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Ms Winterton:
I am afraid that the hon. Gentleman needs to look at the record tomorrow, because he said that the percentage would therefore be lower. The percentage who would qualify under the impaired decision-making test for not being detained is shown in the figures that I have given. He must accept that. [Interruption.] What percentage of people does he
think would not be detained? Given that he says that large numbers would have impaired decision making, how many people does he think it acceptable not to give treatment to?
Dr. Harris: It is about not imposing treatment.
Ms Winterton: Yes. We are talking about compulsory treatment. That is exactly the point that the hon. Member for East Worthing and Shoreham was making. He believes that if an impaired decision-making test were introduced, some people would not get treatment. In that case, I ask Conservative Members how many people is an acceptable number to be turned away from treatment. Such people would be either suicidal or a danger to others. What number would be acceptable?
Tim Loughton: That is scaremongering and disingenuous argument of the worst kind. Which bit of the statement “There is no evidence to suggest that the number subject to compulsion would be higher or lower under an impaired decision-making test” does the Minister not understand? On which bit of that statement is she trying to misrepresent me?
Mr. Deputy Speaker (Sir Michael Lord): Order. The hon. Gentleman should not use such terminology in the House. Perhaps he will withdraw that remark.
Tim Loughton: I will, of course, withdraw “misrepresent”, but there is still some confusion about what I have said, which I would like the Minister to explain.
Ms Winterton: I am confused, because the hon. Gentleman has distanced himself from the points made by the Conservative spokesperson in the Lords. If he is distancing himself from what was said in the House of Lords, that is fine, but earlier he said that a very large number would have impaired decision making and therefore admitted that some would not have impaired decision making.
The hon. Gentleman asked about the evidence on whether some people would not be treated.
Lynne Jones: Will the Minister give way?
Ms Winterton: I want to address some of the submissions about who would or would not get treatment. As I have said, it is important to admit that there are people who would not get treatment.
I have received a letter, which I know the hon. Gentleman will reject, signed by a number of eminent psychiatrists. It states:
“It is not possible to say that because a patient has a particular condition, they necessarily will (or will not) have impaired decision-making. People differ. Their circumstances differ. Even the fact that two people are diagnosed as having the same mental disorder does not mean they will experience or be affected by it in the same way. While impaired thinking is a common feature of mental disorder, impairment of the ability to make treatment decisions specifically is not, of itself, a criterion for diagnosing mental disorder, or any particular mental disorder. For example:
Patients with a long-standing diagnosis of schizophrenia or severe depression, with a history of detention at times of acute illness resulting in high risk. These patients will usually have impaired decision making when in relapse but as they recover
this may no longer be the case. They may, however, not be prepared to accept that they have been ill or to accept the need for treatment. As a result, if we had an impaired judgment test, the psychiatrist would be unable to use Mental Health Act powers to continue treatment—until a further relapse occurred.
Patients with borderline personality disorder who do not have impaired decision-making, but who have a high risk of serious self-harm at certain times, and for whom the psychiatrist may well think that hospitalisation is needed during a crisis. Those patients may well understand the treatment that is being offered and the consequences of refusing it, and they may talk in a clear-headed way about committing suicide. If we had an impaired judgment test, the psychiatrist would be unable to intervene.”
We know that young women with borderline personality disorders who have a history of abuse, whether sexual, physical or emotional, want to commit suicide at times of crisis, but they understand the options. The hon. Gentleman’s new clause means that we, as a society, would say, “We are not going to treat you under the Mental Health Act.” There is absolutely no doubt that that would happen.
The British Psychological Society is in favour of an impaired decision-making test:
“We recognise that this approach may mean that a very small number of people believed to be at risk of self-harm or suicide would be permitted to refuse treatment if their decision-making was not considered to be significantly impaired.”
It has said that the new clause would allow some people to go out and commit suicide, which Labour Members find unacceptable.
7.45 pm
Ms Winterton: I hope that the hon. Gentleman will tell me how many people whom we treat now it is acceptable not to treat.
Tim Loughton: Does the Minister think it acceptable that 1,300 people commit suicide now? If it is all so rosy under her proposals, why are 1,300 not being prevented from committing suicide now?
Ms Winterton: That is a ridiculous argument. The hon. Gentleman has said that we should prevent people from committing suicide, but he has tabled a new clause that would increase the likelihood of its happening. His policy is to accept this Government’s suicide prevention strategy, which includes measures in this Bill to ensure that we can get treatment to people when they need it. He has admitted that the new clause would allow people who are a risk to others to go out into the community in unsafe circumstances, because it does not discriminate between people who are a danger to others or a danger to themselves, as my hon. Friend the Member for Birmingham, Selly Oak has said.
