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19 Jun 2007 : Column 1272

My Bill would aim to protect tenants’ rights to lifelong secure tenancies, which are sacrificed following a stock transfer. The assured tenancy on offer is not the same thing at all because a promise by a new registered social landlord not to use its greater powers in law, for example on eviction, is nothing like comparable to the statutory rights that secure tenants have at the moment. Although we are told that transfers will be made to “community based” organisations, that often does not last because landlords can get into a financial mess and be taken over by remote businesses, or can become caught up in the merger mania that is fuelled by the Housing Corporation’s drive for mega RSL groupings. We should not forget that tenants have no vote on such takeovers and mergers and that the new owners of the housing have no obligation to deliver on old promises made by others.

The Bill would protect tenants from the scandals that we see when unscrupulous and uncaring councils use large-scale funding that comes from the pockets of local taxpayers to run misleading and unbalanced campaigns to frighten tenants into voting for stock transfers. Together with so-called independent consultants and advisers, they produce dubious glossy propaganda booklets that, in essence, say to tenants, “You have no alternative but to vote yes to transfer.” That is an outrage. We need no crystal ball to point to the cracks and stains on the rosy pictures painted by those who are hellbent on flogging off, at a knock-down price, public assets that were built by and for successive generations of tenants and taxpayers.

The track record of stock transfers is often pretty dreadful. Shelter found that homelessness worsened in areas with stock transfers, while the National Audit Office said that it cost thousands more to improve each home after transfer than would be the case if councils were just given the money to do the work themselves, which the Bill proposes. Any genuine consultation on the future of publicly owned housing must, as a minimum, ensure that tenants hear all the arguments, that there is equal access to public funds for both sides of the case to be put, and that there is a formal ballot on any change. As that is just what the Bill spells out, I urge a moratorium on any further ballots until the new Prime Minister’s housing policy becomes clearer.

May I turn to my Bill’s proposals to ring-fence rents and capital receipts for direct investment and to require equal financial treatment in the provision of affordable homes for local authorities, and for housing associations and other RSLs? The argument of the ancien régime about to leave office is that we simply cannot afford the level of investment in publicly owned housing that is brought in by private finance. There are two fatal fundamental flaws in that approach: first, the theory that there is no cost to the taxpayer in the options for privatisation when there most definitely is; and, secondly, the theory that there is a huge increase in public expenditure with direct investment when there most certainly is not. Tenants are right to demand a level building site for councils on which the fourth option can be constructed, as opposed to the three privatisation options. The same amount of public funds spent on subsidising stock transfers, arm’s length management organisations and the private finance initiative should be available in the growing number of cases when council housing is retained.

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The Joseph Rowntree Foundation estimates that right to buy sales have yielded almost £50 billion, but that just a quarter has been recycled into improving public housing. The moonlight robbery campaign points out that tenants pay an average of £800 per year more in rents than they get back in management, maintenance and major repairs. That represents a national annual total of more than £1.5 billion. It is unacceptable that money is being leeched from council housing and council tenants in such huge volumes to subsidise private developers who are building houses that are still priced way out of the reach of ordinary, hard-working families.

The unequal financial treatment between unaccountable and often remote housing associations and democratically elected local housing authorities defies belief. For example, making debt write-off conditional on stock transfer is a form of blackmail, and my Bill would bring that to an end. The Auditor General has stated that that form of debt repayment has no net effect on the Exchequer, so why is it denied to local housing authorities, but doled out to RSLs?

Rental income must be ring-fenced in the national housing revenue account and the pooling of local rents for national distribution needs an overhaul. Housing support for hard-up areas should come from the taxpayer, not the tenant. The rigging of write-offs and gap-funding subsidies to make RSL business plans stack up is a stitch-up. A fresh approach that is rooted in real, unforced choice for tenants, and fair financial deals for councils, with the availability of debt write-off and gap funding, would benefit millions of people throughout the land. Waiting lists will shorten, overcrowding will lessen and living conditions will improve. Council estates can again be the stable and mixed communities in which many in the House, like me, have lived. I was proud to stand in the 2005 election on a manifesto that stated:

We have three years to make good on that pledge.

In the Government’s response to Kate Barker’s review of the supply of housing was a promise, as part of the 2007 comprehensive spending review, to respond

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Option 4 is indeed a policy whose time has come.

