HL Deb 07 March 1988 vol 494 cc424-5

2.45 p.m.

Lord Allen of Abbeydale asked Her Majesty's Government:

When they intend to bring into force Section 7 of the Disabled Persons (Services, Consultation and Representation) Act 1986 relating to forward planning for persons discharged from hospital after treatment for at least six months for mental disorder.

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

My Lords, officials of the Department of Health and Social Security have opened discussions with local authority representatives on Section 7 as part of a continuing dialogue on implementation of the Act. It will be necessary to involve health authority representatives later as the section places obligations on them as well. Officials are seeking to agree a timetable as soon as possible for bringing Section 7 into force.

Lord Allen of Abbeydale

My Lords, I am much obliged to the noble Lord for that Answer, which is slightly more encouraging than I had expected. The Act, which was supported on all sides of the House, received the Royal Assent on 8th July 1986. Here we are almost in sight of a time when two years have elapsed before we have a firm date. Does the Minister accept that, if a mentally ill or mentally handicapped person is to be discharged from hospital, an essential part of any policy of care in the community must be that plans should be made in advance for that person? Does he further agree that the present position up and down the country is rather patchy and highly unsatisfactory?

Lord Skelmersdale

My Lords, to put a slightly different gloss on the question asked by the noble Lord, Lord Allen of Abbeydale, since the noble Lord asked a Question of the Government Front Bench on 2nd March last year, six sections of the Act have been implemented. As I say, discussions are under way to bring into force Section 7. The Government have consistently made it clear that the provisions of the Act would have to be introduced gradually, and so that will come as no surprise to the House.

On the other point, Ministers have repeatedly emphasised the importance that they attach to professional teams agreeing individual care plans with each long-stay patient. I made the point in the House last week in answer to a Question from my noble friend Lord Mottistone. Individual care plans are essential for each long-stay patient including, where appropriate, with their families at the time of discharge from hospital.

Lord Campbell of Croy

My Lords, the progress made to enable people with mental disorders to live in the community is welcome. But does my noble friend agree that care and supervision are needed in case of possible relapse and to arrange, if necessary, for return to hospital?

Lord Skelmersdale

Yes, I must certainly agree with my noble friend. A measure of our concern for effective after-care is that we plan to issue detailed guidance about that in two or three months in relation to mental illness. In relation to mentally handicapped people, the problem is much better known and much more widely understood. In terms of the supplementary question asked by the noble Lord, Lord Allen, the situation is not nearly so patchy.

Baroness Faithfull

My Lords, does my noble friend agree that to achieve good community care there must be a sound relationship between health and social services? Does he agree that the training of social workers is vitally important? Will more money be available for the training of social workers?

Lord Skelmersdale

My Lords, yes, I most certainly agree with the premise advanced by my noble friend Lady Faithfull. A £10 million training award was announced recently by my right honourable friend the Minister for Health.

Lord Ennals

My Lords, in view of the increasing number of hasty discharges and the all too frequent re-admissions of those discharged too early, do the Government accept the urgent need for the implementation of the section? Are resources a reason for further delay and, if so, what sort of sums are involved?

Lord Skelmersdale

My Lords, so far as the sums are concerned, this is something which we are discussing with the local authority organisations. It has been suggested in certain quarters that we are talking about up to £25 milion but I would not put too much reliance on that. As regards the general premise of after-care, as I said in my original answer, this is a joint operation between social services departments and district and sometimes regional health authorities. This is another point on which discussions will have to be pursued.

Lady Kinloss

My Lords, is the Minister aware that in 1986, 25,000 people were admitted to hospital with schizophrenia and 90 per cent. of those were readmissions? Can he say whether there was adequate care for them in the period between their admissions? Is it the responsibility of the health authority, or whose responsibility is it?

Lord Skelmersdale

My Lords, no, I could not say that there was adequate care in 100 per cent. of those cases. I should have to look at the individual cases to establish whether there was. Ultimately it is the responsibility of the district health authority.