HL Deb 27 October 1992 vol 539 cc1011-4

2.59 p.m.

Lord Allen of Abbeydale asked Her Majesty's Government:

Whether they will now appoint a task force, comparable with that for the mentally ill, to work with the national development team in encouraging good practices in services for the mentally handicapped.

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

My Lords, we have no plans to do so.

Lord Allen of Abbeydale

My Lords, I thank the Minister for that rather disappointing reply. Does she recall that in the 1990 Act when the Government conceded a special grant for the mentally ill, they refused a similar concession for the mentally handicapped? I understand that some guidelines are being issued. However, does she agree that the Government should do rather more than issue guidelines and become more directly involved by appointing a task force, as is done for the mentally ill, supported perhaps by a little money? If they do not do so, is there not some risk that those with learning disabilities (if that is the preferred phrase) will again be the poor relation under the new community care arrangements? What better opportunity would there be for a new policy than the relaunch of MENCAP which was announced yesterday?

Baroness Cumberlege

My Lords, I feared that there might be some disappointment in my Answer. Perhaps I may soften it by congratulating the noble Lord on the relaunch of MENCAP yesterday, which I gather was a great success. Your Lordships will be aware that there has been much faster progress in developing services for people with a learning disability than for those with mental illness. For that reason the task force was set up. With regard to resources, the Government have put considerable funds into the field for those with learning difficulties (or mental handicap, as we used to call it). Indeed, this year for the health services it is an increase of 13 per cent., and in local authorities over the past 10 years it is an increase of 91 per cent.

Lord Renton

My Lords, is my noble friend aware that the term "learning difficulties" is an ambiguous one, whereas the term "mental handicap" clearly indicates people who have an incurable mental condition? Is she further aware that there are 20,000 of them still in long stay hospitals, many of whom are getting rather old but all of whom would like to have the opportunity to live in the community? Does she agree therefore that there is a much greater need for a task force to help those people than there is even for those who are mentally ill?

Baroness Cumberlege

My Lords, I thank my noble friend for that question. I am aware that there are people in long stay institutions who still want to be moved into the community to lead a fuller life. The Government are doing all they can to make that possible. The term "mental handicap" is one with which I feel much more comfortable. It is one which is well understood. But when the department consulted the general public, there was a very strong feeling that the term should be changed to "people with a learning disability".

Lord Ashley of Stoke

My Lords, the noble Baroness is quite right; there is disappointment at her response. In view of the fact that the same logic which led to setting up a task force for the mentally ill applies to the mentally handicapped, in so far as they are very vulnerable and subject to being put at the back of the queue, will the Government think again? Does she agree that although progress has been a little faster for those who are mentally ill, it has not been so fast for those who are mentally handicapped?

Baroness Cumberlege

My Lords, your Lordships will be aware that since 1979 we have reduced by half the number of people in long-stay mental handicap institutions. There are now no children in long-stay hospitals. That is tremendous progress. We also have the benefit of the national development team which is doing extremely good work in progressing those policies.

Lord Hailsham of Saint Marylebone

My Lords, does my noble friend confirm my belief that, quite apart from the question of a task force, the Secretary of State has power under the Mental Health Acts to issue a code of conduct in those matters? Have any codes of conduct been issued to assist the mentally handicapped in addition to those suffering from mental disorder?

Baroness Cumberlege

My Lords, I thank my noble and learned friend for that question. Yesterday the Department of Health and the Department of the Environment issued two sets of guidance, one for local authorities and one for health authorities.

Lord Ennals

My Lords, regardless of which of the two terms we use, does the Minister accept that there is and will be a great deal of regret in the country at the Answer that she gave? Does she agree that the mental illness task force has rendered an important service and should be commended? In view of that and, following the relaunch of MENCAP, the need for good practice to be made widely known throughout the country, will she reconsider the Answer given?

Baroness Cumberlege

My Lords, the noble Lord will be aware that good practice is disseminated widely by the national development team. That is its role. The task force was set up for mental illness because we are aware that a great deal more has to be done in that area, unlike in the field of people with learning disabilities in which enormous progress has been made over the past 10 years.

Lord Mayhew

My Lords, every five or 10 years we change the term we use to describe the mentally handicapped. Does the noble Baroness agree that there is nothing wrong with those terms? It is the attitude of the public that needs changing. Why do we not spend more time seeking to change the attitude of the public rather than changing the terms used?

Baroness Cumberlege

My Lords, the noble Lord may agree with me that the two factors are interrelated. The language that we use influences the attitude of the public.

Lord Carter

My Lords, we on these Benches add our welcome to the relaunch of MENCAP, and the issuing of the guidelines for people with learning disabilities to which the Minister referred. The guidance from the health service and management executive states clearly that additional resources will be necessary to enable people with learning disabilities to use the services satisfactorily. However, the departmental circular to local authorities states that it will be, a matter for local determination in the light of assessment of need, available resources and competing pressures on services". Which statement is right? Will there be new money to implement the guidelines? Without new money, they certainly will not work.

Baroness Cumberlege

My Lords, noble Lords will be aware that year on year we put more money into the National Health Service. I am sure that health authorities which are commissioning services will use their powers and their resources to increase funds for that client group. Over the years we have seen places in voluntary and private local authority homes and hospitals increased by 57 per cent. We have also seen staff and places at training centres increase. Year on year we put more resources into the field of people with learning disabilities.

Lord Parry

My Lords, does the noble Baroness accept that, semantics and politics apart, many of us who have worked in that field for many years are deeply worried that difficulties are arising almost by accident? Will she confirm an assurance already given from the Government Front Bench that no changes will be made which will disadvantage the people who are already disadvantaged by closing down establishments which have proved to work and which have shown that they are capable of dealing with conditions of mental deficiency or of mental illness? Will she confirm that such establishments will be closed only when a better provision is in place, regardless of the comparative sums?

Baroness Cumberlege

My Lords, it is with great pleasure that I give that assurance to your Lordships' House.