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Special Hospitals

Volume 958: debated on Monday 20 November 1978

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asked the Secretary of State for Social Services if he will provide an updated and full list of those hospitals which have refused to accept patients from the special hospitals.

asked the Secretary of State for Social Services if he will give a full account of the steps he has taken to transfer suitable patients from the special hospitals to NHS hospitals and the difficulties that have been encountered; and what he has done to try to overcome these.

Officials of my Department are in frequent contact with regional and area health authorities about individual cases.As I explained to my hon. Friend in my letter of 26th October 1977, the difficulties in arranging transfers are varied and complex. My officials are constantly looking for ways of overcoming these difficulties. They have had meetings with representatives of a number of health authorities and have visited NHS hospitals for direct discussions with local consultants about particular cases. They are seeking to encourage closer contact and better understanding between the special hospitals and NHS hospitals. Consultants from NHS hospitals are being encouraged to visit the special hospitals with members of their nursing teams so that they can obtain first hand knowledge of the patients who have been recommended for transfer to their hospitals. Alternatively, in suitable cases, the special hospital patients are being taken to the NHS hospitals for assessment by the local clinical team. In addition, undertakings are increasingly being given to re-admit to special hospitals those patients who fail to settle in NHS hospitals within a reasonable period of time.

asked the Secretary of State for Social Services if he will detail the consequences of overcrowding at the special hospitals.

The main consequence of the current overcrowding at Broadmoor special hospital is that the dormitory accommodation (for those patients who do not have single rooms) and day room accommodation is cramped; this reduces general living standards and increases the problems of staff caring for patients. Despite some recent improvements there is still also insufficient space for educational, occupational and social activities. More generally, lack of space also seriously hampers the modernization of substandard accommodation.When hospitals are full or nearly full it is increasingly difficult to place patients in the most appropriate ward having regard to their age, clinical and security needs; this adds to the problems facing staff.

asked the Secretary of State for Social Services if he will indicate separately the number of patients each of the special hospitals is supposed to accommodate and the number actually contained.

The number of patients for which the hospital buildings are appropriate varies from time to time for example because of the mix of patients and the wards out of use for redecoration etc. The current figures are about 600 at Broadmoor, 1,050 at Rampton, 400 at Moss Side and 70 at the Park Lane advance unit. These figures include beds in specialist wards—for example, admission, pre-discharge, clinical, maximum care, and so on—which by their nature cannot necessarily be fully utilised at all times. Much of the accommodation at Broadmoor hospital is however in need of substantial modernisation.The numbers of patients resident on 31st October 1978 was:

Broadmoor708
Rampton891
Moss Side381
Park Lane67

asked the Secretary of State for Social Services if he will give a full breakdown of the number of patients at the special hospitals who are awaiting transfer to NHS hospitals by age, sex, time waiting and the hospital at which they are presently located.

The information, as at 31st October 1978, in respect of patients who are thought by their responsible medical officers at the special hospitals to be ready for transfer to a less secure hospital is as follows:

Period of waiting

Under 1 year

1–2 years

2–3 years

3–4 years

Over 4 years

Total

Hospital

Age

Males

Females

Males

Females

Males

Females

Males

Females

Males

Females

Males

Females

BroadmoorUnder 20
21–30112
31–4061171
41–5042118
51–60112
Over 6021131
Total132531222
RamptonUnder 20 …11
21–3054112433267
31–401151244332113115
41–5041516331186
51–6061522312166
Over 6021111271
Total28123491710112839836
Moss SideUnder 20
21–30321152
31–405112173
41–50111122
51–6022
Over 60111131
Total11352212111218
Park LaneUnder 20
21–3011
31–4011
41–50
51–6022
Over 6011
Total235
Grand Totai5417471122111439414646

asked the Secretary of State for Social Services (1) if he has entered into any arrangements with hospitals or regional health authorities to swap patients with those at the special hospitals;(2) on how many occasions patients have been transferred from the special hospitals to National Health Service hospitals under a patient swap arrangement.

It is not the Department's policy that the admission of patients from NHS hospitals to the special hospitals should be conditional on the NHS hospitals in question accepting in return a special hospital patient. However, if there is a special hospital patient who has already been recommended for transfer to the NHS hospital concerned, it is usual to ask whether the NHS hospital is pre-pared to accept the special hospital patient.

asked the Secretary of State for Social Services how many vacancies there are in National Health Service hospitals that would be suitable for transferees from prison and special hospitals.

Whether the vacant places in NHS hospitals are suitable for patients on transfer from prisons or special hospitals is a matter of professional judgement in each individual case. The factors which have to be taken into account include the nature of the individual's mental disorder and his treatment and security needs as well as the nature of the facilities including staffing resources of the hospital concerned. I regret, therefore, that it is not possible to say how many of the available vacancies are suitable for these groups.