(5 years, 4 months ago)
Lords ChamberMy Lords, I declare my interest as chair of the Commission on Alcohol Harm. Countless victims know how closely alcohol and domestic abuse are linked. As my noble friend Lady Boycott said, up to half of perpetrators have been drinking at the time of assault, with severe violence and rape twice as likely to involve alcohol. One police sergeant told our commission that the vast majority of domestic incidents he had encountered over 30 years were alcohol related, with the offender, male or female, having drunk excessively prior to offending or being alcohol dependent.
Alcohol’s role in domestic abuse is complex and is often associated with gambling addiction and debt. It is certainly a significant compounding factor and never an excuse. The domestic abuse commissioner’s role must include a focus on the complex relationship between alcohol, domestic abuse and its wider effects, including on children. One anonymous expert by experience recounted how her terrifying father’s drinking and abuse
“bled into every aspect of our lives”,
and that it continued to affect the whole family after his death.
Some survivors self-medicate with alcohol to cope. Women’s Aid reports that women who have experienced extensive violence are more than twice as likely as others to have an alcohol problem, yet sometimes these survivors are turned away from refuges and struggle to find appropriate alcohol treatment services. Only 26% of refuges in London say that they always or often accept women who use alcohol or other drugs. Child contact centres must be registered with all staff trained to observe and to ask appropriate questions.
The role of the commissioner must include a remit to ensure better support and access to treatment for survivors of domestic abuse with an alcohol problem, and these services should also be provided in women-only spaces, as well as in anonymous online spaces, to ensure that their security and mental health needs are met.
One cannot look at domestic abuse as an isolated problem. It is interconnected with problems and inequalities across all society. Those with disabilities are twice as likely to experience severe domestic abuse, often for long periods of time and worsened by communication disabilities. Experiencing abuse can impact the development of communication skills, and those with communication needs are at greater risk of gender-based sexual violence. Non-fatal strangulation must be recognised and prosecuted.
Aspects of vulnerability all intersect, which is why front-line staff everywhere need the skills to ask about abuse and its precipitants in an open way and enable safe reporting. Only when the problem is known can further damage be prevented, and when crimes are reported they must be correctly documented by police and investigated. To be supportive, the commissioners’ board must include understanding the complexities of these antecedents and consequences to abuse, which in turn can inform inclusive support services and appropriate local authority strategies. This excellent Bill warrants support.
(5 years, 7 months ago)
Lords Chamber
The Earl of Dundee (Con) [V]
My Lords, I declare an interest as chairman of the Parliamentary Assembly of the Council of Europe’s Sub-Committee on Refugee and Migrant Children and Young People.
In Committee, my noble friend Minister explained how, early in the pandemic crisis, following talks between her colleague Minister Philp and Greece, three flights of children arrived in the United Kingdom from the Greek islands. All of us will be very grateful to the Government for this. She also referred to the United Kingdom’s humanitarian record in helping vulnerable people, including children.
The amendment of the noble Lord, Lord Dubs, does not so much cast doubt on that or on our future good intentions; instead, and in view of Brexit, its new clause seeks the continuation of rights to family reunion under United Kingdom law, currently secured by the Dublin III treaty yet not necessarily guaranteed after the transition period. Equally, and for the same reason, it aims to ensure that unaccompanied child refugees in Europe will have a legal route to safety in the United Kingdom.
In Committee, my noble friend the Minister gave a number of reassurances. One is the Government’s present endeavour to pursue new reciprocal arrangements with the European Union for the family reunion of unaccompanied asylum-seeking children. Can she say what has been achieved so far and whether that level of progress may now stand to be advanced by the European Union’s paper last week on asylum?
Then there is the role of our local authorities. My noble friend has pointed out that 5,000 unaccompanied children are in local authority care. There may well be councils that would take more, as the noble Lord, Lord Dubs, asserts. My noble friend has commented that, if that is the case, she would like to hear from them, also taking into account the extent to which Kent has to bear the brunt. Does she concur that an approach that is proactive without being coercive might work best? Therefore, should the Government perhaps be more in touch with local authorities to develop co-ordinated plans?
On the protection of vulnerable persons, my noble friend mentioned that current initiatives will be consolidated into a new global United Kingdom resettlement scheme. In outline, can she give us the aims and targets of this new scheme?
