§ Mr. Carter-Jonesasked the Secretary of State for Wales (1) what advice his Department gives to general practitioners and hospital authorities regarding the treatment of incontinence caused by constipation; what investigations his Department has done on the subject of bowel management and faecal impaction; and if he will make a statement;
(2) what guidelines his Department gives with regard to the management of bowel problems by non-skilled and untrained assistants in geriatric units and residential homes; and if he will make a statement.
§ Mr. Mark RobinsonGeneral guidance on the management of incontinence is given in the handbook of guidelines "Improving Geriatric Care in Hospital" and the memorandum of guidance "Residential Homes for the Elderly—Arrangements for Health Care". Guidance for general practitioners will be included in a training package under development as part of the Government's helping the community to care programme. However, it would not be appropriate to issue specific guidance on all the detailed clinical aspects of incontinence, as it is for clinicians to decide how to treat their patients. In geriatric units, a trained nurse should have the responsibility for planning the care of patients. Tasks undertaken by nursing auxiliaries should be under the direction and observation of the nurse in residential homes. The management of incontinence by care assistants should be under the supervision of trained staff. Advice and guidance on health care should be available from the community nursing services.
§ Mr. Carter-Jonesasked the Secretary of State for Wales if his Department will promote a research programme and study of the number of patients in psychiatric hospitals who are suffering from mental confusion caused by faecal impaction; and if he will make a statement.
§ Mr. Mark RobinsonThe results of research on faecal incontinence are widely available. The treatment of patients in psychiatric hospitals is a matter for the health authorities concerned.