Psychiatric and Long-stay Hospitals: Renovation (Hansard, 11 March 1985)

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

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)
My Lords, although a substantial amount of such work has taken place during the period in question, we do not hold information centrally on the renovation of individual psychiatric and long-stay hospitals. Of the new hospital building schemes currently at the stage of planning, design or construction and individually costing over £2 million, 51 consist either wholly or partly of accommodation for mental illness, mental handicap or geriatric services.

§ Lord Auckland
My Lords, I thank my noble friend the Minister for that Answer, which is satisfactory as far as it goes. Is he aware that for many years I served on the committee of a mental hospital in an area where there are several of these establishments? Can he say whether there is progress on the "villa" system as opposed to the long, institutionalised wards? Can he also say what provision is being made for elderly geriatric patients who will spend most of their lives in these establishments? Can he, finally, say what provision is being made for employment, particularly through industrial workshops, in regard to these hospitals?

§ Lord Glenarthur
Yes, my Lords, I am aware of the involvement of my noble friend in this matter. With regard to the last part of his supplementary question, on the industrial workshops, I do not have figures, but I shall certainly do my best to find out and let my noble friend know. I am aware from those hospitals I have seen in the Epsom cluster, which, I think, are those to which he refers, that certainly they do a great deal of good. What I have said does not really cover the whole story because the 51 schemes are only part of health authorities' programmes which are made up of schemes of £2 million and more. Much refurbishment work and the development of community-based schemes has taken place and it continues to do so in projects falling below that figure as well. So I can tell my noble friend that the picture is in fact encouraging.

§ Lord Ennals
My Lords, with regard to the noble Lord's first Answer, would it not be better if he did have information centrally? But, secondly, is it not even more important that residential accommodation should be made available in the community for many of these long-stay psychiatric patients who no longer need hospital care? Can the noble Lord say how much additional accommodation has been provided in the community under the Government's so-called "community care" programme? To what extent does the noble Lord expect this to be affected by reductions in rate support grant and by rate capping?

§ Lord Glenarthur
My Lords, the reason it is not possible to get all the figures for which the original Question asked is really a matter of cost. These things are done locally and to have collected all the costs would have been disproportionate to the value in this particular case. With regard to care in the community, the noble Lord will be aware that the recent report of the Social Services Select Committee in another place broadly endorses the Government's policy in this area. With regard to rate capping, I can tell the noble Lord 5 that it will be for the authorities which are affected by rates control themselves to decide how staying within their expenditure limits will affect spending on particular services. It does not follow that reductions will apply equally or across the board and very many authorities have shown that it is possible to protect services for the most vulnerable and at the same time restrain their expenditure.

§ Baroness Faithfull
My Lords, may I ask my noble friend the Minister what is happening to the wards that have been emptied as a result of the number of hospitals being cut down because of community care? Does he not agree that many of the hospitals have large wards that are being put to no use whatsoever?

§ Lord Glenarthur
Yes, my Lords, in most cases where there is a plan to close a hospital the wards will remain empty until such time as the hospital concerned closes altogether. When such hospitals close altogether, which will happen over a period of years in many cases, the hospitals will be sold and the proceeds will accrue to either the district or the region concerned.

§ Lord Kilmarnock
My Lords, will not the noble Lord take another look at the possibility of exempting from rate capping joint funding arrangements where they apply to the rehousing of the mentally handicapped and the mentally ill in the community, particularly in those cases where the National Health Service contribution has run out and the cost all falls on the local authority?

§ Lord Glenarthur
My Lords, the health side of joint funding already does not form part of that which can be rate capped under the arrangements to which the noble Lord refers.

§ Lord Allen of Abbeydale
My Lords, I suppose that Broadmoor counts as a psychiatric hospital. Can the Minister tell us when the very extensive works which have now been begun there are likely to be completed, and how many patients the new hospital will accommodate?

§ Lord Glenarthur
My Lords, the hospital is being completely redeveloped over a period of 15 years. I cannot state what will be the total number of patients accommodated when the hospital is complete.

§ Lord Kilmarnock
My Lords, with joint funding, is it not so that what the noble Lord has said is not the case for time expired schemes?

§ Lord Glenarthur
Yes, my Lords; but one has to look to other parts of the country where the policies which the Government are pursuing in this area are proving to be successful. Those that want to make a success of it can make a success of it. This has been shown and I can give the noble Lord several examples.

§ Baroness Macleod of Borve
My Lords, can my noble friend the Minister assure the House that if patients are sent out of hospitals into care in the community, they will not be put into only bed and breakfast accommodation where during the day they 6 are not allowed to remain within the walls of the hotel, hostel or wherever they are placed? Such practice has been known. The Minister may know of cases; or, if I know of any, may I bring them to his attention?

§ Lord Glenarthur
Yes, my Lords—certainly. If my noble friend has any particular examples, I shall be delighted to take them up. It is essentially a matter for the authorities themselves to look into these particular problems. I can tell my noble friend that it is not the case, as so often appears from the media, that great numbers of people are likely to be discharged from our mental illness hospitals. The majority of those now in such hospitals need to remain there, and there will not be any huge further reduction in patient numbers.

§ Lord Taylor of Blackburn
My Lords, will the Minister watch "Panorama" this evening, which will inform him of the figures he is now seeking?

§ Lord Glenarthur
My Lords, I shall certainly watch "Panorama"; I saw a trailer for it last night.

§ Lord Molloy
My Lords, can the Minister give an assurance that, when area health authorities announce the impending closure of psychiatric hospitals and the views of the authority are not clear, and representations are made by the British Medical Association and the Confederation of Health Service Employees, their views are taken into consideration? If that is not done now, can they be taken into consideration in future?

§ Lord Glenarthur
My Lords, as I have told the noble Lord on numerous occasions, the views of the BMA and of the Confederation of Health Service Employees are always taken into account.