Mental Illness (Hansard, 19 June 1991)

§ 5. Dr. Godman
To ask the Secretary of State for Scotland what progress has been made on the provision of facilities in the community for those suffering from mental illness and the development of community mental health teams.

§ Mr. Michael Forsyth
Day places in psychiatric specialties have more than doubled to around 5,500, grants of ³3.25 million have been introduced for mental illness and a ³15 million bridging finance scheme will help a number of projects in the mental health field.

§ Dr. Godman
Is the Minister satisfied with progress in implementing the grants under the mental health scheme? I urge on him the need to give sympathetic consideration to the needs of the poor people who suffer from brain injuries. They must surely be brought into the ambit of the grants scheme—at the moment they fall outwith it. I readily acknowledge the Minister's efforts on the medical side, but I urge him to look more sympathetically at the community needs of this group.
A similar plea can be made for dementia sufferers and their families; they too suffer from a lack of day care facilities and of respite care for their carers.

§ Mr. Forsyth
I know that the hon. Gentleman takes a considerable interest in this matter and his suggestion seems sensible. I am happy to give him an undertaking to look into the possibilities of doing as he asks. He will know that we have recently established and made an announcement about a national centre for head injury victims, but I shall look positively at his suggestion of using the grants scheme to help people who have suffered from brain injuries.

§ Mr. Malcolm Bruce
Is the Minister aware that Grampian health board has recently announced that in the next seven to 10 years it intends to close two mental hospitals in my constituency—Kingseat and the House of Daviot? Does he accept that there is concern that those closures are part of a plan that meets the needs of the health board, but not always those of the patients and their relatives and friends? They are anxious because people are being forced into the community without adequate facilities and support. Will the Minister give an assurance that he will not sanction any hospital closures until he is satisfied that adequate community care facilities have been provided?

§ Mr. Forsyth
Yes, I am happy to give the hon. Gentleman that assurance. However, I respectfully suggest to him that asking such questions will not allay the fears that he says exist. He should be in no doubt that one reason why the care in the community programme has moved more slowly in Scotland is our determination that patients should not be discharged from long-stay care unless proper provision is available in the community. The White Paper proposals, which are now being implemented, 281 are designed to ensure that local authorities and health boards operate in partnership to avoid any possibility of patients being put in that position.

§ Mr. Worthington
Is the Minister aware that one reason why the programme has moved more slowly in Scotland is that the resources have not been devoted to community care of the mentally ill. The Minister must be careful not to mislead the House. He referred to ³15 million of bridging finance for the mentally ill. As he well knows, much of that is for the mentally handicapped.
Has the Minister spoken to his hon. Friend the Parliamentary Under-Secretary of State about the cuts in training places for the recovering mentally ill? We have lost 120 training places, three centres have been closed and expenditure for the Scottish Association for Mental Health has been cut from ³1.5 million to ³1 million. That is a backward step for community care.
Why is it that in Scotland two and a half times as many people are in mental hospitals as in England and Wales? Why is the number of training places per 1,000 of the population 15 times greater in England and Wales than it is in Scotland?

§ Mr. Forsyth
The hon. Gentleman asks why there are more people in mental-illness and mental-handicap institutions in Scotland than there are in England. It is because the implementation of the care in the community programme has moved more slowly. The hon. Gentleman suggested that less money was being spent in Scotland on those areas. Nothing could be further from the truth. The health service in Scotland receives about a quarter more expenditure per head than it does in England. The pace at which we have implemented the care in the community programme has been determined by the facilities that are available in the community. That will remain so.