§ Mr. McCrindle
asked the Secretary of State for Social Services what decisions he has reached on "Care in the Community: a consultative document on moving resources for care in England", issued by his Department in July 1981; and if he will make a statement.
§ Mr. Fowler
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 live more independent lives elsewhere if residential and domiciliary care were available. About 700 responses were received from health and local authorities, voluntary organisations and other interested bodies and individuals. Most of them welcomed the broad aims of the consultative document and some of the possibilities reviewed in it received considerable support.
In the light of those comments, I am convinced that it would be right, despite current restraint on resources, to press ahead with a programme aimed at getting out of 560W hospital and into communtiy care as many as possible of those patients who do not specifically require hospital care.
My decisions fall into two parts: those which can be acted on without the need for legislation, and those which require changes in the existing law when the opportunity occurs.
In the first category I have three main proposals. First, district health authorities will in future be able to guarantee continuing annual payments to local authorities and voluntary organisations for people moving into community care. Second, joint finance from the NHS will be available for extended periods for projects for moving people out of hospital. The maximum period of joint financing will be increased from seven to 13 years with a 100 per cent. joint financing for up to 10 years. Third, a programme of pilot projects will be promoted and up to £15 million of joint finance funds will be centrally reserved over the next five years to help develop and assess the programme. There are further proposals for creating more flexibility in the arrangements, but these will require primary legislation. The chief aim will be to enable payments to be made by district health authorities for the support of education for handicapped people and of housing provided by local authorities and other bodies such as housing associations. At present, support may only be given for personal social services.
Detailed guidance on those proposals that do not require legislation will be issued after consultation with statutory authority, staff and other interests. It will be for authorities locally to decide how to take advantage of the extra scope for transferring resources, in the light of local circumstances and opportunities and in full consultation with the staff and their representative organisations. There will be no question of compulsory transfer of staff. I see a vital role for the voluntary sector in all its forms to play 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 the wishes of patients and their relatives.