Forum Brief: Queen's Speech - Health

Controversial plans to establish foundation hospitals are the flagship of the government's drive to reform the health service.

The plans, championed by health secretary Alan Milburn, will see the best-performing hospitals rewarded with extra financial freedoms.

One of the biggest omissions from the government's legislative plan is a bill to overhaul mental health care and treatment. After a sustained campaign by mental health professionals and civil liberties groups, ministers have decided to allow more consultation on the proposals.

Forum Response: Royal College of Psychiatrists

Dr Tony Zigmond of the Royal College of Psychiatrists told ePolitix.com: "The Royal College of Psychiatrists welcomes the fact that the draft Mental Health Bill is not included in the Queen's Speech.

"The College fully supports legislative reform and is keen to continue talking with government in order to ensure that this country has a Mental Health Act which benefits everyone, whether currently a patient with a mental health disorder or not."

Forum Response: Age Concern

Gordon Lishman, director general of Age Concern in England, told ePolitix.com: "We are very relieved and encouraged that the government has backed down from introducing a Mental Health Bill in the face of serious opposition and concerns expressed by many organisations, including Age Concern.

"However, the introduction of a Mental Health Bill remains crucial. The government now has time to get the reform of the Mental Health Act right and alongside this to introduce capacity legislation to ensure thousands of people who do not have capacity to make decisions because of illness or disability get the protection they don't have at present."

Forum Response: SANE

Marjorie Wallace, chief executive of SANE, said: "We hope that the failure to mention the mental health bill does not mean that our 16 years of campaigning will be allowed to run into the sand.

"If we do not introduce mental health reform soon, to reflect the fact that the majority of mentally ill people live in the community, thousands will continue to be turned away when they seek help and the needs and views of families neglected."

"If new laws are not introduced quickly, mental health, despite being one of the government's three health priorities, could once again be regulated to the bottom of the political agenda.

"We hope they will bring forward proposals backed by the pledges - not yet fulfilled - of increased numbers of beds, places and skilled staff."

Forum Response: Disabilities Trust

A spokesman for the Disabilities Trust told ePolitix.com: "We are pleased to see that the government has apparently listened to the mental health lobby regarding the detrimental effect of the Draft Mental Health Bill and has decided against introducing what would have been a regressive measure in the treatment of people with mental health needs."

Forum Response: Royal College of Nursing

A spokesperson for the Royal College of Nursing said: "We hope that the fact that no mental health bill appeared in the Queen's Speech indicates that the government is taking seriously the responses they received to their consultation on the draft Bill and are reconsidering some of their proposals.

"The RCN, along with our colleagues from the Mental Health Alliance, hopes to continue to work with the department of health to ensure that any new legislation provides fair and accessible services for people with mental health problems.

"We are particularly concerned that any detention under a new Mental Health Act should be of therapeutic benefit to the patient. We would like to see a right of assessment of mental health needs, narrower conditions for the exercise of compulsory powers and a limit to the conditions for the use of compulsion in the community.

"We believe the implementation of Foundation Hospitals has many positive aspects but have some serious concerns affecting both nurses and patients. We have concerns that they could lead to the development of a two-tier system with geographical disparities in both hospital resources and nurse recruitment. In addition, Foundation Hospitals must commit to the provision of a comprehensive, wide range of healthcare services, not just services that are financially profitable.

"However, stakeholder councils are a positive development that could lead to greater accountability and transparency of management as well as greater local autonomy for nurses and patients. This could also lead to better evaluation of healthcare outcomes by trusts with positive benefits for patients.

"Without efficient and high quality discharge planning the aspirations of the NHS plan cannot be realised. The RCN remains unconvinced that charging Social Services for delayed discharges from hospitals will lead to better discharge planning. Strong multi-agency co-operation is the key to improvement so that older people are cared for appropriately after receiving hospital care."

Forum Response: Marie Stopes International

A spokesman for Marie Stopes International told ePolitix.com: "Marie Stopes International welcomes the government's commitment to increase resources to the global efforts to reduce poverty.

"It is hoped, however, that in pursuing this agenda, the government will recognise the vital connection which exists between reducing poverty and improving the reproductive health of women in developing countries.

"Now that the US administration - once the champion of reproductive health and rights - has effectively turned its back on women through a series of unprincipled financial, political and ideological attacks, the world is looking to the United Kingdom and the rest of Europe to carry the standard for female empowerment in the future."

