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James Duddridge (Rochford and Southend, East) (Con):
It is a pleasure to follow the hon. Member for Kingston upon Hull, North (Ms Johnson) who made a number of salient points, especially about nearest relatives. However, I disagree with her when she said, referring to the hon. Member for Bridgend
(Mrs. Moon), that the Bill was not the place for considering advance directives. The hon. Member for Bridgend made an impassioned and logical case and I hope that the matter will be discussed in Committee, because it would be wholly appropriate to do so.
I did not enter the House of Commons with a deep knowledge or understanding of mental health issues, but over the last two years—because of the people coming to my constituency surgery and as a result of my travelling around the constituency—I felt compelled to understand more about those issues and how they were dealt with in the House. Indeed, my first meeting with a constituent in this place was with someone from SUNRISE—Services Users Network Representation in South Essex—a mental health advocacy group. He raised with me problems stemming from the Mental Health Act 1983 and asked when there would be a mental health Bill. I tabled a number of written questions to Ministers on that question and I am glad that we are now having a Second Reading debate on the Mental Health Bill.
On the basis of evidence presented to me, I was prepared to oppose—and oppose quite strongly—a mental health Bill, but I am now in the somewhat bizarre position of supporting the Mental Health Bill today, largely because of the amendments tabled in the other place. However, I will be deeply disturbed if, as I think and fear will happen, a number of those very sensible amendments are turned down in Committee.
Looking again to my local area, mental health is covered by the South Essex mental health partnership, whose chief executive, Patrick Geoghegan, does an absolutely fabulous job—
Ms Rosie Winterton indicated assent.
James Duddridge: I am glad to see that the Minister shares my view. In fact, the mental health partnership was one of the first foundation status organisations within the sector. The annual report shows that one of the biggest risks over the next five years is this Bill or Act if it passes through Parliament. If Patrick Geoghegan and the South Essex mental health partnership are concerned, I am certainly concerned. Meetings with organisations such as SUNRISE and more national organisations such as Mind and Rethink have confirmed my worst fears. Visiting a local prison did likewise. The hon. Member for Cheltenham (Martin Horwood) referred to a figure in the high 70s in respect of people in prison with mental health problems. On visiting a local prison, I was told that more than 80 per cent. of the male population were suffering from some form of mental illness. That is truly horrific.
Many hon. Members have mentioned the mental health partnership and been extremely complimentary about the organisation—or collection of organisations. The partnership believes that the amendments tabled in the other place “significantly improve” the legislation, in contrast to the Minister’s assertion that they “seriously weaken” it. With no offence intended to the Minister, I tend to support the view of experienced health professionals over that of politicians. We could say that professionals always have a narrow or biased view, but they are backed up not only by the Mental Health Alliance, but by the Law Society, which has welcomed the amendments, calling them “measured
and judicious changes” and urging the Government not to overturn them. Those are two very eminent societies, as hon. Members on both sides of the House have acknowledged, and what they say is surely right.
Beyond the additional six amendments tabled in the other place, a number of their lordships spoke about independent advocacy, which has also been mentioned in this House. Independent advocacy was included in the 2002 and 2004 draft Bills, but is missing from the current Bill. I would like to see Ministers bring forward more detailed provisions on advocacy in Committee, building on the work already mentioned by my hon. Friend the Member for Tiverton and Honiton (Angela Browning).
The hon. Member for Kingston upon Hull, North mentioned the nearest relative and it is important to expand on who can be nominated by an individual, particularly when they are of sound mind. I ask the Government to reflect on tabling amendments to provide that such choices do not have to be brought before the courts. It is important not to have too much bureaucracy surrounding the process.
In my final minute, I would like to make a point about stigma. Katey J, a local artist, recently invited me to open an exhibition, provocatively named “Sad, Mad and Glad”. Katey suffers from mental health problems, but felt a responsibility as a pillar of the community to say that it is possible for people to come out the other side and to talk about mental health problems.
One concern raised by Members, particularly on this side of the House, is that parts of the Bill may drive people with mental health problems underground. That is the very thing that neither side of the House wants. It is, however, a problem that I fear will be significant.
9.29 pm
Tim Loughton (East Worthing and Shoreham) (Con): We have had a very good debate, with some very knowledgeable contributions from no fewer than 17 Back Benchers—I have counted—all of whom paid tribute to local projects, local services and local mental health workers, who do an excellent job, often in challenging circumstances. It has been a well-attended debate, as the hon. Member for Bridgend (Mrs. Moon) said earlier. That might have something to do with the fact that, from memory, it is the first time in my 10 years as a Member that we have had a debate on mental health in the Chamber in Government time. We have had such a debate in Opposition time, courtesy of us.
