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Patients (Special Hospitals)

Volume 976: debated on Wednesday 16 January 1980

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asked the Secretary of State for Social Services whether he is satisfied that special hospitals provide an appropriate environment for the care and treatment of children and adolescents requiring special security; what are the alternative facilities for this group of patients; and whether he has any plans for creating new facilities for patients of these kinds.

The decision to admit to a special hospital is taken only after careful consideration of all the facts, including what other facilities are available. This is particularly so in the case of a young person. Only if there are no other facilities offering the care and treatment required in the degree of security thought necessary is it decided to admit a young person to a special hospital.No new facilities for this small group of young persons are planned.

asked the Secretary of State for Social Services how many patients who were admitted to each of the special hospitals during 1976, 1977 and 1978 had previously been detained in special hospitals.

The information is as follows:

197619771978
Broadmoor161011
Rampton253417
Moss Side835
Park Lane11

asked the Secretary of State for Social Services how many patients from each area health authority are currently detailed in each special hospital.

I regret that the information is not readily available, and the costs of obtaining it would be excessive.

asked the Secretary of State for Social Services how many patients in each of the special hospitals do not now, in his opinion, require treatment under conditions of special security.

The information, as at 1 January 1980, in respect of patients who have been recommended by their responsible medical officers for transfer or discharge from the special hospitals is as follows:

Broadmoor hospital51
Rampton hospital142
Moss Side hospital34
Park Lane hospital9
236
Where a patient is subject to the special restrictions set out in section 65 of the Mental Health Act 1959, it is necessary to have the agreement of the Home Secretary before he or she can be transferred or discharged. In a number of cases agreement in principle has already been received and in others action to seek it is in train.

asked the Secretary of State for Social Services how many patients there are in each of the special hospitals currently awaiting transfer to a local hospital; how many of these are restricted patients; and into which area health authorities they are to be transferred.

At 1 January 1980 there were 169 patients in the special hospitals who were thought by their responsible medical officers to be ready for transfer to local psychiatric or mental handicap hospitals, and of these 86 were restricted patients. Fuller details are given in the following table.

Broadmoor

Rampton

Moss Side

Park Lane

Totals

Regional Health Authority

Restricted

Unrestricted

Restricted

Unrestricted

Restricted

Unrestricted

Restricted

Unrestricted

Restricted

Unrestricted

Northern611181
Yorkshire242246
Trent167178
East Anglia11323
North West Thames34272
North East Thames157269
South East Thames4591109
South West Thames11112
Wessex2122254
Oxford22343
South Western241822820
West Midlands76421128
Mersey121132
North Western1122143
Wales41353
TOTALS2247671214528683

In addition, there are 14 patients (8 Rampton, 6 Moss Side), all restricted, who are awaiting transfer to the East dale unit at Balderton hospital, Newark. Information in respect of the area health authorities to which the patients are to be transferred is not readily available, and an attempt to provide it would be disproportionate in terms of time and cost.

asked the Secretary of State for Social Services how many patients in each of the special hospitals have been assessed as fit to be discharged but remain under detention on account of the absence of suitable community accommodation and local authority supervision.

I regret that it is not possible to give a numerical answer to this question. The availability of suitable accommodation and support in the community are factors which must be taken into account by those concerned in determining a patient's suitability for discharge into the community, and until such facilities suited to the individual patient's needs can be provided it is usually impossible to say that the patient "has been assessed as fit for discharge". Where for any reason a patient cannot be discharged to his family home it is not always possible to obtain hostel places as quickly as might ideally be desirable. There are, however, only a very few cases in which the delay exceeds six months and these are usually because the patient has very special needs, provision of which is inevitably limited. No difficulties have been experienced in obtaining local authority supervision once accommodation has been obtained.

asked the Secretary of State for Social Services what steps he has taken since 3 May 1979 to facilitate the transfer or discharge of patients from special hospitals in those cases where their detention is no longer necessary in conditions of special security.

The difficulties in arranging transfers of special hospital patients to NHS hospitals are varied and complex. Officials of the Department are constantly looking for ways of overcoming these difficulties. In recent months, they have continued to visit NHS hospitals for direct discussions with local consultants about particular cases and they have had meetings with representatives of a number of health authorities, with further meetings at present being planned. In an effort to encourage closer and better understanding between the special hospitals and NHS hospitals, they have continued to encourage consultants from NHS hospitals 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, arrangements have been made for special hospital patients to be taken to the NHS hospitals for assessment by the local clinical team. In order further to reassure hospital staffs the practice has also been adopted in all appropriate cases of giving undertakings that patients will be readily re-admitted to the special hospital should difficulties arise.

asked the Secretary of State for Social Services what discussions he has had since 3 May 1979 with the Confederation of Health Service Employees and the National Union of Public Employees concerning the imposition of bans by staff in local psychiatric hospitals on the reception of patients detained under part V of the Mental Health Act 1959.

We have not so far discussed this subject with either of these two unions, since I understand that neither union has a national policy against the acceptance of such patients. Any ban at a particular hospital results from a local staff decision and it is primarily the responsibility of local management to resolve such disputes and ensure that the hospital meets its responsibilities.

asked the Secretary of State for Social Services in how many cases in the last five years the power to transfer a patient from a special to a local psychiatric hospital under section 99(2) of the Mental Health Act 1959 has been used; and in what circumstances he would consider its use to be appropriate.

No patients have been transferred from special hospitals to other hospitals under this section during the last five years. All such transfers have been made with the consent of the receiving hospital under section 41 of the 1959 Act. My right hon. Friend would make directions for the transfer of a patient under section 99(2) only where he was satisfied that this would be in the best interests both of the patient concerned and of other patients.