We must defend and extend council housing. No wonder so many people are putting up their hands for it. There is a strong business case for direct investment. There is a powerful social case for constructing council housing to tackle the affordable housing crisis, and there will be a political dividend from reaffirming a core value that council housing is not some obsolete policy from a bygone era, but a key economic activity that adds to our national wealth, promotes social inclusion and is a robust, high value and sustainable solution for one of the most pressing problems that face a new Administration planning their priorities for the next three years.

I am sure that that Administration will recognise that council housing is cheaper to build, manage and maintain than all the alternatives and, most importantly, is more accountable. I hope sincerely that this Bill is a suitable foundation for an overdue and much needed new direction in affordable housing both in theory and in practice, and I commend it to the House.

Question put and agreed to.

Bill ordered to be brought in by David Taylor, Mr. Jim Cunningham, Frank Dobson, Paul Flynn, Dr. Ian Gibson, Kelvin Hopkins, Dr. Brian Iddon, Lynne Jones, Andrew Mackinlay, Paul Rowen, Bob Russell and Mr. Phil Willis.

Council Housing (direct Investment)

David Taylor accordingly presented a Bill to promote the improvement of all council homes and estates; to provide for the building of new council housing; to promote equal financial treatment between local authorities and registered social landlords in the provision of affordable housing; to reserve certain rents and capital receipts for direct investment in council housing; to provide for the protection of rights to life-long secure tenancies and of tenants from involuntary changes of ownership and management; to further regulate and make requirements of registered social landlords; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 19 October, and to be printed [Bill 127].

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Orders of the Day

Mental Health Bill [ Lords]

[2nd allotted day]

As amended in the Public Bill Committee, further considered.

Clause 7

Change in definition of “medical treatment”

5.18 pm

Chris Bryant (Rhondda) (Lab): I beg to move amendment No. 1, page 4, line 16, leave out

and insert—

‘(1) Section 145 of the 1983 Act (interpretation) is amended as follows.

(2) In subsection (1)’.

Madam Deputy Speaker (Sylvia Heal): With this it will be convenient to discuss the following amendments:

No. 2, page 4, line 18, after ‘care’ insert—

No. 3, page 4, line 18, at end insert—

‘(3) After subsection (3) insert—

“(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.”.’.

Chris Bryant: The amendments are in my name and that of all the Back-Bench Labour members of the Committee—I hope the Minister is aware of that—and some Conservative and Liberal Democrat Members. The three amendments tie together rather oddly, so for clarity I should explain that they would have the effect of rendering section 145(1) of the Mental Health Act 1983 as:

(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.”

The British Medical Association has written to all Members of the House, I think, to say:

The BMA is not the only organisation that is urging the Government to accept the amendment. Mind, the mental health charity, for which I ran the marathon earlier this year, has written to say:

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and other Members

Likewise, Hafal, the mental charity in Wales, has also supported the three amendments. The Mental Health Coalition, the new combination of organisations including Unite, which is my trade union, Unison, the Royal College of Nursing, the College of Occupational Therapists, the British Psychological Society and the British Association of Occupational Therapists, has also written to say:

Finally, the Mental Health Alliance has written to say that it welcomes the amendment, although it has some concerns about the concept of manifestations and would want ministerial assurances that what it refers to is clearly part of the mental disorder.

It is perhaps important to stress some of the context in which the amendment comes before us. Ever since 1324, we have had in statute some provision to detain people solely by virtue of their mental ill health, although I apologise for the terms in which the legislation was couched in 1324, when the royal prerogative asserted that the king had jurisdiction over the persons and property of “idiots” and those who happened to “fail of” their “Wit”. Obviously, legislation moved substantially, and in the Vagrancy Act 1714, we had the first articulation of how we should be able to detain somebody purely by virtue of their mental ill health. That subsequently translated into the Mental Health Act 1959 and then the 1983 Act, which made clear the requirement for a therapeutic environment.

The principles that I feel are important in this issue are pretty straightforward. First, no psychiatric unit can be a prison by another name; it must be a therapeutic environment. Secondly, any person, whatever their mental condition, whether or not it is a condition that we currently believe is curable, must have the right to appropriate treatment and we cannot simply wash our hands of them.

Ann Coffey (Stockport) (Lab): Will my hon. Friend confirm that the amendment would certainly enable people with personality disorders to be treated in a therapeutic environment? My concern is that people with such disorders have in the past been refused treatment on the grounds that they are untreatable according to a very rigid interpretation of the terms “alleviate”, “likely to alleviate” or “not worsening” symptoms.

