Psychiatric Secure Units (Hansard, 15 July 1982)

§ Lord Allen of Abbeydale
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 Trefgarne)
My Lords, revenue of £10.5 million has been made available for current spending in 1982–83 for the development of regional secure units and interim secure facilities. Capital amounting to £10.8 million 465 for this financial year has been set aside for approved permanent schemes. The 30-place unit at St. Luke's Hospital, Middlesbrough is as yet the only permanent unit operational, though by the end of the financial year 120 places are expected to be available.

§ Lord Allen of Abbeydale
My Lords, while I thank the noble Minister for that reply, I am bound to say I found it less encouraging than I had hoped. The painfully slow progress of this programme, going back over eight years or so, is not one of the major glories of our island story. May I ask the Minister whether the sums he has referred to as being allotted this year will all be spent on these units and not diverted to other purposes, as has happened in the past?

§ Lord Trefgarne
My Lords, I recognise that progress on these schemes has been slower than we would have wished. However, in addition to the total of 120 places which will be available by the end of the current financial year, 240 places are currently under construction and 90 further places are to be started, hopefully, before the end of this calendar year.
On the question of funds, I cannot give the noble Lord the assurance for which he asks: namely, that all the funds to be allocated will be used for these purposes in the current financial year, but the majority of funds will be; and where they are not used precisely for the RSU programme they will be used in general for psychiatric purposes of one kind or another.

§ Lord Wells-Pestell
My Lords, may I ask the Minister whether he can indicate to the House how much money has, in fact, been given by Governments over the last eight years for this purpose, and how much of it has not been used by the regions, which have used the money, in some cases, for entirely other purposes?

§ Lord Trefgarne
My Lords, the noble Lord will be aware that the designation of funds for this purpose is a curiosity, if I may call it that, in the health service funding generally, because, as a matter of usual course, we do not specify precisely the purpose for which funds which we supply should be used. In fact, £54.7 million has been provided for revenue purposes and £20.3 million for capital purposes in the financial year since 1976/77. I cannot say offhand what percentage of those figures has been used precisely for RSU purposes. But I can say that, during the period that we are discussing, in addition to the creation of the small number of permanent places to which I referred earlier, more than 500 interim places have been provided and, of course, it would be quite proper for the funds to be used for that purpose.

§ Baroness Trumpington
My Lords, may I ask my noble friend whether the Government control in any way the geographical area to which funds are given? Would I be right in thinking that there might be a catchment area problem? It is no good having 220 places in one part of the country, which would be lovely for that area, if another area cannot get secure places because they are outside its catchment area.

§ Lord Trefgarne
My Lords, the system is that funds are provided to each regional health authority for this purpose, and they propose plans for the precise number of places that they think appropriate for their particular region.

§ Lord Avebury
My Lords, may I ask—

§ Baroness Masham of Ilton
My Lords, may I ask the Minister whether only two-thirds of the unit at St Luke's Hospital is being used, because, when I visited it a few months ago, one-third of the beds were closed because of lack of staff? Would he see that there are enough trained staff in the forensic-psychiatric-medical field, particularly senior registrars?

§ Lord Trefgarne
My Lords, my understanding is that the RSU at St Luke's Hospital, Middlesbrough, is fully operational. But I will look into that and, if I am wrong, will write to the noble Baroness.

§ Lord Avebury
My Lords—

§ Lord Harris of Greenwich
My Lords, may I ask the Minister whether he is aware that there are some aspects of the Answer which he has given today which fill a number of us with a great deal of concern, particularly the suggestion that if the money is not used for regional secure units it will be used for other psychiatric purposes? Is he aware that his department has an unenviable record of diverting money in this way, not only during the lifetime of the present Administration but during the lifetime of previous Administrations? Finally, is he aware that, until we make major progress in the development of regional secure units of this kind, we shall not be able to get severely mentally disturbed people out of our prison system and, therefore, we shall continue with the scandalous situation of the mentally ill being kept in prison?

§ Lord Trefgarne
My Lords, I certainly agree that the facilities to be provided by the RSUs will form an essential feature of the range of options available with regard to the detention of mentally disturbed people. I would certainly agree with the thought behind the question of the noble Lord, that prison is the wrong place for the great majority of them. There are difficulties in creating these facilities—for example, in planning permissions—which sometimes cause a great deal of delay, and I think it is right that the funds that are earmarked for this purpose are, with the necessary authority, sometimes used for interim facilities, in particular, pending the completion of the permanent facilities which the noble Lord has asked me about.

§ Lord Avebury
My Lords—

§ Lord Beswick
My Lords—

§ The Lord Privy Seal (Baroness Young)
My Lords, the noble Lord, Lord Avebury, has been trying to get in and has twice given up his place to other Peers. May I suggest that he asks his question and then we move on to the next business, as we have had 33 minutes on Questions.

§ Lord Avebury
My Lords, I am much obliged to the noble Baroness. Did the figures which the noble Lord gave for capital and revenue expenditure include spending by the regional authorities on the interim secure units? Is the noble Lord aware that, even though obviously, in the long term we must have the permanent facilities, the interim secure units are doing a very good job and, at any rate at the one in Beckenham, patients and staff mix in a reasonably civilised atmosphere which would be a lesson to the prison service on how to contain potentially violent and refractory men?

§ Lord Trefgarne
My Lords, I certainly agree that the interim facilities which have been provided play a very important part in this matter. But the security provided in RSUs, whether they be interim or permanent, is not of the same order as is provided in, for example, the special hospitals, and it forms an important halfway house, if that is the right term to use, between special hospitals, on the one hand, and ordinary psychiatric hospitals, on the other.