HC Deb 16 January 1996 vol 269 cc524-6
2. Mr. David Atkinson

To ask the Secretary of State for Health what has been the change in the number of psychiatric community nurses since 1979. [7492]

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

The number of whole-time equivalent nurses working in the community psychiatric area has increased from 1,080 in 1981, which is the earliest year for which figures are available, to 4,760 in 1994, an increase of 340 per cent.

Mr. Atkinson

While I think that my hon. Friend and his predecessor should be given full credit for that impressive increase, which clearly demonstrates the Government's commitment to the mentally ill, does he agree that his Department's report into homicides and suicides by mentally ill people provides even more evidence that there are still not enough psychiatric community nurses to go round to give that essential face-to-face contact with patients—especially schizophrenia patients—to make a success of our community care approach?

In the light of the patients charter for the mentally ill, which our right hon. Friend the Secretary of State has recently announced, can my hon. Friend now announce a further substantial increase in the number of psychiatric community nurses?

Mr. Bowis

My hon. Friend has referred to the confidential inquiry report, which was set against the background of a decreasing proportion of homicides committed by mentally ill people.

Any homicide or act of violence against oneself or somebody else is a matter of concern to us, which is why we asked the inquiry to investigate whether there are common threads that run through such cases. The thread it highlighted is professionals' failure, in some cases, to communicate with each other. That observation ties in with the requirements that my right hon. Friend the Secretary of State has placed on every health authority in the country to report to us on the state of the care programme, the mix of beds and community services and the plans that they have in each case to correct any shortcomings.

We shall look carefully at all those programmes to ensure that the service in every district is up to the standard that we know exists in the best districts.

Dr. Wright

How does the Minister's reply relate to the case of my constituent, Dylan Thomas Jones, a mentally ill patient about whom I wrote to every agency that was involved in his case? I told them that he was likely to kill either himself or someone else unless the most urgent action was taken. A few weeks ago, he killed himself. I wrote to the Department of Health to say that that might happen.

May I tell the Minister that, as far as the people of this country are concerned, including Mr. Jones' mother, community care for that category of patient has become a euphemism for the most monstrous neglect? Instead of waiting for another inquiry or another such death, will the Minister tell us what the Government are going to do about the problem?

Mr. Bowis

That case is a tragedy, and we feel for the family or families concerned. After any such case, the Department of Health and the national health service order a full investigation into what has gone wrong. The lessons learnt are fed into the programming and planning of our mental health services. I can make that pledge, today and always, to the hon. Gentleman.

In return, I hope that the hon. Gentleman will have the goodness to acknowledge the real progress made in the care and treatment of mentally ill people, which is much more humane than it was some decades ago. Dedicated doctors, nurses and social workers are working with families and individuals to make that possible. When Professor Norman Sartorius, the distinguished president of the World Psychiatry Association, came to Britain, he said: Our recent developments in improving mental health services will ensure that the UK continues to lead the world in this area". We should listen to that lesson, learn from it, and pay tribute to the work of our professionals, rather than downgrade them and abuse them every time we speak in the House on a particular case.

Lady Olga Maitland

I congratulate my hon. Friend on developing the community psychiatric nurse programme. Is he aware that there are times when that programme plays a crucial role in rescuing someone who is suffering from mental illness and ensuring that he reaches the appropriate help in time? Does he agree that his programme has now developed fourfold since the Government came to power? That is a far cry from the Labour party, which talked and talked, but did nothing.

Mr. Bowls

My hon. Friend is right—the programme has developed since those days because the Government have made it a priority. My hon. Friend is also right to pay particular attention to psychiatric nurses working in the community and to others who act as the key workers in each case. Every patient who is discharged from hospital care or the mental health services should have a care programme around him or her, monitored and led by the key worker who is often a nurse and who is able to spot things when they are going wrong and alert the necessary professionals to help the individual get through the crisis that he or she may be suffering. If we work towards that end, we shall have a service that is in the best interests of both patients and the wider community.