Care in the Community (Hansard, 20 October 1988)

§ The Earl of Arran
My Lords, we are conscious of the public feeling that our response should not be long delayed and I can assure the House that the Government have not been idle on this issue. They are giving careful consideration to the way forward and taking careful account of the numerous representations they have received. However we cannot yet say when we shall be able to put forward our own proposals.

§ The Countess of Mar
My Lords, perhaps I may thank the noble Earl for that slightly encouraging reply. We have now been waiting nearly 10 years for a comprehensive community care policy from this Government. Will the noble Earl say whether or not they accept all that is in the Griffiths Report, how much communication there will be between the Department of Health, the Department of Social Security and the Department of the Environment, all of which are involved in producing a new policy?

§ The Earl of Arran
My Lords, we recognise the concern that the uncertainty should be ended. We certainly acknowledge the need for vigorous action after this period of scrutiny and review has concluded.

§ Baroness Cox
My Lords. is my noble friend aware that many health care professionals are deeply worried about some of the recommendations in the Griffiths Report and rather hope that they will not be implemented? They are especially concerned about the lack of clinical expertise in the social services and their appropriateness for providing for the growing number of patients coming into the community with very complex clinical problems.

§ The Earl of Arran
My Lords, I take very careful note of what my noble friend has said.

§ Lord Ennals
My Lords, apart from the point made by the noble Baroness, will the Minister broadly accept that across the political spectrum and within the statutory and voluntary organisations there is a consensus that the proposals of Sir Roy Griffiths are about right? Does he further accept that the main organisations involved with community care recognise that there is a growing crisis in providing the services needed by some of the most vulnerable people in our society? Finally, will he accept that some of the concerns are now turning into anger that for so long the Government have refused to give a lead?

§ The Earl of Arran
My Lords, in response to the points made by the noble Lord, Lord Ennals, as I say, we recognise that the state of uncertainty is worrying but there is no reason why health authorities should not press ahead with existing plans and seek to continue their progress.

§ Lord Renton
My Lords, is my noble friend aware that since 1980 it has been the Government's policy—and they have done something about it—to get mentally handicapped people out of long-stay hospitals? Is he further aware that the most satisfactory means of achieving that is to enable the voluntary associations, such as MENCAP, to set up small establishments where those people can be looked after as part of the community? Can he say to what extent the Government are helping in the pursuit of that policy?

§ The Earl of Arran
My Lords, in response to my noble friend's point, I am aware of those matters but I stress that it would be wrong and inappropriate to pre-empt our decisions on Sir Roy's report by debating individual proposals now.

§ Baroness Turner of Camden
My Lords, does the Minister agree that nowadays community care mostly falls very heavily on the shoulders of women often in late or middle age and that without adequate support services, as recommended, the position of such people can rapidly become quite intolerable, as much of the recent publicity has shown? Would the Minister care to comment on that?

§ The Earl of Arran
My Lords, once again, all I can say in response to the point made by the noble Baroness is that I take careful note of it and it is one of the points under consideration in Sir Roy's report.

§ Lord Cledwyn of Penrhos
My Lords, the noble Earl has said that the reason for the Government's delay in responding to the Griffiths Report is that they are working very hard indeed on this, taking advice, listening to people and so on. Can he say, therefore, that at the appropriate moment when the studies are over, the Government will produce a White Paper on Government policy on community care?

§ The Earl of Arran
My Lords, I do not believe that I can exactly answer the question put by the noble Lord the Leader of the Opposition. However, I should like to make one point because there has been a certain amount of criticism in your Lordships' House this afternoon. In dealing with the community care situation we are dealing with government expenditure of some £6 billion. To act too hastily would be improper and unwise.

§ Baroness Masham of Ilton
My Lords, referring to the mentally ill, will the Government look very carefully at the very worrying increase in arsonists and will they work very closely with the Home Office to see where those people should be treated, whether in health or penal institutions?

§ The Earl of Arran
My Lords, I pay attention to the point raised by my noble friend.

§ Lord Dean of Beswick
My Lords, will the Government give very deep consideration to those parts of the report which suggest that some of the community services which were taken away from local authorities during the last reorganisation of the National Health Service could be returned to those local authorities, which in the main carried them out exceedingly well and were closer to the needs of people than the National Health Service could ever he, no matter how good it is?

§ The Earl of Arran
My Lords, that again is among the points that the Government are currently considering as a result of Sir Roy's proposals.

§ Baroness Macleod of Borve
My Lords, there is a recommendation in the report that a great number of managers should be put in place. If the report is implemented will the noble Earl ensure that those managers are trained and qualified, unlike the ones now serving in the NHS?

§ The Earl of Arran
My Lords, once again I believe that it would be wrong for me to give any decision upon that until we are aware of the Government's response to Sir Roy's proposals.

§ Lady Kinloss
My Lords, can the Minister say whether the Government are satisfied that local authorities will have sufficient funds and expertise for care in the community in view of the report of the 1252 Office of Population, Censuses and Surveys, Social Services Division, which finds that there are more adult disabled in Great Britain than it was thought?

§ The Earl of Arran
My Lords, that is a particularly close point and I believe it to be somewhat wide of the Question on the Order Paper. However, it is a point on which I shall undertake to write to the noble Lady.

§ The Countess of Mar
My Lords, in answer to a previous question the noble Earl said that there was no reason why the health authorities should not press ahead with plans to put people into the community. If that is the case, will he please tell the Department of Social Security and the Department of the Environment that they must co-ordinate their policies, because people are being discharged into the community and the Department of Social Security is refusing to pay for them?

§ The Earl of Arran
My Lords, that is something of which we shall certainly take note.