We cannot accept the new clause, because it would lead to more people being allowed to go out and commit suicide, more people not getting treatment and a greater danger to the public, too. I urge my hon. Friends to reject the new clause.
Tim Loughton:
The Minister has used her usual tactics of trying to confuse the Opposition into submission. Why is it that the Royal College of Psychiatrists, the BMA, Dr. Genevra Richardson, the British Psychological Society, the pre-legislative scrutiny committee, black
and minority ethnic groups and the Disability Rights Commission are wrong and she is right?
It being two and a half hours after commencement of proceedings on the motion, Mr. Deputy Speaker put forthwith the Question already proposed from the C hair, pursuant to Order [ 18 June ].
Question put, That the clause be read a Second time:—
The House divided: Ayes 206, Noes 289.
AYES
Afriyie, Adam
Ainsworth, Mr. Peter
Alexander, Danny
Amess, Mr. David
Arbuthnot, rh Mr. James
Atkinson, Mr. Peter
Bacon, Mr. Richard
Baker, Norman
Baldry, Tony
Barker, Gregory
Baron, Mr. John
Barrett, John
Beith, rh Mr. Alan
Bellingham, Mr. Henry
Bercow, John
Beresford, Sir Paul
Binley, Mr. Brian
Bone, Mr. Peter
Boswell, Mr. Tim
Bottomley, Peter
Brady, Mr. Graham
Brake, Tom
Breed, Mr. Colin
Brokenshire, James
Brooke, Annette
Browne, Mr. Jeremy
Browning, Angela
Bruce, rh Malcolm
Burns, Mr. Simon
Burrowes, Mr. David
Burstow, Mr. Paul
Burt, Alistair
Burt, Lorely
Butterfill, Sir John
Cable, Dr. Vincent
Campbell, Mr. Gregory
Campbell, rh Sir Menzies
Carmichael, Mr. Alistair
Chope, Mr. Christopher
Clappison, Mr. James
Clark, Greg
Clegg, Mr. Nick
Corbyn, Jeremy
Cormack, Sir Patrick
Cox, Mr. Geoffrey
Crabb, Mr. Stephen
Davey, Mr. Edward
Davies, Mr. Dai
Davies, Mr. Quentin
Djanogly, Mr. Jonathan
Donaldson, rh Mr. Jeffrey M.
Dorrell, rh Mr. Stephen
Duddridge, James
Duncan, Alan
Ellwood, Mr. Tobias
Fabricant, Michael
Fallon, Mr. Michael
Farron, Tim
Featherstone, Lynne
Field, Mr. Mark
Foster, Mr. Don
Francois, Mr. Mark
Gale, Mr. Roger
Gauke, Mr. David
George, Andrew
Gibb, Mr. Nick
Gidley, Sandra
Gillan, Mrs. Cheryl
Goldsworthy, Julia
Goodman, Mr. Paul
Goodwill, Mr. Robert
Gove, Michael
Gray, Mr. James
Green, Damian
Gummer, rh Mr. John
Hague, rh Mr. William
Hammond, Mr. Philip
Hancock, Mr. Mike
Harper, Mr. Mark
Harris, Dr. Evan
Harvey, Nick
Hayes, Mr. John
Heald, Mr. Oliver
Heath, Mr. David
Heathcoat-Amory, rh Mr. David
Hemming, John
Hendry, Charles
Hogg, rh Mr. Douglas
Holloway, Mr. Adam
Holmes, Paul
Horam, Mr. John
Horwood, Martin
Howarth, David
Hughes, Simon
Huhne, Chris
Hunt, Mr. Jeremy
Hurd, Mr. Nick
Jack, rh Mr. Michael
Jackson, Mr. Stewart
Jenkin, Mr. Bernard
Jones, Mr. David
Jones, Lynne
Kawczynski, Daniel
Keetch, Mr. Paul
Kennedy, rh Mr. Charles
Key, Robert
Kirkbride, Miss Julie
Knight, rh Mr. Greg
Kramer, Susan
Laing, Mrs. Eleanor
