My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether satisfactory arrangements exist for the welfare and treatment of patients at Friern Barnet Hospital during and after the current programme of ward closures and the return of patients to the community.
My Lords, yes. Hampstead Health Authority, which manages Friern Barnet Hospital, expects to maintain services at the hospital until replacement facilities have been completed in the districts served by the hospital.
My Lords, I am grateful for that information. Is the Minister aware of the growing national concern at the plight of patients in such hospitals as Friern Barnet when they are to be returned to the alleged care of the community? Can he tell us what monitoring he and his officials have in order to ensure that before patients are sent, for instance, from Friern Barnet into the London boroughs of Barnet, Enfield and Haringey, they take steps to ensure that the local authority has adequate social services, for instance, in housing and unemployment? I am sure that the Minister is aware that there have been grave situations in which patients who have been returned to the care of the community are left virtually neglected.
My Lords, so far as the department's activities in this area are concerned, it normally only becomes involved, first, on the general oversight of mental illness hospitals, and, secondly, when it is planned to close such a hospital. As far as care in the community goes, we make it crystal clear to regional health authorities, and indeed to the districts, that hospitals that are moving patients out into the community should do so only when alternative sources of provision, whether day centres or whatever, are there.
My Lords, I wonder whether the Minister is yet in a position to tell the House how many patients who have been discharged from hospitals such as this under the closure programme have subsequently had to be re-admitted to others?
My Lords, this all depends on what you call a hospital. It is quite clear that some patients who have been long-term residents in the large mental hospitals such as we are addressing in this Question go into smaller, more local residential units. I am afraid that I do not have the figures on the countrywide position but I shall write to the noble Lord.
My Lords, can the noble Lord tell us what steps his department is taking to try to co-ordinate the closure of hospitals or hospital wards with the provision of facilities within the community, as the latest report from the National Audit Office seems to suggest that there is a time lag?
My Lords, there should be no time lag. Extra money has been provided for the social services departments of health and local authorities to undertake care in the community. We are watching that situation with care.
My Lords, is the Minister aware that many of the old age pensioners returned to the community go back to homes where they live alone and where they will not be looked after? Is it not possible for the hospital concerned to inform local authorities of old age pensioners being returned to the community so that those living alone can be looked after?
My Lords, that is a misguided view, if I may be allowed to say so. As I pointed out to the noble Lord, Lord Winstanley, many of the patients who come from long-stay hospitals move into residential accommodation which is staffed by wardens and others involved in the care of the ex-patients. Many patients in Friern Barnet Hospital are there for short stays and are at liberty to discharge themselves.
My Lords, will the Minister accept that there is a conflict? Does the Minister recall that he told the House that patients leave hospitals such as Friern Barnet only when the hospitals are satisfied that the authorities in whose area they live have adequate resources? Will the Minister accept that practice on the ground shows that very often the system does not work as the Minister and his colleagues believe?Will the Minister look at two matters in respect of Friern Barnet Hospital? Will he satisfy himself that the local authorities into whose areas most of the patients are returned are adequately staffed? Secondly, will he ensure that parents, staff and patients are given a timescale so that not only can the hospital and the local authority be prepared, but also others in making sure that patients are returned in the best of circumstances?
My Lords, yes, I agree with the noble Lord. It is for that reason that the Government have asked Sir Roy Griffiths to inquire into the whole situation of community care. As regards advising patients in good time, where the hospital has decided to discharge a patient it will be necessary to inform the patient and the local authority's social services department so that provision can be made and the patients prepared in the correct way for exit into the community. However, there are long-term plans for closing the hospital; 1993 is currently the suggested date. I do not think that it would be right to begin preparing patients now for what will be a clinical judgment of the doctor concerned much nearer the time of discharge.
My Lords, will the Minister agree that this specific Question, important as it is, and other specific questions merge with the need for a general reappraisal of the NHS?
My Lords, in recent years we have had many reappraisals of the National Health Service, the most recent being that conducted by Sir Roy Griffiths. I do not think that it would be productive to have yet another total upheaval of the National Health Service at the moment.
My Lords, will the Minister tell the House when the report from Sir Roy Griffiths will be received and, more importantly, published?
My Lords, no decision as regards publication has yet been made. Ministers expect to receive the report next month.