§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Bishop.]
§ 11.13 p.m.
§ Mr. Alfred Morris (Manchester, Wythenshawe)
I preface this debate by thanking my hon. Friend the Parliamentary Secretary to the Ministry of Health for being present at this hour to speak on what I know he will recognise to be a matter of the first importance to the community which I represent in this House. He is a Minister whose precepts and practice are one. He not only speaks in the accents of social enlightenment, but always insists on acting according to its spirit. His humanity in his approach to the mentally handicapped was extremely well brought out in the debate on the Motion by my hon. Friend the Member for Woolwich, West (Mr. Hamling) on 18th February this year.
As the Parliamentary Secretary knows, my purpose in seeking this debate is to emphasise the urgency of the need for a new adult training centre for the mentally handicapped in Wythenshawe and to relate this need to the City of Manchester's pursuit of a much improved service for some of the least fortunate of her citizens. There is at present only one adult training centre in Manchester, which has a population of some 640,000. At the last estimate there were 1,173 mentally sub-normal or severely sub-normal adults resident in the city. Our one existing centre is in the north of the city at Domett Street, Blackley, and with 200 trainees in attendance it is full to capacity and serves mentally handicapped adults from every part of Manchester.
Because the Blackley centre has to serve the whole of the city, some 64 trainees from the south of Manchester are daily involved in bus journeys of up to three hours in duration. Many of these trainees live in my constituency in the extreme south of Manchester, and this occasions severe strain for the trainees and both inconvenience and stress for their parents.
The buses commence picking up trainees in my constituency at 8 a.m. and 801 arrive at the training centre at approximately 9.30 a.m. They leave the training centre at 4.30 p.m. and, if all goes well, the last trainee is set down at approximately 6 p.m. The distance travelled by these buses in the morning is 19 miles, and there is then the return journey of 19 miles in the evening, making a total of 38 miles for each bus each day.
Perhaps the worry and stress associated with this amount of travel by the mentally handicapped in my constituency who attend the Blackley Centre can be best brought out by reading brief extracts from two of the many letters which I have received from their parents. One of them writes:I am the mother of a 25 years-old mentally handicapped daughter who until the adult centre opened recently at Blackley was attending a nearby junior centre. She now has to travel for over two hours more a day and, with the winter coming on, this will mean very real hardship for her. Please can you help us?".Another of my constituents, living at Woodhouse Park at the southern end of Wythenshawe, writes:Our daughter now has to go right across Manchester to Blackley. We are very distressed that she has to travel well over 30 miles a day. She leaves at eight o'clock in the morning and is not back home until six o'clock at night. We think this is far too much for a mentally handicapped person to have to endure and it causes us a great deal of worryManchester's distinguished Medical Officer of Health, Dr. Metcalfe Brown, has emphasised to me the effects of excessive travelling both on the trainees themselves and on their mothers or other relatives who escort them to the nearest picking up point in the morning and meet them again when the bus returns in the evening.
Again, the Wythenshawe Society for Mentally Handicapped Children, through its Chairman, Mr. C. S. Marsden, has presented me with much helpfully detailed information concerning which I have been in frequent contact with the Parliamentary Secretary during recent months.
All the 64 trainees from South Manchester to whom I have referred would be served by the new centre at Altrincham Road, Wythenshawe, for which my right hon. Friend the Minister of Health has now been requested to give his approval 802 and grant loan sanction. I do, of course, fully appreciate the recency of the application for loan sanction from the City of Manchester. It was addressed to my right hon. Friend's Department only on 11th November, and I am thus especially fortunate to have the case for approving the application discussed in the House within a week of its submission. My hon. Friend will, however, understand the urgency of the intensely human plea I am making on behalf of my constituents, and I know that he can be relied upon to do all in his power to help.
I know that he will also understand the point put to me very strongly by the Chairman of Manchester Health Committee, Councillar Kenneth Collis. This is that when the Wythenshawe centre becomes operational, with 200 trainees in attendance, there will still be a very serious shortage of places for adult trainees in the City of Manchester, excluding those who are in work and those who it is considered would not benefit from training.
It is estimated that the potential number of adult training centre trainees is 600, of whom many are now in desperate need of places. This number will grow each year as children in the junior training centres attain the age of 16 and, as about 5 per cent. of the adult training centre trainees are placed in employment annually, it is estimated that the annual increase in the number of adult training centre places required will be 30–35. Based on this estimate, a total of 800 adult training centre places will be required in Manchester by 1973.
Having emphasised the extreme urgency of the need for the new training centre in Wythenshawe, I cannot let this opportunity pass to pay the warmest tribute to the parents of those who suffer under mental handicap in my constituency. They are brave and selfless people who cope so well, often with impossible situations and who are liable themselves sometimes to physical, psychological and moral breakdowns. We owe a special duty to them for ensuring that our mentally handicapped fellows are not unloved or uncared for.