Lait, Mrs. Jacqui
Lamb, Norman
Lansley, Mr. Andrew
Laws, Mr. David
Leech, Mr. John
Leigh, Mr. Edward
Letwin, rh Mr. Oliver
Lewis, Dr. Julian
Liddell-Grainger, Mr. Ian
Lidington, Mr. David
Lilley, rh Mr. Peter
Llwyd, Mr. Elfyn
Loughton, Tim
Luff, Peter
Mackay, rh Mr. Andrew
Maclean, rh David
Main, Anne
Malins, Mr. Humfrey
Mates, rh Mr. Michael
McCrea, Dr. William
McIntosh, Miss Anne
McLoughlin, rh Mr. Patrick
Miller, Mrs. Maria
Milton, Anne
Mitchell, Mr. Andrew
Moore, Mr. Michael
Moss, Mr. Malcolm
Mulholland, Greg
Murrison, Dr. Andrew
Neill, Robert
Oaten, Mr. Mark
Öpik, Lembit
Ottaway, Richard
Paice, Mr. James
Paterson, Mr. Owen
Pelling, Mr. Andrew
Penning, Mike
Penrose, John
Pickles, Mr. Eric
Prisk, Mr. Mark
Pritchard, Mark
Randall, Mr. John
Redwood, rh Mr. John
Reid, Mr. Alan
Rennie, Willie
Robathan, Mr. Andrew
Robertson, Hugh
Robertson, Mr. Laurence
Rogerson, Mr. Dan
Rosindell, Andrew
Rowen, Paul
Russell, Bob
Scott, Mr. Lee
Selous, Andrew
Shapps, Grant
Shepherd, Mr. Richard
Simmonds, Mark
Simpson, David
Simpson, Mr. Keith
Smith, Sir Robert
Spelman, Mrs. Caroline
Spicer, Sir Michael
Spink, Bob
Stanley, rh Sir John
Streeter, Mr. Gary
Stunell, Andrew
Swayne, Mr. Desmond
Swinson, Jo
Taylor, Mr. Ian
Taylor, Matthew
Taylor, Dr. Richard
Teather, Sarah
Thurso, John
Tyrie, Mr. Andrew
Vara, Mr. Shailesh
Viggers, Peter
Walker, Mr. Charles
Wallace, Mr. Ben
Waterson, Mr. Nigel
Watkinson, Angela
Webb, Steve
Widdecombe, rh Miss Ann
Wiggin, Bill
Willetts, Mr. David
Williams, Hywel
Williams, Mark
Williams, Mr. Roger
Williams, Stephen
Willott, Jenny
Wilshire, Mr. David
Wilson, Mr. Rob
Winterton, Sir Nicholas
Wright, Jeremy
Yeo, Mr. Tim
Young, rh Sir George
Younger-Ross, Richard
Tellers for the Ayes:
Mr. Mark Lancaster and
Mr. David Evennett
NOES
Abbott, Ms Diane
Ainger, Nick
Ainsworth, rh Mr. Bob
Allen, Mr. Graham
Armstrong, rh Hilary
Austin, Mr. Ian
Austin, John
Bailey, Mr. Adrian
Baird, Vera
Balls, Ed
Banks, Gordon
Barlow, Ms Celia
Barron, rh Mr. Kevin
Battle, rh John
Bayley, Hugh
Bell, Sir Stuart
Benton, Mr. Joe
Berry, Roger
Betts, Mr. Clive
Blackman, Liz
Blunkett, rh Mr. David
Brennan, Kevin
Brown, Lyn
Brown, rh Mr. Nicholas
Brown, Mr. Russell
Browne, rh Des
Bryant, Chris
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Burnham, Andy
Butler, Ms Dawn
Byers, rh Mr. Stephen
Byrne, Mr. Liam
Caborn, rh Mr. Richard
Cairns, David
Campbell, Mr. Ronnie
Caton, Mr. Martin
Cawsey, Mr. Ian
Challen, Colin
Chapman, Ben
Chaytor, Mr. David
Clapham, Mr. Michael
Clark, Paul
Clarke, rh Mr. Charles
Clarke, rh Mr. Tom
Clelland, Mr. David
Clwyd, rh Ann
Coaker, Mr. Vernon
Coffey, Ann
Cohen, Harry
Connarty, Michael
Cooper, Rosie
Cousins, Jim
Crausby, Mr. David
Creagh, Mary
Cryer, Mrs. Ann
Cummings, John
Cunningham, Mr. Jim
David, Mr. Wayne
Dean, Mrs. Janet
Denham, rh Mr. John
Devine, Mr. Jim
Dobbin, Jim
Dobson, rh Frank
Donohoe, Mr. Brian H.
