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The points about other countries are probably valid, but we must remember that we are legislating for this country. Given that clinicians have not detained people for their political beliefs for many years, the idea that the advent of an extreme Government will mean that they will suddenly start detaining people under the Mental Health Act is a little difficult to swallow.
Jeremy Corbyn (Islington, North) (Lab): Is the Minister confident that all the exclusions listed in amendment No. 91 are covered specifically in other legislation, and that there is therefore no need to name them to send the message outlined by the hon. Member for Southport (Dr. Pugh)?
Ms Winterton: It would not be possible to detain people for their religious beliefs, because the Act states that people can be detained only if they have a mental disorder. A person’s religion is not a mental disorder, and neither are his political or cultural beliefs or, as my hon. Friend the Member for Rhondda pointed out, his sexual preference or identity.
The existing legislation provides an ability to appeal to the mental health review tribunal. The principles that will be put in the code were accepted when they were considered by the Lords, and they make it clear that unlawful discrimination is not allowed. The relevant criteria—that the person involved has a mental disorder and is capable of causing serious harm to himself or others, and that appropriate medical treatment is available that must be delivered in a hospital setting—have to be met. If they are not, the person involved cannot be detained.
I can understand why people feel that the amendment would be nice, but I have some concerns about it. The Mental Health Alliance has said that exclusions act as a check on clinical discretion, but I believe that we should be trying to ensure that clinicians can treat people as they need it. The amendment is seen as a safeguard, but I do not think that it is because, as I said earlier, the circumstances that it lists are not mental disorders. Legal exclusions should cover things that are mental disorders, not things that are not.
Tim Loughton: I want to make three quick points. First, the principles to which the Minister referred are not on the face of the Bill. Secondly, I agree that we are legislating for this country, now. However, does she accept that the legislation on mental health and other issues passed by this House sets an example to the world, and that other countries with Governments even less scrupulous than this one take notice? Thirdly, does she admit that our proposal in respect of paedophilia lays to rest the fears that she might have had in that respect?
Ms Winterton: I certainly accept that the hon. Gentleman has made a case for the exception of paedophilia. He says that the legislation may last for a long time, and that to prevent the actions of some future Government we need to include exceptions now, but waving the Mental Health Act at a Government who are locking people up for their political, religious or cultural beliefs is unlikely to have an effect.
Dr. Evan Harris: The Minister has said twice that she believes there are things listed as exemptions that are not true mental disorders, but in paragraph 19 of her lengthy and helpful reply of 1 April to the Joint Committee on Human Rights, she says:
“The Government does not share the Committee’s view...that gender dysphoria and transvestic fetishism could never be regarded as true mental disorders”—
Ms Winterton: They are not in the list.
Dr. Harris: But subsection (b) of the amendment—
“his sexual preference or gender identity”—
could clearly refer to transvestic fetishism and, by definition, gender dysphoria. Can the Minister explain that?
Ms Winterton: We are not discussing that— [ Interruption. ] In fact, I said that most of the exceptions were not mental disorders and those are the ones that worry me.
Although there have been only a small number of challenges to the legislation, they have been worrying; for example, the Clatworthy case, in which the patient was convicted of indecent assault of two young girls and detained on grounds of psychopathic disorder. After the sexual deviancy exclusion was introduced his case went before the mental health review tribunal where it was argued that he did not meet a definition of psychopathic disorder because his only dangerous behaviour was sexually deviant and was thus excluded. The tribunal disagreed but the case went to judicial review and the judge found in favour of the patient. We must not imagine that such circumstances will not arise. There have already been four major cases and they have affected the operation of the tribunal.
Secondly, the more exclusions in the Bill covering conditions that are not mental disorders, the more the possibility of a challenge. Somebody could easily claim that they were detained because of their religious persuasion—because they said, “I have X, Y, Z powers”. A challenge could be mounted on each of the exclusions. When people are detained against their will, they will look for ways to challenge their detention. There can be reasonable grounds that a person does not have a mental disorder, but we must not confuse the issue by including a range of conditions in the Bill that an individual could use to meet a challenge against their detention.
I want to back up the point made by my hon. Friend the Member for Rhondda. He is right: it is patronising to say that we have to exclude sexual preference as a possible mental disorder, when it is clearly not a mental disorder. A similar issue arises in relation to autism. People from the National Autistic Society asked me why we were describing autism as a mental disorder, because some of them do not accept that description. If we say that sexual preference must be listed as an exclusion in the Bill because it is a mental disorder, we are sending the wrong message. That is why we cannot accept the amendment and I ask the hon. Member for East Worthing and Shoreham (Tim Loughton) to withdraw it.
Tim Loughton:
The Minister’s arguments are not new and I do not accept them. The point that I made about our being a beacon of legislation to the rest of the
world is particularly pertinent as we consider this very important part of the Bill. We do need to have these proper checks and balances, so I shall press the amendment to a Division and I ask hon. Members to support it.
Question put, That the amendment be made:—
The House divided: Ayes 196, Noes 282.
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
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
Campbell, Mr. Gregory
Campbell, rh Sir Menzies
Carmichael, Mr. Alistair
Chope, Mr. Christopher
Clappison, Mr. James
Clark, Greg
Clegg, Mr. Nick
Cormack, Sir Patrick
Cox, Mr. Geoffrey
Crabb, Mr. Stephen
Davey, Mr. Edward
Davies, David T.C. (Monmouth)
Davies, Mr. Quentin
Djanogly, Mr. Jonathan
Dodds, Mr. Nigel
Donaldson, rh Mr. Jeffrey M.
