§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will take steps to ensure that resources are available to ensure that every person suffering from, or suspected as suffering from, incontinence receives a medical and nursing assessment; what information he has about variations from one part of the country to another in this regard; and if he will make a statement.
§ Mrs. CurrieWe would expect each health district to have arrangements for multi-disciplinary assessment for people suffering from incontinence. We do not collect information about the precise form of clinical services, and it is for individual authorities to decide for themselves how best to allocate their resources to meet their local needs and circumstances.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what evaluations have been made on the quality of the goods used in the management of incontinence; what evaluation units have been set up within his Department; what are proposed in assessing the quality of goods; and if he will make a statement.
§ Mrs. CurrieTwo evaluations carried out under the DHSS aids assessment programme were reported on in 1982–83. These covered incontinence garments and incontinence aids for handicapped children.
More recently, an evaluation study of incontinence pads and garments was funded by the Department at the department of geriatric medicine, University College hospital medical school. The report of this study was published in the Health Equipment Information series (No. 159, October 1986). Further work is being undertaken and will be reported in due course.
Discussions are in progress with a view to establishing an evaluation unit to undertake a programme of assessments of incontinence products. The need for such assessment is recognised as an important means of achieving the most effective use of the significant resources devoted to this area.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what support his Department is giving to the research into uro-dynamic investigation; if he will provide funds for the establishment of regional uro-dynamic investigation units; and if he will make a statement.
§ Mrs. CurrieUro-dynamic investigation is an established part of urological practice. It would be for health authorities to decide on the need for regional uro-dynamic investigation units and to fund them from their allocated resources.
Research in this field may be undertaken in academic departments of urology and other departments with urological interests. The Department is not supporting such research centrally, but I understand that basic urological research is being supported by the Medical Research Council, which is the main government-funded agency for medical and biological research in the United Kingdom and receives its grant-in-aid through the science budget of the Department of Education and Science.
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§ Mr. Carter-Jonesasked the Secretary of State for Social Services (1) what advice his Department gives to general practitioners and hospital authorities regarding the treatment of incontinence caused by constipation; what investigations his Department has done on the subject of bowel management and faecal impaction; and if he will make a statement;
(2) what guidelines his Department gives with regard to the management of bowel problems by non-skilled and untrained assistants in geriatric units and residential homes; and if he will make a statement.
§ Mrs. CurrieGeneral guidance on the management of incontinence is given in the handbook of guidelines "Improving Geriatric Care in Hospital" and the memorandum of guidance "Residential homes for the elderly—Arrangements for Health Care".
Guidance for general practitioners will be included in a training package under development as part of the Department's Helping the Community to Care programme.
In geriatric units, a trained nurse will have the responsibility for planning the care of patients. Tasks undertaken by nursing auxiliaries should be under the direction and observation of the nurse.
In residential homes, care assistants should be under the supervision of trained staff. Advice and guidance on health care should be available from the resident's own general practitioner and the community nursing service.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if his Department will provide courses for general practitioners to assist them to recognise overflow incontinence in the case of severely constipated patients who are referred to geriatric hospitals; and if he will make a statement.
§ Mrs. CurrieNo; but I refer the hon. Member to the reply given him by my hon. Friend the Minister for Health on 13 January 1987 at columns172–173 in which he pointed to the role of regional general practice educational sub-committees.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services who is responsible for co-ordinating and advising on the problems of incontinence and its treatment in all forms; and if he will make a statement.
§ Mrs. CurrieArrangements for co-ordinating and advising on the problems of incontinence, its treatment and the provision of services are best left to individual health and local authorities. Many authorities have appointed continence advisers to carry out these functions, following advice given by the Department's Chief Nursing Officer in 1977 that the management of incontinence should be clearly identified as the responsibility of a designated special nurse. For individuals suffering incontinence, advice on treatment and management of the problem should be sought from their general practitioner, district nurse or health visitor.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what assistance his Department is giving to the Disabled Living Foundation and other voluntary organisations concerned with the care, treatment and cure of incontinent people; and if he will make a statement.
§ Mrs. CurrieThe Department makes an annual grant towards the costs of the five main services provided by the Disabled Living Foundation, including its Incontinence 535W Advisory Service. It is for the foundation to decide how to divide the grant between the five services. I understand that in the last completed financial year, 1985–86, the Foundation allocated £28,380 to the Incontinence Advisory Service.
Under the "Helping the Community to Care" programme, the Department is funding a three-year project being run by Age Concern (England) to develop a pack of detailed advisory leaflets for those suffering from incontinence and for their carers. This pack should be of significant benefit not only to individuals but also to voluntary organisations which help with the problem.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what developments have taken place regarding the care of incontinent people in the community, in homes and in hospital since April 1980; and if he will make a statement.
§ Mrs. CurrieI refer the hon. Member to the replies given him by my hon. Friend the Minister for Health on 13 January 1987 at columns173–74 and to my other replies to him today, in which reference is made to general guidance on the management of incontinence, to the growth in numbers of continence advisers, to the assessment of incontinence aids and garments, and to the research which has been carried out. These and other relevant developments will be reviewed at the seminar planned for February 1987.