§ 3. Mr. Parkinsonasked the Secretary of State for Social Services what plans she has for improving facilities for patients discharged from mental hospitals.
§ The Minister of State, Department of Health and Social Security (Dr. David Owen)We believe that services for the mentally ill need to be jointly planned between the area health authorities and local authorities so as to link hospital and community care. We are doing everything we can to strengthen the work and effectiveness of the joint consultative committees.
§ Mr. ParkinsonI thank the hon. Gentleman for that reply. Is he aware, however, that there is growing concern throughout the country that community facilities are not developing as quickly as they will need to develop if the Government's policy of getting people out of hospitals is to be implemented? Is he aware that in one of the five hospitals in my constituency there are 160 patients awaiting discharge but that there is nowhere for them to go, and that in another hospital nearly 100 patients are in exactly the same position? From all over the country there is evidence that people are in hospitals who should not be there and that people are being discharged into unsuitable accommodation.
§ Dr. OwenI am all too well aware of this. To some extent it is a reflection of the need to restrain public expenditure. 218 Local authorities are doing their best to make facilities available, and they have done very well over the past few years. The possibilities for us now are to try to see whether we can make an arrangement of cross-financing between local authorities and health authorities, although it is very difficult.
§ Mr. Kilroy-SilkDoes my hon. Friend accept that many of the mentally ill and mentally handicapped patients in hospitals should not be there on clinical grounds, and that a far stronger initiative should be taken to devolve the responsibility for their care and maintenance on to the community, where it properly belongs? Can he assure the House that he will take energetic and positive steps in this direction?
§ Dr. OwenI agree with my hon. Friend's analysis of the problem, one aspect of which is resources. There is also the problem that the health authorities are independent of the local authorities, which provide the personal social services. That is why to join them together and integrate their planning as much as possible is a high priority.
§ Mr. Norman FowlerI think the Minister will accept that some of the evidence now coming forward is very disturbing. Does he realise that in Birmingham many ex-patients who have been discharged have simply been transferred to lodging houses, and in two cases to hotels, which are taking 50 or 60 ex-patients? Will he consider making an immediate review of community provision in this area?
§ Dr. OwenWe know the facts of the situation. The question is one of resources, although I agree that it is possible to be in so-called community care and to be extremely isolated. Therefore, there is still a case for the care and community feeling that can exist in psychiatric or mentally handicapped hospitals, although one of the problems is their size and isolation.
§ Mr. Greville JannerIs it not the case that a substantial minority of patients in mental hospitals could be discharged if they had somewhere to go and someone to care for them, and that it costs a great deal more to keep them in hospital than to assist both local authorities and private 219 organisations, such as Guideposts, which want to care for them but do not have the money?
§ Dr. OwenWe are doing all we can to help voluntary organisations. This is one area in which we can with limited amounts of money undoubtedly produce considerable results. I shall certainly consider any specific proposals my hon. and learned Friend might put to me.