In promoting good practice, it goes without saying that internationally the United Kingdom ought to strive to take a lead. Post Brexit, let alone globally, does my noble friend consider that not least should the United Kingdom’s humanitarian standards be well demonstrated in Europe itself within the 47-state affiliation of the Council of Europe, where the United Kingdom remains a much-respected and prominent member?
As the noble Baroness, Lady Whitaker, has been unable to be contacted, I now call the noble Baroness, Lady Hamwee.
My Lords, I put my name to the amendment on behalf of these Benches. To be saying at this stage—three months from the end of the transition period and very close to the practicable end date of the negotiations—that our draft agreement is still on the table, as was said at the previous stage, feels like a denial of reality, and I follow the noble Lord, Lord Kerr, in that comment. Like the noble Lord, Lord Randall, I will be interested to know the up-to-date position.
Certainly a prudent Government would look for a mechanism to plug the gap, as the noble Baroness, Lady Primarolo, said, in case the draft slips off the table or is just not picked up—and this is the mechanism. I am very glad to support it, as I did in Committee when I too had an amendment on family reunion. At that stage, the Minister said that the Government had acted in good faith and that she hoped that the EU would do the same. Like the noble Lord, Lord Dubs, I cannot say that I regard the draft agreement as adequate. The principal obligations are not obligations—they are discretionary—but, whoever should take the blame for the stalemate, we must not let asylum seekers be the losers by being caught in the middle. They are not illegal, not unless and until their claim is refused.
This is likely not to be the first time that I will be taking a different view from the Minister about pull factors, especially when the push factors are so significant.
Of course we agree on the importance of safe and legal routes. That is the most important thing. Our view is that what is safest is to provide legal routes and deprive criminals of the opportunity to exploit people. It may be that our routes to that differ somewhat—perhaps they are not the means that the Home Secretary is considering—but that is not really for today. As has been said, our current rules are inadequate. The Government refer to that well-known paragraph 319X of the rules as providing the route that allows children to join relatives recognised as refugees, but the scope is very narrow, there are many restrictions and substantial fees are payable. As I understand it, the data does not separate out the categories or the basis of application, and those who take that route are included in the Home Office’s figures with other routes. Including all those routes, there were only 30 successful applications in 2018 and 54 in 2019. It is certainly not an adequate substitute for a successfully negotiated agreement on family reunion or a change in the UK’s rules, at least until an agreement or agreements are negotiated, as the amendment provides.
Working with the UNHCR and resettling people from the Middle East is not something we want to see replaced. The noble Lord, Lord Judd, the noble Baroness, Lady Lister, and others referred to the numbers in this plight across the world. As the noble Lord, Lord Dubs, said, we cannot take everyone but we can play our part. It seems to us that it is a policy decision for the Government whether to make it an “and” rather than an alternative.
(5 years, 8 months ago)
Lords ChamberWe now come to the group beginning with Amendment 86. I remind noble Lords that anyone wishing to speak after the Minister should email the clerk during the debate. Anyone wishing to press this or anything else in this group to a Division should make that clear in debate.
Amendment 86
We now come to the group consisting of Amendment 95. I remind noble Lords that anyone wishing to speak after the Minister should email the clerk during the debate. Anyone wishing to press this amendment to a Division should make that clear in the debate.
Amendment 95
My Lords, the comprehensive improvement plan is due this month, and the first day of Report on this Bill is the last day of this month. I had made a note, before the Minister said it, that Wendy Williams herself talked about the importance of not rushing the change, but I think we can look forward to the review before—albeit immediately before—we start on Report. I accept of course that changing a culture, like redirecting an oil tanker, is a long process. Indeed, changing culture is something that should go on and on; it is necessary that it should always be a current issue.
The noble Baroness, Lady Sherlock, talked about the importance of not getting the policy wrong; it is about both policy and practice. The obvious read-across from the experience of the Windrush generation is indeed the documentation, as my noble friend mentioned. Recommendations are good, but they will only be evidenced by actions. As the Minister has just acknowledged, the lessons learned from the unhappy experience of Windrush are transferrable. “Fairness” and “humanity”, she said; those are very good last words for today—they are very good words for always. On that note, I beg leave to withdraw the amendment.
My Lords, before we proceed to that point, I have a request to speak from the noble Baroness, Lady Lister of Burtersett.
