| Previous Section | Index | Home Page |
11.15 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): I congratulate the hon. Member for Tunbridge Wells (Mr. Norman) on his choice of subject for this debate. The issues that he has raised, although they arise from a particular situation in his constituency on which I shall comment in a moment, go much wider and are important for all people with learning disabilities and their parents, relatives and friends.
Health and social services play an important role in the lives of people with a learning disability, because many of them will rely on those services throughout their lives. We need to ensure that they are delivered in ways that are responsive to them as individuals, enabling them to develop their full potential and to be as independent as possible, yet providing appropriate support and protection for those who need it.
The hon. Gentleman raised the particular issue of the future of the Pines in his constituency. As I am sure he would acknowledge, decisions about the provision of services in a particular locality are rightly a matter for the local statutory authorities. Health and local authorities are best placed to make such decisions in the light of their knowledge of local needs and resources, taking into account departmental guidance and the needs and wishes of the local people with learning disabilities and their relatives.
I understand that West Kent health authority has no immediate plans to close The Pines. Choice Consultancy Services, which was employed by the health authority to review learning disability services in the southern part of west Kent, concluded that the service provided at The Pines in some respects fell below currently applied standards. The health authority is therefore unable to give a firm assurance at the moment that reprovision of the service at The Pines will not be considered at some time in the future. It has, however, confirmed that any possible reprovision will involve full consultation with residents and their relatives and will take account of individual needs. That is as it should be.
Services for people with learning disabilities are becoming increasingly responsive to individual needs. Many people with learning disabilities have a greater choice of living, work and leisure opportunities open to them than ever before, giving them a far better quality of life than was possible in the institutions of the past. The hon. Gentleman recognised that in his contribution.
Many health and local authorities are finding that the aspirations of people with learning disabilities and their families are changing and that what might have been acceptable forms of reprovision in the early days of hospital closures need to be replaced by even more integrated and individualised services.
I have visited services--a village community in Berkshire--and have talked to people with learning disabilities and their relatives. Many would prefer to live in ordinary houses in ordinary streets, and we need to try to respond to that wish when it is clearly expressed. Others would prefer to live in larger units or residential or village communities. It is important that, in planning and commissioning the services to be provided in any given area, health and local authorities take decisions based not on rigid ideology, but on what is best for the individuals concerned. I agree strongly with much of what the hon. Gentleman had to say on that point.
People with learning disabilities and their families have a wide range of needs and an equally wide range of views about the best ways of meeting those needs. It is therefore important that, as far as is practicable, individuals and their relatives should be offered real choices.
Mrs. Curtis-Thomas:
Will my hon. Friend please clarify one point? The hon. Member for Tunbridge Wells (Mr. Norman) mentioned financial considerations and said that running a communal home costs substantially less than furnishing an independent home in a normal street. Will my hon. Friend confirm that financial considerations are not given any notable significance in decisions about what constitutes an appropriate home for an individual?
Mr. Hutton:
The Department's current guidance to authorities on developing health and social services for people with learning disabilities is quite clear on choice. It states that the aim should be
Guidance issued in relation to the 1992 directions on choice also made it clear that there should be a general presumption in favour of people being able to exercise choice over the residential services they receive, and that accommodation should not be deemed unsuitable simply because it does not conform to the authority's preferred model of provision. That is an important point.
To help authorities decide on the most appropriate pattern of residential services for their area, the Department of Health commissioned an independent evaluation of the cost and outcomes of various formsof residential provision for people with learningdisabilities. This complex research compared
dispersed housing, such as supported living and group homes, with NHS residential campuses and village communities. I hope that the results will be published later this month, and I am sure that the hon. Gentleman and my hon. Friend the Member for Crosby (Mrs. Curtis-Thomas) will read the research findings with great interest.
Residential services are not the only services used by people with learning disabilities, and the Department continues to monitor progress in implementing the guidance on learning disability services published by the previous Administration in 1992. In 1997, a national inspection of learning disability services in eight local authority areas found that significant progress had been made in developing more responsive services, such as an expanding range of accommodation, more diverse day services, employment schemes, respite care, domiciliary care services and specialist services for special groups, including those with additional disabilities.
However, the inspection also showed that, despite those significant improvements, services vary both between and within areas, and the range and quality of services currently provided for people with learning disabilities do not yet meet the needs and aspirations of users and carers. I am sure that the hon. Gentleman would agree with me that that is not acceptable. More work needs to be done if we are to provide better services in this important area.
We are taking wider initiatives, which, if I had time, I would go into in more detail. The main thrust of those initiatives, which we outlined in our White Paper "Modernising Social Services", is to raise the quality of services across the board for people with learning disabilities and for other users of social services. We want to ensure that those arrangements are properly enforced, which is why new regional care commissions will operate to national regulatory standards. I hope that that will make a significant contribution to raising the quality and consistency of services.
I hope that the hon. Gentleman welcomes the provisions in the Health Bill that will allow for closer working arrangements between the NHS and social care. Our proposals for pooled budgets, lead commissioning and integrated provision should make it easier for those two statutory authorities to work more closely together. That will be very important, and is of special relevance to services for people with learning disabilities. The provisions in the Health Bill will offer exciting new opportunities for service development.
I shall quickly deal with some of the learning disability initiatives that the Government currently have under way. One of our first steps has been to obtain a clearer picture of current services and of the progress made in implementing the guidance on learning disability services issued in 1992. Officials have studied the plans for the closure of the remaining old long-stay hospitals. To supplement the information obtained from the national inspection, we have undertaken a survey of 21 local authorities and their matching health authorities. The results, which will be published shortly, will provide much useful information to help both local and central decision making.
We have also been working to improve health services for people with learning disabilities. Last year, we published "Signposts for Success", which is good practice guidance on meeting the health needs of people with learning disabilities. That was followed up by regional workshops, and this year we have published "Once a Day", a handbook for primary health care staff. Further work in this area is planned. We are also concerned to improve the skills and competencies of front-line NHS and social care staff.
The needs of users and carers are central to all our thinking. To help us, we have set up a user group for people with learning disabilities and a learning disability advisory group, whose members include users and relatives as well as representatives of the statutory and non-statutory sectors. The groups provide an important forum in which to discuss the many issues surrounding the development of services for people with learning disabilities.
"to arrange services on an increasingly individual basis, taking account of age, needs, degree of disability, the personal preferences of the individual and his or her parents or carers, culture, race and gender."
The guidance gives authorities considerable flexibility over the provision of services, including residential services. There is nothing to prevent authorities from commissioning, or providing places in, supported living arrangements, group homes, residential or village communities or indeed any other form of provision if they deem that to be appropriate. What is important is what will best meet the assessed needs and wishes of the individual and his or her relatives within the resources available.
| Next Section
| Index | Home Page |