| Previous Section | Index | Home Page |
Mr. Philip Hammond (Runnymede and Weybridge): I thank the Secretary of State for that important statement and for making available to me a little earlier a copy of the substantial report. I express the Opposition's support for his action this morning in seeking to protect the identity of the little girl involved through an application to the court for an appropriate order.
As the Secretary of State has said, the management problems at Ashworth hospital go back a long way. They are in many respects linked to a wider question about the appropriate approach to dealing with the most dangerous mentally ill offenders. The provision of a regime that is at once therapeutic and secure, thus achieving the twin imperatives of treatment for the patient and ensuring, as a paramount concern, the safety of the public, poses enormous challenges. Many changes in practice have been introduced since the early 1990s and major steps have been taken towards integrating the special hospitals into the mainstream structure of the NHS. The Opposition support the Government in seeking to continue that process. There has been a good deal of constructive collaboration in the past, and the Opposition hope that that approach will continue.
Even with the benefit of 20:20 hindsight, I believe that my right hon. Friend the Member for Charnwood (Mr. Dorrell) and, before him, my right hon. Friend the Member for South-West Surrey (Mrs. Bottomley) acted promptly and appropriately when these matters came to light.
The Fallon inquiry was established by the previous Government to investigate the operation of the personality disorder unit within the hospital and to make recommendations to ensure that there could be no recurrence of such activities as those revealed by the evidence of Steven Daggett in early 1997.
The Secretary of State has already made it clear that what he has said today is but an initial response to a massive and detailed report. The House and the Secretary of State will appreciate that we have had even less time than he has to digest the details of the report, but I welcome his initial response that he will accept the bulk of its recommendations.
The Secretary of State has said that he will publish a detailed response in due course. Will he give an undertaking that he will make a statement when that response is published and the hospital management's detailed proposals are available? Will he otherwise make arrangements to ensure further discussion of matters once we have all had the chance to consider and digest the report?
The report's central recommendation to close the hospital completely has been rejected by the Secretary of State. In doing so, he is taking on a heavy burden of responsibility. It is his duty to ensure the safety of the public and of patients in the hospital. In rejecting the report's recommendation to close the personality disorder unit at Ashworth, he must be absolutely confident that the action that he has taken and is proposing to take will safeguard both the public and patients.
The House, too, will want to be reassured that the Secretary of State's action will be effective in addressing the long-running and intolerable problems at Ashworth. Will he therefore undertake to review the situation at Ashworth in 18 months, and make a further statement at that time on the effectiveness of the measures which are to be implemented in lieu of the recommended closure of Ashworth hospital?
What measures will the Secretary of State take to oversee the implementation of the recommendations that the Government have accepted, bearing in mind the report's criticism of the implementation task force, which was set
up to oversee implementation of the Blom-Cooper report recommendations? Will he assure the House that outsiders will be involved in that oversight process?
Does the Secretary of State envisage that continuing down the route of regionalisation and providing regional high-security units will eventually lead to the closure of the three special hospitals? Will he confirm that, in the meantime, no offender convicted of a serious offence will be transferred from high-security to medium-secure facilities? Will he further confirm that there will be no reduction in the number of high-security beds that deal with the throughput from the courts?
I noted that the Secretary of State expressed the hope that the relevant employers will take appropriate action in respect of any persons named in the report who are still employed in the national health service. Will he assure the House that he will follow up that expression of hope with action to ensure that, if such people are still employed in the NHS, they will be immediately suspended from their duties while the relevant employers investigate matters more fully?
The Secretary of State acknowledged the failure of management at Ashworth over many years. Given that there have been two changes of chief executive since this Government came to power, does he have full confidence in the hospital's current management and its ability to implement the report's recommendations?
Mr. Dobson:
First, may I report to the House--I think that all hon. Members will be pleased to hear this--that I have just received a note saying that the High Court has granted the order to protect the confidentiality of the child.
We shall certainly be producing a detailed response. Whether that will be given on the Floor of the House and whether there will be an opportunity for debate is a matter not for me but for my right hon. Friends the Leader of the House and the Chief Whip. We shall have to leave it in their hands.
I have never tried to get out of responsibility for any decision that I have taken. Security of the public and of people in the hospital must be the paramount consideration. Some advocates of breaking large hospitals into many smaller units seem to think, in a Pollyanna way, that everything will therefore be all right. There is no guarantee that a collection of small units would be more secure than one large and highly secure unit. I want to ensure that these people are securely locked up and that security is guaranteed in the hospital. I think that I am taking the option that is likely to prove the most secure.
With regard to implementation, I have spelt out who will have responsibility, at least in the short run, for the immediate implementation of the major recommendations. They will report to me and I will ultimately report to the House.
On the eventual closure of Ashworth or the other hospitals, I cannot speculate too far ahead, but I do not envisage any of the three being wholly closed.
With reference to high-security beds, there are people who are moved from high-security units to medium-secure units because the psychiatrists and others responsible believe that they will be safe there. Some of those people are allowed out because the psychiatrists believe that they have changed as a result of treatment, have improved and will be safe. The number of beds therefore varies, and we should not get into a great party political spat about that.
I am fairly confident that it will be possible to mount successful disciplinary proceedings against people employed by the Ashworth authority for something that they did wrong or failed to do at Ashworth. The situation is more complicated if they have moved to other jobs in the national health service. As I said earlier, I share some of the concerns of the Fallon inquiry about accountability in the NHS. I cannot instruct a health authority or a trust to dismiss anyone under the present powers available to me or the powers that previous Ministers used to have.
I have confidence in the arrangements that I am making and the changes that we are making at Ashworth. As I said in my initial statement, I do not suggest that it will be plain sailing. There have been difficulties. One chief executive at Ashworth lost the confidence of the doctors and had to be removed. She has been replaced, and I hope that the replacement will do a good job. He certainly seems to be doing a good job, and it is my job to try to help him and the others to do their jobs.
Mr. David Hinchliffe (Wakefield):
I echo my right hon. Friend's tribute to my hon. Friend the Member for Halifax (Mrs. Mahon) for her role in exposing this sad affair. I am sorry that she cannot be present today, but I am sure that she would welcome many of the steps taken by my right hon. Friend, particularly those relating to the little girl.
Is it not a fact that the special hospital system has been a shambles for years and is one of the great unresolved policy issues of the previous Administration? Will my right hon. Friend confirm that the internal review commissioned by the previous Government, chaired by Dr. John Reed, recommended the closure of Ashworth and the other two special hospitals, and strongly recommended moving in the direction of regional secure units at a localised level?
Does my right hon. Friend accept that the failure of the previous Government to act along those lines has led to serious difficulties in the prison system? Prisons such as Wakefield in my constituency are accommodating vast numbers of seriously mentally ill people who ought to be receiving psychiatric care, rather than prison care. Does he agree that in the longer term, the only way to avoid problems such as those at Ashworth is to move in the direction set out by John Reed?
Mr. Dobson:
I have great respect for the views of my hon. Friend the Member for Wakefield (Mr. Hinchliffe), as he well knows, but I am not sure that I agree with him in this matter. My right hon. Friend the Home Secretary and I are giving consideration to various categories of people suffering from personality disorder: the people in the hospitals who, in theory, are treatable but many of whom are not actually treatable; the people in the prisons who are suffering from personality disorder, are not getting the attention that they deserve and are a real nuisance to the prison system; and the people outside with personality disorder, who are dangerous but have not committed an offence, who the psychiatrists believe cannot be treated and who therefore have no place either in a prison or a hospital.
| Next Section
| Index | Home Page |