Community Care (Hansard, 20 March 1990)

§ 9. Mr. Alton
To ask the Secretary of State for Health if he will make a statement on the progress of care in the community as it applies to patients with mental illness.

§ Mr. Freeman
The Government have set out their proposals in the White Paper, "Caring for People". Key elements are the introduction of the care programme approach, and the specific grant to help increase the social care available for people with a mental illness, which we hope to introduce from April 1991.

§ Mr. Alton
Has the Minister had a chance to consider the tragic case outlined to him in a letter from me and the right hon. Member for Manchester, Wythenshawe (Mr. Morris), acting as trustees of the charity Crisis, which acts for homeless people? Does he agree that that case illustrates the real problem of discharging people with mental problems into the community? Does he accept that this policy can too easily become dumping in the community, which is in the interests neither of the patient nor of the community?

§ Mr. Freeman
I shall be replying to the hon. Gentleman on the specific case that he and the right hon. Member for Manchester, Wythenshawe (Mr. Morris) raised. The whole House will agree that in the past some patients have been dumped from mental illness hospitals. There is no question about that. That is why we are pursuing a number of initiatives, including this year a specific initiative aimed at the mentally ill homeless in central London—to be followed in 1991–92, I hope, by a wider national initiative. The situation is scandalous, and I agree with the hon. Gentleman that we must take firm action.

§ Mr. Simon Coombs
Can my hon. Friend confirm that often the best and most apporopriate quality of care for mentally ill people and mentally handicapped people is provided within the community? To that end, will he promote the citizens' advocacy schemes, which have been growing up on a voluntary basis around the country, notably in my constituency, whereby mentally handicapped people are provided with a friend, advocate and mediator with outside bodies enabling them to establish themselves more easily in the community?

§ Mr. Freeman
I am grateful to my hon. Friend. I am sure that the whole House agrees with him that caring for people with mental illness or handicap to the maximum possible extent in the community is a humane and civilised. policy, but there are limitations. As to advocacy I agree that it has a place, particularly for the mentally handicapped and I am grateful for my hon. Friend's support.

§ Mr. Frank Field
Do the Government accept that not just a few but thousands upon thousands of patients have been dumped into the community and are literally homeless? Does the Minister accept that the measures that the Government have announced, though welcome, in no way meet the crisis faced by this group? When will the Government announce the provision of adequate resources to house those who are homeless?

§ Mr. Freeman
I do not disagree with the hon. Gentleman's analysis. We are trying, first of all, to correct the discharge policy, and the hon. Gentleman will know of the very firm steps that we have taken.
For instance, we have indicated that we shall not permit a mental hospital to close until we are satisfied that there is proper provision for those moving into the community. As regards those who are already in the community—the homeless with a history of mental illness—I agree that in Greater London the number is probably up to 3,000. That is why we shall bring to the House shortly concrete proposals to help to address this problem.