We have heard some excellent contributions. We started with the right hon. Member for Sheffield, Brightside (Mr. Blunkett), who is not in his place at the moment. Rather unfortunately, he chided some of the mental health organisations that are part of the Mental Health Alliance, by saying that they were raising false fears among various sufferers of mental illness. As has emerged time and again, the 79 organisations in the Mental Health Alliance cannot have it all wrong. He made a very good point that we should make provision for the families of victims as well.
The hon. Member for Stafford (Mr. Kidney) made an excellent, well-informed speech, as usual, given his experience from his legal background. He said that
there have been improvements in mental health services around his constituency—of course, there have—but the amount of extra money going into mental health services does not match the amount of extra money that has gone into the national health service as a whole. He also said that community treatment orders were relatively new and that therefore it is difficult to derive research from them. They are not relatively new in other parts of the world, particularly the United States, where they have been going for some time and where there is no definitive evidence that they are as effective as the Government are trying to make out.
My hon. Friend the Member for Tiverton and Honiton (Angela Browning) has enormous experience of this subject, not least with those with learning disabilities, particularly autism. I hope that she will be able to bring that experience to the Committee that considers the Bill; her comments about advocacy were certainly very well made.
The hon. Member for Hendon (Mr. Dismore), the Chairman of the Joint Committee on Human Rights, referred to some of the concerns that his Committee has rightly raised, and we want to debate them in Committee.
The House will agree that my hon. Friend the Member for Buckingham (John Bercow) made an excellent contribution. He praised the cross-party expertise in the Lords during the earlier scrutiny of the Bill. He said that the Government appear to be in splendid isolation and made the relevant point that I have been trying to make to the Secretary of State, who failed to grasp it, that we should treat people with a mental illness on no different a level from people who have a physical illness. The natural extension of what the Government have been saying is that someone who has cancer treatment and decides that they do not wish to take that treatment will not be subject to some form of compulsion, so why should we treat people with a mental illness differently? That only engenders the stigma that so many other hon. Members have spoken about as well.
Many hon. Members also spoke with real passion about very personal experiences, none less so than the hon. Member for Rhondda (Chris Bryant), who rather bravely spoke about his own family’s experiences and those of his neighbour. I am sure that many of us will have had similar experiences with constituents facing such problems. What he did not add, however, is why the Bill in its previous form would solve those problems or why the Bill, as amended by the Lords, would fail to do so. There was therefore something lacking from his contribution.
Again, we heard excellent contributions from the hon. Member for Hackney, South and Shoreditch (Meg Hillier). I have visited the Hackney Mind project, and I know about some of the excellent work that it does with the black and minority ethnic community there and about the very real problems that she has in that part of east London.
The hon. Member for Caernarfon (Hywel Williams) spoke, as usual, with great knowledge of the subject. The hon. Member for Denton and Reddish (Andrew Gwynne) seemed to say that treatment regimes will be adhered to only because of the compulsion parts of the Bill. I failed to understand that. It seems that the
Government follow the rather bizarre logic that people can be guaranteed to get treatment only if we raise the number of people subject to compulsion. That should not be the way. Those services should be there for everyone, without having to subject them to compulsion.
My hon. Friend the Member for Windsor (Adam Afriyie) summed the situation up well when he said that everybody in the House is concerned for vulnerable people. The hon. Member for Stockport (Ann Coffey) brought her own expertise as a former psychiatric social worker to the issue. The hon. Member for Cheltenham (Martin Horwood) spoke about personal constituency cases. He has had to deal with some pretty dire cases, as has the hon. Member for Bridgend. My hon. Friend the Member for Broxbourne (Mr. Walker) said that people with a mental illness look to him as a Member of Parliament to provide a voice for vulnerable people, and I am sure that that is true of many other Members of Parliament. The hon. Member for Kingston upon Hull, North (Ms Johnson), who is a member of the Mental Health Act Commission, was another person speaking with great expertise. My hon. Friend the Member for Rochford and Southend, East (James Duddridge) talked about stigmas.
We have had a well-informed debate, following on from the expertise in the other place. We think that we now have a relatively good Mental Health Bill, which we can support, but only thanks to the excellent scrutiny and expertise across all the parties in the other place and the six key amendments that have made a fundamental difference to what started off as, I am afraid, a fundamentally objectionable Bill. Members of the other place sought to compromise with the Government, but all too often that compromise was not forthcoming. It is unprecedented in my time here for the Government to suffer six defeats in a row on a Bill, as they did in the Lords. It is incredible that, after seven or eight years in the making, two abortive draft Bills, numerous consultations, the pre-legislative scrutiny Committee, and all this time under the responsibility of the same Minister, the Government still do not get it. After thousands of representations from mental health professionals, voluntary organisations, service users and the Mental Health Alliance, the Government still do not get it and are intent on trampling over all the good work and scrutiny done in the Lords by reversing all the amendments—despite all the public and press outcry over recent days.
