§ Mr. AllenTo ask the Secretary of State for Health (1) if she will make it her policy to provide an impartial assessment of the adequacy of the relevant authorities' provision of social care to meet the needs of severely mentally ill people;
(2) if she will make a statement on the finding by the social services inspectorate that in some local authorities evidence of any sense of direction in terms of mental health services is lacking.
§ Mr. YeoThe care programme approach, implemented as from 1 April 1991, should ensure that mentally ill people 67W living in the community receive appropriate social care. We have asked regional health authorities to monitor its implementation consulting the regional offices of the Department's social services inspectorate as necessary.
Under the National Health Service and Community Care Act 1990, local authorities are required to draw up and publish their community care plans for all client groups, including mentally ill people, after consultation with a range of statutory and independent sector bodies, and users and carers.
The White Paper "Caring for People" stresses the importance of health and local authority co-operation in planning services, and in the White Paper "The Health of the Nation", this is extended to joint purchasing of mental health services. The Ministerial Committee on Health Strategy will oversee development in respect of "Health of the Nation" and periodic reports on progress will be published.
We are not aware of a finding by the social services inspectorate that in some local authorities evidence of any sense of direction in terms of mental health services is lacking.
§ Mr. AllenTo ask the Secretary of State for Health what is the average cost per week of psychiatric treatment in(a) an acute, (b) a long-stay ward in a specialist psychiatric hospital, (c) similar provision in a local hospital or unit and (d) long-term treatment and care in a high dependency hospital hostel.
§ Mr. YeoThe average cost per day in 1990–91 for patients in the mental illness specialty was £55. The average costs for groups within the specialty cannot be identified separately.
§ Mr. AllenTo ask the Secretary of State for Health whether the "Health of the Nation" White Paper represents a change in Government policy that the transfer of services away from large psychiatric hospitals to a balanced range of locally based services remains dependent on the actual provision of such services by health and local authorities; and if she will make a statement.
§ Mr. YeoDistrict health authorities and local authorities, as purchasers of health care, are responsible for securing a comprehensive range of psychiatric services to meet the needs of their resident populations. Health authorities will secure these services by means of contracts with national health service trusts, directly managed units and the independent sector. Local authorities will effect contracts with voluntary and private organisations, as well as providing their own services.
The White Paper "Caring for People" stresses the importance of health and local authority co-operation in planning services, and in the "Health of the Nation" White Paper this is extended to joint purchasing of services.
§ Mr. AllenTo ask the Secretary of State for Health if she will make it her policy that the monitoring of local authority mental health services by the social services inspectorate should be focused on authorities whose residents, or former residents, are short or long-stay patients served by those specialist psychiatric hospitals with plans to close by 1997.
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§ Mr. YeoNo, since confining monitoring of services only to those mentally ill people who have been in-patients would exclude those services to people who have never been admitted to hospital for treatment.
§ Mr. AllenTo ask the Secretary of State for Health how the Government plans to replace the services currently provided for many patients in large psychiatric institutions for occupational and recreational therapy, long-term high dependency care, and secure wards for mentally ill offenders and others needing security, including access to fresh air and sheltered gardens or grounds.
§ Mr. YeoMinisters have repeatedly made clear that the closure of obsolete psychiatric institutions should be preceded by the development of adequate alternative facilities which address the health, social and security needs of the re-located people.
The responsibility for providing these services rests primarily with district health authorities and local authority social services departments.
§ Mr. AllenTo ask the Secretary of State for Health how the Government plans to achieve significant improvement in the health and social functioning of severely mentally ill people.
§ Mr. YeoWe are preparing detailed guidance to managers in both the health service and in the personal social services on their part in harnessing together the existing initiatives and new developments generated by the White Paper "Health of the Nation", to achieve demonstrable improvement in mental health services by specific target dates.