for exceptional circumstances to justify consent to the delegation of these functions.
Of the four questions posed by Worthing, my hon. and gallant Friend has answered the first two from the information he already has. The answer to the first was eleven, as I explained. The answer to the second was that Luton and Rhondda had been given permission. The answer to the third is that there are no outstanding applications for consent to operate (f) and (g) functions. The answer to the fourth, namely what is exceptional, I hope that I have already explained in what I have said earlier.
The basis for these decisions as regards the additional residential functions specified in paragraphs (f) and (g) of Section 46 (1), is that the provision of residential accommodation for the elderly, the mentally ill or the homeless needs a large population on which to draw in order to be economical and to justify a variety of types of accommodation. The main concern has been that the residential services for the care of old people, and in future of the mentally ill, shall be administered effectively and economically.
I have checked with the Ministry of Housing and Local Government and find that Worthing has not so far provided any housing for old people which includes provision for resident wardens to keep an eye on the general well-being of the tenants and to look after communal facilities. My hon. and gallant Friend may like to suggest to the borough council that this is one way the council can contribute to the care of the older members of the population. It is generally agreed to be the most desirable way, because it aims at keeping them in their own homes with such outside care as may be needed to help them to keep the independence they so value.
211 Finally, I assure my hon. and gallant Friend, and through him the Borough which he represents, that this decision was taken only after very careful consideration. It was considered personally by my right hon. and learned Friend the Minister and by my predecessor as Parliamentary Secretary. Then when I came newly to the Ministry last October I went through all the applications, including that of Worthing, and had further consultation with my right hon. and learned Friend. I hope that I have at least assured my hon. and gallant Friend that consideration was given to this matter and that the very strong representations which he made on behalf of the borough were included in 212 the consideration which my right hon. and learned Friend gave to it.
§ Sir O. Prior-Palmer
I should like to thank my hon. Friend for the great trouble she has taken in replying to my speech. She has enumerated a large number of facts which we all knew already. I say this to her in the last minute which is left to me—
§ Mr. Speaker
Order. I cannot resist thanks, but I cannot allow the hon. and gallant Member to make a second speech.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-nine minutes past Twelve o'clock.