HC Deb 24 May 1994 vol 244 cc168-70
4. Mr. Ronnie Campbell

To ask the Secretary of State for Health when she last met representatives of the local authority associations to discuss community care changes.

11. Mr. Heppell

To ask the Secretary of State for Health when she last met the Carers National Association to discuss the community care changes.

The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)

I frequently meet the local authority associations and the Carers National Association to discuss a range of issues including community care.

Mr. Campbell

When the Minister next meets the association, will he take up the case of community care for drug abusers? Is he aware that five teenagers in my constituency have died over the past two years, four of them in the past six months? People are beginning to feel that care in the community is not quite working. Although some money has been put into it, we feel that those teenagers died without even getting to the first stage of care in the community. Will the hon. Gentleman call for an inquiry into the circumstances surrounding their deaths?

Mr. Bowis

I am sure that the hon. Gentleman, from his experience in Northumberland, will acknowledge that the inspectors of social services have recorded that a very good start has been made there. That is a great tribute to Northumberland's director of social services.

The hon. Gentleman rightly referred to one particular point about young people. I am aware of the problem affecting them—it is solvent abuse. I am also aware, as he is, that a special group has been set up to look into the problem. It will report to the health authorities, which can then take appropriate action.

Mr. Heppell

Does the Minister accept that carers of people with psychiatric disabilities need respite as much as, if not more than, other carers? How does he account for the fact that although 25,000 psychiatric beds have been lost from hospitals, only 9,000 additional places have been provided in day centres? Why is there such a disparity?

Mr. Bowis

The hon. Gentleman raises an important point and I fully accept that carers need a break. The whole House would pay tribute to the contribution of carers to care in the community and community care. That is one reason why, in this year's financial settlement for local government, we incorporated an additional £20 million for respite services for carers. We want to build on what has been achieved.

The hon. Gentleman is right to say that it is important that health authorities, when planning their services, take account of the need for respite care in psychiatric cases as well as the need for acute services. I am sure that he is pleased about the recent report from the Carers National Association, which shows that of those surveyed who had had an assessment, 78 per cent. had received some form of respite in the previous year.

Mrs. Lait

Will my hon. Friend ask East Sussex county council how it justifies the Lib-Lab policy of referring all respite care cases to county council homes, at a cost to the council taxpayer of £100 per week more than the cost in the private sector? Does he agree that that is a waste of public money—some £3.5 million a year—and will he please tell the council to stop it?

Mr. Bowis

I shall certainly pass on my hon. Friend's words to East Sussex county council. I cannot answer for Labour or Liberal policies in that area; I doubt whether the House could understand them even if the parties explained them themselves. It is right to say, however, that if authorities fail to use the range of provision available, including the whole of the independent sector—private and voluntary—they will not get the best service for those in need in their areas. I imagine that the Audit Commission, when it does its surveys, will have something to say about that.

Mr. Waterson

Does my hon. Friend agree that this would be a good moment to remind local authorities, including East Sussex county council, that the 85 per cent. figure for funding in the independent sector is a minimum, not a maximum?

Mr. Bowis

My hon. Friend is right. That 85 per cent. represents the continuation of the 100 per cent. provision for support for community care in the independent sector under the old social security system. The purpose of the 85 per cent. figure is to give stability to the voluntary and private sectors during this period of change—and, indeed, stability for the residents in the homes. It is also to give authorities and the private and voluntary sectors time to diversify so that they can make an even greater contribution to community care.

Mr. McCartney

Would the Minister like to be a bit more candid about the issues raised in the report of the Carers National Association? Did not 93 per cent. of respondents say either that services had not improved or that they had worsened since the introduction of community care? Perhaps the Minister could be a bit more open about the problems affecting both funding and access to services. That would help the Opposition to come to terms with many of the problems that carers now face—the greatest of which is the Government's disastrous policy of trying to write off the Civil Rights (Disabled Persons) Bill. Can the Minister give us some indication of whether his Department will provide more time for that Bill, so that it can become law?

Mr. Bowis

I suppose that the hon. Gentleman has read the report to which he referred. I certainly have, but, having listened to the hon. Gentleman, I suspect that he has only read the press release that accompanied it. He would learn most by reading the entire report, and I commend it to him.

If he had indeed read the report, the hon. Gentleman would know that the survey was carried out just a few months into the new community care system. More important, he would have read that 72 per cent. of carers interviewed said that they had found the assessment thorough, 75 per cent. said that they had received a break, 92 per cent. said that they encountered no difficulty in obtaining services at weekends and 92 per cent. said that they felt that their position was at least as good as it had been before, if not better.

We care about carers. We recognise the contribution that they make, and we are intent on working with them and continuing to improve care for people in need in our community.

Madam Speaker

We must be brisker.

Rev. Martin Smyth

I welcome some of the positive advances that have been made, but will the Minister bear in mind early-day motion 1176, which reveals some anxiety in the House about the concern expressed by the Carers National Association in regard to needs still to be met?

Mr. Bowis

We shall continue to work with carers, and with the hon. Gentleman, if he brings any specific matters to our attention. I cannot say off the top of my head that I am acquainted with the early-day motion that he mentioned, but we shall examine the issue carefully with the carers. As the hon. Gentleman said, progress is being made; we look forward to further progress in the future.