I am sorry to deter the noble Baroness; I think there was a delay in my request getting from here to there. I thank the Minister for answering most of my questions, but could I just push her a bit further? If the review decided that the only way to address the problems created by the hostile/compliant environment would be to reform the legislation, such as right to rent, is it within its power or terms of reference to be able to recommend that kind of legislative reform?
(5 years, 8 months ago)
Lords ChamberWe now come to the group beginning with Amendment 42. I remind noble Lords that anyone wishing to speak after the Minister should email the clerk during the debate. Anyone wishing to press this or anything else in this group to a Division, should make that clear in the debate.
Amendment 42
My Lords, I have received a request to speak after the Minister from the noble Lord, Lord Paddick.
My Lords, I thank the noble Baroness for expecting me to speak after her. I have two points. The first is that we seem to be playing a whack-a-mole game about whether the amendments are relevant to the Bill or discriminatory. Let us hit the other one on the head: the only reason these amendments are restricted to EEA and Swiss nationals is that the clerks would not allow broader amendments, because they would not be within the scope of the Bill. They are not discriminatory; they aim to get rid of the hostile environment for everyone. That is the first issue.
Secondly, on the specifics, I apologise to the Minister for not making it absolutely clear which group of people I was talking about when I was saying that the right-to-rent scheme did not work. I was talking about EEA and Swiss nationals, at the end of the transition period, and all those other nationals who can now use the e-passport gates to enter the United Kingdom for six months without a visa.
I demonstrated in my speech that these individuals could rent for up to 12 months without a landlord being in peril of a civil penalty or any other penalty. Indeed, if during that 12 months they produced another ticket, boarding pass or travel booking—or a copy of any of those—they could further extend their rental with the landlord, because they had produced evidence that they had arrived in the UK within the previous six months. Therefore, you can see that they could extend and extend their rental of a property, completely undermining the right-to-rent scheme. Only those nationals who can use the e-passport gates, who get six months’ visa-free travel, can circumvent the system in that way. Those other foreign nationals who require a visa cannot do that because the landlord has to check digitally with the Home Office. The Minister may say that eventually everything will be digital, but this will not be digital. There will not be a digital way to check the rights of people who have six months’ visa-free entry to the UK. It will still be done on the basis of passports, tickets, boarding passes and bookings. That is the point I am trying to make.
We now come to the group beginning with Amendment 43. I remind noble Lords that anyone wishing to speak after the Minister should email the clerk during the debate. Anyone wishing to press this, or anything in this group, to a Division should make that clear in debate.
Amendment 43
(5 years, 8 months ago)
Lords ChamberMy Lords, I shall speak in favour of my Amendment 93. It is obvious that many of the amendments in this group are heading towards the same sort of thing, which is protection for people of all kinds as well as holding the Government to account for what they do. I support several of the amendments that have been spoken to, and I have been moved by some of the speeches from noble Lords.
My amendment is supported by over 50 organisations from all the devolved nations, including the Health and Social Care Alliance Scotland, Macmillan Cancer Support, UNISON and the Association of Camphill Communities. Amendment 93 would require an independent evaluation of the impact of the effects of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill on the health and social care sectors across the UK. This would be made after consulting the Secretary of State for Health and Social Care, the Scottish Ministers, the Welsh Ministers, the relevant Northern Ireland department, service providers, those requiring health and social care service and others. One would hope that this would be automatic with any measure that a Government introduce as they really need to know whether it is working or not.
Proposed new subsection (1) would require the Secretary of State to lay a copy of the report before both Houses of Parliament no later than one year after this Bill is passed. Proposed new subsection (8) would require a Minister of the Crown to make arrangements not later than six months after the report has been laid before Parliament, for the report to be debated and voted on in both Houses.
My amendment is necessary to safeguard the interests of the many people who rely on the contribution of EU citizens and non-EU citizens for the provision of health and social care across the four nations. This of course includes disabled people, children and young people, older people, unpaid carers and those with long-term health conditions. I should perhaps declare an interest in that I am getting older and this might apply to me in a decade or two.
Prior to the UK leaving the EU, a number of studies had highlighted the significant adverse impact of Brexit on the health and social care sectors across the UK. These studies, and the initial information about the points-based immigration system provided in the Home Office’s policy paper, The UK’s Point-Based Immigration System: Policy Statement, suggest that the ending of freedom of movement and the introduction of a points-based immigration system will potentially have a major adverse impact on the health and social care sectors across the UK. I think every speech so far has highlighted that fact.
