§ 2.52 p.m.
§ Lord Mottistone asked Her Majesty's Government:
§ Whether the ministerial statement in a Lords debate on 7th December 1988, that the 174 Department of Health did not have forecasts for future closures of mental illness and mental handicap beds (Official Report, col. 655), took account of the South-East Thames Regional Health Authority statement in October last that its seven large mental illness hospitals, with 3,500 patients at the end of 1986, are being run down and closed over the next decade.
§ The Earl of ArranMy Lords, the Government do not formally collect statistics on potential closures, only on hospitals actually approved for closure. We are of course aware of long-term strategies which will involve closures, but these do not enable us to forecast accurately future bed closures.
§ Lord MottistoneMy Lords, I thank my noble friend for that Answer, which did not help us very much. Does he remember that he has said, among other things:
We do not have forecasts for future closures."—[Official Report, 7/12/88; col. 655.]Is he also aware that in September of last year, before he said that, the South-East Thames Regional Health Authority referred in its document Mental Illness Services to:seven large mental health illness hospitals which are being run down and closed over the next decade"?Was my noble friend aware of that fact? 1f he was not aware of it, does he think that it would be a good thing if central government were aware of the comments of regional health authorities?
§ The Earl of ArranMy Lords, plans change and eventual outcomes do not always match initial proposals. In that context, it is quite reasonable to collect formal statistics only on hospitals approved for closure. We are at all times aware of future plans in a general sense through the normal planning and reporting processes such as short-term programmes and regional strategies.
§ Baroness FaithfullMy Lords, if mental hospitals are to be closed, what alternatives are there in the community for the patients? In addition, when will the Griffiths Report be implemented?
§ The Earl of ArranMy Lords, I shall take the second part of my noble friend's question first. I know of your Lordships' keenness and anxiety about the Griffiths Report. As my right honourable friend the Secretary of State has recently said in another place, proposals will be implemented in the near future. I shall now take the first part of my noble friend's question. The Government's long-standing policy is that people with mental illness should have access to all the services that they need as locally as possible. Our aim is to have a full range of local services such as in-patient and day hospital facilities, day centres, residential homes, hostels, sheltered accommodation, supported lodging or special fostering schemes, group homes, drop-in centres, sheltered workshops, social clubs and self-help groups, as well as education, training and employment services.
§ Lord CarterMy Lords, if we follow on from that last answer, is the Minister aware that implementation of Section 7 of the Disabled Persons (Services, Consultation and Representation) Act 1986 would go some way to removing many of the fears regarding the closure of hospitals for patients with mental illness or mental handicap? Does the Minister agree that implementation of Section 7 of the 1986 Act would make discharge without regard to the patient's requirements a thing of the past?
§ The Earl of ArranMy Lords, as part of the discussions on the implementation of the Act, officials from the department met with local authority representatives last November and a further meeting has been arranged for March this year. The timetable for implementation will depend upon the outcome of discussions with local authority and health authority representatives.
§ Lord Allen of AbbeydaleMy Lords, will the Minister tell us whether there is a real prospect of this section being implemented before we reach the third anniversary of the date on which Royal Assent was given to the 1986 Act that— is, 8th July next?
§ The Earl of ArranMy Lords, I regret that I do not think that I can give the undertaking that the noble Lord seeks.
§ Lord Prys-DaviesMy Lords, only about a year ago, the Department of Health said that 28 hospitals for the mentally handicapped were scheduled to close by 1990 and that 35 hospitals for the mentally ill were scheduled to close by 1995. Is that still the position? Will the Minister place in the Library a list of the hospitals for which a closure date has been agreed and a list of the hospitals for which a closure date is still subject to consultation? I believe that those lists would answer the request made by my noble friend Lord Carter in the debate on 7th December last.
§ The Earl of ArranMy Lords, as regards the closure of hospitals, I can place in the Library a list of the particular hospitals due for closure in the South-East Thames Regional Health Authority area. As regards the other part of the noble Lord's question, the department continues to emphasise that no closure of a mental hospital should proceed until a careful assessment of all existing patients' needs has been made and alternative services appropriate to those needs have been provided. As a consequence of the development of comprehensive locally based psychiatric services and only as better alternative services are provided will those mental illness hospitals close which are not needed as part of the developing pattern of district services. The closure of hospitals is not a primary aim.
§ Lord MottistoneMy Lords, do I gather from my noble friend that approval of the closure of mental hospitals is being slowed down compared with a year ago? Do I also gather that such closures will not be approved and those hospitals will not be closed down if facilities for the mentally ill and mentally handicapped people are not available in the community?
§ The Earl of ArranMy Lords, my noble friend is quite right. It is of prime importance to see that the services in the community are appropriate for those coming out of mental illness hospitals.
§ Lord Elwyn-JonesMy Lords, are not the voluntary organisations that are trying to fill the gap which now exists between closure and some provision in the community facing very grave difficulties? Are the Government prepared to assist the voluntary associations which are being impoverished by this burden?
§ The Earl of ArranMy Lords, the answer to that is not totally clear. It is a point on which I should wish to correspond with the noble and learned Lord.