HC Deb 31 July 1974 vol 878 cc414-6W
Mr. Leslie Huckfield

asked the Secretary of State for Social Services when she will announce the proposals promised in paragraph 7 of "Democracy in the NHS" concerning national responsibilities for quality of care in the health and social services and her proposals for the future of the hospital advisory service; and if she will make a statement.

Mrs. Castle

The Hospital Advisory Service set up in 1969, has been a most successful mechanism for providing for successive Secretaries of State information about hospital services for the groups of patients it has covered; and its visits have generally been welcomed by the hospital staff as opportunities for discussion with fellow professionals about their work and its organisation with advice for improvements. But in geriatrics, mental handicap and mental illness it is manifestly unsatisfactory to look at the hospital services in isolation; account must be taken of the increasingly important inter-relationship between hospital community health services and the personal social services. My right hon, and learned Friend the Secretary of State for Wales and I believe it is necessary to consider extending the activities of the Hospital Advisory Service so that it can look in a more comprehensive way at services for those groups of patients it presently covers—the mentally ill and some of the elderly.

We have decided to start the process of consulting the bodies and organisations involved on how this might be achieved. We shall need to consult the professions, the health service authorities and local authority associations. We are proposing that the Hospital Advisory Service might be renamed the Health Advisory Service. We hope it will be possible to agree that the new remit of the HAS should extend to advising on the links between hospital and community health care for these groups of patients, and that it should operate in association with our Departments' social work services which already have a close working relationship with the local authority personal social services. We hope also to be able to agree that a team should be established to visit hospitals, other than hospitals for the mentally handicapped, where children are receiving long-stay care. The objective would be to help us to improve the quality of life for these children and to ensure that each child's prospects of returning to the community are regularly and specifically reviewed. Methods of working, offering advice and recording conclusions will need to be carefully considered. The HAS will continue to concern itself primarily with the organisation of the services which are within its remit; it is not and will not be concerned with the affairs of individual patients or matters of individual clinical judgment.

In our view developments on these lines should be helpful to those working in the health and personal social services as well as to ourselves and our Departments, but as I have made clear there will be wide consultation on them.

Arrangements for services for the mentally handicapped are being considered separately and we hope to be in a position to make a statement fairly soon reviewing progress to date in implementing "Better Services for the Mentally Handicapped".

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