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It being half-past Two o'clock, the debate stood adjourned.
Debate to be resumed on Friday 14 May.
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Remaining Private Members' Bills
ORGAN DONATION (PRESUMED CONSENT AND SAFEGUARDS) BILL
Order for Second Reading read.
To be read a Second time on Friday 14 May.
WILD MAMMALS (PROTECTION) AMENDMENT (NO. 2) BILL
Order read for resuming adjourned debate on Question, That the Bill be now read a Second time.
Debate to be resumed on Friday 21 May.
LOCAL LAND CHARGES (FEES) BILL
Order for Second Reading read.
To be read a Second time on Friday 18 June.
30 Apr 2004 : Column 1182
Asperger's Syndrome
Motion made, and Question proposed, That this House do now adjourn.—[Ms Bridget Prentice.]
2.31 pm
Mr. David Lidington (Aylesbury): I am grateful for this opportunity to raise the case of Piers Bolduc, the son of my constituents, Eugene and Cris Bolduc, and to press the Government about Mr. Bolduc's case and about some of the wider lessons that we may learn as regards the treatment of people with Asperger's syndrome within our secure mental hospitals.
It is now 10 years since Eugene and Cris Bolduc first came to see me. The case of their son, Piers, is tragic. He is now 28 years old, and he has been detained in secure mental institutions for a decade. His childhood, family and school life seemed normal, although with hindsight, it can be recognised that he showed some of the characteristics typical of Asperger's syndrome, such as finding it hard to socialise with other people.
The real problems for Piers started at about the age of 16, while he was studying for his GCSE examinations. At the age of 17, Piers was first prescribed neuroleptic drugs, which as the Minister will well know, are intended for the treatment of schizophrenia and other comparable mental conditions, and not for the treatment of Asperger's. By this stage, Piers was showing increasing symptoms of confusion and an inability to cope with normal society—classic features of Asperger's syndrome. His ability to cope with life was being made worse by the inappropriate drug treatment that he was being given.
While on a course of this drug treatment, Piers travelled alone to High Wycombe and a violent incident took place in which Piers slashed a young man with a penknife. I do not for one moment, and nor would the family, wish to minimise the importance of this event, and particularly the impact on the victim. It also needs to be recorded that the victim's life was not in danger, although he did need stitches in his back.
Piers was later charged with grievous bodily harm with intent. At a hearing at Reading Crown court, he pleaded not guilty on grounds of insanity. That defence was accepted by the jury and Piers was acquitted and then sectioned under section 41 of the Mental Health Act 1983.
The history thereafter is an unhappy one. Initially, Piers was held on remand at Reading prison. After lobbying from his family, in which they enlisted my support, he was transferred to a private psychiatric unit at Stockton Hall in Yorkshire. There, he was wrongly diagnosed as suffering from schizophrenia and once again injected with drugs that were completely inappropriate to his condition.
According to his parents, Piers was locked in a room for eight months while at Stockton Hall, with only a mattress on the floor rather than a bed. No activities or recreations were provided for him and he had no access to radio or television.
The following year, in June 1995, Piers was transferred to Broadmoor. There, in 1996–97, Dr. Lorna Wing finally diagnosed Asperger's syndrome. Few people would claim that a secure mental hospital is the best environment for the treatment of people with
30 Apr 2004 : Column 1183
Asperger's. By 2001, Piers's then doctor, Dr. Vermeulen, had told his parents that the hospital wished to transfer Piers to a more appropriate environment where he could finally receive the treatment that would help his condition. In November 2001, Broadmoor began to assess his suitability for transfer to the Eric Shepherd unit in Watford. That transfer proved not to be possible but by 2003 attention was centring on the Hayes unit in Gloucestershire.
It is important to make it clear that the Hayes unit would not, as a matter of principle, have accepted Piers Bolduc as a patient if he had still been considered to be a danger to other people. The fact that the transfer has been in preparation for a number of years indicates a recognition on the part of the NHS, which is responsible for Piers's care, that he no longer appears to pose the threat that he may once have posed.
On 15 December last year, Dr. Julie Hollyman, chief executive of the West London Mental Health NHS Trust—responsible for Broadmoor hospital—wrote to me about the case, saying:
"I can confirm that it is the clinical opinion that Mr. Bolduc is now ready to move from Broadmoor High Secure Hospital to the Hayes Unit."
On 19 December last year, Mr. Shaun Brogan, chief executive of the Vale of Aylesbury primary care trust, wrote to me that
"the PCT have committed to Piers' future care after discharge from Broadmoor".
So there would appear to be no clinical or financial obstacle to that long overdue transfer, but still the family wait.
My understanding is that the transfer needs to be authorised by the Home Office. The family have been pressing both Broadmoor and the Home Office for that to happen, but it seems that, despite all previous correspondence, Broadmoor did not formally contact the Home Office until March 2004, after considerable pressure from Piers's family. It is known that, as of today, no reply has been received from the Home Secretary's office.
