HC Deb 23 January 1990 vol 165 cc725-7
2. Mr. Day

To ask the Secretary of State for Health what steps his Department is taking to provide psychiatric care for homeless people who need such care.

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman)

The responsibility for providing psychiatric services for people who need them rests with district health authorities and local social services authorities. However, the Department is presently exploring what practical steps might be taken to assist such people who are homeless.

Mr. Day

My hon. Friend will be aware of the concern expressed in the House and outside. Will he confirm that Ministers will not approve the closure of any hospital for the mentally ill without first demonstrating that adequate alternative facilities exist? I cite as an example the £3 million project for a mental illness unit at Manchester royal infirmary, which is to start this year.

Mr. Freeman

I confirm my hon. Friend's remarks about the facilities at Manchester royal infirmary, which I visited recently, and which has excellent plans to meet the needs of patients from Cheadle hospital. I confirm that no hospital for long-stay psychiatric patients will be allowed to close until the National Health Service is satisfied that proper facilities exist in the community.

Mr. Frank Field

Although the House welcomes the Minister's last statement, does he accept that over the past 10 years, more than 40,000 long-stay patients have been dumped in the community with nowhere to go? Is he aware that many of them are homeless and are wandering the streets? While we are grateful for the Government's concern, at least as expressed in words, how much new money is being put up front?

Mr. Freeman

There is no question but that some discharge policies by some hospitals were ill-advised by present standards. The hon. Gentleman is right in saying that it is of concern to the House, and to the Government, that some people are now homeless or roofless. We have outlined specific policies so that no one should be discharged from any psychiatric hospital unless a care programme is agreed for the individual. We have also made provision for the year 1991–92 for a specific mental illness grant, to be distributed through the regional health authorities, to help local authorities to improve the quality of social care in the community.

Dame Jill Knight

The House will be pleased to learn of the sums of money that have been allocated to deal with this problem, and to know that specific instructions are being sent to local authorities to deal with the issue. How long will it take before those plans reach the point where they are helping people who have been released from hospital?

Mr. Freeman

My hon. Friend refers to district and regional health authorities' responsibilities, and those are separate from the responsibility of the consultant and the authority in charge of the hospital. I have stressed that no patient should now be discharged without a proper care programme. By April 1991, every district health authority should have a proper care programme for all patients who have been discharged or will be discharged. We will provide additional funds for local authorities to enable them to improve the quality of social care.

Mr. Alfred Morris

Has the Minister seen the report in The Lancet on homelessness over Christmas, which says that mentally ill people are now living: like feral children…scavenging for food"? Is not that a bitter criticism of the Government's community care policy at a time when The Sunday Times has shown—I speak as a trustee of Crisis at Christmas—that there is massive public backing for more humane provision? Is there not now an urgent and compelling case for full implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986?

Mr. Freeman

I read the article in The Lancet, but I think that, unfortunately, it was written too early to take account of the Government's new proposals on care for the mentally ill. As for roofless people in our cities who have a history of mental illness, the Government recognise that that is a problem and hope to bring forward proposals to deal with it in due course.

Sir William Clark

Is my hon. Friend aware that mentally ill people in my constituency have been discharged from Cane Hill hospital and put in bed and breakfast accommodation by the local authorities? They are walking the streets. It is all very well for my hon. Friend to say that that will be fixed in 1991, but what will happen to them between now and then?

Mr. Freeman

We must be careful to distinguish patients who are discharged from hospital properly, because they are psychiatrically and medically cured and have the same rights as other people. I share my hon. Friend's concern about the past discharge policies. We have given all district health authorities due notice that they must make progress within 12 months. It is not possible to reform procedures overnight. We have made substantial progress, and I shall study the example that my hon. Friend has cited and write to him.