Doran, Mr. Frank
Dowd, Jim
Drew, Mr. David
Dunwoody, Mrs. Gwyneth
Eagle, Angela
Eagle, Maria
Efford, Clive
Ellman, Mrs. Louise
Ennis, Jeff
Fitzpatrick, Jim
Flello, Mr. Robert
Flint, Caroline
Flynn, Paul
Follett, Barbara
Foster, Mr. Michael (Worcester)
Foster, Michael Jabez (Hastings and Rye)
Francis, Dr. Hywel
Gapes, Mike
George, rh Mr. Bruce
Gerrard, Mr. Neil
Gibson, Dr. Ian
Gilroy, Linda
Godsiff, Mr. Roger
Goggins, Paul
Goodman, Helen
Griffith, Nia
Griffiths, Nigel
Grogan, Mr. John
Gwynne, Andrew
Hain, rh Mr. Peter
Hall, Patrick
Hamilton, Mr. David
Hamilton, Mr. Fabian
Hanson, rh Mr. David
Harman, rh Ms Harriet
Harris, Mr. Tom
Havard, Mr. Dai
Healey, John
Henderson, Mr. Doug
Hendrick, Mr. Mark
Hepburn, Mr. Stephen
Heppell, Mr. John
Hermon, Lady
Hesford, Stephen
Hewitt, rh Ms Patricia
Heyes, David
Hill, rh Keith
Hodge, rh Margaret
Hood, Mr. Jim
Hoon, rh Mr. Geoffrey
Hope, Phil
Hopkins, Kelvin
Howarth, rh Mr. George
Howells, Dr. Kim
Hoyle, Mr. Lindsay
Hughes, rh Beverley
Humble, Mrs. Joan
Hutton, rh Mr. John
Iddon, Dr. Brian
Illsley, Mr. Eric
Ingram, rh Mr. Adam
Irranca-Davies, Huw
James, Mrs. Siân C.
Jenkins, Mr. Brian
Johnson, rh Alan
Johnson, Ms Diana R.
Jones, Helen
Jones, Mr. Kevan
Jones, Mr. Martyn
Jowell, rh Tessa
Joyce, Mr. Eric
Kaufman, rh Sir Gerald
Keeble, Ms Sally
Keeley, Barbara
Keen, Ann
Kemp, Mr. Fraser
Kennedy, rh Jane
Khan, Mr. Sadiq
Kidney, Mr. David
Kilfoyle, Mr. Peter
Kumar, Dr. Ashok
Lammy, Mr. David
Lazarowicz, Mark
Lepper, David
Levitt, Tom
Lewis, Mr. Ivan
Linton, Martin
Lloyd, Tony
Love, Mr. Andrew
Lucas, Ian
Mackinlay, Andrew
Mactaggart, Fiona
Malik, Mr. Shahid
Mallaber, Judy
Mann, John
Marris, Rob
Marsden, Mr. Gordon
Marshall, Mr. David
Marshall-Andrews, Mr. Robert
Martlew, Mr. Eric
McAvoy, rh Mr. Thomas
McCabe, Steve
McCafferty, Chris
McCarthy, Kerry
McCartney, rh Mr. Ian
McDonagh, Siobhain
McFadden, Mr. Pat
McFall, rh John
McGrady, Mr. Eddie
McGuire, Mrs. Anne
McIsaac, Shona
McKechin, Ann
McNulty, Mr. Tony
Meacher, rh Mr. Michael
Meale, Mr. Alan
Merron, Gillian
Michael, rh Alun
Milburn, rh Mr. Alan
Miliband, Edward
Miller, Andrew
Mitchell, Mr. Austin
Moffat, Anne
Moffatt, Laura
Mole, Chris
Moon, Mrs. Madeleine
Moran, Margaret
Morden, Jessica
Morgan, Julie
Morley, rh Mr. Elliot
Mudie, Mr. George
Mullin, Mr. Chris
Munn, Meg
Murphy, Mr. Denis
Murphy, Mr. Jim
Murphy, rh Mr. Paul
Naysmith, Dr. Doug
Norris, Dan
O'Brien, Mr. Mike
Olner, Mr. Bill
Osborne, Sandra
Owen, Albert
Palmer, Dr. Nick
Pearson, Ian
Plaskitt, Mr. James
Pound, Stephen
Prentice, Bridget
Prentice, Mr. Gordon
Prosser, Gwyn
Purchase, Mr. Ken
Purnell, James
Rammell, Bill
Raynsford, rh Mr. Nick
Reed, Mr. Andy
Reed, Mr. Jamie
Riordan, Mrs. Linda
Robertson, John
Robinson, Mr. Geoffrey
Rooney, Mr. Terry
Roy, Mr. Frank
Ruane, Chris
Ruddock, Joan
Russell, Christine
Ryan, Joan
Salter, Martin
Seabeck, Alison
Shaw, Jonathan
Sheerman, Mr. Barry
Sheridan, Jim
Simon, Mr. Siôn
Simpson, Alan
Singh, Mr. Marsha
Skinner, Mr. Dennis
Slaughter, Mr. Andy
Smith, rh Mr. Andrew
Smith, Ms Angela C. (Sheffield, Hillsborough)
Smith, Angela E. (Basildon)
Smith, Geraldine
Smith, rh Jacqui
Smith, John
Snelgrove, Anne
Soulsby, Sir Peter
Spellar, rh Mr. John
Starkey, Dr. Phyllis
Stoate, Dr. Howard
Strang, rh Dr. Gavin
Straw, rh Mr. Jack
Stringer, Graham
Stuart, Ms Gisela
Sutcliffe, Mr. Gerry
Tami, Mark
Taylor, Ms Dari
Taylor, David
Thomas, Mr. Gareth
Timms, rh Mr. Stephen
Tipping, Paddy
Touhig, rh Mr. Don
Trickett, Jon
Truswell, Mr. Paul
Turner, Dr. Desmond
Turner, Mr. Neil
Twigg, Derek
Vaz, rh Keith
Vis, Dr. Rudi
Walley, Joan
Waltho, Lynda
Ward, Claire
Wareing, Mr. Robert N.
