Long-stay Mental Patients: Care (Hansard, 29 January 1991)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the Government recognise that there continue to be some mentally ill people who require long-term in-patient care and supervision. Facilities for them will increasingly be provided in small hospitals or psychiatric units with district general hospitals, as part of the wider range of district-based mental health services.

§ Baroness Fisher of Rednal
My Lords, I thank the noble Baroness for that Answer. Will she also take the long-stay hospitals for the mentally handicapped into consideration in the future? Does the Minister agree that it is important to consider the severely multi-handicapped people who are kept in the long-stay hospitals for the mentally handicapped?
Does she accept that among those patients are some who suffer from sensory handicap, including the blind and deaf who receive no help at present with their handicaps? If there are to be smaller hostels or similar places, the Government should seek the co-operation of people who are experienced in dealing with physical as well as mental handicaps? In other words, will the Government seek the co-operation of experts in blindness and deafness?

§ Baroness Hooper
My Lords, the noble Baroness has mentioned a particular problem in the needs of long-stay patients. The basic training of all nurses offers an introduction to the needs of sensorially deprived people. I also understand that blindness does not present the same problems as deafness, as blind people can communicate verbally. However, there are three specialist units within the National Health Service which provide psychiatric services for the deaf. The general approach for long-stay patients is that a consultant, backed up by a multidisciplinary team, reviews the needs of each patient, including the special needs of those who are mentally ill but also have additional handicaps.

Lord Campbell of Croy
My Lords, is my noble friend not concerned that the removal of 25,000 mental illness hospital beds in the past two years in England may produce more cases than can be taken on effectively by the new community care system which is due to start in April?

§ Baroness Hooper
My Lords, the run-down and closure of hospitals should not proceed faster than the build-up of alternative local services. Our guidance to health authorities makes that absolutely clear. There is also a formal consultation procedure which district health authorities will follow when they are considering the closure of hospital buildings. It is true that since 1975, when the community care approach began, the number of beds available in specialist mental hospitals has decreased by more than 50 per 543 cent. and a number of large mental hospitals have been closed. In 1990 one hospital was closed and 32 hospitals are planned for closure by 1996, but that is always subject to suitable alternative provision being made.

§ Lord Ennals
My Lords, I welcome the replies given by the Minister both in her original Answer and to supplementary questions, but I hope she will now give us an assurance that the progress on the discharge of mental patients from long-stay hospitals will be linked with the provision of residential and day-care services in the community. Further, will the Minister elaborate on her remarks made to me on 17th January in the course of replying to a Question tabled by the noble Lord, Lord Mottistone, when she said that funds of £75 million per annum for local authorities' requirements in this area would come from the taxpayer?

§ Baroness Hooper
My Lords, in the community care White Paper and in our ongoing discussions on the subject during the passage of last year's Bill, the Government emphasised that the number of mental illness beds should be reduced only as a consequence of the development of new services. We have made it clear that Ministers will not approve the closure of any mental hospital unless it can be demonstrated that an adequate alternative has been developed. A number of special funding initiatives have been established in this respect.

§ Lord Ennals
My Lords, will the Minister answer the second part of my question in relation to the funding of the £75 million required by local authorities to cover the provision I was discussing?

§ Baroness Hooper
My Lords, that is another question. However, I can tell the noble Lord that the funding of the special initiatives that I mentioned includes a supplementary credit approval of £10 million for 1991–92 which was announced in the Autumn Statement on 8th November.

§ Lord Auckland
My Lords, in the Epsom area where my wife and I have lived for many years there are several mental hospitals in a large cluster. Is my noble friend aware that there is much concern about the future of these clustered hospitals and also about the community care available to the patients of the hospitals? When will a decision be taken on the future of those hospitals? I declare an interest as the president of the association of friends of one of the hospitals.

§ Baroness Hooper
My Lords, I cannot give my noble friend the specific information he has asked for. However, I refer back to a reply that I gave earlier when I said that some 30 hospitals are due to close by 1996.

§ Lord Ross of Newport
My Lords, is the noble Baroness aware that too many people in our community who have suffered mental breakdowns cannot obtain access to mental health institutions or to mental health hospitals and finish up in prison? They are discharged back into the community after perhaps a weekend spent in prison. Is not that 544 situation quite disastrous? Is it not time that we tackled it seriously? There are too many people in prison who should never have been sent there and who should be given more suitable provision.

§ Baroness Hooper
My Lords, my honourable friend in another place has already made an announcement on this subject. He has announced the commencement of a review, the purpose of which is to determine whether changes are needed in the current level, pattern or operation of services and how such changes might be promoted with specific reference to prison conditions. Regular progress reports will be made to Ministers.

§ Lord Denham
My Lords, we have spent 15 minutes on two Questions. Your Lordships' Procedure Committee has recommended that Question Time should last for 20 minutes as far as is possible. I hope we can move on to the next Question now.

§ Baroness Fisher of Rednal
My Lords, does the Minister accept that many of the questions that she has answered—

§ Lord Denham
My Lords, the request that I have just made is usually accepted. I hope that we can move on to the next Question.