Forum Response: Disability Rights Commission

Bob Niven, chief executive of the Disability Rights Commission, told ePolitix.com: "We have been critical of certain aspects of the bill and welcome the government responding to concerns.

"Reform of mental health legislation is long overdue, particularly in relation to capacity to consent to treatment. However, such reform should not be confused with criminal justice issues.

"We need a new approach that ensures that only people who are incapable of making informed decisions are subject to compulsory treatment. The draft bill contains important safeguards for people treated within the mental health system and we look forward to seeing these being enshrined in law."

Forum Response: Depression Alliance

A spokeswoman for Depression Alliance said: "Depression Alliance is pleased that the Draft Mental Health Bill 2002 was not included in the Queen's speech. The organisation takes the view that failings in current arrangements for mental health are due to a lack of resources rather than a lack of legislation.

"The charity feared that the proposed legislation was unfair, unworkable, highly stigmatising and would contravene Articles 3 and 5 of the European Convention on Human Rights.

"Depression Alliance is now seeking clarification from the government on its proposed course of action with regards to any plans for future mental health legislation.

"Communications have been confused by the home secretary's recent comments but we look forward to once again working in partnership with the department of health."

Forum Response: Construction Products Association

Allan Wilen, economics director at the CPA, told ePolitix.com: "We particularly welcome the proposed Local Government Bill and Health and Social Care Bill, which aim to give Local Councils and NHS trusts greater financial freedom to borrow capital and work in partnership with business to deliver the improvement in local infrastructure and health facilities.

Wilen however also sounded the following note of caution: "Greater freedom at local level must not hinder the delivery of the government's national targets for improving public services and the built environment. Effectivemonitoring of local progress by government must still be a priority."

Forum Response: Royal National Institute for the Blind

A spokesman for the RNIB told ePolitix.com: "Although the absence of a Disability Bill from this year's Queen Speech still rankles, this year's legislative programme could yet deliver important gains in civil rights for blind, partially sighted and disabled people. But it will only do this if the government makes good its commitment to increased mainstreaming of disability equality.

"RNIB will be closely examining each element in the government's legislative programme and proposing amendments to strengthen the civil rights and social inclusion of blind and partially sighted people. We hope the government responds positively to suggestions for equality-proofing key bills such as the Communications Bill, the Local Government Bill, the Railways Transport Safety Bill, the Health and Social Care Bill and the Planning Bill.

"Not mentioned in the Queen's speech but key for disabled people will be welcome regulations extending the Disability Discrimination Act to small employers, police officers, qualifying bodies and work-placement providers.

"But the government must ensure these regulations tighten up the rules on the justification of discrimination in employment or the effectiveness of Part 2 of the DDA will be compromised."

Forum Response: Guide Dogs for the Blind Association

Geraldine Peacock, chief executive of Guide Dogs, told ePolitix.com: "Guide Dogs is pleased to see that a number of issues are addressed in the Queen's Speech which have direct relevance for blind and partially sighted people.

"We welcome the commitment to continued investment in the public services and look forward to that money filtering through to ophthalmic and visual impairment services.

"The introduction of an independent health inspectorate offers the prospect of ensuring consistently high standards of ophthalmic care.

"What I think should have also been there was a commitment to closing the various loopholes in the Disability Discrimination Act and proposals to place effective controls on the sale and use of fireworks, which cost Guide Dogs well over £100,000 a year in retiring, retraining and sedating guide dogs."

Forum Response: Consumers Association

A spokesman for the Consumers Association told ePolitix.com: "Consumers' Association welcomes moves to encourage excellence, greater flexibility and responsiveness within the NHS, which can only be good for patients. However, grave concerns remain that this could lead to huge disparities in the resources available for patient care in different areas - potentially resulting in a two-tier NHS."

Governmental Response: Department of health

A spokesperson for the Department of Health told ePolitix.com: "The Queen's Speech is not a comprehensive list of bills for the coming session and other bills may be introduced. The government remains committed to reforming mental health legislation and a Mental Health Bill will be introduced as soon as time allows.

"We are quite clear about the objectives of the legislation, which are to improve patient safeguards, provide a modern framework for the legislation, which is in line with human rights, and protect public safety."