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2.43 pm

The Minister of State, Department of Health (Jacqui Smith): I congratulate my hon. Friend the Member for Peterborough (Mrs. Clark) on securing a debate on this important subject. The Government have made public their commitment to delivering a health service that is truly inclusive, available to everyone on the basis of need and without prejudice, and delivered in a way that is not only accessible to everyone but is appropriate to the communities that it serves.

To provide such a service, the NHS has to understand the obstacles facing ethnic groups in Britain today. As well as racism and racial harassment, those obstacles include institutional discrimination that arises not necessarily from malice, but from ignorance and a lack of understanding between people from different backgrounds and cultures. To deliver the service that we all want and that our communities deserve, we need both to tackle racism and to ensure that the NHS develops services that recognise cultural differences and are of a high standard for all people.

My hon. Friend raises the specific issue of the untimely death of David Bennett, which has rightly focused attention on the wider issue of the experience of people from black and ethnic minorities who have mental health problems. First, I take the opportunity to express in public my sincere sympathies to the family of David Bennett,

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as I have already done in private. I have met David Bennett's sister, Dr. Joanna Bennett, and have been impressed by her commitment to ensuring that lessons are learned from this tragic event and that they are translated into real change in mental health services.

My hon. Friend has called for a public inquiry into the death of David Bennett. I hope that the action that I shall outline in relation to this case and in the wider development of our mental health policies will persuade her that I share her and the Bennett family's commitment to improving mental health services for black people. As I have already explained, I am not convinced that holding a public inquiry is the best way to achieve changes and improvements.

I have already proposed a range of actions that will lead to a full investigation of the circumstances surrounding David Bennett's death; address the issues raised in the coroner's inquest; tackle wider issues of concern regarding the care and treatment of people from black and minority ethnic backgrounds in mental health services; and provide an appropriate platform and gravitas for this important issue.

These measures include the health authority undertaking a local independent inquiry, with Department of Health officials working with the authority to ensure that the inquiry's remit addresses concerns that the family has raised, that there is full access to the inquiry by family members and others, including decisions as to the membership of the inquiry panel, and that the findings are made public.

Furthermore, I have given a commitment to write to ministerial colleagues in other Departments to ask them for their support in considering the specific issues raised by my hon. Friend again today concerning restraint of people with mental ill health. I am commissioning research to address issues of supporting and informing families through traumatic events such as those experienced by the Bennett family, and ensuring that the lessons learned from this inquiry, and other similar inquiries, are taken fully into account in the developing of a mental health strategy for black and minority ethnic groups.

As my hon. Friend has ably outlined, there have been specific concerns for some time about the care and treatment of people from black and minority ethnic groups with mental health problems. I accept that there is still much to be done. However, there is much that we have already done to start tackling these serious issues.

The report of the Select Committee on Health on mental health services raised important issues involving challenging institutional discrimination in the area of mental health. In the Government's response, we acknowledged that challenging institutional discrimination is the responsibility of those who lead and deliver mental health services, as in all other areas of public service. In its report earlier this year, the mental health work force action team highlighted the need for the work force to represent the ethnic diversity of the community that it serves. We are committed to supporting the NHS locally to deliver this diverse work force, and to address some of the important training and education issues that my hon. Friend raised.

Through NHS Direct, we have begun taking action to overcome some of the language barriers to which my hon. Friend referred. NHS Direct sites are now engaging with

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their local black and minority ethnic communities to scope out their needs, promote NHS Direct and raise awareness of the service to the local community. Sites have systems in place to ensure access to advice and information in languages other than English. Currently, help is available in more than 30 languages.

As my hon. Friend rightly said, professional bodies need to be active in tackling racism and discrimination. I welcome the fact that the Royal College of Psychiatrists, for example, has set up a committee to examine ethnic minority issues and stated that it will make training in cultural competence, including racial sensitivity, mandatory for psychiatrists. It has initiated an internal audit to examine its policy and practice on ethnicity. However, as my hon. Friend also rightly said, more needs to be done.

