HC Deb 29 April 1986 vol 96 cc768-70
4. Mr. Chapman

asked the Secretary of State for Social Services if he is satisfied with co-ordination between health authorities and local authorities in the proper provision of community care for the mentally ill and mentally handicapped with particular reference to financial provision.

Mr. Whitney

Good progress is being made in many areas in the joint planning of community care, but there is room for improvement over the country as a whole. The joint finance and care in the community arrangements enable health authorities to give financial support for community care provided by local social services authorities and voluntary organisations.

Mr. Chapman

I am grateful to my hon. Friend for his reply. Is he aware of the confusion and contradiction, at least in my borough, between the local health authority and the social services department of the council as to their exact responsibilities over the provision of care for the mentally ill and the mentally handicapped? That has been tragically underlined in the case of a constituent who is severely mentally handicapped, who within 48 hours lost both her parents who were looking after her at home. In view of that confusion and contradiction, will my hon. Friend look into both the particular case and the general responsibilities so that it is possible unambiguously and unequivocally to assert where the responsibility lies?

Mr. Whitney

This is undoubtedly a difficult matter. As I said in my earlier reply, the good progress is not universal. There may be room for improvement. It may well be that my hon. Friend's constituency is a case in point. I am glad to tell my hon. Friend and the House that a multi-disciplinary meeting on that tragic case will be held on 13 May. I believe that that meeting will demonstrate the good co-operation that exists across the authorities in this tragic and worrying case.

Mr. Carter-Jones

Is the hon. Gentleman aware that, for historical reasons, severe distortions often take place with respect to moving people from long-stay hospitals into the community? Will the hon. Gentleman take into account the anomalous position for Salford health authority and Salford city council regarding his policy on Prestwich hospital?

Mr. Whitney

I shall look into the details. The local health authority and local authorities must work closely together against the background of support facilities, including joint finance, which the Government have provided and continue to provide.

Mr. Sims

Does my hon. Friend accept that, although the policy of moving mentally ill and handicapped people into the community is commendable, it is expensive and shifts the burden on to the social services department and the local authority? It is essential that adequate funds are provided so that the scheme will be successful.

Mr. Whitney

We accept that there are financial pressures. That is why we urge maximum co-operation, to go at the pace of the possible, depending on the local circumstances. That is why we have produced the funding that is now available.

Mr. Kennedy

Is the Minister aware that everybody, including the Government, accepts that successful community care cannot be a cheap option? How, therefore, can there be the co-ordination necessary to ensure the success of the policy when, for example, local authorities are starved of sufficient funds? They require those funds to provide the type of housing and the range of back-up facilities in the community that will enable people coming out of long-stay institutions not to be in a position where they lack sufficient community support or where they simply end up being re-admitted to the very institutions from which they moved. Will the hon. Gentleman consider other aspects of Government policy that operate against the interests of community care?

Mr. Whitney

Local authorities must choose their own priorities. No one would pretend that that was an easy task. Priorities must be set against a background of rising expenditure in the local authority area. The hon. Gentleman should take note of the financial facilities that are being made available. For example, this year, the joint finance allocation will be about £111 million.

Mr. Richard Page

Does my hon. Friend accept that there is considerable concern among parents, especially elderly parents, about their children, often young adults, who are returned to the community without adequate support or back-up? Will he clarify the guidelines between the appropriate authorities so that they cannot argue and bicker among themselves, and so that they will know exactly what their individual responsibilities are?

Mr. Whitney

There should be no question of individuals being returned to places outside the health authority scheme unless suitable and adequate arrangements have been made. That is precisely why the JCCs and the joint care planning teams are provided. They should ensure that the problems to which my hon. Friend referred are solved locally.

Mr. Meacher

Is the Under-Secretary of State aware that a recent survey of private rest homes for the disabled and the elderly found that degradation and exploitation were the norm, not the exception? Is the hon. Gentleman aware that residents were forced to strip in front of others to wash; milk was watered down to save money; incontinent residents were left without underwear; and YTS trainees were made to dispense drugs without knowledge of dosage side-effects? Is it not utterly repugnant that the Government should be encouraging huge commercial profits to be made in this way by private rest homes at the expense of frail and vulnerable patients?

Mr. Whitney

The Government are determined that the highest standards should be maintained in residential and nursing homes and similar accommodation, whether they are operated in the public or the private sector. That is why we instituted the inspection systems. For example, to help local authorities, we have increased the scale of registration fees and introduced regulations under the "Home Life" publication. If the hon. Gentleman sought to suggest that badly maintained homes exist only in the private sector, I invite him to consult his hon. Friend the Member for Peckham (Ms. Harman) to instruct him on the dreadful conditions found in the Nye Bevan home in Southwark.