Worcester Development Project (Hansard, 7 December 1983)

§ Mr. Kenneth Clarke

[pursuant to his reply, 18 November 1983; c. 614]: The Worcester development project was designed, in the words of Mr. Kenneth Robinson when Minister for Health, to demonstrate how the problems of transition from the old to a modern comprehensive psychiatric service can be identified and solved in a co-operative exercise involving health and local authorities.

The main achievement is that such a modern comprehensive service now exists in Worcester and Kidderminster districts, and research studies, which are part of the project, suggest that in general it is serving local people well.

The main failures were that the planning and building of the main elements took much longer than expected, and that the expected closure of Powick hospital, following transfer of the remaining "old long-stay" patients elsewhere, has never taken place. The 1970 forecast that 198W the number of inpatients in Powick hospital would fall to 250 by 1980–81 proved precisely accurate. The assumption was that at that stage another mental illness hospital would take the remaining patients who required continuing inpatient care, so that Powick hospital could be closed. This has not in fact happened, and Worcester health authority has, until very recently, still been considering a number of possible changes, including the use of Powick for another purpose. I understand that proposals were at last agreed by the regional health authority last week and have now been put forward to the Department. I hope that they will provide a clear basis for sensible progress.

The detailed work of converting the 1970 blueprint into the 1983 reality has taught many lessons, as the various research studies arising from the project demonstrate. Some lessons with resource implications are that DHSS had overestimated the need for short-stay beds, and probably for day hospital and day centre places; while the need for beds for the psychiatry of old age, and for homelike accommodation for people with chronic illnesses was underestimated. These conclusions are broadly in line with those reached by studies elsewhere. Research studies are continuing, under Professor Brockington and Professor Wing. They will include studies to evaluate services to particular groups. More generally, I hope our policies will gain in realism from experience of events in the county of Worcester during the "co-operative exercise". The lesson here is that it is too simple to talk as if "bridging finance" was all that is needed for the closure of old hospitals and the building of modern comprehensive services. All the authorities who will be involved need to be party to the plans and to be committed to seeing them through, and the plans need to be carefully judged to match the needs and to ensure that the resources shift to match the interests of the psychiatric patients.