§ Mr. Berminghamasked the Secretary of State for Social Services (1) what proportion of annual National Health Service revenue and capital budgets was spent on services for mentally-ill people during the most recent year for which figures are available;
(2) if he wil provide a percentage figure indicating the proportion of the National Health Service budget on mental health services which was spent on services, facilities, staffing and upkeep of psychiatric hospitals at the most recent year for which figures are available.
§ Mr. Whitney11.1 per cent. of health authority spending in 1983–84 was devoted to services for mentally-ill people. The remaining information sought is not readily available in the form requested but in recent years details of the breakdown of health authority and personal social services gross current expenditure on different groups, including mentally-ill people, have been published in the Department's evidence to the Social Services Committee for the Committee's annual inquiry into public expenditure on the social services—most recently in the Committee's Sixth Report (HC 339) which was published in June this year (pages 11–29 inclusive).
§ Mr. Berminghamasked the Secretary of State for Social Services how many local authority day centre places are available for mentally ill people in England.
§ Mr. WhitneyAt 31 March 1984, the latest date for which complete information is available, the number of places in local authority day centres for mentally-ill people in England was 5,361. A further 1,225 day centre places were made available to local authorities by voluntary and other bodies. The above figures do not include places available in mixed day centres, an unspecified number of which are for mentally-ill people, or day care places available in local authority residential homes.
§ Mr. Berminghamasked the Secretary of State for Social Services how many community mental health centres are operating; how many are planned; and where they are situated and planned to be situated.
§ Mr. WhitneyCentres described as community mental health centres vary in their objectives and in the resources they offer, and we have not so far sought either to define what minimum requirements would justify the term, nor therefore to obtain statistics of the number of centres within such a definition which are operating. Generally we would see their essential function as to provide a local base for a multi-disciplinary team to provide psychiatric144W services to a part of a district; we are aware, however, that in some districts advantages have been seen in such a team not using a "community mental health centre" but instead using the accommodation of a health centre or group practice, so that there can be close links with primary health care, and no unnecessary labelling of minor disabilities as psychiatric. There are also places where such a multi-disciplinary team has found a suitable base in say a day hospital or day centre, but has not sought to identify it as a "community mental health centre".
We are however aware that a number of health authorities have plans for such centres, which may include domiciliary, day and in-patient care as well as a resource centre for professionals, the voluntary sector and the public. We are anxious to secure more evaluative research into the different patterns of community-oriented psychiatric care responding to the needs of neighbourhood areas.
§ Mr. Berminghamasked the Secretary of State for Social Services if he will list the evaluation studies concerned with the effects of hospital rundown on patients and staff and with the buildup of alternative community services undertaken by his Department's mental illness research liaison group.
§ Mr. WhitneyA number of evaluation studies have been undertaken as part of the Department's research programme on the effects of hospital run-down and the provision of alternative community services in the field of mental illness. These have included studies based on the psychiatric case registers at Worcester, Salford, Nottingham, Southampton and Camberwell, by the universities of Birmingham, Liverpool, London and Manchester. Detailed numerical descriptions of the development of these activities are due to be published soon. These will detail results obtained from the registers including the monitoring of change and collaboration between services.
Other studies have covered the more general provision of community services, joint planning and collaboration. A number of research applications in these fields are at present being considered by the Department.
§ Mr. Berminghamasked the Secretary of State for Social Services which health advisory service reports have been published on mental illness services since 1 January.
§ Mr. WhitneyReports have been published on Health Advisory Service visits to the following health authorities concerning mental illness services: West Surrey and North East Hampshire, South West Surrey, South Manchester, Central Manchester, North Manchester, Great Yarmouth and Waveney, North West Surrey, Worcester, Ealing, Harrow, Brent, Wigan and Herefordshire and District health authorities. Reports on all visits made since 1 January 1985 are being published.