HL Deb 06 July 1983 vol 443 cc564-6

2.53 p.m.

Baroness Lane-Fox

My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government what progress has been made to take mentally handicapped children out of National Health Service hospitals.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)

My Lords, the Government have launched a number of initiatives designed to get mentally handicapped children out of hospital and into more suitable settings according to their needs. These included asking every district health authority to review jointly with local authorities the needs of every mentally handicapped child in hospital; financial initiatives to help health authorities with special problems provide more homely units for children needing continuous care in a health setting and to match money raised by voluntary bodies; and an extension of joint finance arrangements.

Baroness Lane-Fox

My Lords, after that very encouraging Answer, I should like to ask my noble friend the Minister: what response was received from health authorities with regard to the request from the Government to set a date to get mentally handicapped children out of hospital?

Lord Glenarthur

My Lords, we have not actually set a date, because setting a date could put unhelpful pressure on authorities to move children before adequate alternative provision has been made. We want to see children in more appropriate care which is suited to their needs. However, in amplification of what I said in my original Answer, regional health authorities are being asked in annual reviews to monitor and report the progress that their districts are making and when they expect to be in a position to say that all children are appropriately located. I am glad to say that progress is good.

Baroness Jeger

My Lords, can the Minister assure the House that local authorities will not be penalised if they spend money on this excellent objective? Is there not a difficulty, in view of the present Government's attitude to local finance, that there may be some hesitation on the part of local authorities to incur any expense? Does he not agree that there is no saving in money in taking mentally handicapped children out of hospitals, and that that is not why we do it? Would he be prepared to ensure that local authorities that spend extra money on giving children this type of care will not be penalised?

Lord Glenarthur

No, my Lords, there is absolutely no suggestion that they should be penalised, and that is why the joint finance arrangements are going to be helpful and, in my view, are encouraging.

Lord Winstanley

My Lords, I should like to ask the Minister two questions. First, will the Government look again at the rules governing eligibility for the attendance allowance and for the invalid care allowance in so far as they affect mentally handicapped children, bearing in mind that those benefits have an important relationship to the possibility of these children being cared for in the community? Secondly, is the noble Lord in a position to tell the House that the grants given to voluntary bodies such as the Elizabeth Fitzroy Trust and many others, which provide excellent, small, family-type units for the care of mentally handicapped children, will be maintained in real terms, and that local authorities will be enabled to pay their share of the support costs for mentally handicapped children who are cared for in those homes, without which a much heavier burden would fall on National Health Service hospitals?

Lord Glenarthur

My Lords, so far as the attendance allowance is concerned, a change in the regulations has been under consideration for some time to remove the difference as soon as funds can be made available. In reply to a Written Question in another place on Thursday, 30th June, my honourable friend the Minister for the Disabled announced that, from August, the four-week concession will be available to children who enter residential accommodation. As regards the voluntary bodies and Government help to them, the pound for pound scheme, under which we allocated£1 million over four years to match money raised by voluntary bodies, has already led to four successful bids totalling£480,000 and involving the removal of about 40 children from hospital. There are a number of other applications in the pipeline.

Baroness Masham of Ilton

My Lords, can the Minister say whether regions and health districts are doing as much about not getting children into hospital as they are about getting them out? There are new handicapped children born every day who are rejected, or who, when they become older, will become too much for their parents. Is the Minister aware that it is a question of not letting them get in as well as a question of getting them out?

Lord Glenarthur

Yes, my Lords, I fully accept what the noble Baroness says. There will always be some children, unfortunately, who need continuous health care, but, of course, consideration is being given the whole time to trying to keep people out and not having to remove them once they are there.

Baroness Lane-Fox

My Lords, can my noble friend the Minister tell me what help is being given by the Government to local authorities to provide the small homely units in which some children will be more appropriately looked after?

Lord Glenarthur

My Lords, earlier this year we launched a scheme making£3 million a year available for three years to help health authorities with special problems make better provision in the way in which my noble friend suggests, that is to say, making better provision for children who need continuous health care. The scheme is designed to get mentally handicapped children in hospitals more appropriately placed, and to encourage districts which at present have no provision of their own for children to set up small homely units. So far there have been 70 bids for this money, and we hope to announce approval of the first successful scheme shortly.

Lord Banks

My Lords, in view of the welcome answer given to my noble friend on the question of the attendance allowance, will the Government declare an amnesty for those parents who, because the regulations are so complicated, inadvertently claimed this allowance while their children were in hostels, and who are now being asked to repay it?

Lord Glenarthur

My Lords, I cannot undertake that the Government will agree to an amnesty such as the noble Lord suggests. The regulations will apply from August, but they will not have retrospective effect, and any parent who is aware that he or she has received an overpayment of attendance allowance should tell the department. Of course, the department has a duty to seek repayment of overpaid benefits to protect public funds, but the noble Lord I think might bear in mind that many parents have notified us of these periods in which they were not entitled to payment. However, I know that this is a sensitive problem. Even when repayment is required, not all cases are pursued; for instance, where there is financial difficulty.

Lord Ezra

My Lords, I should like to ask the noble Lord the Minister whether, in pursuit of this humanitarian objective, the Government are putting aside funds to aid medical research to deal with these unfortunate conditions shortly after birth. If we can save children from getting into these conditions after birth, then obviously the whole problem can be very much diminished.

Lord Glenarthur

My Lords, I do not know the details that would enable me to give a specific answer to the noble Lord, but I am quite certain that research is being carried out the whole time in the way in which he suggests.