HL Deb 08 June 1992 vol 537 cc1095-7

Baroness Fisher of Rednal asked Her Majesty's Government:

Whether they are aware of operational difficulties relating to the implementation of their deadlines for closing specialist mental hospitals.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, no specific deadlines have been imposed by government. Our primary aim is not the closure of specialist mental hospitals but the provision of better care for people with mental health problems. This requires the development of suitable facilities in the community.

Baroness Fisher of Rednal

My Lords, is the Minister aware that there is serious disquiet among many organisations and in reports published by the prisons, resettlement agencies and other government organisations that people who have previously been in mental hospitals are now going to prison, sleeping rough or being placed in resettlement units? These people have received no back-up service at all when they were discharged.

Baroness Cumberlege

My Lords, the noble Baroness will perhaps also be aware that the evidence that we have is that homeless mentally ill people are not those who have recently been discharged from long-stay hospitals but are people who have had little or no contact with psychiatric services. We have recent research to prove that. There is some anxiety with regard to people who are in prison. The noble Baroness may be aware that a review is being undertaken at the moment by the Reed Committee which is looking into that specific aspect.

Lord Renton

My Lords, is my noble friend aware that over the past 15 years or so many mentally handicapped people have been discharged from long-stay hospitals and with the help of Mencap have been enabled to live within the community? Can she give an assurance that it remains the aim of the Government to advance that process? Can she also give an assurance that the matter about which the noble Baroness, Lady Fisher of Rednal, has complained does not apply to the mentally handicapped?

Baroness Cumberlege

My Lords, my noble friend is absolutely right. I should like to pay tribute to Mencap and other voluntary organisations which have done an enormous amount of work in ensuring that such people have a better quality of life. People who were previously in hospital can now enjoy the freedom and the kind of life that many of us expect to lead in the community. I should like to join with him in paying tribute to those voluntary organisations.

Lord Stallard

My Lords, does the noble Baroness accept that there is a great deal of truth in what the noble Baroness, Lady Fisher of Rednal, says about voluntary organisations? For instance, we know that voluntary organisations like CHARD, and particularly the Simon Community, whose record is second to none in assisting people on the streets or people who are about to go on the streets, are suffering because of the cuts in local authority expenditure. In other words, local authority cuts are being passed on to the voluntary organisations, which are now finding it very difficult to find any alternative source of funding. Would the Minister take another look at organisations like the Simon Community to see whether they can be assisted to carry on the very valuable work that they are doing?

Baroness Cumberlege

My Lords, I am very grateful to the noble Lord for those comments. I shall be delighted to meet representatives of any voluntary organisation. But I refute the allegation that resources within local authorities have been cut. In fact for people with learning disabilities and mentally handicapped people the increase in local authority spending since 1979 has been 91 per cent.

Lord Campbell of Alloway

My Lords, will the Minister tell us what happens to the people in the specialist mental hospitals when those hospitals are closed? I find it difficult to understand from the answers that have been given.

Baroness Cumberlege

My Lords, when hospitals for mentally ill people, or hospitals that have in the past cared for people who are mentally handicapped —people with learning disabilities—close, their patients have care plans drawn up for them by the social services, with National Health Service staff and also with voluntary organisations, to ensure that in the future their quality of life is good, that they have somewhere to live and that they are occupied not only during the day but at weekends and in the evenings. It is essential that we have care plans for every single person being discharged. That is the Government's policy.

Lord Molloy

My Lords, is the Minister aware that her statement a moment ago that she is willing to meet voluntary organisations will be very well received? We in this House are very grateful that she said that. Will she also take into consideration that the specialist medical professionals also have many problems that they would like to discuss with the department? Can discussions with them also please be considered?

Baroness Cumberlege

My Lords, the noble Lord will be aware that I am prepared to meet anybody at any time, within reason.

Lord Glenarthur

My Lords, while accepting that my noble friend has in part answered the question in relation to that asked by my noble friend Lord Renton, would she further agree that as far as the mentally ill are concerned there are already some very good examples in the United Kingdom where the problems which the noble Baroness, Lady Fisher of Rednal, has mentioned do not arise and that all along the policy has been one which has concerned the local authorities, the voluntary sector and indeed central government? It would be a pity to write off those organisations which otherwise are doing good work.

Baroness Cumberlege

My Lords, I thank my noble friend for his comment and question. I agree with him that tremendous achievements are being made in the community by voluntary organisations and statutory authorities working together. We should in no way decry that.

Lord Strabolgi

My Lords, what is to happen to the people who are so badly mentally handicapped that they cannot be returned to the community? Will provision be made for them? It is not just a question of people with learning disabilities but of those who are seriously handicapped who have not advanced since the age of two and who are now adults.

Baroness Cumberlege

My Lords, the noble Lord is right. There will always be people who need intensive care. There is a question as to whether or not those people should be cared for in an institution. In my district I have witnessed severely multiply handicapped people being looked after successfully in the community. We should give every person possible that chance.

Lord Desai

My Lords, does the Minister agree that homelessness is a problem connected with people who were previously mentally ill and that homelessness itself causes mental distress? What is the Government's remedy for tackling the connection between homelessness and mental illness?

Baroness Cumberlege

My Lords, I should like to reiterate the comment I made earlier; there is no evidence that homeless people have had experience of hospitals for the mentally ill. I am aware that there is a common belief in the country that that is so, but I draw to the noble Lord's attention the evidence that has emerged recently from several research projects.

Baroness Fisher of Rednal

My Lords, I accept that good work is being done in the community. I congratulate all those who participate in it. I am involved with two organisations. I am worried about the observations of the Schizophrenia Fellowship. Its anxiety is serious. Those who are mentally ill are not receiving a square deal under the Patient's Charter.

Baroness Cumberlege

My Lords, I cannot agree with the noble Baroness. I should welcome evidence of specific instances of things going awry and people not being looked after in the community. It is only by looking into the individual case that we can ensure that that person's quality of life is improved.

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