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Contribution to the Mental Health Debate

Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op):
It is a pleasure to follow the hon. Member for West Chelmsford (Mr. Burns) in this debate. We engaged in many stimulating discussions when we were colleagues on the Health Committee. As usual, he was trenchant this afternoon; but more unusually, I found myself agreeing with much of what he said, at least in the earlier part of his remarks when he was speaking from his experience as a Minister with responsibility for mental health.
Let me first say that I welcome the central thrust of yesterday’s legislative package, which is to tackle the big issues of today—the changing nature of crime, the causes and effects of climate change and the need for pension reform. Each of those issues is of great concern to my constituents, and I look forward to helping to progress the new legislation through this House, and—possibly more important, and as has been remarked on more than one occasion today—to ensuring that it is put into effect once it is enacted.
I wish however mainly to confine my brief remarks to the mental health Bill. It is interesting—and perhaps a little regrettable—that the mental health Bill has been introduced in an atmosphere that emphasises the need for security. It might have been better to have reassured the many people—some estimate the figure to be as high as one in four of the population—who at some time in their lives will suffer from a mental illness. Incidentally, the great majority of them pose no threat to anyone—save, on occasion, to themselves. It would have been better to have reassured such people that the outdated laws—they date back to 1983—will be replaced by modern legislation that will uphold the human rights of patients, provide easy access to care for people with mental illnesses and allow the use of compulsory treatment only as a last resort. The words used by Her Majesty yesterday reflect that:
“A Bill will be introduced to provide a better framework for treating people with mental disorders.”
I hope that that will be the main focus of the Bill as it passes through both Houses of Parliament.
I spent much of the parliamentary Session of 2004-05 as a member of the Joint Committee on the then draft Mental Health Bill. That was an interesting and rewarding experience. We took a great deal of evidence, deliberated long and hard, and eventually produced a fairly lengthy, but well targeted, report. It was well received by most of those best placed to understand the issues. But unfortunately, not long after it was published, the Government thanked us for our work and told us that they had decided that they would not proceed with a draft Bill in that form.
In our report, we recognised that the current legislation was clearly out of date, and that its replacement’s
“primary purpose...must be to improve services and safeguards for patients and to reduce the stigma of mental disorder”.
Naturally, my colleagues in this House and the other place were disappointed that there was to be further delay in replacing the outdated legislation. So the new proposals for a mental health Bill that were put forward yesterday are most welcome, and it is pleasing that some of them clearly reflect a number of the points highlighted in our report: in particular, the increase in availability and appropriateness of treatment, which the Minister has emphasised; the emphasis on patients’ human rights; the introduction of limited supervised treatment in the community, but only after a period of treatment and assessment in hospital; the attempt to agree a single definition of mental disorder; and expanding the skill base of
professionals who are responsible for the treatment of patients treated without consent. All that has been recognised.
Our report also made some other important recommendations which have not so far been addressed in the information provided about the proposed Bill. They include conditions to ensure that legislation cannot be used inappropriately. There is also no mention of the recommendation that the threshold of risk for harm to others should be raised, or that compulsion should be used only where a treatment is available which would be of therapeutic benefit to the patient.
A number of other questions will be asked of the new Bill. Where a person’s decision-making is unimpaired, will they be allowed to refuse treatment, as recommended in the report? Could there be separate criteria, or different legislation, for dangerous people with severe personality disorder, also as recommended in the report? Will the Bill introduce new national training standards and monitoring, as recommended in the report?
Our report also expressed serious concern in respect of the resources needed to implement the proposals in the previous draft Bill, particularly in relation to adequate staffing and funding for mental health tribunals. Some of the evidence we took clearly demonstrated that, even under current legislation, there are frequently difficulties in this area. If there is to be expansion in the role of tribunals—and even if there is not—it is essential that this matter be addressed.
There have been great improvements in mental health services over the past nine years. There has been record spending on the service, and there are thousands more nurses, psychiatrists and clinical psychologists, as well as new early intervention services for young people, new outreach teams improving access to mental health services, and crisis teams providing care in patients’ homes. Against this background of improving services, it is crucial that we have updated legislation, not only to address concerns about public safety, but to keep pace with the growth of modern community-based patient services and to be compatible with the European convention on human rights, as well as to provide properly for the Bournewood judgment, which will have a big influence.
Before I finish, I wish to refer to sperm donation, which was mentioned by my constituency neighbour, the hon. Member for Northavon (Steve Webb). I suspect that we have been briefed by the same consultant at the same hospital in the Bristol area. Something of a crisis seems to have developed since the recent legislation outlawing anonymity. There are now apparently only two centres operating fully in terms of sperm donation for the whole of the United Kingdom, as opposed to certainly more than a dozen, and probably almost 20, before the new legislation began to take effect. That must be addressed, and I trust that the Minister will make sure that that message is relayed back to headquarters.