§ 4. Mr. Nigel GriffithsTo ask the Secretary of State for Health when she last met representatives of the Association of County Councils to discuss the funding of community care; and if she will make a statement.
§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)I meet representatives of the Association of County Councils formally and informally on a variety of occasions, the last occasion having been last Monday. We discuss a variety of matters relating to English social services on such occasions.
§ Mr. GriffithsWhy does not the Minister listen to Lady Farrington, who chairs the association and who presented a list of 20 areas, from Bedfordshire to Wiltshire, that are chronically underfunded for community care? Does he not realise that the murder of Georgina Robinson showed what a failure community care has been and that it is time not for the new mental health Bill that the Minister promises but for a new Minister, a new Secretary of State and a new Government?
§ Mr. BowisI welcome the hon. and Scottish Member to questions about English health, but I shall not be able to do so for much longer if his party has its way. I certainly listen to the ACC. I also listen to the Audit Commission when it tells me that community care has got off to a good start, that some authorities have got into a financial muddle because of inadequate financial control and that others are playing politics with community care, spending money on administration, refusing to use the independent sector and then reducing services to people in need.
§ Sir George GardinerWill my hon. Friend comment on the situation in Surrey county council—a hung council—which appears to have run out of funds to support social services for the remainder of this year?
§ Mr. BowisMy hon. Friend is right. I have seen the letter from Surrey county council to independent homes, which states:
This must seem a strange letter to receive.I endorse that comment. In its letter to councillors, it confesses that everyone took their eye off the budget ball, but, in the end, there were no excuses for Surrey social services.569 I recall that, last year, Surrey social services received £93 million. For community and social services this year, the figure is £108 million. We have announced £121 million for next year, 17 per cent. extra this year, and another 11 per cent. next year. It is beyond my understanding how a county could get into such a muddle when it knew the figures for the current year in December 1993.
§ Mr. HinchliffeFrom his contacts with local authorities and discussions about community care, is the Minister aware of the extent to which councils are increasingly being asked to take on community care people who should be in hospital? Is he aware of unconscious people who are on drips being referred to councils for community care? Is he aware of people who are in a coma being referred to councils for community care? Is not the root of the crisis in community care the operation of the Government's market in health?
§ Mr. BowisI am aware that, this year, we are putting £4.6 billion into community care. I am aware that, for the coming year, as we have already announced, the allocation will be more than £5.1 billion. The hon. Gentleman will be aware that we have issued draft guidance and will shortly issue full guidance on continuing care, which will reinforce the message to the NHS that it has a responsibility for continuing medical and health care for people in need. I look forward to hearing the hon. Gentleman's policies and those of the right hon. Member for Derby, South (Mrs. Beckett) on community care and on continuing care—whether they agree with the views of the Commission on Social Justice, whether they have not yet made up their minds, or whether they are still waiting for Alastair Campbell to tell them.
§ Mr. SimsIs not the hon. Member for Edinburgh, South (Mr. Griffiths) confusing two different matters? Care in the community for the mentally ill has been running for a number of years. It is showing some shortcomings, as in some places provision in the community is not adequate, but there is also evidence that clinicians are releasing into the community some mentally ill patients with a history of violence who should not be released. The community care policy, which has been running only a relatively short time, gives local authorities responsibility for the elderly, children and the disabled. That policy has been generously funded and it is working well in most parts of the country, but some local authorities are financially incompetent.
§ Mr. BowisMy hon. Friend is right on both counts. The amount of resources for mental health is not being criticised, although the use of the Mental Health Act 1983 is criticised on occasions. Implementation of the Government's widely welcomed and accepted policy is sometimes inadequate. That was the message of the Blom-Cooper inquiry, which called for a tightening of the Mental Health Act with regard to severely mentally ill people. That is precisely why, before too long, we shall introduce a Bill to implement supervised discharge.