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Mr. Straw: I am sorry to disappoint my right hon. Friend, but I do not accept a sentence of what he has said.
There is no parallel whatever between what I am proposing and internment without trial. For a start, internment without trial was, and always will be, the result of an Executive decision, whereas we propose a very careful, judicially based process whereby people will be detained only by a court, and that will be subject to review. Internment without trial is, moreover, outwith our obligations under the European convention on human rights, whereas we are satisfied, and I am advised, that these proposals are fully within those obligations, and are entirely compatible with article 5.1, which provides for the detention of people of "unsound mind".
It is generally acknowledged that the Mental Health Acts need to be reviewed, but I do not believe that this kind of change can wait until they are reviewed. Let me say to my right hon. Friend that what is exposed by the need for this provision is an intellectual failure within the Mental Health Acts. I suspect that even he subscribes to the view that it is right to detain people who have severe personality disorders, but are treatable. If that is so, why on earth is it wrong to detain people who are regarded as untreatable, but who continue to pose exactly the same or a worse risk to the public?
Sir Brian Mawhinney (North-West Cambridgeshire):
Like most hon. Members, I welcome the right hon. Gentleman's proposals in principle. As he has reasonably said, we shall want to look at the details.
The right hon. Gentleman spoke of those who would be detained subject to occasional quasi-judicial review. Will he examine those proposals again before producing a White Paper? Depriving people of their liberty is an important and serious step, and the right hon. Gentleman
might consider that, notwithstanding the Butler report, an annual review would be appropriate. He might also consider that it would help the courts if the review were conducted by an independent, mixed tribunal, consisting of both legal and health experts, which could then report independently to a court looking at an annual reflection.
I hope that the right hon. Gentleman will accept my proposals as constructive suggestions.
Mr. Straw:
I accept both proposals in the constructive spirit in which they were offered. The appropriate period for review is a matter for debate, and we will canvass opinion. I hope that the right hon. Gentleman will respond to what will be a consultative document--I should make it clear that there will not be a White Paper at this stage. I think his suggestion of a mixed tribunal combining people from different disciplines is very valuable.
Mr. Gerald Bermingham (St. Helens, South):
I hope that my right hon. Friend accepts that the problem is caused, first, by deficiencies in the Mental Health Acts and, secondly, by the fact that care in the community has collapsed. There are people out there who have committed no crime but who are desperately sick, and there are not the facilities or the means to treat them. Under the Mental Health (Patients in the Community) Act 1995, we have had a series of tribunals which have worked extremely well. I hope that my right hon. Friend will bear in mind the expertise that such tribunals contain, and will allow them to continue. Those who are sick should be taken out of the community, often for their own good, and such cases should be dealt with by tribunals consisting of experts in the field.
Finally, will my right hon. Friend bear in mind the fact that, when people are taken out of the community and reviews take place, not only those people but the community as a whole should benefit? If the Mental Health Acts were amended to contain simply the word "treatable" or "containable", that might go a long way towards dealing with the psychopaths who languish in prison, to the danger of other prisoners.
Mr. Straw:
My hon. Friend is right to say that part of the problem arises from what we now recognise to be deficiencies in the scheme of the Mental Health Acts, and the way in which it has been implemented in recent years. I am glad that my hon. Friend supports the changes and recognises that some of these people have to be detained.
Mrs. Angela Browning (Tiverton and Honiton):
What consideration has the Home Secretary given to existing mental health services in our prisons? I am not talking about psychiatric secure units, where one would expect to have the right level of staffing. He will know that many people who are detained and then say, as they are about to be released, that they believe that they will be a risk, will be the easiest cases to identify, but, throughout our Prison Service, there is very patchy provision of mental health services for serving prisoners. What will he do to ensure that there is proper diagnosis and intervention by appropriate staff while people who could fall into the category that he outlined are serving sentences in mainstream prisons? I must say also that I welcome his proposals.
Mr. Straw:
I am grateful to the hon. Lady for what she says. She is right to say that current mental health
Mrs. Gwyneth Dunwoody (Crewe and Nantwich):
My right hon. Friend will accept that there are no clear clinical definitions of severe personality disorder and that many of those people will not be treatable in the normal sense. Therefore, will he not only ensure that anyone who is committed under the system undertakes more than the normal medical examination under the Mental Health Acts, but seriously consider where such a person will be confined?
The proposal is an abuse of human rights, but many of us believe that it will be justified because of the danger that those very difficult people pose to the community at large. However, before such a change in the law takes place, we must be clear that there cannot be mistakes, that there must be a ready and rapid way in which to put any problems right and, above all, that what happens to those people occurs in a context that can be easily defended and properly policed.
The categories will include not just people coming out of prison or mental health services. It is not acceptable to put extra pressures on to the medical profession, expecting it to cope with people who are not treatable.
Mr. Straw:
It is becoming clear--it was obvious from the Fallon report into Ashworth hospital--that there is a substantial debate among clinicians about the nature of treatability. Some clinicians take a very narrow view of that; the trend has been towards that view. Others take a much wider view. I could quote, for example, Professor Ronald Blackburn, professor of clinical psychology at the university of Liverpool, who has said that there is insufficient evidence to support the opinion of some clinicians that nothing works with this group.
It is as wrong in psychiatric medicine to regard treatability as something that is fixed in time, as it is in any other sort of medicine, whether oncology or another specialty. As the science develops--the science not only of psychiatry, but of clinical psychology and many other disciplines--a condition that we previously regarded as wholly untreatable may become treatable. We always have to bear that in mind.
Above all, the argument for this change is that of the safety of the public. That has to be the paramount consideration.
Mr. Humfrey Malins (Woking):
May I also offer my support to the Home Secretary for what he has said? This is a difficult area.
Who will originate the proceedings: the police or others? Does the right hon. Gentleman envisage that they will be heard in a magistrates court, Crown court or any
other court? Does the Home Secretary agree that they should be heard in public? Does he also agree--particularly as those who will appear, including those with no previous convictions, may be very poor--that, throughout the matter, any defendant, for want of a better word, should have full rights to legal and other representation and legal aid?
Mr. Straw:
Depriving individuals of liberty in such circumstances for an indeterminate period--certainly, in most cases, it would be much more than the 12 months' total maximum that a magistrates court could impose--is a very serious matter and would have to be dealt with by the higher courts. We have to consult on whether the appropriate court is a Crown court, with all its connotations as the court in charge of criminal proceedings, or whether the matter is more appropriately dealt with under the aegis of civil courts. In the consultative document, we shall consider that matter, and the issue of who will originate proceedings; that could vary, as an inmate's propensity to reoffend might come to the attention of the Prison Service, the police, or mental health services, in the case of someone who had not committed any offence known to police but who should still be subject to such an order.
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