Care in the Community

HC Deb 24 May 1994 vol 244 cc165-6

1. Mr. Harry Greenway

To ask the Secretary of State for Health what assessment she has made of the progress of care in the community; and if she will make a statement.

The Secretary of State for Health (Mrs. Virginia Bottomley)

The community care reforms have got off to a good start, a view confirmed not least by the Association of Directors of Social Services—who are responsible for implementing them—and by the Audit Commission. I am confident that the foundations have been laid for a system providing quality, diversity and choice for users and carers. In implementing care in the community, we must be sure that the most vulnerable patients, especially those who are severely mentally ill, are cared for properly. That is why I am introducing a series of measures, including supervision registers and the proposed new power of supervised discharge, to protect both patients and the public.

Mr. Greenway

Is not it typical of this Government that they should put the vulnerable first? Will my right hon. Friend assure me that under no circumstances will dangerous people be released from psychiatric care into the community, where they could be a threat to others? Will she also reassure all elderly people that they will always have the hospital and medical treatment that they need, regardless of their age?

Mrs. Bottomley

We recently issued guidance on the discharge of patients from psychiatric hospitals. Patients should not be discharged unless or until it is safe to discharge them. We are also introducing supervision registers and hope to introduce the power of supervised discharge. No one wants to turn back the clock to the old days of incarceration in isolated communities, but there are psychiatric patients who need active support in the community; they need resources targeted on them and we seek to achieve that. My hon. Friend will be well aware that his constituents, like mine, have increased their life expectancy by another two years in the past 10 years. Some 16 per cent. of the population are over 65, and 40 per cent. of the health budget is spent on them—and quite rightly too.

Mr. Hinchliffe

Is the Secretary of State aware of the very real fears among many people concerned with community care over the Government's proposals to reduce the number of inspections of care and nursing homes, bearing in mind the circumstances of the recent case of a woman in a private nursing home in Dulwich who died with ulcers which had live maggots on them at the time of death? [HON. MEMBERS: "Oh No."] Conservative Members may shout, but in my constituency an elderly lady choked to death in a private care home simply because the staff had no basic first aid training. In view of those cases, is not it nonsensical to move towards reducing inspections? Should not we be increasing them instead?

Mrs. Bottomley

Care in the community provides support for some of the most frail and vulnerable. They need access to complaints procedures and confidence in the places where they live. However, there is a difference between inspections satisfying standards of care and petty bureaucracy and interference. Many of my hon. Friends report from their constituencies concerns that left-wing authorities have been hostile to the private and independent sectors. We want to reduce some of the petty regulation. None of that should undermine the safety of the individuals concerned.

Mr. Barry Field

Has my right hon. Friend seen the threatening letter that the Liberal Democrat-controlled Isle of Wight county council sent to pensioners about care in the community, despite the fact that the Government gave the council an additional £1 million? Does not that have more to do with political ambition than with providing care in the community?

Mrs. Bottomley

My hon. Friend, who is a great champion of the Isle of Wight, is absolutely right. Care in the community has been formidably generously funded.

Madam Speaker

Question 2. Mr. Dalyell.

Mrs. Bottomley

May I finish my answer, Madam Speaker?

Madam Speaker

I thought that the right hon. Lady had finished. We seem to have made a very bad start with questions today. I hope that hon. Members will be more brisk from now on. Of course the right hon. Lady must finish what she has to say.

Mrs. Bottomley

I know the Liberals only too well in the Isle of Wight, as does my hon. Friend. I also know the Liberals in Portsmouth, who circulated scare stories about pensioners paying prescription charges. That is par for the course. We get on and deliver the policies and fund them fairly.