I have myself always had a special interest in those living in danger of being unloved or uncared for. That is why I deeply admire the devotion of so many 803 of the parents of the mentally handicapped. I also pay special tribute to those who work in this field in the City of Manchester, either voluntarily or professionally. They are people of real dedication who spend not only their working hours but often their leisure hours in one of the most difficult forms of social service one can possibly imagine.
Anyone who has visited one of the adult or junior training centres cannot but marvel at the achievements and humanity of the people giving their lives to this service. Anyone who has taught, as I have, both the very able and severely subnormal child knows that the ideal of equality of opportunity is not enough when applied to the person who is severely handicapped mentally. Those who work either voluntarily or professionally for them recognise the need to bias opportunity in favour of those who lack the physical or mental power to compete on the basis of equality of opportunity.
These new training centres symbolise the move away from the pessimism and fear which surrounded for so long the mentally handicapped to a new theme of education, training and purpose more suited to the social and medical advances of our time. Their aim is to ensure that the mentally handicapped have a place in society, that they are fully integrated into the community and are accepted there not with condescension but with genuine sympathy and understanding.I am proud of my son"—wrote a mother of a 17-year-old handicapped boy to me recently. She said:In time he will be doing a good job of work.Such is parental confidence in the value of the new training centre we are seeking to build for our mentally handicapped, and such is the testimony of a devoted parent to the debt all of us owe to those who work, whether voluntarily or professionally, in this vitally important social service.
§ 11.25 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin)
I am grateful to my hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris) for 804 raising the question of the new adult training centre to be provided in his constituency because he has given me the opportunity not only to assure him that the Government are no less anxious than he to see this centre established but also to give the House some indication of the importance which we attach to the provision of facilities for the care and training of the mentally handicapped adult, as is shown by the figures published in the ten-year plans for local authority health and welfare services. I shall return to this later, but, first, I shall refer briefly to the underlying reasons.
The growth of a sense of community responsibility for the mentally handicapped has in recent years made it possible for many handicapped adults who would formerly have entered hospital now to live at home and go to work daily in an environment as nearly like that of the normal place of work as possible. This environment is provided in an adult training centre. Also, it is necessary to provide for the large numbers of mentally handicapped children who are now passing through the junior training centre, as my hon. Friend so rightly said, and who need suitable work and further training in adult centres.
As my hon. Friend knows, this adult training centre in Manchester will be the second to be established in the city and, like the first, it will provide about 200 places. Manchester has a very substantial number of people for whom places in such centres are needed or will be needed in the next five years. With this in view, the council included in its proposals for the next ten years, published last June in the ten-year plans for the development of the local health and welfare services, two more adult training centres of similar size to be provided in the course of the next few years, making four in all with a total of 800 places.
The building of the new centre at Wythenshawe will substantially relieve the difficulties, to which my hon. Friend referred, when trainees have to travel to the present centre in North Manchester. I assure my hon. Friend that I entirely sympathise with both the trainees and their parents and relatives in the travel difficulties which they encounter. The development of further centres will not 805 only meet the needs of the city for places but contribute further to an easing of the travel problem.
A submission from the City of Manchester for the adult training centre in Wythenshawe has been received this week in the Ministry, and officers of the Ministry are engaged in considering it now. Perhaps I should explain the steps which the local authority has had to take to reach this position.
When an authority wishes to build such a centre, it includes it in its long-term capital building programme as part of its ten-year development plan for its health and welfare services. It does the detailed preliminary planning for such schemes which it hopes to start building in the next two years or so and sends these in the form of a scheme submission to the Ministry for approval in principle and the agreement of a cost limit. This is the stage which Manchester has now reached on this scheme.
The Minister issues each year lists of schemes for which, if ready, loan sanctions are likely to be available in the following year. This scheme for the centre at Wythenshawe was included in the Minister's list of schemes for 1965–66 and was subsequently carried forward to 1966–67.
To guide local authorities in preparing such schemes, the Ministry has issued a Building Note on adult training centres giving guidance on function, design, standards of accommodation and cost. Even where, as in the present case, the proposed centre is so large that it falls outside the scope of the Note, the Note is still extremely useful both to the local authority and to the Department in planning and considering a scheme.
The further stages of the building procedure which must be completed before this building can actually be started are probably only too well known to my hon. Friend. First, the Ministry will consider the sketch plans which have been submitted this week with a view to agreeing with the council the cost limit appropriate for this particular training centre. It may be necessary for discussions to take place between professional officers of the Ministry and of the council on any amendments or adjustments to the scheme which may be needed before the cost limit can be fixed.
806 I want to say quite categorically to my hon. Friend that there will be no delay on the Ministry's part in dealing with proposals it now has before it. When the stage to which I have just referred has been completed, it will be necessary for the council to prepare detailed drawings before it is ready to start building. I understand that the council proposed that the scheme should be built by direct labour. The Ministry will also need to be satisfied that this method will provide the training centre at a competitive price, but as soon as these steps have been completed the council will be able then to apply formally for loan sanction.
