Maudsley Hospital (Hansard, 22 March 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, we do not accept that there is a crisis. The Bethlem Royal and Maudsley Hospitals Special Health Authority has been allocated a budget of £ 27 million for the coming year. This represents a cash increase of almost £ 2 million or 71 per cent. It is for the authority to decide how best to use this allocation and to make more effective use of its very valuable clinical resources.

§ Lord Rea
My Lords, I thank the Minister for that Answer, but is she not aware that the increase that has been awarded for next year represents a 5 per cent. increase on the current year's funding? However, that is £ 630,000 short of what is required to meet nationally agreed pay scale increases. Does not the noble Baroness agree that it will be inappropriate, with the current accent on community care for the mentally ill, for the hospital which is the leading training school for psychiatric nurses to have to reduce its intake of nurse trainees?

§ Baroness Hooper
My Lords, as I said, we have increased the budget for this special health authority considerably in line with the increases for other special health authorities. The department is currently considering future funding arrangements for such authorities which will seek to safeguard their special interests, particularly in the light of the Government's proposals for the reform of the National Health Service.

§ Lord Mellish
My Lords, is the Minister aware that both the local and national press are complaining that Maudsley, which is one of the wonder hospitals of London as regards looking after mentally ill patients, is facing a crisis? It is no good for the noble Baroness to say that she knows nothing about that. The fact is that every newspaper states that. Why do the Government not take the initiative to get the matter straightened out?

§ Baroness Hooper
My Lords, the Government are taking plenty of initiatives in the field of health care. The measures which are currently being proposed in the Maudsley Hospital reflect the changing pattern of need for mentally handicapped children and seriously disturbed adolescents. The shift in emphasis is to outreach facilities from hospital care. However, we believe that there is inbuilt in the budget and the allocation made to this special health authority the possibility for further savings within the authority's activities.

§ Viscount Mersey
My Lords, will my noble friend comment on the walk-in service for psychiatric out-patients which I believe is managed by the emergency clinic at Maudsley?

§ Baroness Hooper
My Lords, the emergency clinic which provides a 24-hour walk-in service for people with psychiatric problems and a drop-in service for former in-patients is a highly rated service not only by patients who use its facilities but also by local general practitioners, social workers and voluntary organisations. In recognition of that and in addition to the budget increase to which I have referred, the department has agreed to fund a proposal to relocate this emergency clinic in new purpose built facilities on the Maudsley site. That funding amounts to an additional half a million pounds.

§ Lord Ennals
My Lords, is the Minister aware that I am absolutely amazed that she said that there is not a crisis at the Maudsley? A visit to the Maudsley and discussion with the consultants and the management team indicate that it is a crisis which, with a cut of £ 632,000, will mean reductions in the services for seriously mentally ill patients, the mentally handicapped at the Hilda Lewis hospital and the 24-hour emergency drop-in service. Does the Minister accept that the Maudsley is a national flagship of high quality services for the mentally ill and that for that hospital to have to make reductions after it has already made cuts of £ 1–4 million in the last three years is intolerable?

§ Baroness Hooper
My Lords, we recognise that the Maudsley represents a centre of excellence. That is
404 why the Government have supported it and continue to support it. The special health authority is funded in a way which takes account of its teaching and research role. In the case of the examples to which the noble Lord referred— the Hilda Lewis House and the Tyson House adolescent unit— the changes being made are, as I indicated previously, a reflection of the general shift in the pattern of services away from using hospital beds towards outreach programmes in the community.

§ Lord Ennals
Not so!

§ Baroness Seear
My Lords, in view of the anxiety about psychiatric treatment and training at the Maudsley, can the noble Baroness confirm that there is no truth in the rumours that the Cassel Hospital is also under threat of some closures, because that in its turn is an extremely famous hospital providing care and training in the same important field?

§ Baroness Hooper
My Lords, there is a formal procedure which health authorities are required to follow when considering the closure or change of use of health buildings. The proposal to close the Cassel Hospital is currently out for consultation. As the matter may ultimately come before Ministers for decision it is not one on which I can comment. However, I can assure the noble Baroness that should the closure proposal come to Ministers it will receive the most careful consideration before any decision is taken in view of the important work that we recognise is carried on there.

§ The Earl of Listowel
My Lords, following what the noble Baroness, Lady Seear, said, are the Government not already giving serious consideration to the future of Cassel mental hospital at Richmond, which is of national and international importance and not just a local hospital, and in that respect like the Maudsley? Is the noble Baroness aware that a recommendation has been made by the Riverside Health Authority for the closure of the hospital? Since the final decision is to be made in June should not the Government already be giving some consideration to the future of the hospital after June?

§ Baroness Hooper
My Lords, perhaps we are moving away from the Question on the Order Paper. However, in response to the noble Earl, I can say that any application of that kind receives the most careful consideration within the department.

§ Lord Ennals
My Lords, returning to the Question on the Order Paper, will the Minister please discuss the matter with her right honourable friend? Does she recognise that the suggestion that the proposal is all part of a natural tendency to changes in psychiatric services is not accepted at all by the consultants and the doctors at the Maudsley who are horrified by what is about to happen? As president of MIND perhaps I may say that I share their horror. Will the noble Baroness take the matter more seriously and discuss it with the Secretary of State?

§ Baroness Hooper
My Lords, I have had the pleasure and privilege of visiting the Maudsley Hospital, seeing the work that is carried out and meeting many of the people who work there. I recognise that they would like to have more funds. That is normal where people are intensely interested in the work they do. We believe that they have been treated very fairly and that the rise in funding will be adequate to meet their needs.

§ Lord Rea
My Lords, is the noble Baroness aware that her colleague, the Minister of State for Health, Mrs. Virginia Bottomley, today visited the Maudsley Hospital? Will she make sure that the Minister is made fully aware of the concern of everyone who has spoken in the House this afternoon?

§ Baroness Hooper
My Lords, I am aware that my honourable friend visited the Maudsley this morning. I had an opportunity to speak to her subsequently. She felt that she had been able to reassure the people she met as to their future. As I said previously, in any event the department is considering future funding arrangements for special health authorities to safeguard their special interests, particularly in the light of the new proposals for the reform of the health service.

§ Lord Cledwyn of Penrhos
My Lords, the noble Baroness has failed to respond to the request of my noble friends Lord Ennals and Lord Rea. They asked her whether she will convey to the Secretary of State the profound concern of this House about the possible future of the Maudsley Hospital. She has not said that she will. Will she be good enough to do so?

§ Baroness Hooper
My Lords, I regret having perhaps given a misleading impression. I feel that it almost goes without saying that I shall certainly refer the remarks that have been made in this dicussion to my right honourable friend.