Mentally III People (Hansard, 6 December 1994)

§ 5. Mr. Miller
To ask the Secretary of State for Health what arrangements she has in place to ensure that money saved from the closure of mental hospitals is spent on the needs of the mentally ill; and if she will make a statement.

§ Mrs. Virginia Bottomley
The NHS executive has written to regional general managers to make it clear that the resources released from the closure of a long-stay hospital should be reinvested in community-based services for the same client group. The number of beds available for mentally ill people has remained at about 80,000 for the past 10 years, but there is now a wider range of accommodation in the community.

§ Mr. Miller
Twice this afternoon, the Secretary of State has referred to stewardship of moneys by local authorities. In that context, does she agree that—in the light of her answer—it would be inappropriate for the Tory-Liberal alliance in Cheshire county council to continue its policy of charging for mental health day-care places?

§ Mrs. Bottomley
The Conservative group on Cheshire county council will be wanting to point out that Cheshire has 15 per cent. more money this year—£13 million more. I hope that it will also welcome the increases in the mental illness specific grant, particularly the recent allocation in the hon. Gentleman's constituency. It may be that, on charging, it will have considered the report of the Commission on Social Justice, which made it clear that there is a distinction between health care and social care and that it is reasonable to expect a contribution towards social care from those who can afford it if we are to 131 extend the quality and quantity of care for all who need it. I suspect that, in that respect, the Commission on Social Justice had much to offer.

§ Madam Speaker
Order. I want brisk questions and answers today.

§ Sir Giles Shaw
I welcome my right hon. Friend's commitment to the fact that the consequences of selling or closing large mental institutions will result in ploughing back money into health funding. Will she confirm that she is satisfied that there are adequate facilities for care in the community for those discharged from mental hospitals and that there is proper doctor control for those who are having to be transferred?

§ Mrs. Bottomley
My hon. Friend makes a vital point. We need to tighten up the care of those who are discharged from hospital and are severely mentally ill. Unless or until it is safe to discharge people from hospital, they should not be discharged and for those in the community who have severe problems we have introduced supervision registers and new guidance. I hope that all hon. Members will support the new power of supervised discharge to ensure that the minority who get into difficulties have better support and better care and are better watched over in the community. I hope that that reassures my hon. Friend.

§ Mr. Alex Carlile
How can the Secretary of State be satisfied with a situation in which people discharged from mental hospitals are finding themselves in inadequate accommodation with inadequately funded social services support and without the necessary housing provision? What are the Government going to do to improve that?

§ Mrs. Bottomley
It is extremely important that health and social services give the necessary priority to mental health. There has been a dramatic increase in resources for mental health services with about £2.5 billion being spent. I am surprised that the hon. and learned Gentleman should not be aware of the new £10 million mental illness specific grant, let alone the £1.3 billion for the NHS next year which will allow health authorities to give mental health services the priority that they deserve. Report after report suggests that better co-ordination, better management and better monitoring are also required.

§ Mr. David Atkinson
Will my right hon. Friend acknowledge the valuable work of those who run halfway hostels for the discharged mentally ill? Does she agree that there are still insufficient numbers of such hostels to make community care for the mentally ill a reality? Will she encourage social services authorities to use their ring-fenced grants more for that purpose?

§ Mrs. Bottomley
I can affirm my hon. Friend's comments. We need comprehensive and coherent mental health services. There is much good practice and we have to ensure that there is greater coherence in every community and that it is targeted on the severely mentally ill.