Mentally Handicapped Children: Accommodation (Hansard, 10 February 1982)

Lord Campbell of Croy
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Elton)
My Lords, the number of children resident in all mental handicap hospitals and units has fallen from 7,100 in 1969 to around 2,000 now. Very few are at present being admitted for long term care, so we expect the numbers to continue to fall. In addition, we have asked health and local authorities to co-operate in planning alternative forms of care. We have also launched a scheme for voluntary agencies matching pound-for-pound money spent by them in getting mentally handicapped children out of large institutions. The funding for this is £1 million over four years.

Lord Campbell of Croy
My Lords, I thank my noble friend for that Answer. Is he aware that the Government's recent announcement on policy was welcome to all concerned with the best interests of mentally handicapped children? While a small proportion of such children may need the care and attention of a hospital, will the Government make sure that the difference between mental handicap and mental illness is clearly recognised? Most children who are mentally handicapped can live outside a hospital and should be enabled to do so.

§ Lord Elton
My Lords, I am grateful for my noble friend's comments. Our awareness of the distinction between mental handicap and mental illness has been made manifestly clear in the amendments which we have put into the Mental Health (Amendment) Bill, at present before your Lordships' House. On the question of getting mentally handicapped children into the community, I would take the opportunity to commend to your Lordships a small blue book which was commissioned from Ann Shearer to show the various ways by which this can be done. I have a few spare copies if noble Lords are interested.

§ Lord Wells-Pestell
My Lords, may I ask the noble Lord the Minister whether I have understood him correctly: that about 5,000 mentally handicapped persons have left institutions and, presumably, have returned to the community? Is the noble Lord 172 able to say where they have gone? Have they gone home? Or have they gone to other institutions run by voluntary organisations or local authorities? And can the noble Lord say whether the department are satisfied with the care they are getting now?

§ Lord Elton
My Lords, the Question addressed itself to children and the figures I gave related to children. However, there has been a steady move into the community of all age groups. They go to local authority provision, to voluntary provision, to private provision and, in some cases, into individual homes. The supervision of all but the latter is normally the responsibility of the local authority concerned. I am not aware of any defects in that provision. If the noble Lord has reservations, 1 should be very glad to hear of them.

Lord Winstanley
My Lords, bearing in mind the fact that some children, mentally handicapped and otherwise, have to remain in hospital for long periods, would the noble Lord the Minister agree that we ought to do everything possible to develop more small family based hospital units, and that we ought to do something to halt the continual closure of small hospitals, something which has been going on for very many years?

§ Lord Elton
My Lords, I agree entirely that some children, sadly, will have to stay for a long time in institutions. I agree also that those institutions are usually better when they are small than when they are big. That is part of the Government's point of view. I can endorse what the noble Lord says in that respect.

§ Baroness Masham of Won
My Lords, may I ask the Minister how many local authorities are undertaking fostering schemes for handicapped children, and whether these are working well?

§ Lord Elton
My Lords, there is a growth in fostering schemes for handicapped children. At present it is on a fairly small scale. I think that the experience of those authorities which at present are running schemes will be of great benefit to other authorities who, I hope, will follow their example.

§ Baroness Faithfull
My Lords, may I thank the Minister for his mention of voluntary organisations. If local authorities are in financial difficulties—and many of them are—may I remind the noble Lord that the voluntary organisations (I am vice-chairman of Dr. Barnardo's) are running special small units for mentally handicapped children in the community? I would only say—

Several noble Lords
Question!

§ Baroness Faithfull
My Lords, is the Minister aware—he must be aware, because he is giving us pound for pound! May I thank the Minister for the trust which he puts in the voluntary organisations which are doing this work.

§ Lord Elton
My Lords, I am even more aware than I was before of the value of this work. The noble 173 Baroness will be aware of the high regard in which she is held by this House in that it allowed her to trespass for so long!

Lord Wallace of Coslany
My Lords, is the noble Lord aware that the Government's very welcome amendments to the Bill which is at present before the House will make this matter very important and urgent'? Will he hear in mind that it is possible that some extensions to local hospitals, as indicated by the noble Lord, Lord Winstanley, could be the answer for those children who are in need of hospital care?

§ Lord Elton
My Lords, in reply to the noble Lord's question I ought perhaps to say, although the noble Lord is well aware of it, that the Bill relates only to detained patients who do not impinge very significantly upon what we are looking at this afternoon. However, I will bear carefully in mind the rest of what the noble Lord has said.

§ Lord Glenamara
My Lords, will the noble Lord say a little more about the pound-for-pound scheme? Does it apply to capital works or to current expenditure or to both? And will it apply to such excellent voluntary institutions as the Maclntyre Homes in Bedfordshire, of which I am sure the noble Lord is aware?

§ Lord Elton
My Lords, while I cannot give the position on an individual scheme, I can say that in general principle the pound-for-pound scheme is basically a one-off payment for capital expenditure, for the conversion of buildings and such like. But there are occasions when we are prepared to look at schemes where there is an initial revenue expenditure which is heavy, and which a voluntary organisation might not undertake in view of the risks entailed, but we think the risk is worth taking to see whether the scheme works. It is for capital schemes, basically.

§ Lord Auckland
My Lords, in support of the figures which my noble friend has given, will he undertake to try to ensure that the 2,000 children who are still in these large institutions will be as far as possible put into villa-type care, where the wards concerned can be made to look far more cheerful and suitable for children than can the large institution?

§ Lord Elton
Yes, my Lords; we are well aware of the advantages of small units. They have to be considered in conjunction with any medical requirements that the children may have and the possibility of providing them in small, separate units. I am very well aware of the advantages of having these places near the children's homes.