HEALTH – PSYCHIATRIC CARE UNITS – 9 November 2009

Mr Charles Walker: ... There are problems with existing mental health wards, as I have touched on. About 20 per cent. of patients feel physically threatened in them, while a further 50 per cent. feel threatened at times. A mental health ward is three times more likely to be assessed as being unsatisfactory than a ward treating people with heart disease or cancer, for example. Unfortunately, as my hon. Friend the Member for New Forest, East (Dr. Lewis) knows, such wards are too often located a long way from people's homes.

Dr Julian Lewis: I know a cue when I hear one. Not for the first time, my hon. Friend makes a remarkably eloquent case on the plight of the mentally ill. I was delighted that the brand-new Woodhaven Hospital was built and opened in the past few years in my constituency. One reason why its acute ward is not a threatening place to be is that it has alongside it a psychiatric intensive care unit, so that if people get into a threatening state, they can be looked after there – except for the fact that that unit has been temporarily closed and might never reopen. Does my hon. Friend agree that to lose a psychiatric intensive care unit, which functions as a complement to an acute ward, is to make things worse not only for the people in need of the intensive care beds, but for those who need to go from the acute ward, at short notice, into intensive care, and who will now be sent, as he says, a long way away?

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Dr Lewis: I promise that this will be my last intervention. I had not intended to make it, but as my hon. Friend has referred to rehabilitation in intermediate stages, I must draw attention to the fact that Crowlin House – a state-of-the-art rehabilitation centre in Totton, in my constituency – is threatened with closure. It has been reprieved for the moment because no places have been found for residents to be sent in the meantime, but once again, exactly the scenario that my hon. Friend is describing in theory is developing in practice in my Hampshire constituency.

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The Minister of State, Department of Health (Phil Hope): ... The hon. Member for New Forest, East (Dr. Lewis) also described excellent work by staff in these units, which are a key part of the mental health landscape. I am committed to continuing to raise standards and to improving the facilities available for in-patients into the future. [...]

Dr Lewis: I just say to the Minister that Hampshire County Council's Health Overview and Scrutiny Committee chairman is as alarmed as I am at the proposal to close the PICU and the intermediate beds in the rehabilitation centre. What can the Minister do if that committee, the local Member and the experts all say that the foundation trust is getting it wrong?

Phil Hope: I do not want to repeat the debate that we had in another Adjournment debate on another occasion. The truth is that these PICU beds are assessed on the local needs by the trust and the clinical leaders of that trust. It must be for local determination to achieve the balance between acute beds, community services and intermediate services. The important thing is that there needs to be spare capacity to cater for acute admissions, as and when they arise – that point was made by the hon. Member for Broxbourne [Charles Walker].

The truth is that we are simply getting better at treating people effectively in the community. That is what people say they prefer, and what experts say provides better long-term outcomes for them. This is something to celebrate, not criticise – not that I believe that the hon. Gentleman was doing so.

There will always be people who need to be admitted, so we have to arrive at the right blend of community and in-patient services. I want to counter any impression that might be left that the decline in bed numbers, which we welcome, has meant that some patients were being forced out of in-patient units before they were ready. Let me say this straight off: just as admitting someone is subject to very careful scrutiny, so is discharging them back into the community. [...]