HC Deb 29 October 1981 vol 10 cc452-4W

Mr. Alexander asked the Secretary of State for Social Services whether he is yet in a position to make a statement following his consideration of the Associated Television documentary "The Silent Minority".

Mr. Fowler: I have now seen the ATV documentary "The Silent Minority" and considered the reports my predecessor called for from the health authorities concerned. I understand the authorities consulted appropriate members of staff in the preparation of the reports. The film criticised the, care of mentally handicapped residents in St. Lawrence's and Borocourt hospitals and used incidents portrayed in the film to question what was described as the Government's policy towards mentally handicapped people. I have placed in the Library a summary by my Department of the comments received from the health authorities concerned on the detailed incidents portrayed in the film.

First, I should like to describe the general position. Most mentally handicapped people are cared for in the community—by parents or relatives or in homes or hostels—with the support of the health services, the social services and the voluntary services. The numbers in hospitals are falling and, in particular, the number of children in mental handicap hospitals has fallen from 7,000 in 1971 to 2,800 in 1979. Very few children at all are now being admitted for long—term care. The Government have accepted unequivocally that large mental handicap hospitals do not provide a suitable environment for children to grow up in. Authorities have been urged to ensure that, where the children's handicaps are such that they need continuous health care, this should be provided in small, homely units in the community. In June this year, my Department sponsored a conference at which feasible alternatives to large hospital care were demonstrated and discussed. These included a number of units similar to the one at Beech Tree House shown in the film, which are now being provided by health and local authorities and voluntary organisations in various parts of the country.

I am glad to say that this conference prompted a number of inquiries from authorities and organisations which are interested in using one or other of the units demonstrated as a model for their own developments. We are arranging for a booklet describing these and other units to be distributed widely later in the autumn. Also, to encourage local initiative, we are offering a scheme to match £1 for £1 funds raised by voluntary organisations to get children out of hospital into suitable provision elsewhere.

The film concentrated its attention on certain categories of the most severely handicapped in particular circumstances. In doing this, I believe it gave an unrepresentative picture both of the two hospitals and of the care given by National Health Service staff to mentally handicapped people in general. My particular concern must be to see that no programme gives a wrong impression of the nature of mentally handicapped people as a whole which would undermine the efforts of all those, including the Government, concerned to improve services for mentally handicapped people and to enable them to live, as far as possible, normal lives in the community. The summary of comments shows that the authorities concerned have considered the implications of the film very carefully and that they have reacted positively to the experience.

However, the documentary did show very vividly why the Government's policy is to reduce and replace the large mental handicap hospitals even for people needing a high degree of care. Much smaller units are now being developed in the health and social services. These can more easily provide a homely atmosphere. We have urged authorities to give priority to this policy. To help speed the process we issued on 16 July this year a consultative document—"Care in the Community"—which invites comments on a number of possible ways of transferring patients and resources from hospital to community care. This has had a very favourable reception and will, I hope, promote wide and constructive discussion.

The advisory services of the development team for the mentally handicapped have been sought by most authorities in the country and the team has visited most areas at least once since its inception in 1975. The team visited St. Lawrence's before this programme was transmitted and, as the summary indicates, the health authorities have already started to implement some of the team's recommendations.

It is necessary to bring the needs of mentally handicapped people more into the public eye. In this respect, the publicity generated by "The Silent Minority" elicited genuine compassion and concern from hundreds of viewers, and I welcome this. But I also want to place on record my recognition of the devoted work of the staff in these two hospitals and, indeed, throughout the National Health Service which has made possible the positive developments that are taking place.