The proposed independent evaluation that would be introduced by Amendment 93 could play a key role in supporting the health and social care sectors across the UK, helping them to address a range of concern about the proposals. These include concerns that many health and social care workers from other European countries, and from non-European countries, would not meet the proposed income threshold under this system, and that the requirement to have a job offer is unnecessarily restrictive, and will create addition administrative burdens and cost for health and social care organisations trying to recruit staff from abroad. As we have heard, there is a lack of recognition of health and social care specific skills, experience and professional qualifications in the proposed points-based system. As a result, it does not recognise the skills and experience of the workers from across the EU, and from non-EU countries, to enrich health and social care support and services here. Nor does it value the sector and its growing importance as a result of demographic changes.
There is much wrong with the Government’s immigration policy, but health and social care will feel a particularly brutal impact. This independent analysis is required so that the Government can think properly about the needs of health and social care and develop policy accordingly.
My Lords, I declare my interest as chair of the National Mental Capacity Forum. I speak to Amendments 2 and 66, to which I have added my name, and I strongly support Amendment 82, tabled by my friend Lord Patel.
The current proposals will exclude a group of workers we desperately need: carers for those with physical and/or mental disabilities, especially, as my noble friend Lady Masham highlighted, those with spinal injuries and similar severe physical constraints, and those with severe impairments of mental capacity for a wide variety of reasons. Many of these people are at a high risk of Covid and some will have been on the official shielding list. They wish to remain in their own homes and need care around the clock. For them, a live-in carer is the best option, but the annual salary of such a carer will fall below the level to accrue points in the system. That workforce just does not exist here. UK residents are not coming forward to train as live-in domiciliary carers.
Those carers already here are fearful that they will not obtain leave to remain. UNISON is calling for key workers to remain here and be eligible for NHS care—that is, to be exempt from the “no recourse to public funds” criteria—during the pandemic. Around 17% of the social care workforce is made up of migrant workers, with 115,000 European nationals and 134,000 non-EU nationals.
(6 years ago)
Lords ChamberIf the Minister would promise to write on that question, we will move on, to get everybody in.
My Lords, I declare that I am chairing an inquiry into alcohol harms. When will the data on alcohol-fuelled domestic violence during lockdown be made available and collated with sales, given that over half of intimate partner and almost all family homicides in 2014-15 involved alcohol and that the latest research shows that alcohol-fuelled violence is disproportionately clustered in the lowest socioeconomic groups—the people living in particularly difficult situations?
One positive thing to come out of the current pandemic, if there is anything positive to report at all, is the decline in drink-related crimes after hours. However, the noble Baroness is absolutely right that data on the harms of alcohol behind closed doors is yet to be released. I think we will know it retrospectively, and the House will of course be interested in this and all other aspects of domestic violence as time goes on. We will report back to the House on the outcomes of that. So one of the positive things is the lack of violence on our streets, but the downside of that is what is happening inside the home.
(6 years, 2 months ago)
Lords ChamberTo ask Her Majesty’s Government what assessment they have made of the case for accepting refugee doctors to the United Kingdom.
My Lords, our new immigration system will ensure that the UK has the skills it needs, including those of doctors. Our refugee resettlement schemes rightly focus on support for the most vulnerable recognised refugees, and those we resettle are supported to apply their skills in the UK.
My Lords, I declare my interest as a member of a BMA working group to support refugee and asylum-seeking doctors. Given the significant hurdles when people flee with no papers or proof of qualifications and are unable to meet the English language requirements or pay the exam fees they need to register, how have the Government sought co-ordination across all healthcare regulators to ensure refugee doctors and other such professionals can achieve registration and bring their experience and skills to the NHS? Given that UNHCR estimates that over 1,000 people who identify as qualified doctors are stranded in refugee camps—many having been trained, in part, in English, yet only 46 having applied last year to the GMC—can the Minister tell us how many were refused entry last year?
The noble Baroness will know, I am sure, that doctors and nurses are on the shortage occupations list. In that sense, they would not be refused entry, but I completely understand the point she makes about someone who is fleeing who does not have proof of their qualifications. The National Academic Recognition Information Centre is the designated UK agency to help doctors and healthcare professionals get their qualifications recognised by various NHS bodies. Individuals can, I know, apply for a statement of compatibility to have that recognised.
