§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will give the actual or best estimated figures for the numbers of children and young people in the age ranges (a) 0 to 5 years, (b) 5 to 11 years, (c) 11 to 16 years, (d) 16 to 20 years, and (e) 20 to 25 years living in long-stay mental subnormality hospitals in the years (i) 1975, (ii) 1977, (iii) 1978, (iv) 1979 and (v) 1980; and if he will make a statement.
§ Sir George YoungInformation is not collected centrally for these precise age bands. However, the table below shows the numbers in mental handicap hospitals on 31 December each year for similar age groups. Statistics for 1980 are not yet available.
Age 1975 1977 1978 1979 0– 4 213 148 101 68 5– 9 1,225 916 746 627 10–14 2,788 2,380 2,094 1,797 15–19 4,119 3,919 3,829 3,625 20–24 4,300 4,130 4,108 4,214 Totals 12,645 11,484 10,878 10,330
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will define the special facilities mentioned in his Department's booklet "Better Sevices for the Mentally Handicapped" that are available to children in long-stay mental subnormality hospitals; and if he will make a statement.
§ Sir George YoungI assume that the hon. Member is referring to paragraph 158 of the 1971 White Paper. This concerns mentally handicapped children or adults who need to go to hospital because of physical handicaps or behaviour problems. It is for the health authorities and the professional staff concerned to decide on the special facilities and medical, nursing and other skills that are needed to meet these varying and often severe problems; but they are able in this, to use the publications of the National Development Group for the Mentally Handicapped and the services of the development team which is sponsored by the Department. In addition, following the review of mental handicap services, "Progress, Problems and Priorities", published last year, the Department is undertaking further studies into the needs of mentally handicapped people with additional special needs and hopes to make guidance available to authorities.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services, in respect of how many children living in long-stay mental subnormality hospitals the local authority 442W from whose area they came recognises a continuing responsibility by allocating social workers to attend to their long-term interests.
§ Sir George YoungI regret that this information is not collected centrally. Normally, social work services are provided to children in mental handicap hospitals from either the hospital's own social works service department or from the social services department of the area from which the child originates. I would hope that hospital workers would contact the child's own social services department whenever their involvement is needed.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will publish the national development team's reports on its visits to long-stay mental subnormality hospitals; and if he will make a statement.
§ Sir George YoungWe do not propose to alter the present arrangement whereby the team's reports become the property of the field authorities concerned, who are free to publish all or part of the reports themselves. Health and local authorities invite the team to visit and report on their mental handicap services, and I do not consider that routine publication of the team's reports would be a helpful way of responding to these local initiatives. The development team has published two reports describing its work and its views on how services for the mentally handicapped could be improved. A third report will be published later this year.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what complaints machinery exists for those working in long-stay mental subnormality hospitals; and whether he is satisfied that adequate means exist to safeguard the confidentiality of such complaints.
§ Sir George YoungThe primary responsibility for investigating complaints is that of the health authority concerned and its management staff. I regard it as of the greatest importance that staff who are concerned about aspects of patient care should have open to them known avenues for complaints and be assured of appropriate management support and an adequate investigation. Wherever possible confidentiality will be preserved.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services in how many long-stay mental subnormality hospitals there are individual treatment and rehabilitation programmes for every child and adult; and if he will name the hospitals.
§ Sir George YoungI regret that this information is not collected centrally. However, a systematic assessment of the individual needs of each mentally handicapped patient leading to a programme of action designed to help him to make progress was recommended by the national development group for the mentally handicapped in its report "Helping Mentally Handicapped People in Hospital", and this recommendation was endorsed by the Department.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what have been the ratios of psychologists, speech therapists and physiotherapists to the number of under 16-year-olds living in long-stay mental subnormality hospitals during the last three years for which figures are available.
§ Sir George YoungInformation about the proportion of their time which staff in these disciplines devote to 443W children under 16 is not collected centrally. The ratios of such staff in mental handicap hospitals to resident patients of all ages for the years 1977–1979 were as follows:
Number of staff employed (whole-time equivalents) per 100 resident patients 1977 1978 1979 Psychologists 0.29 0.34 0.37 Speech Therapists 0.07 0.08 0.10 Physiotherapists (qualified staff 0.21 0.23 0.27 (helpers, etc) 0.13 0.14 0.17
§ Mr. Carter-Jonesasked the Secretary of State for Social Services how many children under 16 years of age living in long-stay mental subnormality hospitals receive six monthly dental check-ups; who gives this treatment; whether it is carried out within or outside the hospital; and if he is satisfied that a sufficient dental services is available.
§ Sir George YoungInformation on the frequency of dental check-ups for children living in long-stay mental handicap hospitals is not collected centrally. Health authorities are responsible for providing appropriate dental care for these patients. Treatment is usually given in the hospital by hospital dentists, although where necessary treatment may be arranged elsewhere. I am aware that the report of the Royal Commission on the National Health Service was critical of the level of dental services provided for the mentally handicapped in hospitals; on the other hand, in its second report, covering the period 1978–1979, the development team for the mentally handicapped noted that in all the hospitals it had visited regular dental examination and conservative treatment were available. Arrangements for the provision of dental services for this group of patients falls within the remit of the dental strategy review group, whose report is expected later this summer.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will take steps to facilitate the provision of advocacy help to patients in long-stay mental subnormality hospitals in the way already arranged between the Advocacy Alliance and three such hospitals.
§ Sir George YoungI shall follow this development with interest but my present view is that it is for the hospitals and health authorities concerned to decide whether and, if so, on what basis such help should be provided.