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Mr. Adrian Sanders (Torbay) (LD): The hon. Gentleman read out names of his constituents. There are constituents of mine who also depend on that unit. If we are in an age where people are living longer and getting older, will not demands be even greater than they are at present? Does he share my feeling that the plans that are being talked about for the future of mental health care services do not take into consideration the needs of those who require support at such a centre, or of those who need respite in order that their loved ones are cared for while they have some time out?

Mr. Steen: The hon. Gentleman could not have put it better. He and I share the bay—he has slightly more of it than me—and we are of one mind about the matter. Mental health services must be led not by what the administrators want but by what the patients and the carers need. I am grateful for that intervention.
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In a letter that Mr. Tulley wrote to me on 5 January, he said:

But he has done nothing about it. The chief executive also refers to the closure of Briseham as a "short-term decision." Six months later and we are no further forward.

In the letter of 5 January, the chief executive admitted:

at Briseham. It is not just the Member of Parliament who was not consulted but the staff, the patients, the carers, the Devon Partnership patient and public forum, Devon county council and the Torbay unitary authority, the later two having scrutinising responsibilities. How can the trust justify failing to consult the interested parties before taking such a monumental decision, which has devastated so many of my constituents' lives?

What is the point of the Government setting up a consultation and scrutiny mechanism if it is totally disregarded? Does not the Minister agree that the behaviour of the trust leaves much to be desired and that it must put its consultation process in order? The manner of Briseham's closure and the lack of consultation give weight to allegations that the trust behaves in an autocratic, cavalier and even bullying way, rather than as a responsible public body.

Consultation has been prolific over whether to reopen the unit, which has so far taken six months without any conclusion. Why is it that the unit can be closed summarily and without consultation, abandoning patients and carers, but cannot be reopened without endless committee meetings? It seems that services can be suspended at speed but that reinstating them is a painstaking process.

The trust conveniently forgets that it cannot put on hold the debilitating effects of the disease while it debates the future. I believe the Torbay unitary authority's health scrutiny committee will produce a critical report later this month, which will quite rightly draw attention to the failures of the trust in a number of important areas, particularly in relation to the closure of Briseham.

One constituent of mine who received day care at Briseham before its closure was given no alternative care immediately following the closure of the unit, and his wife had to look after him unassisted for seven weeks until an alternative unit was able to provide some help. Sadly, he has since died. It is simply not acceptable that, in the last few months of a person's life, when they need care most—and the health trust knows that they need it most—care is unilaterally withdrawn, and their life is made worse, not to mention that of the carer. Their lives are callously turned upside down without any regard to the impact. The worst thing is that, too often, the administrators are not taken to task for that because the people hit hardest by their actions are those least able to speak up for themselves. Few believe the reasons given by Devon Partnership NHS trust as to why Briseham was closed and the trust has not been forthcoming with a detailed explanation that fits with the reality.

The whole area of mental health still suffers from public suspicion and distrust. A key step in overcoming it is for the mental health authorities to be more open
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about the way that they run their organisations. There needs to be transparency not just in the decision-making process, but in day-to-day operations. We should never forget that those who rely on mental health services are the most vulnerable and confused people who are the least able to say what they want for themselves. That is made even more unacceptable by virtue of the fact that those who rely on mental health services, for whom the partnership is supposed to provide, are sometimes extremely confused. They need their carers listened to and they need to be heard.

I ask the Secretary of State to review the running of the Devon Partnership NHS trust, its decision to close the   Briseham unit, the manner in which the decision was made, current scrutiny procedures and the failure to      provide day care facilities in Brixham—with 18,000 people, it is the largest town in my constituency—for people with dementia.

I believe that the Government are planning a new approach to care for elderly people with mental health problems whereby responsibility will switch from health to social services. That will enable the providers of services to charge for whatever they offer, which could mean Alzheimer's patients and their carers being squeezed of every penny piece until the pips squeak. Everyone will be means-tested. If a carer needs respite care, he will have to pay for it, and the Minister will appreciate that many carers will not be able to afford it and will be forced to give up caring and put the patient back into the health service, along with the accompanying additional costs. Have the Government not realised that the consequence of their penny-pinching approach towards those least able to fend for themselves will be disastrous? Furthermore, it is rumoured that the Government's position that dementia and Alzheimer's are no longer to be treated as an illness, but as a condition, may result in health care for people with those diseases no longer being free at the point of delivery.

Carers save the state millions of pounds by providing care that the state would otherwise have to provide. That should be remembered when arguments about the cost of facilities for people with dementia are being bandied about. It is vital that the carer's desire to look after their loved ones is not exploited by the state as a way to avoid responsibility for looking after people with serious mental health problems.

Yesterday, I met the chairman, chief executive and chief nursing officer of the partnership trust. I have no doubt that their intentions are good and that they wish to do the best they can for those with mental illnesses in Devon, but they are going about it in a very strange way. If they are to win back the confidence of not just myself, but very many others, they will need to prove that they do provide people with the front-line services that the patients—not the administrators—need and deserve, with the £85 million budget that they have at their disposal.

The trust was at pains to point out that the type of support for people with dementia is increasingly focused on support in the home rather than in special units, but there is still a need for day respite services, as carers often want some time to themselves in their own home. Briseham provided that with its day-care facilities and the popularity of the service speaks for itself. People with Alzheimer's often benefit from mixing with other
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people in a different environment, particularly one where medical treatment for any ailments can be provided immediately. I am not entirely convinced that the evidence bears out the trust's suggestion that care in the home is preferable to care in a specialist unit. It is not an either or situation: both are needed.

We are the fourth richest economy in the world, so it is simply not acceptable that, with the resources and skills available, we treat those in desperate need of support so badly. How society treats its elderly and vulnerable is a most significant reflection of its values. There are too many public bodies in Britain whose employees feel unaccountable to anybody other than their immediate superiors—certainly not to the people whom they are meant to be serving. Some of those bodies behave like third-world dictatorships rather than   publicly accountable and socially responsible organisations.

Will the Minister ensure that she takes a very close look at the Devon Partnership NHS trust and makes a clear and unequivocal statement as to the future of the Briseham unit in Brixham, what facilities will be available in Brixham for people with Alzheimer's, what respite facilities will be available for carers and what domiciliary care and home facilities will be on call? The testimonies of carers of people who were cared for at the Briseham unit show that it was a hugely valued and vital resource for people coping with incredibly difficult situations. The way the Devon Partnership NHS trust has behaved cries out for an explanation. Perhaps the Minister can make some suggestions as to how it can move forward with the support of the entire community.

7.49 pm

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