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Elderly Mentally Infirm Patients

Volume 929: debated on Tuesday 5 April 1977

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asked the Secretary of State for Social Services if he will issue guidance to the area health authorities covering their responsibility for the elderly mentally infirm, and the balance of responsibility between area health authorities and local government.

Guidance on the provision of services for mental illness related to old age was issued to statutory health and local authorities in 1972. I am considering whether further advice is needed.

I am grateful to my right hon. Friend for that reply. Is he aware that an argument is developing in Sheffield between the local authority and the area health authority about the care of the elderly mentally infirm? Is he aware that the health authority claims that they do not need medical treatment and that the local authority claims that they are beyond basic care? Should not the position be clarified?

One thing that pleases me about the dispute is that a joint working party has been established between the Sheffield Area Health Authority (Teaching) and the Sheffield Metropolitan District Council to see how they can improve the services for the elderly mentally infirm in the area. They have recently accepted the recommendation of their joint consultation committee and a joint working party has been set up to try to work out an agreement. It held its first meeting on 11th March, and I hope that an agreement will be reached on this difficult issue.

Does the Secretary of State accept that this, sadly, is an increasing problem? Is he satisfied that sufficient resources are allocated tinder the National Health Service for mental health care, particularly for the elderly?

It is a problem in many parts of the country. In the consultation document that was sent out last year we emphasised that priority should be given to services for the mentally ill and mentally handicapped, and particularly to the elderly mentally ill. In many regions that priority has been fully accepted. In some areas it has not been accepted as fully. I am investigating the situation as it applies region by region because it is one of the services to which priority should be given even at a time when the growth of resources is admittedly modest.

When looking at the situation region by region, will the Secretary of State give guidance to the area health authorities, because there is some evidence that psychiatrists and geriatricians find it difficult to deal with elderly psychiatric patients because they believe that geriatric patients should be treated as psychiatric patients and that in some instances psychiatric patients should be treated as geriatric patients? Will he look at this situation, because many elderly people are suffering unnecessarily?

I understand that there is some dispute. Our anxiety is to ensure that the elderly mentally infirm should be able to live as long as possible in the community and not in our hospitals. We lay great stress on domiciliary services to minimise the number of people who have to be admitted to psycho-geriatric wards.

Does the Secretary of State agree that, despite his guidance to area health authorities, the funds available to deal with this problem are completely inadequate? Is it not a fact that this is unlikely to be overcome until we increase our gross national product and have more money to spare?

I cannot disagree with that. It is true that if there was more money in general we could allocate more funds for this purpose. Conservative Members are very insistent on limiting public expenditure, and we cannot exclude even the Health Service from such limitation. However, what we can do, within our limited resources, is to get our priorities right, and our principal priority must be to give help to the Cinderella services, which include those for elderly people, the mentally ill and the mentally handicapped. This is the policy that I am pursuing.