§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Sackville.]11.35 pm
§ Mr. James Kilfedder (North Down)
I am extremely pleased to have this opportunity to raise a matter of immense importance to my constituents. It is not just a local issue but a wider question involving the morality of a Government Department and the Eastern health and social services board in making a decision that runs counter to a decision and a promise of two years ago.
Two years ago the Eastern health and social services board announced that it intended to close Croft House, a home for the elderly. That decision came as a shock to my constituents and, indeed, to myself. Croft House has been a home for senior citizens for the past 38 years. A homely atmosphere and caring attention have been provided by dedicated staff. Most of the residents orginally lived in the Holywood area, where their relatives still live. As the residents are familiar with the environment, the move to a residential home was not as dramatic as it might have been had they been taken away from churches, relatives and friends who had given their lives a considerable degree of warmth.
It was not surprising, therefore, that a decision, in 1987, to close Croft House was challenged by the people of Holywood and by their elected representatives, including myself as the Member of Parliament. At that time there was no talk of a home for the elderly mentally infirm being built in Holywood or, indeed. anywhere else in North Down or Ards. Croft House was being closed because a report said that it would be too costly to make it satisfy all economic and technical requirements and that, consequently, it was too costly to run.
In its strategic plan for the period 1987–92 the board confirmed the need for residential accommodation for the elderly in the North Down and Ards areas. Protest meetings were held at that time, and eventually the board decided to replace Croft House with new purpose-built premises to provide 45 beds, on a site attached to Marmion children's home, which is in Church road, Holywood. This decision was welcomed by the people of the area, by those connected with the home, and by all who had the elderly people's welfare at heart. It was thought that it would bring the elderly people and the children from Marmion together in a very happy relationship and that that would make the elderly people feel part of the local community.
At a meeting of the Eastern health board on 26 March 1987 it was explained—I quote from the minutes—that … it had been possible to obtain a commitment from the Department of Health and Social Services to use the proceeds of this sale of Croft House together with an advance from the Department to allow a replacement 45 bed home for the elderly in the grounds of Marmion Children's Home to commence as soon as possible.It was resolvedto proceed with action to replace Croft House as soon as possible.Work on the site commenced in November last year and progressed at a reasonable rate for two months, during which time the residents of Croft House, who knew that their home was to be closed in due course, came along to see the development of what they thought would be their new home, not far away.
871 But suddenly everything changed. In private, a proposal was put forward by officials of the boardto redesign the elderly persons' home".Those words are bureaucratic shorthand for "demolish what has been built and start again". On 26 January of this year the board agreed that the home "be so redesigned". That was to ensure that the new facility could cater for the needs of the mentally frail elderly. In other words, the solemn undertaking that had been given by the board two years ago to the people of Holywood, to the residents of Croft House, to the clergy in the area and to the public representative was broken by the board.
Suddenly, with only five days' notice, the board reversed the decision. It gave the people five days to make representations. Of course, privately officials gave instructions to the contractor to demolish what had already been built. That was before the board formally made the decision to abandon the replacement home for Croft House. Demolition was quick and sudden. The chairman of the board admitted that the community was taken by surprise. As an excuse for the quick action—the board having waited two long years—the chairman said that the matter required urgent resolution. Yet the director of social services admitted at a meeting which I attended that the issue had been considered by officials for a considerable time.
Despite the extensive and secret consideration by officials of the board, the public was not consulted and no attempt was made to postpone the building work even though for some time the officials knew that they might put forward a recommendation to the board to abandon the project and, better still, to reach a decision before the erection of the building had begun. I should have thought that there was a duty on public officials to be careful about public money.
§ Mr. Roy Beggs (Antrim, East)
Does the hon. Gentleman agree that the action that took place illustrates clearly just how little influence the elected representatives have when serving on boards in Northern Ireland?
