Mental Health Act 1983 DebateFull Debate: Read Full Debate
David HansonMain Page: David Hanson (Labour) - Delyn)
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That highlights the importance of having a nominated person earlier in the journey. I do not disagree with my right hon. Friend, but he highlights the difficulty of our work to get the balance right between keeping someone safe and respecting their wishes. I fully anticipate that when we produce the White Paper on this issue, he and I will probably have another debate about it. It is important that we get it right, with the safety of the patient in mind while empowering them to make their own decisions.
I have already mentioned that we will end police stations being places of safety under the Act, and that will be included in any legislation. On equalities, we are working with the NHS to introduce the first ever race equality framework to ensure that mental health care providers work with local communities to improve the ways that patients access and experience treatment. An important point is that although we are concerned that under the Act there are far too many detentions of people from black and minority ethnic communities, it is possible that is partly because they find it difficult to access services. We need to address that properly.
To help to address that, we are also launching a pilot programme of culturally appropriate advocacy. Clearly, we will need to make that resource available to ensure that people have access to it. The review said that we need to learn a lot more about that whole issue, so we will work with the National Institute for Health Research, which will launch a call for research later in the year to give us more answers. Jacqui Dyer MBE is our Mental Health Equalities Champion, and she will play a leading role in taking forward the review’s recommendations on tackling the injustices faced by black and minority ethnic services users.
I have spoken for quite some time; I hope I have covered most of the aspects mentioned. On the issue of funding, I have probably bored everyone senseless by saying that we are determined to deliver a much-expanded service, and our focus must be on developing those community services. We have made resources available to do exactly that through the long-term plan, but that is not to say that the issue is not still challenging. However, I hope we will be able to do much more in the community for people with severe mental illness, so that we can treat them in the community rather than have them go into crisis care.
To illustrate that with an example, if we can get people out of beds and into the community, the ability to look after more patients is really stark, so it starts to pay for itself. I discussed that with a clinical director from the NHS, who said that if they remove three people from in-patient beds and have them in the community, the productivity is so much greater straightaway. We rely on good local leadership to crack that and make it happen.
I have covered most of the things I wanted to. I will just reiterate my thanks to all Members who have participated in a very good debate, and I look forward to having discussions on the White Paper as it develops.
I thank all colleagues for their comments and personal experience. When I worked at the National Centre for Independent Living, the charity ran Experts by Experience across social care. I hope that the Minister takes note of that—it sounds as if she is talking about involving survivors, service users and carers in future plans. I thank the Minister for her frank admission that we need to do more. Again, I thank all the organisations involved.
Some people are commenting online that too few of us are here in the Chamber, but lots of work goes on outside such debates as this one. For example, my hon. Friend the Member for Stockton North (Alex Cunningham) and my right hon. Friend the Member for North Durham (Mr Jones) referred to the all-party group on social work. The hon. Member for Plymouth, Moor View (Johnny Mercer) also works on mental health outside that group, and reference was made to the previous legislation of my hon. Friend the Member for Croydon North (Mr Reed).
I asked the Minister 10 things, I think, most of which were covered in her response, but I will follow up on some. On children’s access to mental health care, it is great to acknowledge the leadership of Charles Dickens Primary School in Southwark, but that 35% target is a national one, and it would be good to know from the Minister what more is coming in the system. On the principles in the independent review, she mentioned gratefulness, an indication about the principles, and she just touched on the advocacy issue. It is important to note that the piloting of the culturally appropriate advocacy is more limited in scope than the review intended, so it needs to be expanded to everyone, whether informally through in-patient care or to people detained. The model should be an opt-out one, which was the preference of the review.
The Minister confirmed that the White Paper will still be on time. My right hon. Friend the Member for North Durham talked about when legislation might appear, and perhaps the Minister will indicate that in correspondence. She touched on resources, the need to expand the service offer and how it pays for itself—how she is making the case for parity of resource allocation in the system would be good to know. She spoke positively about the nominated person and better involvement of nearest relatives, and that is really welcome. That person is of course chosen when someone is well—that is the key difference. No matter how ill someone becomes later on, or how badly they suffer delusions, the person whom the patient chose when well is important.
Earlier upstream interventions were mentioned by my hon. Friends the Members for Bristol East (Kerry McCarthy) and for Oldham East and Saddleworth (Debbie Abrahams), and others. The Minister commented that the high level of detention through not getting that right was a mark of failure. The spirit of the plans is to get that level down. It would be good to see more.
It was brilliant to hear about the custody cells, which will be included in any legislation. That is a brilliant commitment. On sexual assaults, I think that the response was that we need to learn more. I welcome the earlier campaign of the right hon. Member for New Forest East (Dr Lewis) to end mixed-sex wards, but such incidents are still occurring. More needs to be done, just as it does on the issue of deaths. There was a specific request for an inquiry, and it would be good to know the Minister’s view of that.
On standardised support and care, my hon. Friend the Member for Bristol East told us about the family of a child with autism having to make that decision on whether to travel. The Minister said that too many are in that position, and it is something that the CQC should look at. Given that the CQC may only gain the powers and resources that she mentioned through Government, I think a stronger case needs to be made for that.
On advance decisions, there were some positive comments but I will come to an end. The lyrics of “Karma Chameleon” were mentioned by the Minister, and Prime Ministers might “come and go”, but the people who need their lives transformed and who need better mental health care experience the outdated legislation every day. I hope that after the White Paper we will see real pace to deliver reform.
Question put and agreed to.
That this House has considered reform of the Mental Health Act 1983.