The Observer last week carried an article with the heading:
“Mentally ill deserve more than cynicism”.
“A small minority of people who suffer from acute mental illness pose a threat to society. The overwhelming majority pose a threat only to themselves. All are equally deserving of compassionate treatment, but most are being failed by the National Health Service.”
Another article in The Observer was headed:
“Inside the violent, chaotic world of our mental wards”.
The Times carried an article about under-18s being placed with the most dangerous patients. Lord Patel said:
“If I was a parent of one of these children, I would be expecting not only this House, but the Government to take immediate and urgent action”.
The Independent on Sunday yesterday carried the headline:
“Insane! Stop the Mental Health Bill”.
I think it got the second line slightly wrong. Inside, a father reveals the suffering of his child on a secure adult ward.
Yesterday Sheila Hollins, president of the Royal College of Psychiatrists and a deeply respected figure in mental health, said:
“Overturning the Lords' amendments would be a grave mistake and deeply damaging to the future care and treatment of mental health patients. The Government now has the opportunity to achieve mental health legislation which is ethical, principled and supported by patients, professionals, carers and families, and the public.”
Another article is entitled: “The vote for sanity.” It goes on and on. These are not reactionary, right-wing publications. They are publications with a serious interest in mental health and, in particular, in patients and the families of patients who are suffering. I hope that the Government will not close their mind and their ears, but will listen to the many voices of reason that have echoed around this Chamber and the wider world in the last few weeks.
Despite all that and the enormous amount of interest shown in the debate today—the first day back after the recess—the Government still do not get it, as was clear from the opening contribution from the Secretary of State, and want to return to their original Bill, which has been condemned as deeply stigmatising, as the latest attack on civil liberties, and as undermining the therapeutic relationship between clinician and patient. It is counter-productive in that it threatens to deter people with a mental illness from presenting in the first place, thereby driving mental illness underground, as many colleagues have said.
Fiona Mactaggart: Will the hon. Gentleman give way?
Tim Loughton: I will not, I am afraid, because I have very little time.
Potentially, the most dangerous patient with a mental illness is the one whose condition deteriorates under the clinical radar. We are talking about people who have committed no offence, but just happen to be ill. So, despite all the Government’s claims to the contrary, the measures that the Minister of State, the right hon. Member for Doncaster, Central (Ms Winterton), would have us revert to would not just prejudice the health of the patients, but could put at risk the safety of the public. So, the Government’s position is not only arrogant and misinformed, but counter-productive and, perhaps, dangerous.
The fact is that people in this country with a mental illness are being let down by a lack of not coercive powers, but prioritisation in the NHS and the Department of Health. There is an absence of a real champion for mental health in the Department. Whatever the Secretary of State says, mental health is the Cinderella service of the NHS. As many hon. Members, especially Labour Members, have said, services for children and young people are the Cinderella service of the Cinderella service. It is absolutely scandalous that one child a day is still being placed in an adult ward. As the children’s
commissioner said, putting such vulnerable children in intimidating acute wards cannot have a therapeutic benefit. The report produced by his department was called “Pushed into the shadows”.
It is a scandal that mental health trusts are still bailing out other parts of the NHS with deficits. It is a scandal that the number of mental health beds has fallen by 20 per cent. since Labour came to power—in fact, the second largest fall has taken place in the Doncaster and South Humber Healthcare NHS Trust, which covers the constituency of the Minister of State. We are told by Louis Appleby that non-legislative options are being explored for dealing with children, which is why the amendments will be overturned. The Government have had seven years to address the matter, so when will we see results?
It has already been stated that the Government’s worst offence has been to pander to tabloid prejudices and ramp up the aura of dangerousness attached to mental illness.
Fiona Mactaggart: Will the hon. Gentleman give way?
Under the original terms of the Bill, clinicians would be turned into jailers. Indeed, the measure has become a Home Office Bill, so it is rather interesting that a former Home Secretary has made a speech and a former Home Office Minister wishes to intervene. We have a focus on locking people up on the false premise of a threat to public safety, rather than a health Bill that is dedicated to giving support and treatment to people who happen to have a mental illness.
The Government have also behaved with contempt towards parliamentary scrutiny with regard to the research that they commissioned in January 2006 involving the Institute of Psychiatry, which was part of a research package costing £236,000. Despite freedom of information requests, they did not publish the research until the day after the House of Lords had finished its deliberations on the subject.
The Government still seem to be in denial. Despite the fact that the report said that there was no empirical evidence from 72 studies in six different countries throughout the world to support the efficacy of community treatment orders, the Minister wrote in a letter to me last week that she would like to take the opportunity briefly to draw my attention to the positive evidence for CTOs that exists. She wrote that we only have to look at what clinicians, patients and families around the world say about their own experiences. The Government are in denial. Where is the evidence? They have failed to produce it, so I hope that we will see more of it.
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