§ Mr. Kilfedder
It proves what I have said all along, that it is high time the Government abolished the board and gave democracy back to the people of Northern Ireland so that we might get rid of the colonial type of Government which we have, with Ministers going over from England and the people having no say. They are invited sometimes to put their views, but when it comes to the bit, arrogance overrules local wishes. I have no objection to arrogance if it is matched with intellect and compassion, but sadly that is not so.
The present case is a perfect example. The officials of the board waited until the foundation of the building had been laid and the walls erected. How much money has been spent needlessly on design and construction costs? It is impossible to discover the amount from the board. My estimate—it is a conservative estimate if I dare use the word "conservative" in that context—is that as a result of its actions the board has cost the taxpayer in excess of £160,000. The board must be held to account for the money that has been thrown away.
I have spoken to the Chairman of the Public Accounts Committee about the shameful waste of taxpayers' money, because it is the people who are paying. The Chairman of 872 the PAC has promised to give the matter his attention when I submit the papers to him. I propose to give a copy of the Official Report of the debate to him in due course.
The board has the temerity to castigate those who criticise its decision by saying:To proceed with the original design and build an elderly persons' home which is not needed would be a waste of public money.If it is not needed, I would have thought that the officials would have known that before they started to erect the building, before the contract was handed out, and indeed before they commissioned the architect to design the building. All that money has been lost for ever. However, the officials appear to set themselves up as the guardians of the public purse on the basis of their experience and their having poured £460,000 of the taxpayers' money down the drain. The board states emphatically that the elderly persons' home is not needed, despite the fact that it is to replace Croft House, which is and has always been full, and despite the fact that it was the Eastern health board on 26 March 1987 that made the decision to provide the replacement building.
The board tries to put a brave face on its inconsistency and muddled thinking by stating that there is a need for a home for the elderly mentally infirm. If that be so, the need has not suddenly become manifest to the board. Officials must have been aware for some time of the requirement for accommodation for the elderly who suffer from dementia. Indeed, the board states that there are 80 mentally frail elderly people in the North Down area. I do not doubt that there are many who need such treatment. Some may now go down to Downshire, which is far away from their relatives. However, If that is so, why was the decision not made last year, the year before or the year before that to provide a home for the elderly mentally infirm?
That is not something new. The matter has been mentioned occasionally in the House, and I should have thought that the officials were aware long ago that a home was needed. When pressed on the issue, the board had to admit that, although it says that there are about 80 mentally frail individuals in the North Down area, it could identify only seven people who were mentally infirm in the Holywood area. However, even that number is in doubt and is challenged.
I make it clear that I believe that we need a home for the elderly mentally infirm. I am in favour of proper provision for the elderly who are mentally frail, but a home should be built between the two areas of heavy population, Bangor and Newtownards, so that it is accessible to relatives from both areas. I ask the Minister to respond to the plea from the people of North Down. The Government should agree to pay for the erection of a home that would serve patients from a wide area—perhaps North Down, Ards, Castlereagh and even further afield.
What has happened to the money that was raised from the sale of Cultra House, Holywood that was used for the elderly mentally infirm and was originally a gift from a private benefactor? I understand that that house was sold for about £800,000. Have the Government pocketed that money? Has the board put that money to other uses? It should have been kept for the building of a home for the elderly mentally infirm. Is it being used for that purpose?
The chairman of the Eastern health board stated that the board's commitment to the residents of Croft House will not be prejudiced by this new decision. What does that mean? If it means the same as the board's commitment to 873 build a replacement home for Croft House, it is worthless. What is more, it is a callous and cruel way to treat the elderly in Croft House.
It is well that the public in Northern Ireland—even though they may have no relatives in Croft House and may not live anywhere near Holywood or North Down—should be made aware of the indifferent and appalling attitude of the board in this matter. The board has offered to accommodate the present residents of Croft House in the new building that has been redesigned for the mentally infirm. If it can agree to do this, that effectively rebuts every argument it put forward about the urgent need for a home for many mentally infirm in Holywood. If the board accommodates the residents in Croft House, there will be only five places left for new residents. At the moment, Croft House provides accommodation for 25 residents and the replacement home was to provide 45 beds—the board's estimate of need for the area. The new premises for the elderly mentally infirm will provide 30 places.
