HC Deb 29 March 1984 vol 57 cc233-5W
Mr. Knox

asked the Secretary of State for Social Services what progress is being made on the care in the community initiative aimed at enabling long-stay patients to leave hospital and be cared for in the community; and when the relevant provisions of the Health and Social Services and Social Security Adjudications Act will be brought into force.

Mr. Fowler

The Government aim to provide care at home or in small homely units near to a patient's home in all those cases where an elderly patient or a mentally ill or mentally handicapped person would be better cared for in that way. We feel that this is a better and more civilised way of supporting many people, particularly those who would otherwise become unwilling or unhappy long stay patients in large hospitals or institutions.

We are therefore bringing changes in the law which extend the so-called joint finance arrangements into force on 1 April. From that date health authorities will be able to help finance education for mentally and physically disabled young people, and housing, as well as personal social services. This extension of the joint financing arrangements removes an unnecessary legal obstacle to the joint planning that we encourage health and local authorities and voluntary bodies to engage in on behalf of elderly and disabled patients. It helps authorities to match services more closely to the needs of individual people and to achieve a more effective use of the money that we make available. Health authorities can use their normal resources as well as their joint finance allocations —which we have now raised to £100 million in 1984–85—in supporting community services.

Voluntary organisations as well as local authorities and other housing bodies can take part in joint schemes and receive support from NHS funds. We want to see the voluntary organisations play their full part and so we are now making statutory provision for voluntary organisation representatives on the joint consultative committees of health and local authorities. An order has been laid before the House giving three seats for voluntary organisations on every joint consultative committee and prescribing the way in which the appointments are to be made. We believe that it is very important that the voluntary organisations themselves should choose their new representatives. The order comes into force on 1 April and the appointments should be made by not later than 1 January 1985.

Finally, we have now set up a programme of care in the community pilot projects. Ten have been selected so far from over 120 applications, for starting in 1984, and the authorities have been asked to go ahead. A few more projects are still under consideration. A further selection will be made in the autumn for starting in 1985. We are setting aside some £16 million over four years to provide finance from the Government for the initial costs.

The whole purpose of these projects is to improve the quality of life for people who need not remain in hospital. Assessment of each person's individual needs and the provision of appropriate support are therefore central features. We shall monitor and assess each project in terms of quality of life and value for money and publicise the results. Some of these projects will also help in the running down of some of the old unsuitable hospitals, which ought not to play a part in a modern civilised system of care for elderly, mentally ill and mentally handicapped people.

We are issuing today guidance to health and local authorities on the implementation of the new statutory provisions. Copies of this guidance, and details of the selected pilot projects, have been placed in the Library of the House.