§ Mr. Harry GreenwayTo ask the Secretary of State for Health what action she is taking to protect those released into the community from psychiatric institutions; and if she will make a statement.
§ Mr. YeoFrom 1 April 1991 all district health authorities were required to initiate, in collaboration with local social services departments, explicit individually tailored care programmes for all in-patients about to be discharged from mental illness hospitals and all new patients accepted by the specialist psychiatric services.
Under this initiative, known as the care programme approach, the needs of each patient should be systematically assessed and the appropriate arrangements made. These include the appointment of a key worker to keep in close touch with the patient and to monitor that the agreed health and social care is given.
The rescources being devoted to the care of mentally ill people in the community have increased significantly in recent years. Gross spending on local authority social services for mentally ill people increased by 86 per cent. in real terms between 1978–79 and 1990–91 to £116.5 million. National health service provision in the community has also increased, for example, the number of community psychiatric nurses rose by 227 per cent. between 1981 and 1991, from 1,100 to 3,600.
The Royal College of Psychiatrists has recommended that the Mental Health Act 1983 be amended to incorporate a community supervision order. Following discussions with the college and other professional and
Malaria Plasmodium species Year Falciparum Vivax Malariae Ovale Mixed Unstated Total Deaths 1972 134 167 12 13 2 8 336 ? 1973 145 309 21 13 19 34 541 5 1974 138 434 29 14 25 21 661 2 1975 174 471 32 17 42 13 749 5 1976 229 903 29 15 32 12 1,220 3 1977 236 1,203 29 20 32 9 1,529 7 1978 349 1,370 19 42 14 115 1,909 10 1979 435 1,469 20 33 8 88 2,053 6 1980 405 1,131 12 31 18 73 1,670 9 1981 370 1,110 13 21 18 44 1,576 2 1982 442 931 20 24 26 28 1,471 12 1983 535 937 22 30 17 170 1,711 6 1984 680 943 20 42 43 206 1,934 6 1985 654 1,344 23 63 33 95 2,212 5 1986 719 1,404 30 64 22 70 2,309 4 1987 696 1,005 13 64 29 9 1,816 7 1988 1,028 530 22 67 24 3 1,674 7 1989 1,072 734 33 101 47 — 1,987 4 1990 1,057 831 17 149 41 1 2,096 4 19911 1,268 863 21 133 47 — 2,332 12 19921 — — — — — — 1,630 11 1 Provisional figures only. Source: Annual tables from the PHLS Malaria Reference Laboratory.