§ Dr. StrangTo ask the Secretary of State for Scotland what instructions he has given to the Management Executive of the Scottish health service requiring the health service purchasers to change the arrangements for provision of care to the elderly.
§ Mr. Stewart[holding answer 8 March 1994]: My right hon. Friend has issued no such instructions. It remains for individual health boards to determine the care needs for their elderly client group and to purchase accordingly. In so doing, they are expected to have due regard to the Government's community care policy objective of seeking a move away from institutional to community-based care. However, patients who require specialist medical and nursing supervision will continue to be the responsibility of the NHS. This means the NHS will continue to be responsible for providing assessment and rehabilitation facilities, and for retaining long-stay facilities for those whose medical needs or patterns of behaviour would be difficult to manage in a community-based setting.
Those not requiring such hospital services will increasingly have their health needs met within the 268W community, through general practitioners and other members of the primary health care team. Any other care needs will be a local authority responsibility. But in any event we expect shifting the balance of care, from hospitals to community, to be a matter for local discussion and agreement with the emphasis on joint working and joint assessments of needs.