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was perfectly true : there were no such plans. However, I have explained in some detail why the position of the SHA changed during the nine months beginning with the investigation by the HAS and the SSI, the findings of which were published last June. No hon. Member would argue that a commitment, albeit in an august letter from a Secretary of State to you, Mr. Speaker, that there was, as accurately stated then, no intention to close Hilda Lewis house, should bind the managers of the health service for ever, particularly if the managers receive advice from the psychiatrists and specialists in the field with the pedigree that I have described to the House.Even though the undertaking was made in a letter to you, Mr. Speaker, I feel perfectly comfortable that the advice available--not to the Government, because this is not directly a Government decision--to the special health authority charged with managing that important national resource, and the circumstances have changed sufficiently for a decision to be reached that clearly contradicts the statement made by my right hon. and learned Friend when he was Secretary of State for Health some time ago.
The hon. Gentleman also asked whether we and the SHA recognised that the service provided at Hilda Lewis house was a national service. It is true that the services provided by any SHA are available to the whole NHS. It is part of the purpose of the SHA system that those authorities should develop the delivery of health care and that the results of their experience should be available widely through the health service. To that extent, the service provided at Hilda Lewis house was a national service. However, when we consider the pattern of where the patients came from, it is difficult to argue that Hilda Lewis house was a national service that was used throughout the country.
Between 1985 and 1991, 70 in-patients were cared for at Hilda Lewis house of whom 63 per cent.--very nearly two thirds--came from the South East Thames region in which Hilda Lewis house was located. Of the remainder, 16 per cent. came from South West Thames, which is the next nearest region, and only 21 per cent. of the total--15 cases--came from outside one of the two south Thames regions.
Against that background, I do not think that the case is made that that was a service of extensive value to the Trent region, for example, which covers my constituency, still less to the Scottish Home and Health Department, which covers the hon. Gentleman's constituency. However, that service undoubtedly performed valuable work for the people who went there, and it developed a better understanding of the care of those conditions, but I do not think that it was a resource that met a national need.
Mr. Canavan : The previous Secretary of State described it as a unique service. Is the Minister reneging on that statement? He has only five minutes in which to answer. What provision has been made for the children who were discharged last Friday? If it was a unique service, there is literally nowhere else for those children to go.
Mr. Dorrell : Those were to be my final two points to the hon. Gentleman. One was whether an alternative service of a similar type is available to meet that need elsewhere in the country. I am advised that two institutions offer similar
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treatment for children who suffer from the combination of acute psychiatric conditions and learning difficulties. They are Harper house, which is in North West Thames region, and the Haven, which is in Paignton, in South Western region. Those facilities offer, I am advised, care that is comparable with that which was previously available at Hilda Lewis house.I repeat that, bearing in mind the geographical home territory of the people who were treated at Hilda Lewis house, there is simply no support for the assertion that it was a national service. Certainly, there was learning which may be useful on a national scale--I do not dispute that-- but I dispute that the service was uniformly available and used through the national health service.
Mr. Canavan : Do any of the places that the Minister has named offer 24-hour treatment combined with the assessment that was given at Hilda Lewis house?
Mr. Dorrell : Again, I am advised that the North West Thames, Northern and South-Western RHAs have a range of services that provide multi -disciplinary in-patient, out-patient community assessment and specialised consultancy for such patients. "In-patient" means residential care for those for whom it is most appropriate. I stress to the hon. Gentleman, as I have stressed to many audiences, both friendly and hostile, the health service's commitment to ensuring that, where possible, all people who suffer from a learning disability, and most particularly young people who suffer from a learning disability, are cared for in a domestic context and, where humanly possible, with their families. That is simply because the overwhelming weight of evidence is that, when that risk is taken and when that attempt is made, the outcome in terms of the lifestyle of the individual is dramatically better than is possible in an in-patient context. There are repeated examples of patients surprising themselves, their families and professional staff by what they are able to do when supported in that context.
I now refer to the hon. Gentleman's question about the three patients who were discharged last Friday. I remind the House that the closure of that facility did not involve a massive dislocation ; it involved the relocation of three patients--all of them individuals with the right to expect that we discharge a proper responsibility of care for them. I am advised that two of the existing patients, one from Waltham Forest and one from Worthing, were already in local authority care and have returned to respite care in their home areas. The third has returned to his home in the Oxford area while a suitable placement nearer home is found. The SHA continues, because we are talking about the closure of only a tiny part of its activity. It will use some of the money that is released by the closure of Hilda Lewis house to ensure that there is proper follow-up of not only those three cases but all the cases that stand to benefit from the type of services offered through that important centre of excellence.
The centre of excellence is the SHA. It has a deep and continuing commitment to continue to improve the quality of care available in the health service for this type of patient. It is its professional judgment that such care is best delivered by following the route that it has set out.
Mr. Canavan : Why were the children discharged before the treatment was completed?
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Mr. Dorrell : As I have said, the treatment of such conditions by its nature is never completed. We seek to ensure that for all discharged patients there is follow-up and that continuing care which meets their needs is available. That is the commitment which I have given and repeat and which the health authority has given. Question put and agreed to.Adjourned accordingly at half-past Ten o'clock.
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