| Previous Section | Index | Home Page |
The Parliamentary Under-Secretary of State for the Home Department (Mr. Tom Sackville): This has been an interesting and thoughtful debate about a subject that has to be addressed: the appropriateness of sentencing and disposals for some people who may be mentally disordered and who in the past may often have been remanded to prison inappropriately.
13 Jan 1997 : Column 62
The value of mental health assessment at magistrates courts is fully accepted and the Home Office has been active in encouraging the development of such schemes. Guidance was issued, as the hon. Member for Cardiff, South and Penarth (Mr. Michael) said, in 1990 and 1995, and funds were made available to assist with the costs of medical staff attending court. Support has been increased from £0.5 million in 1993 to more than £1 million this year, and substantial additional funding is expected to be available from the next financial year.
It is important not to be prescriptive about how such schemes should operate; they are local initiatives and it would be unhelpful to tie the hands of the local agencies involved, which are best placed to devise the right response to local needs and to make the most effective use of the available resources.
The hon. Member for Hammersmith (Mr. Soley) talked about flexibility. I am not sure whether the new clauses would achieve that. Two points of detail may illustrate the point. First, the new clauses appear to limit those who can run the schemes to doctors, as defined by the Mental Health Act 1983, when in fact teams of community psychiatric nurses and others would be, and are, involved.
Secondly, it would be a step back to restrict assessment to the pre-sentence stage, as that would limit examination to those who had been convicted and exclude those on remand. A major benefit of any assessment scheme would be the early identification of mental disorder and the availability of advice to the court at first hearings, to avoid unnecessary remands to prison.
On new clause 12, existing arrangements for sentencing mentally disordered offenders already require the court to consider the offender's condition and the treatment available for it before passing a custodial sentence. When there is evidence of a treatable mental disorder, the court can make a hospital order in most cases. If the offender is psychopathically disordered, the court will have the option under clause 43 of attaching a hospital direction to a custodial sentence. Our aim is to extend the hospital direction to other mental disorders.
If, having considered the offender's mental state, the court has not selected one of those options, the question of the availability of treatment in the custodial setting is unlikely to serve any purpose and should not be a major part of the sentencing decision.
It may be argued that information about treatment facilities would allow the court to express a view about where the offender should serve his or her sentence--that is clearly part of the thrust of new clause 12--but I do not think that it is either sensible or appropriate to predict at the time of sentencing where a sentence will be served,
13 Jan 1997 : Column 63
I recognise that there may be prisoners whose mental condition at the time of sentence may not be such as to justify imposing a hospital order or a hospital direction, but that need not prevent treatment from being provided. The Prison Service has procedures in place to identify prisoners who are suffering from recognised categories of mental disorder. The identification can be on first reception into prison after sentence or, for those who develop such disorders, during the course of a term of imprisonment.
Where a prisoner is suffering from mental disorder so severe that he or she needs treatment in a psychiatric hospital, the prison doctor will seek to arrange his or her transfer to such a facility, using procedures provided in section 47 of the Mental Health Act 1983. The number of sentenced prisoners transferred to hospitals by direction of the Home Secretary under that provision has increased significantly in recent years, from 87 in 1985, to 145 in 1990, to 251 in 1995. There are already arrangements in place to identify offenders suffering from mental disorder who would be better held and treated in hospital. If an offender appears to be mentally disordered, the court will have considered evidence about his or her need for treatment before sentencing. If the offender needs treatment in hospital, he or she should be sent to hospital either by the court on sentencing or by warrant of the Home Secretary. It is not clear what the courts would be expected to do with the information that new clause 12 proposes that they should have.
Mr. Alex Carlile:
If he will forgive me for saying so, the Minister is to some extent ducking the question. The real question is not about people who are so ill that they are sent to mental hospitals for treatment, but about people suffering from relatively minor psychiatric illnesses, such as depression or incipient schizophrenia. Surely he would agree that in the real world, the Prison Service fails to give people the treatment that would, in many cases, prevent them from offending in future. Do the Government have any proposals to deal with that large-scale problem?