If Piers Bolduc had been convicted of a crime and been disposed of through the criminal justice system, perhaps by way of a custodial sentence, it would have been over years ago and he would rightly have been rehabilitated by now. It is an indication of something seriously amiss with the way in which our country deals with people like Piers Bolduc that, after more than a decade, we should still be talking about this young man, incarcerated in an institution like Broadmoor, having had a history of misdiagnosis and mistreatment. He has been let down badly by the system.
May I ask the Minister a couple of direct questions about Piers's case? Can he confirm that there is no clinical or financial obstacle to Piers's transfer to the Hayes unit? Can he say what progress his Department and the relevant trust have made with the Home Office towards authorising that transfer? Will he undertake to press his colleagues in the Home Office, in view of the history that I have recounted, to deal with the case as swiftly as humanly possible?
This case raises wider questions about the treatment in secure mental hospitals of people with Asperger's syndrome. Piers Bolduc's detention in Broadmoor has probably cost taxpayers in the region of £2 million so far
30 Apr 2004 : Column 1184
for that 10 years, in part for the wrong sort of treatment in the wrong sort of institution. I therefore have several issues to put to the Minister, to which I hope that he will be able to respond during this short debate or, if time does not permit, take advice on so that he can write to me later in greater detail.
First, will the Minister comment on the legality of holding people with Asperger's syndrome under the Mental Health Act 1983? My understanding is that a report by the National Autistic Society back in 1996, instigated by the three special hospitals, suggested that Asperger's syndrome was not actually a mental disorder under the meaning of that term as laid down in the 1983 Act. If that is so, it raises serious issues about the detention of not only Piers Bolduc, but a fair number of other people. I hope that the Government will make their view on that clear.
Secondly, can the Government say how many people with Asperger's syndrome are being detained under the provisions of the 1983 Act? In a written answer to me of 10 November 2003, the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) told me that the Government did not have that information. The Government should have had that information and, if they did not have it then, they ought to have found it out by now. The Government should inquire into the number of patients with Asperger's syndrome who have been misdiagnosed, as was the case with Piers Bolduc, and given the wrong treatment.
I should make it clear that my aim, and that of Piers's family, is not to point fingers at people who may have taken incorrect decisions in the past. Rather, we want to establish the truth about what is happening in our secure mental hospitals now, and about the scale of the problem, so that we can understand what steps need to be taken to put matters right.
Thirdly, what action are the Government taking to improve the quality of training in the management of Asperger's for the staff at secure mental hospitals? It was two or three years after Piers's arrest before he was diagnosed as having Asperger's at all, despite the fact that his parents had raised that possibility at an earlier stage. Even after that diagnosis, the family expressed to me serious concerns that not all the staff responsible for Piers's care really knew how to deal with a case of Asperger's syndrome. They also commented to me that internal communications between staff from different disciplines often appeared to be lacking.
Fourthly, are the Government reviewing the quality of care available at secure hospitals for people with Asperger's? In a letter to me of 8 February, the Minister of State, Department of Health, the hon. Member for Doncaster, Central stated:
"The normal practice is to allow increasing freedom within the grounds of the hospital followed by escorted visits into the community and to a possible placement."
However, on the information given to me by the family, despite the fact that Piers was approved as ready for transfer three years ago, none of that happened in their son's case until November last year. Coincidentally, that was after critical reports of Piers's treatment were published in The Sunday Telegraph and broadcast on Radio 4's "Woman's Hour". All that has apparently happened since then is that Piers was allowed to prepare
30 Apr 2004 : Column 1185
and cook a pizza for himself in the Broadmoor kitchen and has been on two day visits to the Hayes unit. That seems to fall a long way short of what that Minister suggested to me should be the normal regime for a patient being prepared for transfer.
Finally, will the Minister and the Government accept the principle that families ought to be part of a process of healing and readjustment to life outside mental institutions? For me, the most distressing aspect of this case is Mr. and Mrs. Bolduc's feeling of exclusion from their son's life. In fairness, Broadmoor hospital says that such exclusion is at Piers's request, but that, in turn, is based on the hospital's insistence that he is capable of taking that decision himself and is not influenced by the staff. Of course, the people who have assessed him as competent to take that decision are the staff of the very hospital that is the subject of the complaint.
As the Minister will recall, my hon. Friend the Member for Tiverton and Honiton (Mrs. Browning) raised this issue, among others, with him in an Adjournment debate on 10 September last year. It is utterly wrong if families feel that they are being pushed out and excluded from contact with relatives detained under mental health legislation, rather than being engaged in and involved with a programme of healing and rehabilitation.
I hope that the Minister can tell me that, after 10 years, a new life is at last ready for Piers Bolduc to start. But I hope, too, that his tragic case will serve as a lesson—not just to the Government but to us all—that we need to do far more to ensure that people with Asperger's syndrome in our secure mental institutions are given the standard of care and treatment that they are entitled to.
2.46 pm
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