§ Mr. WigleyTo ask the Secretary of State for Health what specific measures he proposes to encourage general practitioners to act as gatekeepers to social services, social security and housing for their patients with mental handicaps.
§ Mr. Kenneth ClarkeIt is the Government's aim that all the statutory authorities concerned with the provision of services for mentally handicapped people should co-operate in providing access to a comprehensive and integrated range of services to meet the individual needs of mentally handicapped people and their families. I am sure general practitioners will continue to help to achieve this aim.
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§ Mr. WigleyTo ask the Secretary of State for Health if he will make it his policy to provide earmarked additional funding for the development of mental handicap services; and if he will make a statement.
§ Mr. FreemanNo. The development of mental handicap services is already one of the priorities for the statutory authorities responsible for their provision. The statistical bulletin "Personal Social Services: Provision for Mentally Handicapped People in England 1976–86" a copy of which is in the Library and which was issued last year, describes the progress that has been made in increasing residential and day provision in the community.
§ Mr. WigleyTo ask the Secretary of State for Health if he will publish a paper setting out the short and long term implications of "Working for Patients" for (i) the National Health Service contribution to mental handicap services, (ii) the National Health Service partnership with other statutory services, and (iii) voluntary sector mental handicap services.
§ Mr. Kenneth ClarkeWe are examining the future organisation and management of services for mentally handicapped people as part of our wider consideration of community care policy, following Sir Roy Griffiths' report and taking into account the implications of "Working for Patients". We are also looking at ways of strengthening collaboration between the NHS and other statutory and voluntary agencies in the provision of those services.
§ Mr. WigleyTo ask the Secretary of State for Health if he will invite the Audit Commission to work closely with the national development team in monitoring the quality and quantity of health and local authority mental handicap services.
§ Mr. FreemanThe Audit Commission remains a wholly independent body but does, of course, have access to the published reports of the national development team as part of the body of knowledge to be taken into account when approaching value for money exercises on mental handicap services. The two bodies already have informal links.
§ Mr. WigleyTo ask the Secretary of State for Health whether mental handicap hospitals will be eligible to form themselves into National Heath Service hospital trusts; if such trusts would have responsibility for community mental handicap services; and whether they would be authorised to charge for non-hospital residential care.
§ Mr. Kenneth ClarkeAny hospital which meets the criteria in chapter 3 of the White Paper "Working for Patients" would be eligible to become an NHS hospital trust, and trusts will be able to run community services, where this is sensible. NHS hospital trusts will be subject to the provisions on charging for residential care which apply to the NHS generally.
§ Mr. WigleyTo ask the Secretary of State for Health if he will make a statement on the National Health Service White Paper proposals for greater flexibility across health authority boundaries, and their effects on the Department's policy for comprehensive and integrated local services for people with mental handicap.
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§ Mr. Kenneth ClarkeIt remains my Department's policy to encourage the development of comprehensive and integrated local services for people with a mental handicap. The greater flexibility and other proposals in the White Paper "Working for Patients" will further assist the implementation of this policy.
§ Mr. WigleyTo ask the Secretary of State for Health if, as a result of "Working for Patients", there will be any substantial extension of the role of the private health sector in catering for the general or special needs of people with mental handicap.
§ Mr. Kenneth ClarkeThe private and voluntary sectors in collaboration with the statutory services play an essential role in provision for mentally handicapped people, and I hope this will continue to expand when its is for the benefit of mentally handicapped people and their families.
§ Mr. WigleyTo ask the Secretary of State for Health if the revised funding arrangements proposed in "Working for Patients" will take account of the transitional and long-term costs of funding higher quality mental handicap services.
§ Mr. Kenneth ClarkeThe White Paper proposals will fund health authorities for the populations they serve rather than for particular services they provide. By providing greater choice and flexibility the new arrangements will promote access to better standards of service.
§ Mr. WigleyTo ask the Secretary of State for Health if he will issue up-to-date guidance to health authorities on the positive use, for the individual's own benefit, of accumulated funds held by health authorities on behalf of patients in mental handicap hospitals.
§ Mr. FreemanWe know that many hospitals are devising imaginative schemes within the existing guidelines to use patients' own money for their personal benefit and to enhance their quality of life. There are no plans to issue new national guidelines.
§ Mr. WigleyTo ask the Secretary of State for Health if he will extend the requirement for peer group review and professional audit to those parts of the mental handicap service which are led by psychologists, nurses or social workers.
§ Mr. Kenneth ClarkeNot at present, although I would expect all professional staff providing services to mentally handicapped people to keep the quality and effectiveness of those services under continuous review.