(9 years, 5 months ago)
Lords ChamberMy Lords, I am most grateful to the noble Baroness. Lady Hamwee, for speaking to me beforehand; we have had some discussion. I would like to go straight to answering both those questions, from my perspective, as I was the person who tabled the original amendment. I must declare my interest, as I now chair the National Mental Capacity Forum. I took over and started to do that in September of last year.
In terms of consultation, when I was listening to the voice of the person who had been on the receiving end of the Mental Capacity Act it was very evident very quickly that the automatic requirement for an inquest was causing an enormous amount of distress to families. It was also through that process that Ann Coffey MP consulted widely in her constituency and further afield—and coroners have been asked. So this was not brought forward lightly.
There was also consultation with the adviser to the Care Quality Commission, who feels strongly that DoLS are a useful process for safeguarding people who are particularly vulnerable. He was very supportive of the process following the judgment of the noble and learned Baroness, Lady Hale, which clearly laid out the acid tests under which DoLS should be applied.
As for cost savings, I see there being absolutely none. Actually, there is a possibility that costs might go up. Although unnecessary inquests will not, I hope, happen, so coroners will not be taken away from inquests that really do need to happen by the bureaucratic process of the unnecessary inquests, of which there were almost 7,000 last year, that find that death was due to natural causes, it is possible—indeed, I hope that this will happen—that more people will be inclined to make a deprivation of liberty safeguards application if there is a doubt about whether somebody is being deprived of liberty, because the deterrent of knowing how much distress would be caused to people, including families, will be removed.
Care home, clinical and hospital staff find it very distressing to say, “We’re going to go through this process of applying for a deprivation of liberty safeguards authorisation—and, secondarily, by the way, that means that there will automatically be a coroner’s inquest”. For those who culturally need a burial very rapidly after somebody has died, that causes profound upset—as it does to other families. As one coroner’s officer said, to me, “Sadly, sometimes the first time the families realise there has to be an inquest is when I have to pick up the phone to tell them, and they are deeply distressed”.
I suggest that by putting this measure in place we are removing a barrier to the deprivation of liberty safeguards, which are a way of protecting the rights of the most vulnerable person, because there is an inspection process. It must be necessary, proportionate and in the person’s best interests, and the person has a power to appeal to the Court of Protection against a deprivation of liberty safeguard. So people have far greater rights than somebody who ought to have a deprivation of liberty safeguard authorisation in place but where no application is being made. So I hope that this will increase the rights of the most vulnerable as well.
The process of scrutiny is that the Care Quality Commission has to be notified when a standard DoLS is in place. It will know whether a place has unusually many or unusually few DoLS applications, and will look in depth at the quality, the atmosphere and the culture around the way that care is given there. With all due respect to coroners, I think that the CQC is far more likely to detect where things are going wrong than a coroner’s inquest on a single case. But I reiterate that if a family have any concerns whatever, irrespective of whether there was a DoLS in place, they can ask for a coroner to look at a case when somebody has died. If they are suspicious, they can ask the question.
My Lords, I am grateful to the noble Baroness, Lady Hamwee, for raising this important issue. The Government take seriously their responsibilities to the very vulnerable group of people in society whom this amendment concerns. I also thank the noble Baroness, Lady Finlay, for her deep knowledge of this issue, and for the words that she has spoken this evening.
Coroners in England and Wales play a critical role in investigating the deaths of persons where there is a suspicion that death may have resulted from violence or unnatural causes, or indeed where the cause of death is unknown. Coroners will continue to have this duty with regard to persons who have been deprived of their liberty as authorised under the Mental Capacity Act 2005. There is no restriction on when or by whom deaths can be reported to a coroner. Indeed, the registrar of deaths has a duty to report deaths to the coroner where he or she considers that the coroner’s duty to investigate may apply.
The Government recognise that there is a need to improve the scrutiny of deaths that are not investigated by a coroner. The Coroners and Justice Act 2009 contains provisions to introduce medical examiners who will contact the deceased’s family and those involved in the deceased person’s care to identify any concerns as part of a reformed death certification process.