Chris Bryant: I believe that there have been instances since 1983, and that there were certainly instances before, in which people believed that the treatability test was actually a curability test, and that because one could not cure somebody of a personality disorder, one should not therefore bother to treat them. That view is certainly not held now among most psychiatrists, most consultants working in hospitals and most of those working in mental health services today. I hope that, in future, as science advances in this area, we will be able to provide many more treatments. Who knows? Perhaps in the distant future, we will be able to get closer to curing some of these personality disorders.

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Meg Hillier (Hackney, South and Shoreditch) (Lab/Co-op): Will my hon. Friend comment on the situation of one of my constituents, who murdered a man? The murderer, my constituent, had been in and out of Homerton hospital in my constituency for two years to be treated for schizophrenia prior to the day release on which the murder took place. He was sent immediately to Broadmoor, where he spent 10 months being assessed. At the point of conviction, in trial, the judge was told that he could not send the man to Broadmoor under sentence and could send him only to a mainstream prison, because under current mental health legislation, he could not be treated. Does my hon. Friend believe that the amendment will capture such situations, and will he join me in urging the Government to take note of what is being laid down today?

Chris Bryant: I am grateful to my hon. Friend, who has made a valid point. We should consider not only people who might commit a homicide, but, far more significantly, those who might be considering suicide. As last year’s report on avoidable deaths by the university of Manchester pointed out, some 1,300 people who had been through mental health services committed suicide last year in the United Kingdom compared with some 30 homicides. It may be that when some people’s minds are very disturbed, the dividing line between homicide and suicide is not as clear as it might be for others. We should consider the rights and needs of the patient, which is an important principle.

Dr. Evan Harris (Oxford, West and Abingdon) (LD): I am a little concerned by something that the hon. Gentleman has said. Will he accept—I declare an interest as a member of the BMA medical ethics committee—that treatment is more than just intervention? Treatment is something that has a chance and that has been shown to be effective in having a chance, although not in every case, of alleviating the condition in some way. That is different from intervening or placing someone in a therapeutic environment. If the concern is to protect the public, it should not be done under a notion of treatability when it simply involves intervention or detention. Will the hon. Gentleman give me that assurance about his amendment?

Chris Bryant: I return to the first principle that I articulated, namely that no psychiatric unit should be a prison by another name. However pleasantly it might be arranged, we cannot detain people just for the purpose of detaining them, and there must be some kind of therapeutic benefit. That is the purpose of the amendment.

We also need to adhere to two other important principles. First, the public have a right to protection. Historically, mental health legislation has always allowed for the protection of the public. Originally, the legislation addressed the protection of the King, but it was subsequently extended to cover all members of the public.

I know from personal experience in my family that families, friends and carers of those who have significant mental health problems sometimes want mental health services to have the right to detain and sometimes feel that mental health services were too hesitant in detaining
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somebody, because they consequently saw that person travel further and further down the route towards significant mental ill health in a way that they think is irretrievable.

Having said that, it is important to bear in mind that I do not believe that the Bill will balance the rights of the patient, the rights of the public and the rights of families and friends on the security of society and the rights and freedoms of the individual without some kind of treatability test. The treatability test in section 3(2)(b) of the 1983 Act specifies that

That is clear, but it refers only to those with a psychopathic disorder or mental impairment and not to those with other mental disorders. Because of the way in which we are changing the 1983 Act, any treatability test that we introduce tonight will apply to not only the historical definition of “psychopathic disorder”, but anybody who might be detained for any mental disorder.

As I am sure that all hon. Members know, the Lords insisted that there should be a treatability test and inserted one almost identical to that in the 1983 Act, before the Commons Committee—I see that most of its members are here this afternoon—removed it. However, I believe that there is a need to insert a form of treatability test if we are to get the balance right. The Lords version of the treatability test sets too high a hurdle because it insists on the word “likely ”, as in a treatment being

Likelihood is a very high hurdle. Is it more than 50 per cent. likely—that is what “likely” means in most dictionary definitions—that the treatment will produce one of those two outcomes? That is difficult to argue. It is also difficult to argue at the beginning of an individual’s treatment under detention that their condition will be alleviated or will not deteriorate further, because the process of detention or of starting treatment may itself bring about a deterioration in the condition.

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