§ 2. Mr. Dubsasked the Secretary of State for Social Services what recent representations he has received about community provision for patients discharged from mental illness hospitals.
§ Mr. FowlerA number of hon. Members and organisations concerned with mental health have written to Ministers on this question.
§ Mr. DubsIs the right hon. Gentleman aware that there is widespread concern about what happens to the mentally ill when they are discharged into the community? Is he further aware that local authority social services departments simply do not have sufficient money to provide adequate support? Will he study that problem in the light of what the Government are doing to weaken further the resources of local authorities?
§ Mr. FowlerI do not accept the last part of the hon. Gentleman's question, but I certainly accept what he said about the importance of community care. I believe that both parties are committed to that policy, which clearly has financial consequences. We have never regarded community care as a cheap option. It has consequences for personal social services. The hon. Gentleman is wrong to suggest that personal social services spending has been reduced — indeed, during the past five years it has increased by 18 per cent. in real terms.
§ Mrs. Kellett-BowmanI welcome my right hon. Friend's emphasis on the importance of community care. Will he stress the importance of closing the very large Victorian-built mental hospitals, which are almost impossible to modernise? However devoted the staff, it cannot be in the interests of patients for them to remain in such hospitals.
§ Mr. FowlerI agree with my hon. Friend. There is a clear need for hospitals and for the continuation of hospital care. However, no one wants to continue unsatisfactory and inadequate treatment in those surroundings.
§ Mr. KennedyAs the right hon. Gentleman has said that he will study the problem and take into account the concern expressed, will he especially consider the position of local authorities and the effect that the potential rate-capping programme will have on the encouragement of joint funding projects? Are not those projects of exactly the sort that are relevant to the community care programmes?
§ Mr. FowlerThe hon. Gentleman is in error to suggest that restrictions on local authority spending fall upon specific projects—they fall upon general spending. Joint financing is continuing to develop.
§ Ms. HarmanIs it not true that buildings and services for the care of patients previously in institutions are simply not developing? Is that not for two reasons: first, that regional health authorities are not handing over the necessary finance; and, secondly, that social services departments cannot take up additional spending commitments because of rate penalties?
Should not the right hon. Gentleman do two things? First, should he not have a positive plan, backed by a circular to regional health authorities; and, secondly, give an absolute guarantee that any increased spending by social services departments as a consequence of bringing people into the community is 100 per cent. disregarded?
§ Mr. FowlerThe fault in the hon. Lady's supplementary question is the suggestion that joint finance is in some way not being taken up. This year, allocation of joint finance money is about £100 million, and there is no evidence that that is not being taken up by local authorities. In addition, the personal social services budget has increased, as has the money made available for care in the community. Obviously, we regard this matter as a priority. I hope that there will be as much agreement as possible between both sides of the House on the importance of this matter.