HL Deb 02 November 2004 vol 666 cc145-7

3 p.m.

Baroness Neuberger asked Her Majesty's Government:

In what ways the forthcoming Green Paper on adult social care directly addresses the specific needs of people with physical impairments who also have mental health support needs.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)

My Lords, my ministerial colleague, Stephen Ladyman, announced on 12 August that we would be developing a Green Paper on the future of adult social care. The emphasis will be on individually tailored services that enable people to fulfil their potential and promote independence through earlier intervention. Services need to be seamless with partner agencies and professionals working to improve co-ordination and accessibility.

Baroness Neuberger

My Lords, I am grateful to the Minister for his reply and for his assurance that we will see individually tailored packages. Does he agree that the recent report sponsored by the Rowntree Foundation, One town for my body, another fin my mind demonstrated that there was virtually no communication between those who provide services for people with physical disabilities and those who provide services for people with mental health needs?

Will the Minister further reassure us by telling us that he will make every effort to ensure that those who are working on the Green Paper will do something to address the silo mentality that still exists, however much we try to provide seamless services in much of our social and healthcare packages?

Lord Warner

My Lords, there sometimes can be a silo mentality, as the Government accept. However, it would be unfair to suggest that that is happening everywhere. For example, a report by Professor Philp, the National Director for Older People's Services, was published today—bearing in mind that older people often have significant physical disabilities and problems of mental impairment on occasion. The report, launched by the Secretary of State and Professor Philp, shows that there has been dramatic improvement. It shows increased investment and improvements in intermediate care, which are useful for the people about whom the noble Baroness was talking. We have seen improvements in stroke services and dementia services for older people and others with physical disabilities.

Lord Renton

My Lords, may I mention that I have a 50 year-old daughter who cannot walk, talk or feed herself, although she has a lovely personality? May I also mention that, in all the years that I have had to see that she is properly maintained there has never been enough help from the state to enable that to be done? Luckily, I have been able to provide the balance. However, there are many people who simply would not be able to do so. Will the Government bear in mind that this is a major problem that needs to be looked at afresh?

Lord Warner

My Lords, I congratulate the noble Lord on the care that he and his relatives have provided within his family, which is the way that many people prefer things to happen. However, the Government have done a lot to assist carers, although the noble Lord may not be aware that he has been one. We have invested substantial extra money in adult social care and will go on growing those services in line with the adult social care Green Paper.

Baroness Pitkeathley

My Lords, does my noble friend agree that it is also important to bear in mind the needs of those who combine physical impairment with learning difficulties of some kind? Does he also agree that those people are particularly vulnerable at the so-called transition period, when they pass into the remit of adult social care from the services provided for children and young people?

Lord Warner

My Lords, I agree with my noble friend. I know from my own experience in running a social services department that a particularly difficult transition often has to be made and a lot of support must be given to the parents of those children to help that transition take place successfully.

Lord Avebury

My Lords, is the Minister aware that a service that provides advocacy for those with long-term disabilities in Doncaster is about to close down through lack of funding? Does he not agree that there is a difficulty, especially with elderly people—as he said—suffering from multiple disabilities? They have great difficulties communicating with the system about problems such as housing. Advocacy services such as the one that is about to be closed in Doncaster are too valuable to be allowed to vanish.

Lord Warner

My Lords, I am not aware of the particular problems in Doncaster, but I do know that advocacy services are very important. However, we should not be too downcast. We are seeing a very substantial increase in the amounts of intensive home care provided to people to help keep them at home, and a massive growth in intermediate care services. Clearly, these messages are getting through to state providers of services as well as voluntary and private providers. We are seeing an expansion of services in those areas, but we are not complacent.

Baroness Barker

My Lords, will the next NSF on mental health contain guidance on the integration of medicines for mental and physical conditions?

Lord Warner

My Lords, I am sorry. I do not have information available on that subject, but I will write to the noble Baroness.

Baroness Greengross

My Lords, will anything be done to stop the unfortunate transition between being an adult receiving social care and being an elderly person receiving care, when the standard of care and sometimes the benefits available are severely reduced?

Lord Warner

My Lords, one of the reasons for producing the Green Paper on adult social care is to ensure that we have more personalised and individually tailored services, so that as people move through their lives and their care needs change we can address those particular concerns.

Earl Howe

My Lords, did the Minister share my disappointment that the official survey on adult social care designed to help inform the Green Paper revealed what can only be described as a considerable hostility among many within the social care sector towards direct payments, which can do so much to empower service users? Why have not the Government done more to convince social care professionals of the merits of direct payments?

Lord Warner

My Lords, we have done our best in this particular area. Direct payments are a great success story. They are very popular with recipients and it behoves everyone working in social services departments to address their minds to the needs of the service users. They should discover how service users like to receive services and the extent to which they have independent needs that can be met more effectively through the direct payment system that this Government introduced.