As my hon. Friend knows and as I have said, this scheme is among those for which the Minister has said he hopes to be able to recommend the issue of loan sanction in the current financial year if the scheme is ready. If, however, loan sanction stage is not reached by the end of March next year, it will be necessary for us to consider the scheme for inclusion for the building programme for 1967/68. I am only making this point so that I can assure my hon. Friend that we see no difficulty about this.
As I said at the beginning, I am very glad that this debate affords me an opportunity of saying a few general words about the provision of services for mentally handicapped adults. The handicapped adults for whom these training centres are provided are those who, because of mental handicap, are temporarily or permanently incapable of earning their living either in open or sheltered employment. Most of them will as children have attended one of the local health authorities' training centres for children; some will have attended ordinary or special schools but not have developed to the stage where they are capable of supporting themselves in remunerative employment. The object of adult training centres, like that of training centres for children, is to provide training and occupation of a kind which will create the best setting and the right stimulus for the mentally handicapped to develop to their full potential.
In recent years a much more positive approach has been adopted to training adults. We know more and more about the extent to which even the severely subnormal can progress towards useful and meaningful work in adult life, if 807 they are given the right training from an early age.
The nature of the work done in adult training centres has changed fundamentally. Not so very long ago, the people attending what were then known as "occupation centres" were kept occupied on what was essentially diversionary occupation, with little or no economic value—the slow and laborious manufacture of wicker baskets or very simple occupations. It is now recognised that a proportion of trainees will in due course progress to open or sheltered employment in factories or other types of jobs.
Local authorities, therefore, with our guidance and encouragement, seek to establish a suitable balance in adult training centres between training and work. While many will not progress to ordinary employment, it is beneficial to all to be trained so far as possible in the disciplines and responsibility involved in holding a job. Experience has shown that the capacity of the mentally handicapped for industrial work is far greater than anyone used to think. We know that many firms have been astounded by the quantity and quality of work done in these centres. Indeed, there are one or two particularly interesting schemes where trainees from a centre work under supervision side by side with the staff of a factory. For some time much of the emphasis in the development of training centres for the mentally handicapped has been naturally on provision for children, but more recently developments in the provision of training for sub-normal adults have been no less marked.
In 1964, for the first time, the number of trainees in adult centres exceeded that in junior centres, and at 31st December, 1965, the figures were 16,918 and 16,106, respectively. Under the ten-year plan the total number of places for adults is planned to reach 33,971 by 1976, and in the same ten-year period the total number of places provided for children is planned to increase to 28,493.
It is not possible yet to say what would be the desirable provision of training centre places for adults in this country as a whole. There are wide variations in the future provision planned by individual authorities. We know that some authorities are making too little provision, although there will often be 808 local factors which would justify variations from what would normally be regarded as appropriate.
I am happy to assure my hon. Friend that Manchester is not to be numbered among those authorities of which this can be said. Manchester's plans for adult training centre places per 1,000 population are among the highest in the country. The difficulty in this field, as so often happens in mental health, is that needs appear to grow as services are established. Only the provision of a particular service brings fully to light the extent of the real need for it and there can be no doubt that we shall need to expand training centre provision for many years to come, especially for adults.
It is not to training centres alone that we should look when considering the range of services required by mentally handicapped adults. The ten-year plan also looks forward to a substantial provision of residential accommodation, although we would, I think, agree that placement in lodgings privately with families or in small self-supporting groups in ordinary houses are alternative methods and for some to be preferred. Our aim should surely be to enable each person to live as normal a social life as possible. But, even so, we have no doubt that a great many more hostels will have to be provided and staffed by local authorities, and in this field also I am glad to say that Manchester is planning substantial provision.
Perhaps I have spoken a little too much about bricks and mortar and not enough about the staff without whom the service could not function. I should like to echo the tribute paid by my hon. Friend to the staff of the adult training centres. The work which they undertake is arduous and often no doubt frustrating, especially to those who come with experience of every-day industrial work. At the same time, it is a challenge to their skill and patience. The training centres depend on them, and it is they who have the prime responsibility for helping each individual trainee to live a happy life in which he can fulfil himself to the greatest possible extent.
I have had the opportunity during the time that I have been in my present office to visit many training centres. Indeed, I was in two training centres yesterday. Whatever tributes can be paid 809 by my hon. Friend to the staff of the training centres, they cannot be greater than the feeling of gratitude and admiration which I have for them.
I think that there is, as I hope I have shown, plenty of room for experiment with different services aimed at enabling mentally handicapped adults to be independent to the limit of their individual capacity and to enjoy as far as possible the ordinary life of the community.
I should like to finish by saying once more that I am very grateful to my hon. 810 Friend for giving me this opportunity, in the course of answering the points he has raised about the new adult training centre in his constituency, of speaking more generally on the development of these services for the mentally handicapped.
I should like to conclude by paying a sincere tribute to my hon. Friend for his long and valuable service in this field.
§ Question put and agreed to.
§ Adjourned accordingly at nineteen minutes to Twelve o'clock.