HC Deb 07 December 1994 vol 251 cc295-7
3. Mr. Canavan

To ask the Secretary of State for Scotland what assessment he has made of the adequacy of the provision of NHS beds for frail elderly people.

The Parliamentary Under-Secretary of State for Scotland (Lord James Douglas-Hamilton)

National health service provision for the frail elderly will vary from health board to health board, depending on the local assessment of need in each area. The aim always is to match local national health service and social work services to need.

Mr. Canavan

Will the Minister arrange to visit Lochgreen hospital, which is threatened with closure, and Bellsdyke hospital, where 155 beds for frail elderly people are similarly threatened, so that he can see for himself the high standard of patient care that is provided by the dedicated staff there? Will he intervene to stop the closures, especially in view of the increasing population of elderly people and the fact that the Government's so-called community care programme is so inadequate? If he does not, many frail elderly people will be deprived of the hospital beds that they require.

Lord James Douglas-Hamilton

I shall certainly pass on to the Minister of State the hon. Gentleman's request for a visit. I have made inquiries about the two hospitals, and I understand that the board proposes to offer patients currently resident at Lochgreen hospital a choice in 1995. They will be able to transfer either to alternative NHS accommodation or to a suitable nursing home. The consultation will finish in January. We also look forward to seeing the board's strategy for mental health, which I understand will include proposals for Bellsdyke hospital involving the reprovision of care.

The board will go out to public consultation, and the strategy will require ministerial approval. I undertake that approval will be given only if Ministers are satisfied that the changes will lead to a higher standard of care for patients in more homely settings. I am sure that if the hon. Gentleman wishes to ask specific relevant questions, the Minister of State will be prepared to see him.

Mr. Gallie

Is my hon. Friend aware of the proposal made by Ayrshire and Arran health board to close the accident and emergency unit at the new Ayr hospital? Given the considerable investment made by the national health service in that hospital, is my hon. Friend not glad to join me in commending the trust management, who will fight this move tooth and nail?

Lord James Douglas-Hamilton

Trust status has brought many benefits to many hospitals. Closures of key services, such as those my hon. Friend mentioned, have to be put to the Minister for approval before they can be agreed. The matter will be looked at in great depth.

Mr. McAvoy

Does the Minister recall that a long-planned and long-awaited national health service hospital for the elderly in my constituency was cancelled? It was removed from the plan and care of the frail elderly was turned over to Takare, a private health firm. Bearing in mind the fact that the reason for that decision was an alleged lack of cash for Greater Glasgow health board to build the hospital and bearing in mind the public money that the Secretary of State for Scotland put into HCI, does the Minister agree that the decision to transfer care of the frail elderly to a private company in my constituency was a disgrace?

Lord James Douglas-Hamilton

There are two considerations. First, the decision to invest in HCI was an inward investment decision that had nothing to do with funds provided for the national health service. Secondly, Greater Glasgow health board and its partners are seeking to improve care and facilities for vulnerable elderly people and to provide better alternatives, not to withdraw care. It is very important that, before patients are discharged, the proper support arrangements are put correctly in place. Any breakdown in those arrangements is contrary to official policy and should be followed up speedily so that mistakes do not recur.

Mr. Kirkwood

Will the Minister acknowledge that there is a great deal of concern about the definition of treatment and the definition of care for the frail elderly? Is he aware of the difference between people who are able to get treatment within the national health service and those who are decanted out of NHS beds because they are deemed only to require care, and who are then assessed in the context of social work, which requires their means to be tested? What steps is the Minister taking to clarify the definition of the two classifications? What steps is he taking to advertise the fact that if people are decanted out of free NHS beds, they may have to pay, using their meagre resources, to get the treatment that they require in the community?

Lord James Douglas-Hamilton

Before patients are discharged, the care agencies must have been involved in a full assessment of all the needs of the patients concerned in terms of health, social welfare and housing. It must be ensured that all necessary support facilities are in place. Social work authorities have discretionary charging powers for day and domiciliary care. The principle that individuals should not pay more than they can afford is applied to discretionary charges and charges for residential care. There is considerable discretion for local authorities.

Mr. Ian Bruce

What is the increase in national health service resources in Scotland? How much extra has gone into care in the community through local government, and how do the figures compare with those for the rest of the United Kingdom?

Lord James Douglas-Hamilton

Resources have increased considerably, by about 53 per cent. The total for health boards in 1994–95 was £3,234 million, which shows high spending. Spending per head on health is, of course, far higher north of the border than it is south of the border for a number of reasons. The health needs are more pressing in certain respects—the incidence of heart disease, for example, is far higher. We can readily justify the higher figure.

Mr. George Robertson

Is the Minister aware that all over Scotland today, thousands of frail elderly people, in hospitals and out of them, will cheer the news that the second phase of the increase in VAT has now been scrapped because they were worried sick by the prospect? Is it not true that the Chancellor snubbed and ignored the views of the Secretary of State for Scotland and Scottish Office Ministers on this issue? Will the Minister take the opportunity to welcome the fact that Parliament did what Ministers could not? Does he agree that scrapping the second iniquitous increase in VAT on fuel is extremely good news for Scotland?

Lord James Douglas-Hamilton

Votes in the House of Commons have to be respected and, as the hon. Gentleman knows, the Chancellor will make a full statement tomorrow, but I can say that compensation for the first stage of VAT on fuel and power will most certainly remain. That includes 50p cash compensation, which was given in April, and the uprating due next April. I can also confirm that the extra funds for the home energy efficiency scheme will certainly not be scrapped.

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