What will happen to the hapless residents of Croft House? If the Eastern health board has its way, they will be installed in the new building, together with people who are suffering from dementia. It is shocking that the board should contemplate such a thing. In its annual report of 1987–88 it said:An EMI home caters for demented, elderly people whose confusion makes them unsuitable for ordinary residential care. It only takes one or two to become severely disturbed for the whole house to be disrupted.Such a situation would be alarming for ordinary, elderly residents who are alert and lively. They would be distressed and upset if a severe disturbance, perhaps even an assault—I have heard about many in such homes—were to take place. That would be a recipe for the mental and physical deterioration and collapse of the residents.
In addition, the residents of Croft House would lose their freedom. They would all be locked up—the ordinary, elderly people as well as those suffering from dementia. What is coldly and cruelly called the "race track" would be provided for the inmates so that they could endlessly walk round it—but out they will not get. The ordinary elderly people in Croft House will not be able to get out without special permission.
I am trying to calculate when I began so that I can allow the Minister enough time.
§ Mr. Kilfedder
I am much obliged, Madam Deputy Speaker. That means that I have another three minutes, because I believe that the Minister wanted 10 minutes.
Another excuse put forward by the board for abandoning its pledge to provide a replacement home for Croft House is the reduction in the waiting list for Croft House from 40 to 20. Private profit-making homes for the elderly are mushrooming all over North Down, and elsewhere in the Province; all their beds are filled, and more private residential homes are being built for profit.
If people are building such places, they must have calculated that there are plenty of people to fill the beds. In the circumstances, it would be foolish for the board to believe that fewer people want to reside in one of its homes for the elderly—I do not for one moment accept that it believes that. In fact, it will be a considerable time before those 20 on the waiting list are accommodated in Croft House.
874 I do not have time to go through all the other facts that I have before me. I shall precis them by saying that the population of North Down and the number of elderly people continue to grow. The board admits that the number of elderly people will increase by 4,500 by 1996 and those over 75 will increase by 8,500. It admits that. there is a need for places for the elderly. The state should. not opt out of providing places for the elderly in residential homes.
If the Government were to increase the old-age pension so that people could live in dignity in their own homes, they might be able to manage. However, each individual needs at least £5 per week more if he or she is to meet the increased cost of living. If the Government did not cut back on the money provided for the board to enable home helps to visit the elderly, perhaps more of them could stay in their own homes. I know of instances of elderly people being provided with help for half an hour a week. That is an insult. It enables the Government to say that they provide home help, but not much can be done in half an hour.
I make a final appeal to the Government to respect the wishes of the people of North Down and to examine the situation there. The solemn promise that was made should be honoured.
In the preparation of the new premises, the contractor demolished mature trees, and pulled out hedges to provide an alternative opening that was wholly unnecessary. More work and expense was thus entailed in providing the change of entrance. The builders had to re-wire and re-route electric cable for the road lights and erect a new electric light pole. The electricity supply to private dwellings facing the development had to be re-wired. All this additional trouble and cost was required to provide an opening to a new building that was unnecessary.
I ask the Government to hold the board to account and to ensure that its promise is honoured. If that does not happen, I hope that the Public Accounts Committee will hold them all responsible.
§ The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Richard Needham)
The hon. Member for North Down (Mr. Kilfedder) has not left me long to reply after his eloquent speech of 23 minutes. He was wide in his condemnation of the Eastern health and social services board on which there are 34 members and which therefore includes a wide spread of professional, political and geographical interests. If the hon. Gentleman and his colleague the hon. Member for Antrim, East (Mr. Beggs) feel that democracy is not working as well as they would wish in the boards of Northern Ireland, perhaps the first thing they should do is encourage their friends to take their places again on the boards and stop their ludicrous boycott—
§ Mr. Needham
I shall not give way. The hon. Gentleman spoke for 23 minutes.
