Circular produced by the Ministry of Health

Ministry of Health

English

Oxford Brookes University: RADAR

To County Councils, ~ 026 3 7 [ 342. MIN Circular 16{58. MINISTRY OF HEALTH, SAVILE Row, LONDON, W.l. lOth July, \958. County Borough Councils (England and Wales) Sir, Services for Handicapped Persons I. I 3Jill directed by the Minister of Health to refer to ~he conclusions and recommendations of the Committee of Jnquiry on the rehabilitation, 1raining and ·resettlement of disabled persons (Cmd. 9883) so far as vhey concern services provided under vhe National Healtb Service and National Assistance Acts for \W!ich he is lihe central authority. 2. As ~egards services which local authorities have power to provide under Section 29 of nhe National Assistance Act, 1948, lihe Committee concluded (paragrruph 106 of their Report) that there is a need for fu'ller and beUer prov.ision and scope for considerable development. They urged increased provision of day dlubs or centres for the handicapped (paragraph 115) and a wider 'provision of occupational homework (paragraph 228 and recommendation 31); and more 'help 'by local authorities in the supplying of necessary personal aids (paragraph 131 and recommendation 14) and in effecting structural alterations in disabled persons' homes (paragraph 135 and recommendation 15, and also recommendation 42 with particular refer· ence to para,plegics). In paragraph 124 the Committee e)(Jpressed the: view _ that more would have been done by local authorities in developing welfare services under Section 29 if more assistance from central funds had been available and they recommended that local auvhorities &hould be grant-aided by ·the Exchequer in their expendivure on these services. The Govern-ment consider vhat, in view of their proposal, embodied in the Local Govemment Bill now before Parli3Jillent, to iniXoduce a genera'! Exchequer grant covering a large number of services, including the local ihealvh services, it would be ina•ppropriate to introduce a new specific grant for weilfare services for the handicapped. On the assumption, !however, llhat the Bill is enacted in su!bstantially its present form, they have decided that a measure of assistance should be •given through nhe general grant towards the eX!pendi-rure of Jooal aunhorities in developing vheir sel'Vices in future years and an appropriate allowance for this purpose will be inclruded in the amount of the general grant .for the first grant period starting in the year 1959- 60. While appreciating thM nhe development of Section 29 services must !have regard ro current financial considerations, the Minister feels sure that th is decision will encourage local authorities to ,proceed as opportunity serves along the •lines endorsed by the Committee. 3. I am to take this opportunity to refer to circular 32 / 51 dated 28th August, 1951, in which t!he Minister invited authorities to submit to him schemes for the provision of welf.iare services for handicapped persons other than the blind and partially si~hted. In llhat circular it was said in regard to the duties which adoption of a scheme makes obligatory on the Council The Clerk of the County Council , The Town Clerk. that " these services seem to him ~the Minister) to represent a substantial advance on existing measures for the welfare of ·the handicapped and yet to impose no undue burden on any area, even in the difficult circumstances of today ". llhe Minister asks the relatively small number of local authorities who have not yet submitted schemes to him to give renewed consideration to their adoption in the light of the remarks quoted and the other con-siderations advanced in the 1951 circular. He appreciates that a n=ber of these authorities are supporting financially the provision of services by voluntary organisations lbut he is satisfied that adoption by an authority of ·powers ·to rprowde services themselves (whioh they can exercise in full co-operation wi~h the voliUiltary organisa>tions) enables better and more uniform provision 10 be made. 4. In recommendation 40 the Committee urge that more hostels for tuberculous ,persons whose !home circumstances are unfavourable or for whom suitable employment cannot be found in their home area, of the kind already provided by one or two local authorities, should be establi~hed where they are found to •be necessary ; in recommendation 44 that local authorities should be encouraged to e~periment in nhe ·provision of hostels for convalescent mental patients whi~e undergoing industrial rehabilitation or training, or on first entering employment. Neither of t'hese recommenda-tions is of universal application. If an individual a;uthority ~hinks there is a need for and wishes to provide a hostel of either type in their area the Minister will 1be ready to consider proposals as sympathetically as he is able within the limits necessarily imposed by existing financial circum-stances in rel'ation to capita!! expenditure. The Committee did not specify whether powers under the National Healvh Service Act or under the National Assistance Act should be rused by ·local authorities for this purpose. In the case of ~he tuberculous, one of we main purposes in esta;blishing a hostel !>e , to supervise and provide appropriate advice for infectious cases so that they adopt proper precautions when at work or mixing in the community, while at tlhe same time a watch is kept on their own health. If this is to be the main purpose of the hostel there are good reasons for proposing that it should be •provided as part of the local authority's arrangements for the care and after care of the tuberculous under Section 28 of nhe National Heal·th Service Act. Use of the same powers to provide for convalescent mental .patients a hostel of the sort recommended by the Committee would fit in well with the subsequently published recommendations of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency on the needs of the mentally disordered in the community. 5. In paragraph 119 the Committee say that "it appears that a stage has now been reached where tlhey (local authorities) could with advantage devote some of their resources to ,providing short-st·ay hostels ". In cirolillar 14157 relating to local authority services for ·the ohronic sick and infirm the Minister drew a;ttention to the value of short-stay accommodation as a means of ,helping with llhe care of old people and expressed ·the hope that local authorities woruld extend their arrangements in this direction as their commitments allow. He is sure that authorities will wish to give the same consideration to the needs of the disabled for this form of provision as of the elderly. 6. The Committee recommend in paragraph 110 the nomination by local authorities of a suitable officer ·to a•ttend hospital case conferences designed to assess the we!l!fare needs of particular patients. This recommendation is linked in •part with recommendation 3 in which it is suggested that each major hospital sets up a resettlement clinic. The Minister thinks the approach 2 in regard to case conferences could most conveniently be made by the hospital authorities and he asks Jocal authorities to consider favourably any requests made to them by Boards of Governors or Regional Hospital Boards (either direct or through Hospital Management Committees) to be represented at these conferences 1by an appropriate officer. Since these con-ferences would be concerned only with especially difficult cases they would probably not be held very frequently. A copy of the memorandum which ~he Minister has sent to hospitai authorities on this and other recommenda-tions is enclosed for information. It will be observed that attention has been drawn .amongst other things to recommendation 13 relating to prompt notification of discharge from ·hospitals. 7. In paragraphs 112, 113 and 321 the Committee make some general observations on co-operation including liaison where necessary between the local authority officer responsible ifor providing a welfare service for a severely thandicapped tperson and his general practitioner. The Mi-nister concurs with what the Committee say but since he has recently referred to 'this subject in circular 14/ 57 he does not think he need further allude to it here. He desires however to invite attention to what is said in paragraph 254 of the report as to the importance of close contact between the youth employment service and ~he local aut:hority welfare department in lihe case of disabled school leavers and other young disabled persons. He under-stands that the youth employment service fully accept the need for such contact and that reference to it is included in the memorandum of guidance issued •to youth employment officers. T'he Minister believes however that in a nlllD'ber of areas the fu~l co-operation between .the youth employment and Vhe welfare services that is obviously most desirable remains to be developed. 8. A copy of this circular is enclosed for the Council's Chief Welfare Officer. A copy •has been sent separately to the Medical Officer-of 9. Cor·respondence from auvhorities in Wales and Monmouthshire in regard to this circular s·hould be addressed to The Ohairman, Welsh Board of Health, Cathays Park, Cardiff. I am, Sir, Your obedient Servant, (87SI2) Wt. 8014-24S2 SOO 1/ S9 D.L./372. 3 't ( , . ._ ) 

'Services for Handicapped Persons'

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'Services for Handicapped Persons'

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