§ Lord Windleshamasked Her Majesty's Government:
On what date a regional secure unit (interim or permanent) will finally be in operation in each of the regional health authorities in England and Wales; how many patients are currently receiving treatment in such units; what capacity is planned for the future; and what is the total amount of additional funding in the capital and running costs provided by central government to the regional health authorities for this purpose since 1975; and
Whether any part of the additional central government funds authorised since 1974–75 for the provision of regional secure units in each of the regional health authorities in England and Wales has been diverted to other psychiatric services provided by the RHAs.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)Ten of the NHS Regions now have permanent regional secure units (RSUs) in operation and two more have permanent buildings almost completed, as follows:
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Region Location Current Bed Complement To be completed 1986/87 Northern St. Luke's Hospital, Middlesbrough 30 Yorkshire Fieldhead Hospital, Wakefield 48 Trent Towers Hospital, Leicester 60 East Anglian St. Andrew's Hospital, Norwich 36 NW Thames St. Bernard's Hospital, Ealing 40 (14 beds in an interim RSUalready open)
Region Location Current Bed Complement To be completed 1986/87 NE Thames Runwell Hospital, Nr. Southend 10 SE Thames Bethlem Royal Hospital and linked units at Bexley, Croydon, Maidstone and Eastbourne(1) 90 Wessex Knowle Hospital, Fareham 31 South Western Langdon Hospital, Dawlish 30 West Midlands Rubery Hill Hospital, Birmingham 100 (35 beds in interim RSUs already open) Mersey Rainhill Hospital, Prescot 50 North Western Prestwich Hospital, Manchester 20(2) (1) Eastbourne Unit (15 beds) not yet open. (2) Plus 88-bed unit (also at Prestwich Hospital) to open shortly. Thus by the end of 1986/87 633 beds should be available. On the remaining two regions, Oxford currently has an interim secure unit, and its first permanent unit should open at Borocourt Hospital in 1987. South West Thames's permanent RSU at Netherne Hospital should open in 1988 or 1989; meanwhile the regional health authority has not designated any interim secure unit, but has spent much of its special revenue allocations in developing several "close supervision" units in existing hospitals, which are performing a somewhat similar function and are intended to work in association with the future RSU to provide a region-wide service.
The number of patients receiving treatment fluctuates from day to day and information about this number is not collected centrally.
A number of regions have plans for additional secure accommodation. This does not always take the form of an additional regional secure unit, but in some cases takes the form of smaller units, sometimes described as "close supervision" or "intensive care" units, which can offer appropriate levels of care to patients who, while requiring treatment under secure conditions, are not necessarily in need of treatment within the RSU environment. This is in line with the emphasis we have increasingly placed on the need for a range of facilities to cover the wide range of patients requiring different degrees of security and types of care, including in particular patients with chronic mental illness which is unlikely to respond to treatment and serverely mentally handicapped patients, neither of which group is appropriate for the RSU regime.
Meanwhile, we are funding a research study on the work of RSUs. When it is completed its findings will have to be evaluated, along with other research and relevant evidence, before decisions can be taken about the ultimate capacity to be planned, either for RSU accommodation or for secure accommodation more generally.
Since 1976, earmarked capital funding has been made available solely for development of permanent 297WA RSUs: £23.527 million has been spent for this purpose up to 1984–85 and none has been spent on any other purpose. Revenue funding has not been similarly earmarked, but since 1976 the department has identified a special recurring amount within RHAs' general revenue allocations for funding the running costs of RSUs and of interim secure facilities pending the establishment of RSUs. The different approach to revenue funding was decided on in 1976 because it was recognised that RHAs might not always be able to spend the whole sum on running costs of interim or permanent facilities for psychiatric patients, particularly in the early stages of the programme before even interim units had been established. The department, however, asked RHAs to use any revenue funds not 298WA currently required for secure facilities on developing and improving other general psychiatric services, especially those which will assist in the care and treatment of the type of mentally disorded patient for whom secure facilities are intended. The amount of revenue funding spent on permanent and interim secure facilities between 1976–77 and 1984–85 was £24.350 million. I will write to the noble Lord with further details of capital and revenue expenditure.
There is no regional health authority in Wales. The Secretary of State for Wales has approved a phased development over the next six years of four medium secure units in the Principality, which will provide treatment for 65 patients and will be fully funded by the Welsh Office.