§ Mr. McCrindle
asked the Secretary of State for Social Services (1) if he will make a statement on the provision of services for the mentally ill;
(2) if he will make a statement on the provision of accommodation in the community for patients discharged from hospitals and mental institutions.
§ Mrs. Currie
[pursuant to her reply, 19 November, c. 219]: Before long-stay patients in mental illness or mental handicap hospitals are considered for discharge a full assessment of their abilities and needs should be made, and those people found capable of living outside the hospital should have an appropriate course of rehabilitation. When it is decided that the time for discharge from hospital has been reached plans should be made, in consultation with the patient, the family and with any other people or bodies who may be involved, for a move to a suitable setting with an appropriate level of ongoing care and support.
The statutory authorities need to have access to a wide range of accommodation as individuals' needs vary and it is important that each should be helped to find the setting that best meets his needs. Many people will of course return to a family setting. Some may benefit from the freedom of ordinary housing, but may still need regular support, for example from social workers. Some people do well in board and lodging accommodation with a sympathetic landlady. Others may need sheltered housing, or an unstaffed group home. Others, particularly some mentally handicapped people, will need the day-to-day help with ordinary living which a residential home can provide. We are anxious to ensure that no hospital discharges a long-stay patient without a jointly agreed plan to settle the patient into the community, with statutory and voluntary services working together to plan and provide an appropriate range of services. The Disabled Persons (Services, Consultation and Representation) Act 1986 when implemented will give statutory support to existing good practice.
I should also comment on the discharge of short-stay patients, mainly mental illness patients, many of whom have had a hospital stay of less than a month. Most such patients will of course return to their previous accommodation. Difficulties may arise when a patient for some reason cannot do this, and does not have friends or resources to provide new accommodation. Under the 361W Housing Act 1985 local housing authorities have a duty to ensure accommodation for vulnerable groups, including people recovering from mental illness.
Since the reply from my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) to my hon. Friend on 26 July 1985, at columns 957–58, progress continues to be made in the development of community care. Provisional figures for 1985 show that places for mentally handicapped adults in local authority homes and hostels or sponsored voluntary or private provision number over 15,000 and adult training centre places increased to nearly 49,000. Places funded by local authorities in residential accommodation for mentally ill people increased to nearly 6,000. There were nearly 18,000 day hospital places for mentally ill people, and day centre places increased to nearly 9,000. The number of psychiatric nurses working in the community was over 2,500.
A study in 1981 showed that over 1,000 supported housing schemes for mentally ill and mentally handicapped people had been developed in the preceding 10 to 15 years, providing over 5,000 places. Many more people will have moved through these schemes into ordinary accommodation over the period. But some of the useful forms of sheltered accommodation I have mentioned will not show up in statistics at all.
Between 1978–79 and 1985–86, local authority expenditure on the personal social services grew in real terms by 20 per cent. We have continued to support the development of community care by the injection of over 362W £700 million of National Health Service funds through the joint finance arrangements, including over £100 million this year.
In addition, my right hon. Friend on 5 November announced special grants to regional health authorities totalling £6 million for development projects providing community care for mental illness.