§ Mrs. DunwoodyTo ask the Secretary of State for Health (1) if she will discuss with regional health authorities the training of informal care providers in the prevention and treatment of pressure sores and incontinence for the physically disabled;
(2) what plans she has to help local health authorities to set realistic objectives and targets for services for physically disabled people;
(3) what plans she has to encourage the funding of rehabilitation programmes under the National Health Service and Community Care Act 1990;
(4) what plans she has to discuss establishing new methods of measuring the performance of services for the disabled.
§ Mr. YeoRehabilitation spans the responsibilities of health authorities, social services departments and a number of other agencies including the employment900W services. Health authorities fund rehabilitation services out of their general allocations and existing guidance sets out the range of services we would typically expect to see.
The professions involved have done much to promote rehabilitation in recent years, and we are considering what further action is needed to develop services to meet the needs of people with disability or chronic illness and to identify and disseminate good practice including methods of measuring the performance of services, the setting of realistic but challenging targets and the provision of training.
Health authorities are responsible for purchasing services to meet the health care needs of their populations. The assessment of needs for rehabilitation services is a complex matter. Special co-ordination is needed in the case of young people leaving full-time education and seeking to live as independently as possible. The Department will shortly make available to health authorities an epidemiologically-based assessment of the needs of young adults with physical disabilities to assist in deciding what services to purchase.
We will encourage the development of good practice in the prevention and management of complications which often impede rehabilitation. We reaffirm the view expressed in our consultative document on the Health of the Nation, Cm 1523, that an annual reduction of at least 5 to 10 per cent. in the incidence of pressure sores is a reasonable target for health authorities and will initiate steps to identify and disseminate the best ways of achieving this. In July 1991 we published the agenda for action on continence services, which commended to health authorities the elements of an effective local service. We shall be taking further steps to keep key professions well informed and adequately trained on good practice, and to identify the prevention and treatment services which are most effective, taking account of the role of informal care providers.
We will also be taking action to encourage the development of clinical protocols, standards of good practice, targets and performance indicators for services used by the people with impaired hearing or vision.
We are providing £ 1 million to improve rehabilitation services following brain injury, and we are also funding a major research study of the 12 sites around the country receiving these funds to evaluate their services.
There is insufficient knowledge about appropriate performance targets to make rehabilitation one of the key areas in our White Paper on the health of the nation but the Department will work with relevant experts to ensure that rehabilitation can become a national key area in due course. In the meantime we will pursue with regional health authorities where developments have progressed sufficiently the possibility of its adoption as a key area in those regions.
§ Mrs. DunwoodyTo ask the Secretary of State for Health what plans she has to discuss the dissemination to the physically disabled of the services available to them under the national health service.
§ Mr. YeoFrom 1 April 1992, the patients charter requires regional health authorities to set up general information services for the public. This will empower the patient to make more informed choices about health care, with improved access to information about the range of treatments available, greater knowledge of their condition and detailed information on waiting times.
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§ Mrs. DunwoodyTo ask the Secretary of State for Health what plans she has to improve respite care for the physically disabled.
§ Mr. YeoWe are looking to health and local authorities to develop respite care services as part of the implementation of the White Paper, "Caring for People". We recognise the contribution which such services can make to providing practical support for carers.
§ Mr. Frank FieldTo ask the Secretary of State for Health when she intends to implement sections 1, 2 and 3 of the Disabled Persons (Services, Consultation and Representation) Act 1986.
§ Mr. YeoThe requirements of these sections are now, to a very large extent, reflected in our new and wide-ranging reforms of community care, which demonstrate our commitment to high quality care and which are responsive to the needs and wishes of service users and carers. The need to implement these sections of the Act will be reviewed in the light of several years' experience of the community care arrangements.
£ million 1991–92 1990–91 1989–90 Regional health authority Revenue Capital Revenue Capital Revenue Capital Northern 3.377 1.885 2.541 1.648 1.677 1.350 Yorkshire 4.145 1.079 2.992 4.748 2.106 1.849 Trent 3.352 2.157 2.768 2.229 1.434 2.786 East Anglian 1.735 1.889 1.345 0.706 0.300 0.440 North West Thames 3.277 2.351 2.382 3.527 0.022 — North East Thames 4.249 3.677 2.895 2.789 — — South East Thames 3.148 2.128 2.364 2.848 1.414 0.822 South West Thames 2.543 0.638 1.496 0.242 — — Wessex 2.125 2.431 1.786 0.549 0.448 0.050 Oxford 2.418 1.461 1.819 2.766 0.970 0.470 South Western 2.245 1.183 1.566 2.810 0.005 — West Midlands 5.100 4.998 3.606 4.600 0.865 0.050 Mersey 2.219 0.076 2.206 1.924 1.178 1.363 North Western SHAs 4.358 4.719 2.835 3.414 1.045 0.060 National Heart and Lung 0.165 0.475 0.211 0.011 — — Hammersmith 0.165 0.181 0.094 0.171 — 0.110 Hospitals for Sick Children 0.165 — 0.186 0.461 0.025 — Total1 44.786 231.286 33.092 35.433 11.489 9.350 1 Expenditure incurred by the Department of Health centrally is not included in the totals. 2 Excludes £10.616 million made available to 30 NHS trusts via external financing limits.