§ Mr. Hooson
asked the Secretary of State for Wales what decisions he has reached on "Care in the Community: a consultative document on transferring patients and resources from the National Health Service to the personal social services in Wales" issued by his Department in August 1981; and if he will make a statement.
§ Mr. Nicholas Edwards
The consultative document looked at ways of removing obstacles to the transfer of patients and matching resources from hospital to community care. Many people now in hospital could lead more independent lives elsewhere if residential and domiciliary care were available. Over 80 responses were received from health and local authorities, voluntary organisations, and other interested bodies and individuals in Wales. The great majority welcomed the broad aims of the consultative document and some of the possibilities reviewed in it received considerable support.
In the light of these comments I am convinced that it would be right to press ahead with a programme aimed to 523W get out of hospital and into community care as many people as possible who do not require hospital care. My decisions fall into two parts: those which can be acted upon without legislation; and those which require changes in the law when the opportunity can be taken.
My main proposals, which can be taken without having to wait for a change in the law, are, first, health authorities will in future be able to guarantee continuing annual payments to local authorities and voluntary organisations for people moving from hospital to community care; second, I shall be prepared to consider bids for the central support of schemes jointly financed by health and social services authorities, which will enable people to move out of hospital. For these schemes, the maximum period of joint financing will be increased from seven to 13 years with 100 per cent. Health Service financing for up to 10 years.
I have further proposals to facilitate the transfer of the burden of care which we wish to achieve. My principal proposal is to seek powers to make direct payments to local authorities for community care. I propose, in the first instance, to use this power to make payments to develop services for mentally handicapped people. I have before me the report of the All-Wales working party on services for mentally handicapped people, which I set up last December and I propose to make a statement about this before the House rises.
My other main proposal requiring legislation will be to enable payments to be made by health authorities for the support of housing and education functions. At present support may be given only for personal social services.
Detailed guidance on the proposals that do not require legislation will be issued after consultation with statutory authority, staff and medical interests. Authorities locally will need to consider how to take advantage of the changes in full consultation with their staff. There is no question of the compulsory transfer of staff. There will be a vital role for the voluntary sector in the implementation of the arrangements for extended community care.
The Government intend to do all they can to ensure that people who do not require constant hospital care are looked after in ways which match their needs more closely and which respect their wishes and those of their relatives.