If the hon. Gentleman wants to make changes, he should do something about that, as it is in his power to do so. He is well aware that since the decision to build a replacement for Croft House in 1987 a great deal has 875 changed. He is also aware of the rapid expansion of special housing schemes and the increase in private residential homes for the elderly in his constituency.
Since March 1987, a new sheltered housing scheme providing places for 37 dependent elderly people, with a resident warden, has been completed. Two further schemes providing an additional 160 places, supervised by three resident wardens, are also at an advanced stage. In addition, the Housing Executive has carried out major adaptations to 75 homes of disabled elderly tenants in North Down and Ards. Further major adaptations to the homes of another 16 disabled elderly residents are currently under way.
Accommodation in residential homes has also increased. In March 1987, the date of the replacement decision—perhaps the hon. Gentleman will stop shuffling his papers and listen—there were 17 statutory, voluntary and private residential homes for the elderly in North Down and Ards, providing a total of 447 places. Since then, 10 further private homes have been set up, providing a further 138 places. That is the clearest possible evidence of the Government's determination to ensure that there is proper co-operation between the public and private sectors and that old people can enjoy the widest possible choice.
The hon. Gentleman asked about the present position of the people in Croft House and commented that in 1987 the proposal was for 45 new places. Only 18 elderly persons in the area are currently assessed as needing admission to long-term residential care, and only two of those are down for Croft House. I am told that in those cases application has been made only within the past three weeks, so the evidence clearly shows that there was and is a need for the board to look carefully at the need for this home.
There is an acute need to help the elderly mentally frail and it was monstrous for the hon. Genteman to suggest that elderly people currently in Croft House would be pushed together with the elderly mentally frail. There has never been such a suggestion. The hon. Gentleman is well aware that everybody currently in Croft House will be looked after and consulted individually on the future position.
876 There are, at present, 60 mentally frail, elderly people living in the community and a further 30 in psychogeriatric hospital care who could benefit from care in a home designed to meet their needs, which is what Croft House will become. Such a facility does not currently exist in the Ards area and I am surprised that the hon. Gentleman should seek to make the suggestions that he did. He should reflect on what he said about the needs of elderly, mentally infirm people in his area.
I agree with the hon. Gentleman that the board made a decision in 1987 and, rightly, reassessed that decision at the end of 1988. I am sure that when the hon. Gentleman puts his points to the Select Committee on Public Accounts it will wisely and sensibly come to the conclusion that it made more sense to spend £63,000—not £163,000 as the hon. Gentleman said, but he is never given to exaggeration when he does not need to be—when the cost of such a home would be £1.3 million. The need for places for the class of people to whom he referred is down to two, whereas the requirement for places for the elderly mentally infirm is 60. The board was right to make its decision. I agree with the hon. Gentleman in only one sense—that the board would have been wiser to make its decision before it let the contract and before the builder was on site.
I can understand the concern and the worry that the situation caused to residents of Croft House. It is crucial that all the residents there are carefully counselled and that their needs are individually looked after to ensure that they are properly cared for wherever they may go. As I said to the hon. Gentleman, those decisions will be taken by the board. Looking at the provision currently becoming available in the hon. Gentleman's area, I have no doubt that the residents will be found happy alternatives.
The Government are determined to ensure that elderly people who need to be in residential accommodation are looked after properly and that their condition is monitored properly. That is exactly what has happened in the hon. Gentleman's constituency and it will continue to happen while the Government are in control in Northern Ireland. We are determined to ensure that the needs of the elderly people of Northern Ireland are looked after sensitively and carefully.
§ Question put and agreed to.
§ Adjourned accordingly at two minutes past Twelve o'clock.