We consulted on our proposals earlier this year and aim to publish our response to the consultation in the new year. This will of course be particularly relevant to vulnerable people in hospitals and care homes, regardless of whether they are being deprived of their liberty. Medical examiners will not just be responsible for scrutinising individual deaths not investigated by the coroner but will have a role in analysing data on deaths across their area. They will identify patterns and contribute to lessons that will reduce avoidable deaths. They will also have a duty to report to coroners deaths for which a coroner’s investigation may be required.
The effect of Clause 155 will be that the death of anyone subject to a deprivation of liberty safeguards authorisation, or an appropriate Court of Protection order, will no longer trigger an automatic coroner’s investigation. We supported this change in the law in the light of views expressed by the then chief coroner, his honour Peter Thornton QC, in his 2015-16 annual report. He called for immediate action to remove deprivation of liberty safeguards cases from the definition of “in state detention”—a point that, just prior to his recent retirement, he reiterated to the Minister for Victims, Youth and Family Justice.
The issue here is not simply one of the resources needed to undertake these inquests. The then chief coroner had addressed this to some extent through his 2014 guidance, revised in 2016, which set out a streamlined process. But, as he has said, these inquests “serve no good purpose”. It cannot be right that more than 20% of inquests undertaken each year are unnecessary, with all that that implies in terms of added anguish for bereaved families.
I thank the noble Baroness for raising the profile of this important issue, but I hope that she will accept that the Government’s recently completed consultation on reforming the death certification process will, when its proposals are implemented, complement and support the work of our coroners who investigate suspicious deaths.
I think that the noble Baroness, Lady Hamwee, asked who we consulted in the consultation. The Ministry of Justice consulted the former and current chief coroner. Having said that, we consider that this removes any further need for further consultation on the coroner’s statutory duties, and I hope that the noble Baroness will therefore be content to withdraw her amendment.
(9 years, 5 months ago)
Lords ChamberSeven people with mental health concerns died in police custody in 2015-16 out of 14 deaths in total. That of course is still too many. The number of people with mental health problems in police custody has significantly come down since the Government decreed that nobody with a mental health problem should be held in a police cell but should be taken to a place of safety in every situation where that is possible, and never for children. On the second part of her question, the noble Baroness is absolutely right: training is essential for police officers, not just in combating crime but in knowing the symptoms of somebody with mental health problems.
I declare my interest as chair of the National Mental Capacity Forum. Do the Government agree that in situations in the community where others are at risk because somebody is becoming very violent, it is appropriate to call the police and inappropriate to expect ambulance and other staff to attempt to use any form of restraint? The police are trained and are therefore safer than people using restraint who are not appropriately trained. The College of Policing is actively addressing this issue at the moment through its revised training guidelines.
The noble Baroness is right—restraint is the last possible option. It is certainly not for ambulance staff to deal with someone who is extremely violent and a danger to both themselves and others. So, yes, in rare circumstances the use of Taser will be necessary.
(9 years, 6 months ago)
Lords ChamberMy Lords, I thank the Minister and her officials for their time and help over the issue of this amendment. I declare my interest as independent chair of the National Mental Capacity Forum, and it is in that role that I have heard repeatedly about a problem relating to people who die when subject to deprivation of liberty safeguards. This new clause amends the meaning of state detention in Section 48 of the Coroners and Justice Act 2009 to correct the problem that I will now explain. I want to explain first how the amendment works and then some of the background as to why it really is needed.
The amendment removes the duty on coroners to conduct an inquest in all cases where the deceased had an authorisation for the deprivation of their liberty in place either under deprivation of liberty safeguards or a Court of Protection order or because the deprivation of liberty was otherwise authorised by the Mental Capacity Act 2005.
Subsections (2) and (3) of the new clause amend Section 48 of the Mental Capacity Act 2005 to provide a new definition of state detention. To do this, there is a new subsection inserted into the Coroners and Justice Act 2009 to provide that a person is not considered to be under state detention for the purposes of that Act when they are deprived of their liberty under the relevant sections of the Mental Capacity Act 2005. This covers the deprivation of liberty safeguards, which can be from a Court of Protection order, from a DoLS authorisation or, where the deprivation of liberty was urgently required, pending a decision by the Court of Protection on the authority to restrict the person’s liberty. The second amendment makes a consequential change to the Long Title of the Bill.
