Below is the text of the speech made by Richard Needham, the then Conservative MP for North Wiltshire, in the House of Commons on 3 July 1985.
It is not very often, I suspect, Mr. Deputy Speaker, that you find two unrelated Pattens sitting on the same Bench at half past 4 in the morning. I welcome the arrival of my hon. Friend the Member for Oxford, West and Abingdon (Mr. Patten) to reply to this short debate. I am grateful to my hon. Friend the Member for Bath (Mr. Patten), who suggested over a year ago that I should instigate the debate. I owe much of the information and knowledge that I have gained about the problems of schizophrenia and the problems of parents who have to look after schizophrenic children to a constituent of my hon. Friend the Member for Bath, Mrs. Baker, who is the secretary of the Bath schizophrenia group.
I have been in correspondence with the Department of Health and Social Security on the issue on behalf of one of my constituents for a considerable time. In August 1983 Lord Glenarthur wrote to me, making the following points:
“In the light of comments received on that document”—
he was referring to a document entitled “Care in the Community”—
“we are pressing ahead with a programme aimed at getting out of hospital and into community care as many as possible of those patients who do not specifically require hospital care … As you know, the needs of people who are, or have been mentally ill vary greatly. Both local health and social services authorities are obliged to provide care and after-care for these clients. A community psychiatric nursing service is an important component of health service provision in the community. This aims to provide help outside the hospital and so prevent unnecessary admission to hospital and to provide a nursing aftercare service following discharge from hospital.”
It is that paragraph that I want to bring to the Minister’s attention in relation to a case in my constituency. I have an elderly couple in my constituency. The husband is 77 years old. His wife is half a year younger than he is and is bedridden. They are not badly off financially, but the last few years of their lives have in many ways been a living hell as they have struggled to look after their chronically schizophrenic daughter. Two and a half years ago she discharged herself from a mental institution. She then squatted in an abandoned farmhouse, but was finally persuaded to move to a MIND hostel, where she set fire to her bedclothes. It was then agreed mutually that she should return home. Since then she has been living at home. I should say that she had also been living at home on and off before that.
As I have explained, the parents are old and infirm, and what assistance do they get for her care? Once a fortnight they are visited by the community psychiatric nurse, who gives the daughter an injection. The nurse is extremely busy and does not have much time to talk to the parents. That is understandable, and I make no criticism of it. Once every three or so months the head social worker from the local mental hospital comes to visit them. The daughter receives invalidity benefit of £30 to £40 a week and the bedridden mother gets home help five days a week.
Therefore, the sum total of the assistance referred to in the noble Lord’s letter is a visit once a fortnight from the CPN — the community psychiatric nurse — who, as I have said does not have much time, and who is changed quite regularly, and that is it. There has been no respite for the parents, according to them, to enable them to get away while their daughter is cared for.
The point that I want to bring to the attention of the House is that chronic schizophrenia is a young person’s disease. It strikes between the ages of 15 and 30 and makes no distinction between rich and poor, clever and stupid. One third of those who suffer have a reasonable chance of total remission, one third do not recover, and one third continue to have attacks with varying degrees of intensity.
That most of the patients are better treated outside the confines of long-stay mental institutions is not in doubt. What is in doubt is whether in certain cases the policy of returning to the community is being properly and adequately organised and financed, or whether an increasing and intolerable burden is being placed on the very often aging parents.
What provisions are being made for cases such as the one that I have quoted? I see in his place my hon. Friend the Member for Norwich, North (Mr. Thompson), who also has a great understanding of these problems and whose views are similar to mine on this matter. When will there be individual care plans? When will there be places to which patients can go with their parents to have care dispensed and where the different organisations responsible for patient care can come together to discuss care, provision and future needs so that parent substitutes can be built up, so that general practitioners can feature much more in looking after the problems of the chronically disabled — general practitioners play a vital part in emergencies, but it is often felt by elderly parents that it would be much more useful to have them involved in a more permanent way—and also so that the chances of any likely increase in the suicide rate can be resisted? Parents may feel that without a place which is specifically set aside for them to discuss these matters, the care that their children get and that they can look for is disjointed.
Chronic schizophrenia is a dreadful disease. It is dreadful for the sufferer, as he or she withdraws from the family circle, suffers hallucinations and delusions, hears voices, loses the will to work and suffers acute stress and worry. Physically robust the sufferers may be, but they become mentally wrecked. It is dreadful for the parents as they see the love of their children wither and change. It is dreadful for the parents as their hopes for their children are dashed and as their responsibility for the care of their children increases and the prospect of a peaceful old age recedes.
When one parent was told that his child had chronic schizophrenia, he was advised, “React normally. Try to treat your child as normally as you can, and try to be as normal as you can.” After years of care for his child, he said to me, “You have to become abnormal yourself if you are to survive.” The point that I make follows on from the report of the Select Committee on Social Services. It does not seem to be right that in the care of chronic schizophrenics the parents should be other than a bonus in the provision of those services that patients require. They should not be the centre around which the various bodies which are responsible for patients hover uncertainly.
The report of the Select Committee, which was published in January, covers the ground very adequately and puts forward recommendations and solutions. When the Government respond to it, I hope that they will follow the recommendations of the Committee and do so with urgency. I trust that they will do nothing to close down existing provisions until adequate community provision is demonstrably in place. It cannot be right that very elderly people have their last years ruined by stress and worry because their children, whose love they find fading and withering away, cannot adequately look after themselves and they, the parents, cannot adequately look after them.
Mr. Patrick Thompson (Norwich, North) rose—
Mr. Deputy Speaker (Sir Paul Dean)
Order. Does the hon. Gentleman have his hon. Friend’s agreement to intervene?
Yes, Mr. Deputy Speaker.
Mr. Patrick Thompson (Norwich, North)
I am grateful for the opportunity to intervene briefly in this short debate in support of my hon. Friend the Member for Wiltshire, North (Mr. Needham). In my short time as a Member of Parliament, I have already come across cases in my constituency identical to those which my hon. Friend described. The matter has also come closely within my experience and knowledge. Therefore, I can reinforce my hon. Friend’s description of the great distress and catastrophic effects of this disease on the families of sufferers.
It is right to emphasise that schizophrenia is remarkably common although, for obvious reasons, not widely publicised. The National Schizophrenia Fellowship was formed to support families who face this difficulty and who are not receiving the necessary support. It started with a letter in The Times by the founder, and the flood of response to it reflects how common the problem is, yet how little the general public know about it.
My hon. Friend referred to the effects of recent Mental Health Acts, the fact that treatment cannot always be completed and the fact, therefore, that the burden falls back on the family. Therefore, I do not need to deal with that.
Relatives cannot easily cope with the problem, especially elderly relatives. Families find it difficult to put up with the emotional stress and the violence. In supporting my hon. Friend, I encourage the Government to provide understanding and support, and to encourage society also to provide understanding and support for people facing this serious problem. I hope the that the Minister will respond in that spirit.