| Previous Section | Index | Home Page |
10.48 am
The Minister of State, Scottish Office (Lord James Douglas-Hamilton): I congratulate the hon. Member for Dunfermline, West (Ms Squire) on having secured this
debate. People who suffer from dementia and those who tirelessly care for them deserve our understanding and support: I echo the words of the hon. Member for Glasgow, Springburn (Mr. Martin) who congratulated the hon. Member for Croydon, North-West (Mr. Wicks) on introducing the Carers (Recognition and Services) Act 1995 which substantially improved matters.
This debate is a welcome opportunity to restate the Government's and our personal commitment to making certain that people suffering from dementia receive the highest quality health and social care, which they need and deserve. In a moving speech, the hon. Member for Wakefield (Mr. Hinchliffe) described his personal experiences.
Although this is Alzheimer's Week in Scotland, we must keep the needs of those suffering from Alzheimer's and dementia and our responses to them at the forefront of our minds all the time. I agree that large impersonal institutions are not the ideal surroundings for long-stay care, especially not in respect of the social aspects. The aim is to provide care in smaller, more homely settings, and to improve the opportunities for social stimulation.
Of course, community care planning involves health boards, local authorities and others in joint planning and a joint response to a continuous assessment of need. The aim is to reflect local needs and circumstances and to replace outdated institutional care with care that meets existing needs and will continue to do so.
The hon. Members for Darlington (Mr. Milburn) and for Wakefield highlighted the need for quality of care. Inspection teams should ensure that all homes have structured day activities for their residents. Teams can carry out unannounced visits to ensure that necessary stimulation takes place.
The hon. Member for Eastleigh (Mr. Chidgey) raised the case of the Richardson family. It would not be appropriate for me to go into the detailed circumstances, but I stress that we have set out very clearly in England and Scotland the procedures that should be followed in arranging the continuing care of any person who has been in hospital. I would have expected those arrangements and procedures to be followed in that instance. The Under-Secretaries of State for Health, my hon. Friends the Members for Orpington (Mr. Horam) and for Battersea will be responding to the hon. Gentleman, whose correspondence will be studied closely.
The hon. Member for Springburn made certain criticisms of unsatisfactory activities in the social work department. Those matters should be taken up with the director of social work. We have of course introduced a formal complaints procedure to examine alleged unsatisfactory care, and have strengthened the procedures.
The hon. Member for Alyn and Deeside (Mr. Jones) raised the important issue of research funding. I am happy to confirm that the Scottish Office chief scientist's office is always happy to consider and fund research proposals in that area. Similarly, the Department of Health will look sympathetically at any proposals. In Scotland, we provide significant funding to the dementia services development centre, which carries out research. That centre in Stirling was set up in 1989. We provide it with a core grant of £185,000. It provides information, development assistance, training and research to service planners and providers.
The hon. Member for Moray (Mrs. Ewing) mentioned funding. Funding of authorities reflects their lead role in planning and purchasing community care services. Councils in Scotland have received £662 million in community care resources this year--an increase of£41 million on the previous year. I say to the hon. Member for Darlington that expenditure on social care for older people has been increasing by an average of 9 per cent. in real terms for the past 15 years, from about£2 billion in 1980 to £7.3 billion last year.
Dr. Spink:
Does my hon. Friend agree that, since the Government have made adequate funds available, the question is not so much one of funds as the use of them? Is he aware that Essex county council increased its funding from £89 million in 1992 to £192 million today, but continues to misuse those resources by sending young thugs on safari holidays instead of providing proper levels of care? Essex county council is Labour and Liberal Democrat-controlled.
Lord James Douglas-Hamilton:
I am glad to hear that resources are being correctly applied with regard to community care in the area to which my hon. Friend referred. It is important that resources should follow the patient and that an agreed strategy is in place before any patient is moved. We are keen to make certain that that happens.
Lord James Douglas-Hamilton:
I must move on to the points made by the hon. Member for Dunfermline, West, since she initiated the debate.
She quite rightly wants the NHS and local authorities to attach priority to giving dementia a higher profile. We have commissioned work to develop a framework for mental health that will include consideration of the special needs of people with dementia, and, of course, their carers. We shall be consulting widely on the draft framework in the summer. Alzheimer Scotland--Action on Dementia will be fully involved in the process. I should mention in passing that, for the few weeks that I was responsible for the community charge, I exempted those suffering from Alzheimer's. That was my only act of consequence while I had that responsibility.
I should like to refer to the report of the hon. Member for Dunfermline, West and her recommendations. The report was a very useful and constructive contribution, and we have referred it to a working group on residential care in Scotland, which will be reporting in a few weeks. I should like to go through some of her excellent points.
She called for better training for inspectors. We are examining that. The Scottish Office group will make recommendations in about three weeks, which are very likely to be to that effect. She called for better training of home staff. Inspectors check to ensure that staff are appropriately trained for the client group for which they care, especially dementia sufferers. Such provision has been in place for some time.
The hon. Member for Dunfermline, West called for a joint local authority and health board team. The Scottish Office group is considering that recommendation. It is encouraged by the good practice guidance, and is likely to support a mandatory position. She called for an
independent inspectorate, and the Scottish Office group is considering the need for it. She called for the encouragement of best practice. Consultation on nursing home national standards is being issued this week. The residential homes working group is examining the need for standards and, as I mentioned, will be reporting shortly.
The hon. Member called for better funding for more inspectors. The fee charged should cover the need. There should be no bar to increasing the fee if required. That should make the operators self-funding. The fee is, of course, paid by home owners. She called for the publishing of inspectors' reports. There is no bar to that, and I would encourage such openness. She called for tougher guidance on staffing levels. Inspection teams must ensure the appropriate level of staff for the number and dependency of residents. She also called for tougher enforcement of standards, including quick closure where necessary because standards have not been implemented. The working group is examining simplifying and speeding up the procedures. The system must be fair to owners and clients alike.
The hon. Member for Dunfermline, West called for national standards and work is under way on it. She called for the registering of sheltered housing and domiciliary care. I understand that that is likely to be one of the group's recommendations. She called for an urgent review of the Nursing Homes Registration (Scotland) Act 1938. The board is examining the need for that and we shall be happy to consider amending the law in the light of the review. All her points have either been implemented or are in the process of being dealt with. I assure the House that I shall act speedily as soon as I receive the working group's recommendations.
Ms Rachel Squire:
I want to make it clear to hon. Members that the Minister is referring not only to what I have said in this debate about the Alzheimer Scotland--Action on Dementia's report, "Putting Quality First", but to a report that I conducted last year on registration and inspection procedures for residential and nursing homes in Scotland.
Lord James Douglas-Hamilton:
I am glad to confirm that we either have acted or are acting in relation to the hon. Lady's points, which have been helpful.
| Next Section
| Index | Home Page |