Learning Disabilities (Hansard, 17 November 1994)

§ Mr. Lang

I am today announcing my approval of Lothian health board's strategy for people with learning disabilities and the consequent closure of Gogarburn hospital in Edinburgh before the end of the century. The strategy was developed by Lothian health board and other agencies last year and went out to public consultation in the summer. I have considered the proposals carefully and I am satisfied that they will provide for the development of a comprehensive community care service which will enhance the quality of life for people with learning disabilities in Lothian and, in particular, those currently at Gogarburn hospital. I applaud the collaboration between the key agencies that has made the agreement on Gogarburn possible, and their joint commitment to provide the resources needed.

The board's strategy is for the provision of support, care and treatment services for people with learning disabilities away from hospitals and into the community. The planning and purchasing of long-stay care accommodation, day-time activities and other social care services will become the responsibility of Lothian regional council. Lothian health board will continue to purchase specialist health care, support and treatment services for this group of people as an integral part of the comprehensive network of services proposed. Two NHS units—a challenging behaviour unit and a dual diagnosis unit, for those with both a learning disability and a mental health problem—will be built to provide short-stay, specialist assessment and intensive treatment for in-patients, together with day hospital facilities. The board will also purchase medical and paramedical services 5W provided in the community, and these services will be expanded above current levels.

The public consultation demonstrated wide support for the aims of the strategy and for the closure of Gogarburn hospital which, it is now recognised, is an inappropriate and inaccessible place for the care of people with learning disabilities. There will be a carefully planned and phased rehousing, between now and the end of 1999, of more than 300 residents into supported accommodation in the community. A strong message from the consultation was the importance of ensuring that there was proper alternative accommodation in the community and that all placements would be based on a thorough assessment of the needs of Gogarburn residents.

I am satisfied that these issues have been fully addressed. A comprehensive network of alternative services will be developed with an emphasis on achieving domestic style accommodation in ordinary housing where possible. This will mean considerable adaptation of properties, the provision of social care and, in some cases, paramedical support, and carefully planned day activities. Each of the residents will be rehoused only after a detailed assessment of his or her social and health care needs has determined exactly what kind of care and accommodation he or she needs. Full account will be taken of the wishes of users and their carers, and particular attention will be given to the needs of the more profoundly handicapped of the residents who will need the most intensive support.

The board and other agencies have addressed the need to ensure that carers delivering support in the community are appropriate trained and skilled. As far as possible, staff of Gogarburn hospital will be offered the opportunity to deploy their skills in the community and much effort is already being put into identifying new job opportunities and providing retraining where necessary.

There will be considerable transitional costs incurred in maintaining Gogarburn hospital while alternative provision is being developed and relocation of residents gets under way. I am therefore pledging a substantial amount of bridging finance to meet these double running costs. This will amount to £1.4 million in this financial year, up to £2–8 million in 1995–96 and a further sum in the ensuing years, bringing the total sum up to £14.14 million. In addition, I will provide £2–5 million, spread over the first two years, to help with the capital costs of supported accommodation.

These substantial Government contributions are a measure of our commitment to ensuring that community care for this vulnerable client group is a success.