Alcohol, Drug Crisis and Rehabilitation Centres (Hansard, 2 December 1992)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the Government are not reducing the amount of funding available for alcohol and drug crisis and rehabilitation centres. Rather than clients being funded through income support, from April 1993 local authorities will become responsible for assessing and meeting their needs, and for collecting a means-tested contribution from the client where appropriate.

§ Viscount Mersey
My Lords, I thank my noble friend for that Answer, but there is now a large local element involved. Is she aware that many of the people about whom we are talking are homeless, and that it is, in practice, difficult to get their original local authority to accept any responsibility for them? Let us take the case of a young man sleeping rough on the Embankment who decides to take treatment in Lambeth and who claims to come from Dagenham. Will he be able to persuade the Dagenham local authority to pay £130 a week to Lambeth? That is what it must be. Surely Dagenham will be tempted to say something like, "We have never heard of this chap". The whole crisis is not a local one; it is a national issue. It should be funded entirely nationally.

§ Baroness Cumberlege
My Lords, my noble friend will be aware that it is funded nationally in that the money is given to local government from the revenue support grant. The Government appreciate that this is a very special group of clients, and the concerns expressed by my noble friend are accepted by the Government. We are establishing good practice with local authorities. We have asked them to identify a particular scheme that they can operate to ensure that out-of-area referrals are taken into consideration, are followed up, and that those people are not disbanded.

§ Lord Ennals
My Lords, does the Minister recognise that good practice is fine, but it is fine only if those centres can stay in existence? Does she recognise that there are many centres, especially residential ones, dealing with drug abuse and alcohol abuse cases that are fearful that after 1st April they will not be in business? This is not something that until now local government has had as its responsibility. The ending of ring-fencing for those projects is putting many of them in grave danger.

§ Baroness Cumberlege
My Lords, the noble Lord is right. This is a very difficult area. It is a new area for us. From 1st April next year it will be the local authorities' responsibility totally, with social security funding. The Government are very well aware of those problems, and have introduced a special monitoring system for the first three months of this scheme. It will be independent monitoring and from then on the Social Services Inspectorate will take on the monitoring. So we are keeping a very close eye on it.

§ Baroness Masham of Ilton
My Lords, with the crime rate having risen by 45 per cent. in some areas, and thought to be drug-oriented, does the Minister think that the prisons will fill up if the rehabilitation centres have to close?

§ Baroness Cumberlege
My Lords, it is the Government's intention that no rehabilitation services that are offering a good service will close. That is why the new monitoring system has been introduced.

§ Lord Mancroft
My Lords, does my noble friend accept that the answers she has given today will not give great comfort to this area of the voluntary sector? Bearing in mind that the arguments put forward were agreed by her right honourable friend the present Home Secretary, then Secretary of State for Health, after considerable work in your Lordships' House and in another place during the passage of the National Health Service and Community Care Bill, we find it slightly galling that the Government have reversed completely that well-debated policy, without having the courtesy to bring it to the Floor of either House.

§ Baroness Cumberlege
My Lords, my noble friend Lord Mancroft will be aware that when the ring-fencing was first introduced the total sum of money for community care was not ring-fenced. My right honourable friend the Secretary of State has gone further. She has ring-fenced the entire amount of money for community care. As one who has worked in local government, perhaps I may say that I am aware that local government does not like targeted, 1337 ring-fenced, small amounts of money because that does not enable it to exercise its own discretion. To local government ring-fencing is a little bit like what King Herod was to Mothercare.

§ Lord Desai
My Lords, will the Minister bear in mind that the agencies will have to write to many local authorities and that delays in payment by local authorities can cause a serious problem? What steps will the Government take to speed up the payment of moneys due to such agencies?

§ Baroness Cumberlege
My Lords, the Government have written to local authorities. My honourable friend the Minister has met voluntary organisations and together they are working out a fast-track assessment procedure so that just the sort of instance that the noble Lord has raised will not happen.

The Viscount of Falkland
My Lords, does the noble Baroness agree that, should the Government's new arrangements prove too cumbersome, with more people living on the streets needing treatment, that will inevitably lead to a rise in homelessness and people living rough?

§ Baroness Cumberlege
My Lords, the whole strategy that has been adopted to start on 1st April next year is to ensure that there are not more homeless people on the streets. It is to ensure that those who need the services for alcohol and drug misuse will be catered for. We believe that the new system will do that.

§ Lord Moyne
My Lords, will not the new arrangements starting in April impose an extra and unwanted burden on carers, who, in any case, are overworked?

§ Baroness Cumberlege
My Lords, I do not believe that that is the case.