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The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): When will that be?
Mr. Heald: Unfortunately for us, we must wait three years, or possibly four, before we can sit on the other side of the House and present our policies; but I look forward to that day. I am determined that when it comes, our policy on mental health will be one of which we can be proud. The Secretary of State should not be complacent.
We have important questions about the Bill, and we want answers. We want to know whether the compulsory treatment in the community to which the Bill refers means that medication will be given only in a hospital setting. The Bill mentions a clinical setting. What exactly does that mean?
What is the effect of the changes made since the White Paper to treatability and the definition of mental disorder? Do they mean, as was suggested by the hon. Member for Oxford, West and Abingdon (Dr. Harris), that those with personality disorders will be detained indefinitely, or can the Minister promise us that reassuring new safeguards have been introduced? Will she also answer a question put by my hon. Friend the Member for Woodspring (Dr. Fox)? What will the Bill do to improve arrangements for the transfer of those with mental illness from prison to more suitable settings? That is one of the major issues of the day.
Then there is the issue of sanctuary. Let us not forget the experiences described by my hon. Friend the Member for East Devon (Mr. Swire). He told us of a tragedy in his constituency involving a triple suicide. Such incidents make us realise what a priority mental health is when vulnerable people are at risk. I welcome the Government's target of a 20 per cent. reduction in the number of suicides over 10 years, but the fact is that the number has risen by 1 per cent.
The Secretary of State is right to be pleased about movement on crisis resolution teams, but halfway through the period he identified—2000 to 2004—there are 52 of them. He promised that by 2004 there would be 335. He is nowhere near halfway there, at the halfway stage. He promised that there would be 77 more this year. Will there be? He promised that there would be 50 early intervention teams by 2004. So far there are 16. He is not halfway there, but he is halfway through the time. Only 4 per cent. of local teams have established complete services of the sort that was promised. The Audit Commission has complained that less than half the number of specialist teams for the elderly are present in the areas where they are needed.
We were promised 700 extra workers to give carers respite. As far as we know, none have been appointed. We were promised 1,000 new primary care workers; there is not even a system enabling those who are there to be counted. The Secretary of State laughs. The fact is that he promised that by 2004 every prisoner would be seen and given a care plan on leaving prison. Here we are in 2002, and what has the Secretary of State done? He has changed the target: he now says that that will happen by 2006. We were told that there would be such services in every prison. In fact the Government aim to provide them in only 70 prisons—70 out of 136—by 2004. That cannot mean "every prisoner".
There are gaps in provision. Where is the money going? Day by day, we hear that money is not reaching the front line—money that was promised. We know that last year £10 million promised for child mental health was simply reallocated for general expenditure. We heard in the Chamber recently from my hon. Friend the Member for Salisbury (Mr. Key) that Wiltshire faces cuts. Some of us attended a recent event organised by the Zito Trust, where its latest report on prescribing was to be unveiled. A consultant from Shropshire said that he faced cuts there as well. We have been lobbied about cuts in Manchester, and we have heard evidence of cuts in Buckinghamshire, Hertfordshire and North Cumbria.
It is all very well for the Secretary of State to twit me and say that we have had some extra services in North Hertfordshire. I am grateful for that and so are my constituents, but we are still two consultants short. Whatever area the Secretary of State mentions, he does not give the complete picture. He says that the constituency of my hon. Friend the Member for Woodspring has been given extra services, but the hospital is being closed. Right across the country the money is not getting through. It is no good having targets if they are not met.
It is the Opposition's job to do what I am doing now—to push the Government, and make them keep their promises on mental health. We have a duty to do that, because we are talking about trying to help the most vulnerable members of society. I want the new Bill to recognise that carers and other users of the system want conditions allowing them, as far as possible, to consent to treatment. We will read the Bill carefully, but the Secretary of State should be in no doubt about this: we want a Bill that will improve conditions for those who experience the tragedy of mental ill health, and that is not what the White Paper promised originally. If the Secretary of State has moved in our direction, we shall be pleased.
Above all, the issue is about human rights as well as money. When it comes to preferences for treatment, we want the Bill to ensure that patients and carers are at the centre of what is proposed and planned. We want the mental health sector to have the dignity that for so long it has not had. That means that when people suffering from mental health problems present themselves at hospital, they will not be turned away—as happens in one out of three cases at the moment.
6.50 pm
The Minister of State, Department of Health (Jacqui Smith): Like other hon. Members who have spoken in this debate, I am grateful for the opportunity that it has
afforded to focus the House's attention on this very important topic. As my right hon. Friend the Secretary of State for Health pointed out, it has been high on the Government's agenda since we first published the "Modernising Mental Health Services" White Paper in 1998.I hope that it has been apparent in the debate that the Government share the concern expressed by Opposition Members and many other hon. Members about those in society who suffer from mental health problems. The concern is shared by hon. Members of all parties, but although I do not want to cast aspersions on the conversion of Opposition Members, my hon. Friend the Member for Leeds, West (Mr. Battle) described compassionate Conservatism as apparently having no roots. Given the numbers of Opposition Members present, it does not have many branches either.
The hon. Member for Woodspring (Dr. Fox) was right to express concern about homeless people who also have mental health problems. I remind him that it was not a Labour Minister who described the difficulty of stepping over the homeless to get into the opera. The Opposition's conversion to concern about the vulnerable and people with mental health problems is relatively recent.
We share the concerns of those who have expressed their anxiety about mental health problems. However, we do not share the analysis of the causes.
Sir Michael Spicer (West Worcestershire): Will the Minister accept that a Labour Minister started the process of closing mental hospitals on a large scale in the 1970s? That happened to the detriment of my constituency, where two mental hospitals were closed in the 1970s.
Jacqui Smith: In fact, the hon. Member for Woodspring—in a rare mood of contrition—claimed that a Conservative Government were responsible for that, and apologised for it.
We share Opposition Members' concerns about mental health services, but we point the finger at the decades of underinvestment by the previous Administration. That led to crumbling buildings, demoralised staff and inadequate treatment. We inherited that legacy of neglect when we came to power, and we have been addressing it with vigour ever since.
We set out our agenda in 1998. Our aim was to modernise mental health care and social care, to provide new investment for reform and to ensure a modern legal framework to support effective treatment outside as well as inside hospital. We are delivering on that agenda.
All over the country, services are being reconfigured to meet the standards set out in the national service framework for mental health, to ensure better and faster care for people with mental health problems. New community teams have been established, and there are more staff and improved acute in-patient care. Of course, the scene will not be transformed overnight, and we would all like services to progress further and faster. However, across the nation, local implementation teams and front-line staff are working hard to improve mental health care. We do them a grave disservice if we fail to recognise how far they have come already, given the low base from which they had to start.
We are investing in mental health services, with £329 million set aside to support our NHS plan commitments. That money for the future was described
by Opposition Members as "reckless" when we first allocated it, and they voted against it. With the draft mental health Bill that we published today, we have started the process that will lead to the 21st century legal framework that we need to underpin 21st century services.The hon. Member for Oxford, West and Abingdon (Dr. Harris) raised concern—
Mr. Heald: Will the Minister give way?
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