To ask the Secretary of State for Health if he will make a statement on the progress being made in implementing the Government's community care reforms.
The policies set out in the White Paper "Caring for People" are widely supported by local authorities, health authorities, voluntary organisations, practitioners in the field and many other interested commentators. The objectives are that good quality local services are provided that are responsive to the needs of users and carers, that provide choice and that enable elderly, disabled or vulnerable people to live as independently as possible in their own homes or in homely settings in the community. The Government attach particular importance to the successful implementation of these reforms.Special monitoring arrangements have been established. The regional social services inspectorate and regional health authorities have been asked to submit six-monthly reports on the progress being made by authorities in their regions against a checklist of issues. The first reports were submitted at the end of September.These reports showed that overall, satisfactory progress was being made at that stage in implementing the reforms. Most local authorities had met the specific requirements of the first phase of implementation by establishing complaints procedures and "arm's-length" inspection units for residential homes by 1 April 1991. They were also establishing a wide range of projects under the new mental illness specific grant which supports £30 million of expenditure in 1991–92 and £43·6 million in 1992–93 and under the new alcohol and drug misuse specific grant which supports £2 million of expenditure in 1991–92 and £3 million in 1992–93. Nearly all are on course to produce their first community care plans for 1 April 1992. A number of local authorities were making progress in clarifying the different "purchaser" and "provider" roles within the authority. We expect all authorities to make progress on this issue in the next few months. It is also clear that the degree of collaboration between health and local authorities which is essential to successful implementation has notably improved and that many authorities are making significant efforts to involve voluntary organisations, users and carers in preparing their plans.Authorities should now be addressing the detail of the reforms' implications, having undertaken much of the necessary groundwork for full implementation by 1 April 1993. At that stage, local authorities must have in place needs-based assessment systems. Funds will also be transferred to them from the Department of Social Security to enable them to arrange care for those people who would have entered residential or nursing home care and looked to the Department of Social Security for financial support. Implementing the remaining aspects of the reforms will be a challenging task. Local and health authorities will need to tackle a number of difficult issues. Closer collaboration will also be required between authorities generally and independent sector providers of community care services. The next round of the monitoring exercise will concentrate on those aspects to which authorities must give priority in order to achieve a smooth and successful introduction of the remainder of the changes required by legislation. Once these elements are in place authorities will be in a good position to take advantage of the opportunities created and to develop more appropriate and more responsive services to meet the needs of users and carers.