§ Ms Rachel SquireTo ask the Secretary of State for Scotland what specific instructions he has provided to the purchasers of mental health services in respect of the seriously mentally ill.
§ Mr. StewartMy right hon. Friend has issued no such instructions. The organisation of mental health services is determined by clinical assessment and local need. It is for individual health boards to assess the needs for their population and to purchase mental health services accordingly. In so doing they are expected to have due regard for the Governments community care objectives and what is best for individuals.
§ Ms Rachel SquireTo ask the Secretary of State for Scotland what specific instructions he has issued, and to whom, on good practice on hospital discharge for mentally disordered people and on continuing care for mentally disordered people.
§ Mr. StewartThree circulars on this matter have been made available. Discharge of Patients from Mental Illness and Mental Handicap Hospitals, SW10/1988 was sent to directors of social work and copied to general managers of health boards on 1 June 1988, and dealt with the management issues. Assessment and Care Management, SW11/1991 HHD/DGM, (1191)40 was issued on 17 June 1991, and "Guidance on Care Programmes for People with a Mental Illness including Dementia", SOHHD DGM 1992/9 SW 1992/1 was issued on 7 February 1992. These were sent to general managers of health boards, the Common Services Agency, the state hospital and the Health Education Board for Scotland, and to chief242W executives of district councils, appropriate professional and voluntary bodies, directors of social work and directors of housing. Local bodies have developed discharge protocols based on this guidance.
§ Ms Rachel SquireTo ask the Secretary of State for Scotland what plans he has to issue instructions within one year on the minimum acceptable provisions for mental health services by way of(a) 24-hour staffed community houses, (b) day-staffed residential care, (c) day centres and hospital places and (d) provision of community-based multi-discipline teams; and if he will bring forward proposals to require the inspection of such establishments every three years.
§ Mr. StewartThese are not matters on which central guidance on standards would be practical. The frequency of inspections is a matter for determination in the light of local circumstances but some guidance has been offered on the frequency of inspection which would be appropriate for residential accommodation.
§ Ms Rachel SquireTo ask the Secretary of State for Scotland if he will make a statement on the use of discharge contracts by health boards in respect of the mentally ill.
§ Mr. StewartHealth boards do not use discharge contracts. Patients assessed as requiring continuing specialist medical and nursing care are the responsibility of health boards. Those patients who are discharged and do not require such care have their needs assessed by the local authority taking account of the views of health care professionals. An individual care programme should then be drawn up.