We are pleased to be making progress, but we are not by any means complacent. The mental health taskforce, set up to drive forward the NHS plan and the national service framework for mental health, has been given a specific remit to consider the mental health needs of black and ethnic minority service users. Taskforce member Professor Sashidharan, rightly referred to by my hon. Friend as a leading expert on ethnicity and mental health, who is also the medical director of North Birmingham mental health trust, is leading the development of a strategy that will address head on many issues of concern surrounding the provision of mental health services to people from black and minority ethnic groups.

I take very seriously the points made by Dr. Joanna Bennett and by my hon. Friend. Both the timing and the way in which we engage users in the development of our strategy will be absolutely crucial in ensuring that it makes the difference in practice that we intend. A strategy is no good on its own unless it affects service and the treatment that people from black and minority ethnic groups receive in the mental health system.

Many of the services that Professor Sashidharan pioneered are now part of the improvements that we have set out in the NHS plan and the national service framework for mental health services. It is very important that, as we improve our mental health services—which is clearly very necessary—we bear in mind the range of services available. Among other initiatives, early intervention, crisis resolution and assertive outreach services are to be made readily available in all parts of the country.

My hon. Friend rightly said that a range of high-quality services must be in place to respond to the different needs of different individuals, and black and minority ethnic communities in particular. I agree with her analysis that the provision of a uniform service is not necessarily the best way of responding to the varying needs of people from different communities. We need to ensure that the views and needs of minority ethnic users are at the centre of our service development.

To take one example, Professor Sashidharan has shown that black people are far more likely to seek help if they can have access 24 hours a day, seven days a week, to crisis resolution teams. The teams respond immediately and whenever possible treat people at home. Such a service is much preferred by many service users, but is particularly welcomed by black people, whose experience of hospital care has often been negative.

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I have also asked the new National Institute for Mental Health to examine the issues of ethnicity and mental health as one of its first priorities. It will be developing a specific work programme on black and ethnic minority mental health, with a remit to include communications with black and ethnic minority groups and interests; the development of targeted programmes such as those on cultural competencies, outcomes and research; and the involvement of black and ethnic minority groups in the development of the institute. I am aware that words are not enough to improve the services for users, and that we need a vehicle to implement change and ensure that that becomes a reality in the services offered by the NHS. The National Institute for Mental Health will ensure that the recommendations from the strategy will be given substance and taken forward.

The consultation document for the black and minority ethnic strategy will be issued next spring, and the final strategy will be published later next year. I am confident that the strategy will be a major step forward. It will provide a coherent and clear direction for mental health services and highlight the key issues that mental health services must address to tackle inequality and injustice. The problems experienced by black and minority service users in mental health cannot be put right overnight, but I believe that our actions already speak louder than words. The actions we have already taken, and those that we plan to take, show the priority that we have rightly given to tackling racial discrimination.

The Race Relations (Amendment) Act 2000 will help to ensure that public services, including the NHS, promote racial equality across the board. It will demand that all public sector bodies implement and audit race equality strategies, and that any major proposal to change service provision is assessed for its impact on black and ethnic minority service users. We have already taken action from the centre to ensure that all parts of the NHS recognise the significance of the racial equality agenda that is at the centre of the NHS plan. The plan sets out our vision for health services and our commitment to ensuring that, both as an employer and as a provider of services, the NHS works to eliminate discrimination and promotes equality across all parts of society.

We have moved from years of neglect by giving mental health a firm footing in the NHS plan and the national service framework. For the first time ever, we have a broad vision that is acceptable to and supported by service users. Now we must target areas of concern, which is why we have instigated the first ever national black and minority ethnic mental health strategy.

We have a particular duty in mental health to ensure that when people are ill and at their most vulnerable, they receive services that are respectful and address the diversity of their needs. To achieve that, we must acknowledge and understand those needs. Racism cannot be tolerated, and neither can ignorance. I will do my utmost, as will the Government, to ensure that these changes transform the experience of all those who use mental health services, across every community in the country. Everyone deserves the best that the NHS has to offer, and we are committed to ensuring the widest possible access to the best possible services for all our communities.

Question put and agreed to.

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