HC Deb 16 January 1996 vol 269 cc526-7
3. Mr. Hardy

To ask the Secretary of State for Health what assessment he has made of community care provision. [7493]

The Secretary of State for Health (Mr. Stephen Dorrell)

Since April 1993, the Department of Health has monitored the implementation of the community care reforms. In addition, the social services inspectorate carries out regular inspections, statistics are regularly collected and published, and longer-term research is in hand to evaluate the progress of the policy.

Mr. Hardy

While I pay tribute to the dedication of the medical and nursing staff engaged in the sector, would not they—and does not the report of the Royal College of Psychiatrists—point to serious and growing need? May we have an assurance not only that the Government are pledged to maintain supervision, but that they will provide more psychiatric hospital beds and improve staffing to assist those at the sharp end of sometimes horrifying and intensifying need?

Mr. Dorrell

The House can certainly have the assurance that we shall continue to invest to ensure that adequate, up-to-date hospital space is available for those with acute hospital needs who are mentally ill. In addition, we have already announced our intention to introduce a mental health patients charter that will define the standards that patients are entitled to expect from the mental health services. I also announced at the time of the Budget a package that will provide an extra £50 million of new money for the delivery of mental health services. I hope that the hon. Gentleman will welcome those steps.

Mrs. Roe

Will my right hon. Friend confirm that the resources that the Government have devoted to all community care services have more than doubled in only five years and have been increased by 9 per cent. this year over last year?

Mr. Dorrell

My hon. Friend is absolutely right to highlight the fast rate of growth in the resources available for the community care of elderly people. Indeed, my hon. Friend understates the scale of the public resources committed by the Government to care for elderly people. The figure in 1979 was £851 million in total—almost all of it was spent by local authorities. In today's values, that figure is £2.5 billion. The figure that we, local authorities and the Department of Social Security are spending this year is just over £7 billion. There has been an increase, in today's values, from £2.5 billion to more than £7 billion. We have multiplied support by a factor of nearly three.

Mr. Milburn

Does the Minister accept that there is a crisis in public confidence about care in the community policies that has culminated in today's report on the tragic toll of suicides and homicides involving severely mentally ill people? Has not the Government's mismanagement of mental health policy left the NHS in the worst of all possible worlds—with too few beds in hospitals, inadequate facilities in the community and a shortage of trained staff in both? Surely the Minister does not believe that vulnerable people should simply be left to fend for themselves. When will he address the serious shortcomings identified in the report in order to help to avert further tragedies in future?

Mr. Dorrell

In dealing with this subject, the House is dealing with two separate issues: when answering my hon. Friend the Member for Broxbourne (Mrs. Roe) I dealt with community care for elderly people; my answer to the two questions from the Opposition involves community care for the mentally ill. I might have hoped that, when he referred to the confidential report, the hon. Member for Darlington (Mr. Milburn) would draw attention to the fact that it demonstrates that, despite public perceptions to the contrary, there has not been—

Mr. Milburn

That is the point.

Mr. Dorrell

The hon. Gentleman says that the perception is the point. The fact that there has not been an increase in the number of homicides caused by people suffering from mental illness is important. It does not excuse—

Mr. Milburn

One is too many.

Mr. Dorrell

One is too many, of course, but there is no rising trend.

To improve the quality of mental health services, we must first define our objectives. That is why we are setting out a charter to state the objectives. Secondly, we must ensure that the resources flow to deliver the improvement of mental health services that we all want. That is why, at Budget time, I announced an extra £50 million of public money over two years to enhance the resources available to develop mental health services.