Mr. Sackville:
The hon. and learned Gentleman may feel that the medical services available in prison are inadequate, but it is not clear what new clause 12 would do to improve them. The courts can pass hospital orders. Prisons can use section 47 transfers to refer prisoners for mental treatment outside. The mechanisms are there; he is making a statement about how they are working.
Mr. Michael:
It is clear that the Minister did not understand the intervention of the hon. and learned Member for Montgomery (Mr. Carlile). As the Minister may by now have received more advice, I ask him to consider seriously the question that he was asked. He also said that the facilities in prison are inadequate. There is overwhelming research and other information from his
13 Jan 1997 : Column 64
Mr. Sackville:
I believe that there may be room for improvement in prison medical services, but there is nothing in new clause 12 that would achieve it. Doctors are available to prison medical services and there are contracts between prisons and local community mental health services. All those services are in place. The hon. and learned Member for Montgomery (Mr. Carlile) simply said that he believes that they are inadequate. We are dealing with an amendment about hospital direction, which provides further flexibility on how mental services can be offered.
Mr. Carlile:
Will the Minister give way on that point?
Mr. Sackville:
If I may continue, I was just going to deal with amendment No. 37, which was tabled by the hon. and learned Gentleman. It would prevent the hospital direction that is introduced by the Bill from being extended beyond people who are deemed to be psychopathic. We believe that it is reasonable that there should be an order-making power to extend the hospital direction beyond such people. There may often be cases where prisoners appear to be mentally ill and in need of treatment at the time of sentence, but cannot be deemed to be psychopathic. There may be many instances where they need treatment and, having been treated, need to be remanded back to prison. If someone was deemed sufficiently dangerous to be given a long sentence--perhaps a large importer of drugs, who merited a sentence of 10 years or more--but appeared to need mental treatment at the time of sentence, it would be wrong for the court not to have the flexibility to allow that treatment to be given, with the prisoner then being remanded back to prison. I think that the hon. and learned Gentleman will agree that to do otherwise would mean that the public were not adequately protected from the behaviour of that individual.
I do not think that there is disagreement about the value of assessing prisoners before sentence or in the early stages of the process, but the best that I can say for the new clauses is that they provide a statutory framework for a process that is already happening apace in our system: the extension of psychiatric assessment at all stages of the sentencing process. I cannot advise the House to accept the new clauses.
Mr. Michael:
The Minister's response was disappointing. Some of his points were simply wrong. I suggest that he looks again at the report of the Reed committee, and especially at the advice given by solicitors, who deal with their clients in the courts but are not directly involved in the Prison Service or the health service. The evidence from the Law Society about the experimental or pilot projects involving duty court psychiatrists or other such liaison schemes that are in operation was specific. The Minister was wrong to say that our new clauses would limit the involvement of medical practitioners to doctors. We specifically drafted one of the new clauses to allow the use of psychiatric nurses. That was one of the practicalities that we noted in considering amendments that might help the Bill.
13 Jan 1997 : Column 65
When discussing such schemes, the Law Society said that one of the advantages reported to it was psychiatric reports that could be quickly identified and acted upon. That is an important requirement. As I said earlier, it is far too easy for the need for professional help or specialist advice to lead to delays in the criminal justice system. I have always thought that justice delayed is justice denied, and we have frequently tabled amendments to address that point of principle. Psychiatric reports are one of the advantages identified by solicitors who, in my experience, are not always identified with the avoidance of delay.
The Reed report praises the involvement of all relevant agencies, which assists co-operation and the speedy arrangement of services. It points out that the availability of local facilities can be made known to the court so that it has the knowledge with which to address the point of my hon. Friend the Member for Hammersmith (Mr. Soley) about courts targeting their sentencing decisions and knowing that their intentions can be followed through properly.
| Next Section
| Index | Home Page |