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Ann Clwyd (Cynon Valley): I am glad that my right hon. Friend is consulting widely, and also that he is supporting further research into the subject. May I tell him that I sat for many years as a lay member of a mental health tribunal, and that I found it a most difficult job to decide who was sane, who was not sane, who should be confined in hospital and who should be released? After many years of observation, I found that people who were locked up in hospital were far saner than those on the other side making the decision. It is a matter not only of treatability but of how initially we assess severe personality disorder. Among health professionals, there is an argument about making such assessments. I am concerned also, of course, about putting people in prison--locking them up--on the basis not of what they have done but of what they might do. I am sure that my right hon. Friend will agree that it is very difficult--perhaps it is the most difficult thing of all--to prove that one is not dangerous.
Mr. Straw: I accept the gravamen of what my hon. Friend says from her experience. There is no question but that this is a very difficult matter, and that we have a gap in provision precisely because it is so difficult. However, the result--about which there is no argument--of the gap is that there are very dangerous, personality disordered people about who, if they are not detained, will go out and commit further offences. Some of those people themselves know that they will commit further offences. Hon. Members on both sides of the House have had detailed dealings with some of the offenders and with some of those who have had to advise them. Some of the offenders themselves have begged for the security of detention, because they do not trust themselves not to commit the most serious offences.
Strangely enough, as well as owing it to the public, we owe it to those offenders to provide incarceration. At the margin, there are other offenders about whom there will
be an argument. Diagnosing the condition is very difficult. That task is not made easier by the fact that many of those individuals are masters of deceit, in deceiving not only others but themselves. However, we have to use the best skills available to do the best job we can.
Mr. Robert Key (Salisbury):
I thank the Home Secretary for finding what seems to be a sensible way through a tangled web and also his officials, for the way in which they have dealt with individual cases. Certainly in the case in my own constituency and South Swindon, it was of enormous benefit that the Member of Parliament was included in the early-warning system. In the early stages, there was a serious lack of co-ordination, which was much helped by ready access by a Member of Parliament to the Home Secretary and his team.
Will the Home Secretary consider also the matter of funding and of what happens after a decision is taken? If a prisoner nearing release is instead re-detained, is it fair that the cost of keeping him or her inside an institution should be borne by the local health authority rather than by the Home Office? That is a genuine problem.
Mr. Straw:
I am grateful to the hon. Gentleman for his remarks, particularly his approbation of the work of my officials, who have worked very hard indeed with local police and local probation services to ensure proper consultation with local Members. I should say that I had him, some other Conservative Members and some Labour Members in mind when I thanked hon. Members for the very responsible approach that has been taken to the matter, despite the huge public pressure in their areas and demands for extreme action, which of course could not be delivered. The hon. Gentleman raises an important point about funding. We must consider that, because I accept that the current arrangements are unsatisfactory.
Mr. Win Griffiths (Bridgend):
I welcome what my right hon. Friend has said, and I believe that he has recognised that this is an incredibly difficult area in which to come to the right solution. One issue that worries me--it has been alluded to by others--is the physical resource of the trained and qualified forensic psychiatrists and clinical psychologists in a range of services. We know that hundreds of people languishing in prison should be receiving treatment in medium or highly secure units, but that there are no places for them. What steps will be taken during the consultation to look at the skilled professionals who will be needed for the work? In Wales, what consultation will take place through the Welsh Office and, later, the Welsh Assembly?
Mr. Straw:
As my hon. Friend intimates, this discrete issue is only one part of a range of necessary reforms to mental health provision in England and Wales. My hon. Friend may know that my right hon. Friends the Secretaries of State for Health and for Wales have announced expenditure of more than £700 million on improvements to mental health services in England and Wales, which will have some impact on the wider problem that my hon. Friend raises.
Mrs. Virginia Bottomley (South-West Surrey):
With others, I welcome the statement today, but I share the reservations--first, on the difficulties of cost shunting.
May I associate myself with those who have referred to civil liberties? The Government are known as effective followers of fashion, but this is an issue where the loophole needs to be closed. We could have a situation where an individual's civil rights were overlooked and where people were incarcerated and forgotten in the long term. At a time when legal, prison and health services are creaking under the strain of additional expectations and constrained resources, I hope that the Home Secretary will make sure that this is an area in which we deliver, and that his statement is the beginning, and not the end, of his initiative.
Mr. Straw:
We will deal with cost shunting, and we are proposing a range of options in the consultation document on how the new service should operate--including whether it should be a separate service or a combined one under the health and prison services--precisely to cope with that issue. Although I made the statement today, the fact that it is a joint statement by my right hon. Friend the Secretary of State for Health and me shows our close working relationship with the Department of Health. Whatever other charge is made against me, I cannot be accused lightly of being a follower of fashion.
The Minister of State, Home Office (Mr. Paul Boateng):
Certainly not.
Mr. Straw:
My hon. Friend the Minister, who is a follower of fashion--although he is not wearing his Ozwald Boateng suit today--says, "Hear, hear," to that.
The right hon. Lady is right: we must be conscious of individuals' civil liberties. This is a serious step that should be taken only where the gravest risk to the public is shown to be likely. Under the comprehensive spending review, substantial sums are being invested in the Prison Service to improve regimes and to improve the possibility of treatment for at least some of those people while they are incarcerated.
Mr. Tam Dalyell (Linlithgow):
May we return to the topic raised by my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) on the pressures on medical staff? In particular, will the Home Secretary clarify what he said in his statement about compulsory post-release supervision? Is it not all too easy to be lulled into complacency? Is not hindsight a very wonderful thing? What will be done to help staff who have made errors of judgment? None of us has perfect foresight, and staff can often get into great difficulty with people who do not understand the problems of such judgments. Will some help be given to medical staff in such circumstances?
Mr. Straw:
I hope that such help is given. My hon. Friend is right to raise the issue. We should not condemn medical staff for trying to operate the Mental Health Acts on inadequate and flawed criteria. Having hindsight is easy. Even if the changes that I am proposing are acceptable to this House and the other place, some people will slip through the net. This is not a counsel of perfection; it is an
Mr. Crispin Blunt (Reigate):
Given the warning of the hon. Member for Cynon Valley (Ann Clwyd) about the difficulty of diagnosing severe personality disorder and the fact that we have a "something must be done" society, shown by the mentality of the tabloid press, will the Home Secretary bear in mind the enormous pressure that will be put on those who have to assess whom to incarcerate in an attempt to eliminate all risk to society? One of the prices of a free society is the acceptance of risk.
Mr. Straw:
That is very important. We cannot eliminate risks; we can only do our best to reduce risk. That is the purpose of the proposals.
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