HC Deb 18 April 1995 vol 258 cc10-1
10. Mr. Jim Cunningham

To ask the Secretary of State for Health if she will make a statement on the Audit Commission's recommendation that access to help for mentally ill people should be available outside office hours. [17562]

Mr. Bowis

The recent Audit Commission report did not make a specific recommendation on the subject. Nevertheless, we encourage health authorities and social services departments to provide access to out-of-hours services.

Mr. Cunningham

That is the Minister's interpretation of the Audit Commission report, but is not the Audit Commission really saying that care in the community, particularly for mentally ill people, is grossly underfunded? Is it not suggesting that the Government, who have boasted about their achievements this afternoon, are following the same policy as California, which is to remove mentally ill people from mental homes and institutions as that saves money? Are not the Government being heartless towards homeless people, who also need after-hours services? What does the Minister plan to do about it? Will the Government put more resources into the scheme?

Mr. Bowis

Had the Audit Commission referred to resources, it would have referred to the £2 billion that is put into the health service year on year. The hon. Gentleman's question is about 24–hour crisis care services. He will know that the Government have issued guidance to encourage the provision of 24–hour crisis services. He will also know that exactly those services are being provided in his own health district. Coventry, which already has a community psychiatric nurse on call and a 24–hour assessment service emergency night care team, is spending £200,000 in the coming year on a more comprehensive crisis service, and has made that its highest priority.

Mr. Illsley

Is it not clear that most organisations involved in mental health care have endorsed the call for 24-hour emergency services? The Government say that they are doing all they can to encourage such services and there was cross-party support for a recent private Member's Bill that dealt with the issue of 24-hour emergency services, but could not the Government do more to enable patients to gain access to care when they need it, rather than concentrating on legislation, which deals with compulsory conveyance for treatment? Should not the user benefit?

Mr. Bowis

I do not see that those are in conflict. We want to improve discharge arrangements for patients from hospital, which is the purpose of the Mental Health (Amendment) Bill and the supervised discharge arrangements. We also want to ensure that money is spent on 24-hour care and access to services; that is the purpose of our guidance. We do not issue prescriptive directions from the centre about specific services, but we make it clear that we expect services to have crisis accommodation, crisis assessment and intervention teams, help lines and access to care teams, including the general practitioner and key workers.