Pensions and Education

Part of Orders of the Day — Queen's Speech – in the House of Commons at 12:00 am on 31 October 1969.

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Photo of Lord  Balniel Lord Balniel , Hertford 12:00, 31 October 1969

Another basic security is a job. On television the Prime Minister said: We see no reason why it"— unemployment— should rise at all apart from seasonal increases. That was on 30th March, 1966, one day before the election. This month the "Employment and Productivity Gazette" has been published and so we can compare the employment position of March this year with that of the March when the Prime Minister was speaking. There are 66,000 fewer jobs in the North; 106,000 fewer jobs in Yorkshire and Humberside; 111,000 fewer jobs in the North-West; 49,000 fewer jobs in Wales; 66,000 fewer jobs in Scotland. There are 688,000 fewer jobs than when the Prime Minister was making that pledge on the day before the election.

I will certainly concede that this has helped to swell social services spending. Unemployment benefit has risen from £49 million in 1965 to £125 million in 1968, due partially to the earnings-related unemployment benefit scheme but very largely due to the increase in unemployment.

I will concentrate the main part of my speech on the other basic securities, the care of the sick and the disabled and of the old. In the vast range of health and welfare services one can concentrate on only a few of the main strands, and I shall refer to these. The first is the care of the mentally ill, about whom the public conscience has been awakened. Secondly, and related to the first, there is the need to develop community care services where the old can be helped to live in their own homes and where the disturbed and disabled can live in sheltered or specially designed accommodation. The third is the administrative structure of the health services, the need to create one authority which can make a comparative judgment between the different needs and different services. As one example of the need for this comparative judgment, the cost of keeping a child in a remand home is more than £1,000 a year and yet if one social worker could keep two children out of residential care, his or her wages would have already been paid and the children would have benefited.

I shall deal with the mental health services first. When the history of the mentally ill and subnormal comes to be written, the past 12 months will have their place in that history. Unfortunately, it will not be because of any great advances. It is because of the findings of tribunals inquiring into allegations of ill-treatment, because of the disastrous fire at Shelton Hospital, because of a recent coroner's report, because of the increased demand by the Press, television and the professions for reform.

I believe that the past 12 months will have their place in history because these tragedies have awakened public conscience. It has been hurt, and I can only say, "Thank God for that". I make absolutely no partisan point. It is the duty and, with public conscience now awakened, the opportunity for leaders in public life to hammer home the fact that the facilities for the care of the mentally ill and the mentally subnormal are very unsatisfactory. I happily give the Secretary of State for Social Services credit for his speeches on this subject. There is, of course, a good side. Most local authority training centres and many of the hospital schools are a joy to visit. One comes away from them thrilled at what one sees. But it only makes the contrast with the children's wards and the adult wards in so many of our subnormality hospitals the more heartbreaking.

On the good side there is the dedicated work of the nurses, staff and administrators and the brilliant achievements of many of our doctors. But such dedication only makes more frustrating the appallingly difficult—indeed almost impossible—conditions in which they have to work. I saw a film earlier this week which has not yet been released to the general public. It showed something which I have seen too often in walking round these hospitals—two nurses caring for a ward of 50 subnormal children. We have only to ask a mother who has to care for a family of four or five healthy children what her task is to get some understanding of the strain under which our medical staff is working.

Also on the good side there is the wonderful advance in medical knowledge. But this again, as the Minister mentioned, brings its problems. Not so long ago the subnormal did not often live beyond the age of 50. But today the number of people over the age of 55 in the subnormality hospitals has doubled since 1954. We should like to debate this crucially important sector of the health services, and I ask the Minister whether he would try to arrange time for such a debate.

But, in spite of all the speeches, I am concerned to see virtually no action which gives any indication of the Government's determination to secure a higher priority for the mentally ill. The weekly inpatient cost of the mental illness hospitals in 1964–65 was 31·6 per cent. of that in the acute hospitals. Today it remains 31·6 per cent. The last Annual Report of the Department of Health and Social Security fisted 85 major building projects, each costing over £1 million, which have been completed in 1967–68 or have been started since then. Only four of them are said to include a psychiatric unit. Only one is a mental subnormality hospital. Only one includes any geriatric department. The total cost of these 85 projects is £284 million. The six schemes concerned with mental ill-health amount to only £9 million, 3·17 per cent. of the total cost—a fall on the previous year's figures.

When one projects into the future, an equally unsatisfactory picture emerges. The Minister's own departmental report on the subnormality services shows that only 4·4 per cent. by value of all starts on capital schemes over £75,000 from 1968–69 to 1972–73 will be for the subnormality departments in subnormality hospitals. This simply is not good enough. These figures do not reflect the priority which should be given to the care of the mentally ill. I agree with Professor Townsend, who was referring to the rather better figures of the previous year when he said on 20th February this year: I conclude that there is no evidence of relatively higher priority being given to the psychiatric services in hospital; if anything, rather the reverse". I have no time to deploy in detail the policy which should be followed, so I shall mention only one aspect. Clearly much emphasis must be placed on community care—hostels, sheltered lodgings, sheltered accommodation, sheltered jobs, special training for those who need training, shelter and care rather than medical treatment. But, in the hospital service, for those children and adults who have defeated the junior training centres, who have defeated the paediatric clinics, who cannot be cared for in children's homes, the Government should take a firm decision that within a set time no unit of care should be allowed which houses more than 30 adults or more than 20 children together.

Not only should the upgrading of present wards be in the direction of small unit provision, but the Government should accept that much of the money which they are pouring into archaic buildings—patching, painting, reconstructing and repairing—is going into buildings which any commercial enterprise would have knocked down 50 years ago. It might give a pleasant historical nostalgia to read that the foundation stone had been laid by the Prince Consort. But the bulldozer is the only answer to these buildings.