HC Deb 17 October 1994 vol 248 cc124-6W
Dr. Lynne Jones

To ask the Secretary of State for Health when the survey of English mental hospitals initiated by the mental health task force in 1993, and repeated in 1994, will be published to give the latest figures.

Mr. Bowis

The report of the 1994 survey has not yet been submitted to Ministers.

Dr. Lynne Jones

To ask the Secretary of State for Health what action she proposes to improve the planning of mental health services and to develop standards for community mental health care.

Mr. Bowls

District health authorities are responsible for planning mental health services in the light of their assessment of local need. They are also responsible for developing appropriate quality standards for the mental health services which they purchase, and for monitoring compliance with those standards. I issued the revised edition of the mental illness key area handbook on 29 September and tomorrow I shall be issuing the Mental Health Task Force's guide on "Local Systems of Support". My right hon. Friend the Secretary of State last week published guidance on inter-agency co-operation.

Dr. Lynne Jones

To ask the Secretary of State for Health to what extent the statistics about admissions and discharges for mentally ill people to and from psychiatric hospitals can identify how often an individual patient is admitted and discharged; and whether further information can be provided in future to assist in identifying those who need particular care.

Mr. Bowis

Information available centrally does not identify how often an individual patient is admitted and discharged. The introduction of the care programme approach, supervision registers and a new minimum data set for mental health services will help identify those in need of particular care.

Mr. Spearing

To ask the Secretary of State for Health if she will give in respect of each of the persons killed since 1990 by those receiving mental care in the community(a) the names, status and age of those killed and killing, (b) an outline of the medical and statutory listing of the latter, (c) the names of relevant health and local authorities responsible for the offending patient from the time of their initial treatment and (d) the bodies producing official reports on each incident, including coroners' or other courts.

Mr. Bowis

Information is not available in the form requested.

Mr. McCartney

To ask the Secretary of State for Health whether she has considered making available incentives for health and local authorities and the voluntary sector to set up specialist supported after-care facilities for difficult-to-place patients coming out of hospitals.

Mr. Bowis

Yes, we have not only considered it but we have taken action by the introduction of the mental illness specific grant, which is available to support the development of a range of innovative projects and has been warmly welcomed by both local and health authorities and by the voluntary sector. In 1994–95 the central grant is £36 million supporting total expenditure of £50.5 million. We have recently announced that the grant will continue for at least another three years.

Mr. McCartney

To ask the Secretary of State for Health (1) how many district health authorities do not provide long-stay, intensive care units for chronically ill patients with long term behavioural problems;

(2) if she will list those district health authorities which use private intensive care facilities for both (a) chronically ill patients with long-term behavioural problems and (b) acutely ill patients with temporary behavioural problems;

(3) how many district health authorities do not provide psychiatric intensive care units or wards for acutely ill patients with temporary behavioural problems.

Mr. Bowls

Provision for patients with behavioural problems can either be provided as part of district mental health services, or via access to highly specialised units. The precise configuration of services, including, where appropriate, use of private sector facilities, is a matter for determination locally.

Mr. McCartney

To ask the Secretary of State for Health what representations she has received concerning the lack of medium secure beds, and what plans she has to resolve the problem of transfer delay of patients from special hospitals to medium secure units.

Mr. Bowis

Various people have pointed out that the recommendation for medium secure places made by the Glancy working party in 1974 resulted in not one single purpose-built unit being provided by 1979. By contrast this Government recognise the need to expand medium secure psychiatric services and have made available capital funding of over £45 million for this purpose between 1991–95 to raise the number of such beds from the 600 places which were created between 1979 and 1991 to over 1,150 by 1996. In addition I announced on 7 September that we were allocating an extra £4.4 million revenue funding in the current year to help meet immediate pressures on these services.

Health authorities have been required, since April 1994, to ensure that patients who are ready to leave the special hospitals are placed within six months. The implementation of this is being monitored by the national health service executive and we shall shortly be issuing further guidance on the practical steps needed to minimise delays.

Mr. McCartney

To ask the Secretary of State for Health (1) if she will provide details of the number of people in special hospitals who require long-term medium secure unit bed provision;

(2) what costed and committed plans she has to build long-stay, medium secure units in the NHS; and what capital moneys she plans to allocate specifically for this purpose;

(3) how many people in (a) NHS hospitals and (b) private sector hospitals who have been in medium secure units for more than two years, and are unlikely to be ready to move to low security units in the near future.

Mr. Bowis

I refer the hon. Member to the reply I gave my hon. Friend the Member for Somerton and Frome (Mr Robinson) on 14 July at columns701-702.

Mr. Spearing

To ask the Secretary of State for Health what advice, guidance or instruction she has made concerning the level of funding by area health authorities of psychiatric medical services within the area of each local authority with responsibility for community cases; what national areas for staffing, beds and secure accommodation apply to such cases; and how are demonstrable variations in need reflected in the relevant funding.

Mr. Bowis

It is for individual health authorities to determine the overall level of funding for health services for mentally ill people living in their district based on their assessment of local needs. Health authorities are also responsible for deciding which parts of the mental health service should receive priority for development within the available resources. Health authorities are allocated funds on the basis of a weighted capitation formula which takes account of factors associated with health need.