Community Care (Hansard, 6 July 1994)

7. Mr. Robert Hughes
To ask the Secretary of State for Scotland when he intends to conduct a review of community care in Scotland.

§ Mr. Stewart
We continually monitor and review the progress of the operation of community care in Scotland. A major evaluation and research project is being undertaken at Stirling university.

Mr. Hughes
Is the Minister aware of the great anguish and anxiety caused when trusts publish business plans stating how many people are to be discharged into the community and which hostels are to be closed, but make no mention of how the care is to be provided?
Would not it be more sensible to publish a patient plan in conjunction with the authorities that will provide patient care and, in tandem, produce a business plan showing how the costs of the whole package will be met? Does the hon. Gentleman agree that until that is done and until there is a sensible way of planning and operating community care, there should be no hospital closures in Scotland?

§ Mr. Stewart
I am aware of the hon. Gentleman's concern about these matters, which he raised in the Scottish Grand Committee yesterday. First, a business plan is an essential starting point. Secondly, like the hon. Gentleman, I believe that close co-operation with local authorities is very important, and we have a working party studying that. Thirdly, no hospital can be closed until after a period of public consultation and after a submission to my right hon. Friend the Secretary of State.

§ Mr. Bill Walker
When my hon. Friend and his colleagues are consulting, will they consider Meigle cottage hospital and the proposal to turn it into a day-care centre? If, on examining that proposal, it is found that its capital and revenue costs, especially transporting people long distances to the hospital, are the same as, or greater than, the cost of maintaining the hospital as it is, will my hon. Friend review the decision to close it?

§ Mr. Stewart
It is no great surprise to hear my hon. Friend raise the issue of Meigle cottage hospital. I reassure him that my right hon. Friend the Secretary of State, my 308 right hon. and noble Friend the Minister of State and I will keep the position at Meigle under the closest review and scrutiny.

§ Mrs. Fyfe
Does the Minister realise that his avowed concern for these matters is somewhat less than convincing because earlier this year he admitted that he did not know the number of people paying the full cost of accommodation in residential care and nursing homes, or how many people had sold their homes to meet the charges for their residential care? Is the hon. Gentleman any better informed now?
Will the Minister, before it is too late, consider the impact of the break-up of the social work departments on this and other aspects of community care? It is a consequence of his tearing apart of Scottish local authorities to meet the Government's narrow political ends.

§ Mr. Stewart
We regularly collect and publish a whole range of statistics on community care as part of the monitoring process. Inspections are carried out by the social work services inspectorate and the reviews by the NHS management executive.
I do not for a moment accept the hon. Lady's views on the consequences of local government reform. A single-tier system will be a great deal more sensible. There are enormous advantages in, for example, having social work and housing services in the same authority.

§ Mr. Kynoch
Does my hon. Friend agree that the principle of care in the community is commendable? Does he further agree that to keep the elderly and mentally sick in normal conditions in the community for as long as possible is better than institutionalising them and putting them in hospital? Will my hon. Friend join me in commending Grampian health care trust on its business plan, although it is only an outline plan? It not only includes, sadly, proposals to close some hospitals, but—this is something that the hon. Member for Aberdeen, North (Mr. Hughes) did not mention—plans for significant capital expenditure on new hospital provision for those who have to remain in hospital, so that they can have even better care.

§ Mr. Stewart
My hon. Friend is right. The trust's plan includes considerable capital expenditure. The objective is not simply to maintain, but to improve the standards of patient care.