Watson, Mr. Tom
Watts, Mr. Dave
Whitehead, Dr. Alan
Wicks, Malcolm
Williams, rh Mr. Alan
Williams, Mrs. Betty
Wills, Mr. Michael
Winnick, Mr. David
Winterton, rh Ms Rosie
Woodward, Mr. Shaun
Woolas, Mr. Phil
Wright, Mr. Anthony
Wright, David
Wright, Mr. Iain
Wright, Dr. Tony
Wyatt, Derek
Tellers for the Noes:
Mr. Alan Campbell and
Tony Cunningham
Question accordingly negatived.
‘(1) Section 135 of the 1983 Act is amended as follows.
(2) In subsection 1(a) leave out “for neglected or kept otherwise than under proper control” and substitute “and neglected”.
(3) After subsection 1(b) insert “or (c) may be in need of treatment or care for his mental disorder and is living in any such place, and, access to that place is necessary for the purpose of establishing whether or not he is in need of treatment or care, and it has not been possible to gain such access without a warrant.”.’.— [Tim Loughton.]
Brought up, and read the First time.
Tim Loughton: I beg to move, That the clause be read a Second time.
Mr. Deputy Speaker: With this it will be convenient to discuss amendment No. 88, page 39, line 20, in clause 41, at end insert—
‘(4) In section 135(6) for the words from “means” to the end of that subsection substitute—
“(a) (i) residential accommodation provided by a local social services authority under Part III of the National Assistance Act 1948 (c. 29),
(ii) a hospital as defined by this Act,
(iii) an independent hospital or care home for mentally disordered persons,
(iv) any other suitable place the occupier of which is willing temporarily to receive the patient or, if, in the circumstances of the case it is impracticable to use any of these places,
(5) In section 136 (Mentally disordered persons found in public places) of the 1983 Act after subsection (2) insert—
“(3) Where a police station is used as the place of safety the person may not be detained there for a period longer than 24 hours.”’.
Tim Loughton: We have only a little time left to consider the final groups of amendments, and I am sure hon. Members who wish to participate are especially keen to comment on the exclusions from mental disorder provisions in the second raft of amendments. I shall therefore speak only briefly about the first raft, and mainly about new clause 11. My hon. Friend the Member for Broxbourne (Mr. Walker) is keen to catch your eye, Mr. Deputy Speaker, to discuss amendment No. 88.
The British Association of Social Workers has supported and provided briefing notes for the new clause, which covers warrants to search for and remove patients. It would update the 1983 Act, which is out of date and causes some problems. Section 135 of the 1983 Act allows magistrates, on the application of an approved social worker, to issue a warrant when it is necessary to gain access to private premises to assess someone for possible admission under the Act. Warrants are requested far more often than they were.
In addition, court procedures have been tightened up, and the approved social worker now needs to make a formal application to the court, supported by written evidence. That has served to highlight the shortcomings of section 135, which does not reflect the whole range of circumstances in which warrants are needed and, indeed, issued, forcing approved social workers and magistrates to bend the law to ensure that access can always be gained to someone who is in urgent need of admission to hospital. The reason is that the section basically dates from the Lunacy Act 1890 and the Mental Deficiency Act 1913. It has never been updated to conform with modern needs and circumstances.
The section provides for a warrant to be issued in only two circumstances: when the person lives alone and is unable to care for themselves, and when the person does not live alone but is being
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