Community Care (Hansard, 23 January 1990)

§ 1. Mr. Rogers
To ask the Secretary of State for Health which organisations concerned with community care he has met since the publication of the National Health Service and Community Care Bill.

§ 20. Mr. Martlew
To ask the Secretary of State for Health which organisations concerned with community care he has met since the publication of the National Health Service and Community Care Bill.

§ The Minister for Health (Mrs. Virginia Bottomley)
We regularly meet local authorities, health authorities and voluntary organisations. They all have vital roles to play in the provision of community care.

§ Mr. Rogers
The Government, in their proposals, and in the answer that the Minister has just given, have rightly emphasised the part that the voluntary organisations can play in this sector. If that is the case, why do not the Government give adequate time to consult those organisations on the proposals contained in the Bill? Can 724 we have an assurance today that the Government will provide enough funds for voluntary organisations fully and properly to carry out their functions?

§ Mrs. Bottomley
The whole spirit of the proposals, leading on from the original Griffiths report, "Community Care: Agenda for Action", has been on the basis of consultation with voluntary organisations and local authority associations. About 280 representations were made on the original report. Since my right hon. and learned Friend's statement last July, about 100 further representations have been made. Since the publication of the Bill I have been involved with local authority associations and voluntary organisations in carrying forward these important plans. We have made it clear that adequate resources will be available.

§ Mr. Martlew
Had the Minister held discussions with voluntary organisations, perhaps the future role of hospices in community care would have been raised. Will she explain why hospices in Scotland are funded pound-for-pound by the Scottish Office, yet, despite repeated requests from my hon. Friends and me, the Minister steadfastly refuses to do the same for those in England and Wales? Will she explain to those involved with the Carlisle hospice appeal why they are working so hard to build a hospice in my constituency when nine miles up the road in Scotland the Government provide money? Is it not time that the Government stopped discriminating against the terminally ill in England and Wales?

§ Mrs. Bottomley
The hon. Gentleman may have been drawing attention to the way in which matters have developed in Scotland. One way in which we manage matters is to have some variation between different parts of the country. I thank the hon. Gentleman for giving me the opportunity publicly to pay tribute to the voluntary hospice movement which has been a major force for good. I draw his attention to the announcement that I made shortly before Christmas of a further £8 million for the voluntary hospice movement to be distributed by the regional health authorities. That will greatly add to the financial assistance that they already receive.

§ Mr. John Greenway
Does my hon. Friend agree that all organisations, with the exception of the Labour party, welcome the Government's proposals for community care, which are largely in line with the Griffiths recommendations? What discussions has my hon. Friend had with the Association of Directors of Social Services, particularly in respect of funding and the timetable for implementation?

§ Mrs. Bottomley
The proposals offer a major opportunity to improve care in the community, and many people have long looked forward to them. The key is now to make a reality of them. We have held discussions with local authority associations on the ways in which we can work together on projects and in giving guidance and training. I reiterate that we made it clear that adequate resources will be available, taking account of demographic factors. At present, many resources are misspent, without any proper assessment of the necessity, for example, for residential care. The proposals provide an opportunity to ensure that the frail and vulnerable are well cared for in the community.

§ Mr. Nicholas Winterton
Has my hon. Friend had any contact with the National Schizophrenia Fellowship. 725 SANE Concern or allied organisations about the over-rapid closure of pyschiatric hospitals and the placing of their former patients into the community when there are inadequate facilities, and an inadequate number of qualified persons, for looking after them? Sadly, those people are going off medication, sleeping under arches, and in some cases ending up in prison.

§ Mrs. Bottomley
My hon. Friend draws attention, rightly and properly, to a particularly vulnerable group. There is general recognition that the great swing to remove people from psychiatric hospitals—in which many of them were quite improperly incarcerated a generation ago—needs tempering. My hon. Friend the Under-Secretary of State for Health has presented proposals for dealing specifically with that needy group.

§ Mr. Ieuan Wyn Jones
Is the Minister aware that local authority social services departments are examining local plans for delivering community care? The hon. Lady will be aware of the concern expressed by many voluntary organisations that, in view of their increased responsibilities, local authorities are taking insufficient account of their views in the consultation process leading to publication of community care plans. What guidance are local authorities being given to consult voluntary organisations before publishing such plans?

§ Mrs. Bottomley
Clearly, we want community care plans to be discussed with voluntary organisations and the users of services, and, above all, with carers—who have so often been overlooked and neglected in the past. We are giving local authorities precise guidance on the importance of preparing their plans properly, and I assure the hon. Gentleman that the role of voluntary bodies in community care is perceived to be enormously important. We want a mixed economy of voluntary organisation, local authority, and private and independent provision. We want choice and dignity for the vulnerable.