Dorrell, rh Mr. Stephen
Duddridge, James
Duncan, Alan
Duncan Smith, rh Mr. Iain
Ellwood, Mr. Tobias
Fabricant, Michael
Fallon, Mr. Michael
Farron, Tim
Featherstone, Lynne
Field, Mr. Mark
Francois, Mr. Mark
Gale, Mr. Roger
Garnier, Mr. Edward
Gauke, Mr. David
George, Andrew
Gibb, Mr. Nick
Gidley, Sandra
Gillan, Mrs. Cheryl
Goldsworthy, Julia
Goodman, Mr. Paul
Goodwill, Mr. Robert
Gray, Mr. James
Green, Damian
Hague, rh Mr. William
Hancock, Mr. Mike
Harper, Mr. Mark
Harris, Dr. Evan
Harvey, Nick
Heald, Mr. Oliver
Heath, Mr. David
Hemming, John
Hendry, Charles
Holloway, Mr. Adam
Holmes, Paul
Horam, Mr. John
Horwood, Martin
Howarth, David
Hughes, Simon
Huhne, Chris
Hunt, Mr. Jeremy
Jack, rh Mr. Michael
Jackson, Mr. Stewart
Jenkin, Mr. Bernard
Jones, Mr. David
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
Loughton, Tim
Luff, Peter
Mackay, rh Mr. Andrew
Main, Anne
Malins, Mr. Humfrey
Mates, rh Mr. Michael
McCrea, Dr. William
McIntosh, Miss Anne
McLoughlin, rh Mr. Patrick
Miller, Mrs. Maria
Milton, Anne
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
Pugh, Dr. John
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
Syms, Mr. Robert
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. David Evennett and
Mr. Mark Lancaster
NOES
Abbott, Ms Diane
Ainger, Nick
Ainsworth, rh Mr. Bob
Alexander, rh Mr. Douglas
Allen, Mr. Graham
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
Benn, rh Hilary
Benton, Mr. Joe
Berry, Roger
Betts, Mr. Clive
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. Alan
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
Corbyn, Jeremy
Cousins, Jim
Crausby, Mr. David
Cryer, Mrs. Ann
Cummings, John
Cunningham, Mr. Jim
Cunningham, Tony
David, Mr. Wayne
Davies, Mr. Dai
Dean, Mrs. Janet
Denham, rh Mr. John
Devine, Mr. Jim
Dismore, Mr. Andrew
Dobbin, Jim
Dobson, rh Frank
Donohoe, Mr. Brian H.
Doran, Mr. Frank
Dowd, Jim
Drew, Mr. David
Eagle, Angela
Eagle, Maria
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, Mr. Mike
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
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
Irranca-Davies, Huw
James, Mrs. Siân C.
Jenkins, Mr. Brian
Johnson, Ms Diana R.
Jones, Helen
Jones, Mr. Kevan
Jones, Lynne
Jones, Mr. Martyn
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
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
McDonnell, Dr. Alasdair
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
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
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
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
Williams, rh Mr. Alan
Williams, Mrs. Betty
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. John Heppell and
Liz Blackman
Question accordingly negatived.
It being after Nine o’clock, Mr. Deputy Speaker put forthwith the Question necessary for the disposal of the business to be concluded at that hour, pursuant to Order [18 June].
Amendment made: No. 50, page 44, line 14, leave out ‘or different areas’ and insert
‘(including different provision for different areas and different provision for different descriptions of patient)’.— [Ms Rosie Winterton.]
9.12 pm
Ms Rosie Winterton: I beg to move, That the Bill be now read the Third time.
The Mental Health Act 1983 —[ Interruption. ]
Mr. Deputy Speaker: Order. I apologise for interrupting the right hon. Lady, but it is quite unfair to the Minister at the Dispatch Box if conversations are going on in the Chamber. Hon. Members should stay if they wish to listen to the debate, or depart quietly.
Ms Winterton: Thank you, Mr. Deputy Speaker.
The Mental Health Act 1983 is primarily about the circumstances in which people with a serious mental health problem can be detained and treated without their consent to protect themselves or others from harm. Not surprisingly, this is a sensitive matter, so any Bill to amend that Act is likely to provoke much debate and controversy.
It might be helpful if I set out why the Government want to update our mental health legislation. We want to ensure that people with serious mental health problems receive the treatment that they need to protect themselves and others from harm. We need to recognise that the world has moved on since 1983. Many more people can now be treated in the community, rather than in hospitals, so the use of compulsory powers should reflect that. Professional demarcation lines have changed since 1983, and functions are now being carried out by people with the right skills and experience, rather than individuals from particular professions. Again, our legislation should change to reflect that fact. We also want to strengthen patient safeguards, which includes tackling human rights incompatibilities.
The Government began their review of mental health legislation in 1998. Since then, reforming the legislation has been the subject of wide-ranging debate, which has been enormously helpful. We have listened to relevant stakeholders and made many changes as a result of discussions with them. The decision to proceed with an amendment Bill rather than the 2004 draft Bill was a response to the recommendations of the pre-legislative scrutiny Committee. I take this opportunity to thank that Committee for all the work that it did.
We have had long and helpful discussions in the House on the Bill before us. The discussions in Committee were particularly helpful—
Dr. Ian Gibson (Norwich, North) (Lab): Superb.
Ms Winterton: Absolutely. I am glad that I was able to table a range of amendments on Report covering issues that were raised in the other place and in Committee. I am pleased that we were able to accept the excellent amendments from my hon. Friends the Members for Rhondda (Chris Bryant) and for Bridgend (Mrs. Moon), which were supported by many other members of the Committee. I am glad that the Opposition parties also gave their support to a number of the amendments that we tabled. I am thinking particularly of the amendments on age-appropriate accommodation and, crucially, those on victims and on advocacy.
There has been much debate on other amendments that the Government did not accept. I hope that I have been able to explain why we have not accepted them, although I am not sure that I convinced everybody on the Opposition Benches of the merits of our case.
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