Joint Finance Agreements (Hansard, 27 November 1984)

§ 6 Mr. O'Brien
asked the Secretary of State for Social Services if he will consider the current financial problems facing local authorities with joint finance agreements with health authorities; and if he will consult the Association of Directors of Social Services and area health administrators on the matter.

§ Mr. John Patten
The working group on joint planning, which we have set up with the National Association of Health Authorities and the local authority associations, will be looking at the arrangements for transferring resources between health and local authorities. The group is expected to complete work next spring and we shall consult health and local authority interests on its findings.

§ Mr. O'Brien
Will the Minister take into consideration the serious circumstances facing local authorities whose resources are being cut while there are demands for extra resources for the elderly, the mentally ill and the disabled? Will he examine the tapering system and ensure that services that are in being will not be lost to communities because of penalties imposed on local authorities by the Department of the Environment?

§ Mr. Patten
I appreciate the hon. Gentleman's constructive attitude. By saying that, I do not wish to do him any personal political harm. However, some of the problems facing local authorities are of their own making. One has only to consider the high disparity of unit costs in, for example, the provision of local authority accommodation for elderly people to see that. Of course, we shall consider the points that the hon. Gentleman has made. We are looking forward to receiving advice in the spring from the body to which I have referred.

§ Mr. Sims
I know that my hon. Friend will welcome schemes, such as that in my constituency, by which mentally handicapped people are being moved from institutions to small homes. Will he bear in mind that, if the scheme is successful, the next step will be for those people to go into individual accommodation, but that they will still need the services of, for example, social workers? Will he therefore persuade our right hon. Friend the Secretary of State for the Environment to ensure that local authorities have the funds to maintain an adequate number of social workers to continue the process?

§ Mr. Patten
We greatly admire the work being done in my hon. Friend's constituency involving the movement of those who suffer mental handicap back into the community and, we hope soon, into flats and sheltered accommodation of their own. Local authorities have the power to protect the especially vulnerable. Many local authorities, Labour as much as Conservative, have done exactly that recently by good and prudent housekeeping within the substantial sums of money that they already get.

§ Mr. Carter-Jones
Will the Minister confirm, or deny, the hardship caused by his joint financing alteration to the local authority, the health authority and the mentally ill and severely frail people who live in Salford?

§ Mr. Patten
As we have increased expenditure on joint finance by 50 per cent. in real terms since 1979, I do not know how anyone can speak of hardship.

§ Mr. Nicholas Winterton
My hon. Friend is well aware of the policy pursued by successive Governments of transferring mentally ill and handicapped people from hospitals into the community. Will he assure the House that the Government will provide adequate funds to ensure that the facilities, the services and the care that were available to such people while they were in hospital are available to them when they move into the community?

§ Mr. Patten
We are already providing at least £100 million this year for joint finance schemes. In addition, we are making it possible for health authorities, with patients who go back into the community, to transfer permanently money which will not count against targets for local authorities. We also have several centrally funded initiatives, such as the care and community initiative, at a cost of £16.5 million, and the helping carers to care initiative, which costs £10 million.

§ Mr. Madden
Will the Minister confirm, or deny, that his Department issued guidance to regional health authorities, including that in Yorkshire, to alter the rules in calculating bed norms, thus substituting commercial criteria for technically derived criteria, with the result that there is a serious under-estimation of the need for beds in future, especially for the elderly?

§ Mr. Patten
The modern Health Service does not have bed norms. It is concerned not with beds but with treating patients. We are treating more patients than have ever been treated in the history of the National Health Service. The hon. Gentleman could play a constructive role in his area where, I am told by local people, joint planning between health authorities and the social services department is not going well. He should do all that he can to smooth the growth of an effective joint planning procedure such as we have in several authorities elsewhere in his area.

§ Mr. Meadowcroft
I accept that partial abatement from penalty during the period of joint financing has helped, but does the Minister agree that there is a growing reluctance among local authorities to embark on joint financing because of the improbability of being able to cope with it under rate-capping when the taper is finished? That is especially so in local authority areas where the need is greatest, as the possibility of rate-capping there is highest.

§ Mr. Patten
I am grateful to the hon. Gentleman for his characteristic courtesy in welcoming what we have been able to do, which he thinks has helped. Of course I appreciate the tapering problems which some authorities face, but we have no evidence that joint finance is not being taken up, because a record sum of money is being taken up—about 95 per cent. of the money available to local authorities.