Let me explain why this new clause is needed. After the Cheshire West judgment, the number of DoLS applications has risen enormously. This was the subject of a debate in this House on 16 March 2015. Prior to the Cheshire West judgment, in 2012-13, there were 11,887 DoLS. In 2014-15, 122,775 individuals had an active DoLS application either granted or in process. That is more than a tenfold increase in the number of DoLS. Some of these people were seriously ill and some died. In 2015, there were 7,183 such deaths. The vast majority of those were expected, anticipated and accepted by the family and those responsible for care. These were not deaths that came as a surprise to anyone. When that family was then told that the death must be referred to the coroner for an inquest they were often shocked and worried, as if there were some sort of accusation against them or others. They could not progress with their grieving and arrange the funeral, as they then had to wait for the inquest.
In 2015 the average time for inquests was 20 weeks, although coroners tried very hard to ensure that deaths under DoLS, when clearly of natural causes, were dealt with more quickly. To put the numbers in context, of the more than 7,000 deaths under DoLS, 6,760—or 94%—were found at inquests to be natural.
The distress to the bereaved has become a common cause of complaint to the Department of Health. In addition, it is not a good use of coroners, who should be investigating deaths where there is any suspicion whatever. Indeed, I remind the House that the Ministry of Justice’s Guide to Coroner Services states:
“Registrars of births and deaths, doctors or the police must report deaths to a coroner in certain circumstances. These include where it appears that: no doctor saw the deceased during his or her last illness; although a doctor attended the deceased during the last illness, the doctor is not able or available, for any reason, to certify the death; the cause of death is unknown; the death occurred during an operation or before recovery from the effects of an anaesthetic; the death occurred at work or was due to industrial disease or poisoning; the death was sudden and unexplained; the death was unnatural”—
so that includes all suspected suicides—
“the death was due to violence or neglect; the death was in other suspicious circumstances; or the death occurred in prison, police custody or another type of state detention”.
The Ministry of Justice document goes on to say:
“If you believe that a death of this kind has not been reported to the coroner, you may report it yourself”.
In other words, relatives who have any concern can themselves report to the coroner. It goes on to say:
“You should do this as soon as possible and before the funeral. The coroner will then inform you of the action he or she proposes to take”.
Nothing in the amendment removes the obligations to inform the coroner if there is any suspicion whatever around a death. The amendment is to remove the mandatory requirement to hold an inquest where the deceased was deprived of their liberty under all relevant sections of the Mental Capacity Act—or, indeed, where the deprivation of liberty was to provide care to them.
Under the Mental Capacity Act a person who lacks capacity may be detained in circumstances which amount to deprivation of liberty. No detention amounting to deprivation of liberty may be permitted without lawful authorisation, because it would otherwise constitute false imprisonment. The Mental Capacity Act provide safeguards known as DoLS and Court of Protection orders to be made depriving a person of liberty for their care. It also allows for the deprivation of liberty of a person for the purpose of giving life-sustaining treatment only where a decision of the court is pending.
I want to address a concern that has been raised with me in relation to anyone who dies under the care of a mental health trust. A suicide or an unexpected or a sudden death must always be referred to the coroner, but I would expect there to be a routine review of any death in a mental health trust or similar organisation. Such a review should be available to the Care Quality Commission inspectors and I would expect the inspectors to ask about the number of deaths that had occurred in people subject to a deprivation of liberty safeguard application or authorisation. They should look in depth at the quality of the review of care that had taken place. Additionally, anyone who has concerns at any stage should raise those concerns, whether through whistleblowing or through the complaints process.
Complaints and how they are handled also form part of CQC inspections and I believe that such searching questions are far more likely to detect poor care than relying on a referral to the coroner, who is only looking at one instance and cannot see how care is delivered across a whole organisation. The recent incidents of poor care of those with learning difficulties that have come to light are certainly alerting inspectors that they must be more rigorous in their inquiries than before. To summarise, I hope that this amendment will correct an anomaly that has caused more than 6,500 bereaved families unnecessary distress in the last year alone. I beg to move.
My Lords, I am grateful to the noble Baroness, Lady Finlay, for this amendment. The Government are pleased to be able to offer our support for this amendment, which will minimise the stress on bereaved families at a very difficult time for them. The amendment will fully address the concerns that no family, having watched and comforted their loved one through his or her final days, should then be unnecessarily subject to the anxiety and confusion of having their death investigated by a coroner. I thank the noble Baroness for raising the profile of this important issue and for her valuable input, which the Government very much welcome and support. I commend her amendment to the Committee.