Personal Social Services (Hansard, 22 March 1994)

§ 2. Mr. Gunnell
To ask the Secretary of State for Health what research she has undertaken on the relationship between the national health service and personal social services at the local level.

§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
Considerable and continuing.

§ Mr. Gunnell
The Minister has not told us very much. Has he studied the Health Service Commissioner's report on the long-term care that Leeds health authority has failed to provide? Is he aware that a recent meeting of the Leeds community health council reported four similar cases and that other CHCs around the country were getting in touch with Leeds about similar cases? Does that not demonstrate a failure to provide long-term care? Is that not why, despite the Government's stated objective of looking after carers, many carers have to finance long-term respite care out of their own pockets—

§ Madam Speaker
Order. The hon. Gentleman might take a leaf out of the Minister's book.

§ Mr. Bowis
The quick answer is no, but I shall expand a little. I have seen the report. I am pleased to know that Leeds health authority has accepted it and is putting right the individual case. As the hon. Gentleman knows, the case predates community care. It confirms the Department of Health guidelines and underlines why the discharge agreement was one of the conditions for the special transitional grant.

§ Mr. Rowe
Does my hon. Friend accept that, at least in Kent, the relationship between the national health service and social services has been greatly improved by the introduction of the National Health Service and Community Care Act 1989? Does he also accept that further improvements could be made if a small handful of national health service patients who are also clients of the social services were allowed direct control over that part of their budget which allows for domiciliary care?

§ Mr. Bowis
My hon. Friend is persistent, persuasive and eloquent in making his cause. As he knows, I have discussed the matter with him. Once the community care system has bedded down for a year, we shall be happy to look further at his ideas.

§ Mr. John Evans
Does the Minister agree that one of the most important social services is that provided by school nurses? Is he aware that St. Helens and Knowsley health authority is proposing to cut by half the number of school nurses in St. Helens and Knowsley? Will he join me in condemning an action that will be detrimental to the health and welfare of children in St. Helens and Knowsley?

§ Mr. Bowis
It is not for me to second-guess the provision of services in the hon. Gentleman's constituency. That is a matter for the local health authority, the local authority and the local education authority. I am sure that he is putting his case to them so that school children can benefit from all the resources available to meet the needs assessed by those areas.

§ Mr. Nicholas Winterton
Does my hon. Friend accept that there is increasing concern about this subject and increasing evidence that many people requiring long-stay hospital care are not getting it under the national health service but are being directed to the private sector—either residential homes or private nursing homes—where they or their families are having to pay a heavy price for a service that should be free under the national health service?

§ Mr. Bowis
My hon. Friend is knowledgeable about these matters. He is, of course, referring to the Leeds judgment, which underlines the Department of Health guidance that it is for the national health service to provide or to purchase long-term care for those who need it on grounds of ill health. The guidance says that no patient in such circumstances should be required to go into a home where there is a charge. As for people who need social care, rather than health care, for many years the principle has been that the charge should be according to the individual's means.

§ Mr. Hinchliffe
Will the Minister listen to his hon. Friends—such as the hon. Member for Macclesfield (Mr. Winterton), who is absolutely right in saying that the NHS is not discharging its duties to people requiring long-term care? Will the Minister tell me why there is no review system allowing consideration of the cases of people who were placed in long-term residential or nursing home care before the community care changes? Given that people are now paying for care that was formerly freely available under the NHS, has not the ombudsman provided concrete evidence of the way in which the Government are privatising the service?

§ Mr. Bowis
Continuing, long-stay care is available for those who need it; moreover, provision for elderly patients has reached record levels. Under the present Government, the number of elderly people receiving in-patient treatment has risen by 125 per cent. to 526,000, and the number receiving out-patient care has risen by 89 per cent. to 452,000. That is a record of care for the elderly of which we can be proud, and which the hon. Gentleman can only envy.