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Mental Health

9. Mr. Michael Fallon (Sevenoaks): What the proposed timetable is for taking forward the proposals in the Green Paper "Reform of the Mental Health Act 1983". [127518]

The Minister of State, Department of Health (Mr. John Hutton): Consultation on our Green Paper "Reform of the Mental Health Act 1983" ended on 31 March. We have received more than 1,000 responses to this Green Paper, and we are considering all of them carefully. We will be making an announcement on the next stage of this reform process in the near future.

Mr. Fallon: Does the Minister's reply mean that he is ruling out legislation in the next Session? If compulsory powers are to be more widely used, does he agree that they should be balanced with better rights to assessment and effective early treatment?

Mr. Hutton: On the second part of the hon. Gentleman's question, we have always made it clear that we believe the answer is yes. That is precisely why the proposals on which we consulted set out the establishment of a new independent tribunal. In future that body would take decisions about whether compulsory treatment should be authorised. That would be a significant change from the present procedure whereby such decisions are essentially made by the clinical teams. That would be a substantial contribution to improving patients' civil liberties.

We would expect exactly the same approach to be taken in terms of the treatment of people with mental health problems as for any other group within the NHS, where possible. That should be by agreement and consensus. In some instances where people have very serious mental health problems, that is sadly not the case. Legislation has always recognised the need for a compulsory framework. We think that the present framework can be reconstituted on a fairer and more equitable basis, and that is the basis on which we intend to proceed. As the hon. Gentleman knows, decisions about the introduction of Government legislation will be taken not by me, but by others.

Dr. Lynne Jones (Birmingham, Selly Oak): My hon. Friend will be aware that many of the people who responded to the Green Paper expressed concern that the Government had not wholeheartedly accepted recommendations made by the expert scoping group on the use of compulsion. Does he agree that compulsion should

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not be used as a substitute for good quality care? When legislation is introduced, will he consider using the capacity-based approach to safeguard against the inappropriate use of compulsory treatment?

Mr. Hutton: I must correct my hon. Friend: we did not reject the Richardson committee proposals in that regard. We simply posed an alternative procedure as a different gateway into compulsion. The consultation response revealed a marked divergence of opinion about the benefits or otherwise of a capacity-based system, and we must take that seriously. Of course, compulsion is not a short cut into second-quality treatment. We want patients who have mental health problems to have access to exactly the same high-quality standards of treatment and care as any other group of patients in the NHS.

Mr. Simon Burns (West Chelmsford): Does the Minister accept that notwithstanding any legislation that may be needed to reform the Mental Health Act 1983, it is equally important that the Government do not lose sight of the massive amount of work that must be done--led by the Government, one hopes--to seek to reduce the ignorance, the discrimination and the stigma attached to mental health problems in this country? If the Government can lead on that and help to educate people and to minimise the fears and the stigma, they would be doing a great favour to the whole of society.

Mr. Hutton: I strongly agree with what the hon. Gentleman says. He has held the same position as I in the Department of Health and he will know the situation. We accept our responsibilities to make sure that people who suffer from mental health problems are not routinely discriminated against in our society, because they certainly are; we know that. There is new legislation about disability discrimination rights on the statute book.

I can reassure the hon. Gentleman and the whole House--I am sure the whole House is with him on this--that the reform of the mental health legislation is only one part of the modernisation programme and the reforms that we have set in train for mental health services. We are putting substantial new resources into improving and changing the front-line services available for people with mental health problems, making them more proactive and able to reach, in particular, patients with severe mental health problems, who do not make contact with traditional mental health services. An important element of the wider work is certainly combating discrimination. We fund a number of initiatives in that area and will continue to do so.

Cataract Operations

10. Mrs. Ann Cryer (Keighley): If he will make a statement on the number of cataract operations carried out on the NHS in the last year. [127519]

The Secretary of State for Health (Mr. Alan Milburn): In the last year for which figures are available, there were just over 200,000 finished consultant episodes relating to cataract treatments. The £20 million that we are investing in our action on cataracts programme will ensure more efficient services and will increase the

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number of operations performed to 250,000 over the next few years. The programme will also ensure that we get waiting times down for cataract treatment.

Mrs. Cryer: I thank my right hon. Friend for his helpful announcement. What impact will those plans have on the situation of my Ilkley constituent, who will have her first out-patient appointment on 25 October, by which time she will have been waiting 16 months; and then, of course, she will have to go on the waiting list for her operation for cataracts? In the early 1990s, I had four elderly relatives suffering from cataracts. All of them had to withdraw their savings in order to pay for an initial appointment. Will my right hon. Friend comment on that?

Mr. Milburn: My hon. Friend is right--waiting times are too long at present. That is why we want to get them down. With regard to action in her area, I understand that Bradford health authority is to introduce a new programme of work over the next few months precisely in order to get the waiting times down for cataract operations. It is partly a matter of investing more cash, and that is what we are doing, and hopefully also employing more staff. It is also a matter of redesigning the way in which the system works.

In my hon. Friend's health authority area, for example, I understand that a new system will shortly be introduced whereby patients can be referred direct from the optometrist to a hospital waiting list, rather than having to go through the push me-pull me system, backwards and forwards between the optician, the GP, the out-patients department, back to the GP and so on. The delay is almost designed into the system, and we must change that. By streamlining the system and getting more staff and more money in, we can get the waiting times down for treatment. The idea is that through the 60 schemes that we have introduced to take action on cataract waiting times, at the end of the next few years the waiting time for treatment will be down to six months.

Mr. Edward Leigh (Gainsborough): I congratulate the Secretary of State on his announcement on 30 June that an extra £20 million is being made available for cataract services. The only slight problem was that that announcement was first made in February; it was a re-announcement. Is the fact that the Government are prepared to acknowledge that it was a re-announcement proof that at last they are waking up to what was said in the leaked report yesterday by the Minister's colleagues that enormous damage is being done to confidence in the health service by the constant announcement and then re-announcement of money available to the service?

Mr. Milburn: As a matter of fact, the hon. Gentleman, who is nearly right, is actually wrong on this issue, as so often. What I announced on 30 June were the areas where the £20 million would be invested. They included the area represented by my hon. Friend the Member for Keighley (Mrs. Cryer). There will be 60 local schemes. Many parts of the country will benefit. People will draw the clearest of contrasts between the policy of the current Government, designed to get waiting times down for all conditions, and the Conservatives' policy, which is to force people to take out private health insurance for treatment such as cataract operations, hip and knee replacements and so on.

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I remind the hon. Gentleman, should he need reminding, of what the hon. Member for Woodspring (Dr. Fox) told The Sunday Times on 16 January. [Interruption.] These are the hon. Gentleman's words, not mine. I shall gladly circulate a copy to all hon. Members on the Opposition Back Benches if they would like to see what the hon. Gentleman said, because he obviously fancies himself as the next leader of the Conservative party and this is to be part of his manifesto. What he said on 16 January was:

There is a very simple choice between this party, determined to get waiting times down and to keep NHS treatment free, and the party opposite, determined to lengthen waiting times and force people to pay for their care.

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