§ 1. Sir David Priceasked the Secretary of State for the Environment whether he will propose amendments to the rate support grant formulae to accommodate the increasing transfer of long-stay geriatric, mentally handicapped, mentally ill and physically handicapped patients from National Health Service hospitals into community care.
§ The Parliamentary Under-Secretary of State for the Environment (Mr. William Waldegrave)The grant-related expenditure assessments used to calculate rate support grant entitlement already take account of the general responsibilities of local authorities, including caring for patients moving from hospital into community care.
§ Sir David PriceIs my hon. Friend aware that the present rate support grant arrangements do not sufficiently accommodate the movement of that category of patients to whom I refer in my question. Will he undertake to review the matter? Does he recognise that there is a case for introducing a specific grant for moving long-stay patients out of hospital into community care?
§ Mr. WaldegraveMy hon. Friend's question straddles the boundary of responsibilities between my Department and that of my right hon. Friend the Secretary of State for Social Services, but we shall certainly consider the matter. Many local authorities do not welcome an extension of the principles of specific grants, but I note what my hon. Friend says.
§ Mr. MeadowcroftDoes the Minister accept that the areas of greatest difficulty, where there are old and large long-stay hospitals, are under the severest pressure on their rates and from rate-capping? Does it not make a mockery of the wholly commendable proposal to get patients into the community when the cost of keeping patients in hospital is cheaper per head than when they come out and are cared for by the local authority, which may have its rates penalised?
§ Mr. WaldegraveI am not sure that the statistics would show that the hon. Gentleman is right about that. These hospitals are not usually located in inner city constituencies, some of which may be troubled with rate-capping. Authorities face rate-capping because obvious economies can be made in the rest of their areas of spending.
§ Mr. Patrick ThompsonBearing in mind that in my constituency of Norwich, North there are two hospitals, at Hellesdon and at Thorpe St. Andrew, with those categories of patients, and that in Norfolk the resources through joint funding are unlikely to match the challenge of community care, I hope that my hon. Friend will have further urgent talks with the local authorities about this great problem.
§ Mr. WaldegraveMy right hon. Friend is considering other aspects of joint funding and has announced a disregard from target expenditure for the increase in spending. Representations have been made on other aspects, which my right hon. Friend is still considering. I shall draw my right hon. Friend's attention to my hon. Friend's question.
§ Mr. StrawDoes the Minister recognise that two problems are raised by the question asked by the hon. Member for Eastleigh (Sir D. Price)? First, the grant-related expenditure assessments do not take proper account of the increasing impact of community care on local authority social services departments. Secondly, under the public expenditure White Paper, for which the Secretary of State is as much responsible as any other Cabinet Minister, social services expenditure will be forced to be cut by £111 million in real terms this year over last year, and by £232 million in real terms by 1986–87. How does the Minister expect local authorities to meet their increasing commitments when the total resources available for social services are being cut in real terms?
§ Mr. WaldegraveThe GREAs recognise the numbers in local authority care, but, I as I said to my hon. Friend the Member for Eastleigh (Sir D. Price), we shall discuss with our opposite numbers in other Departments whether the weightings that are given are adequate.