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Lord Renton: My Lords, my noble friend Lord Hacking has raised an extremely important matter and we must get it right. I hope that my noble friend Lady Blatch will agree, for the reasons given by my noble friend, that we should accept these amendments. Before this debate she kindly drew my attention to Clause 45, but there are two problems there. The first is that it applies only in the case of a person convicted before the Crown Court of an offence the sentence for which is not fixed by law.
What is worrying is that the sentences under Clauses 2, 3 and 4 of the Bill are to be fixed by law. Under Clause 2 it is to be a life sentence; under Clause 3 it is to be at least seven years' imprisonment, which comes near to being fixed by law; under Clause 4 it is at least three years' imprisonment, which seems to me to be fixed by law. Under Clause 2 there is no doubt whatever about the position. It is arguable that under Clauses 3 and 4 there is still a discretion on the part of the court, but it is a very limited discretion and to an extent fixed by law.
Be that as it may, my noble friend the Minister has invited my attention to a provision on page 32 in subsection (10) of new Section 45A of the Mental Health Act 1983 which states that:
- "The Secretary of State may by order provide that this section shall have effect as if the reference in subsection (2) above to psychopathic disorder included a reference to a mental disorder of such other description as may be specified ... "
That is very good; that gives the opportunity of applying the provisions of Clause 45 to, for example, mental handicap, people suffering from hallucinations, people who have no control over their willpower or perhaps even over their actions.
We are dealing here not with first offenders but, as my noble friend the Minister said, with people who have committed third or further offences. All the same, we must be very careful. I am worried about people suffering from mental impairment, mental handicap or, as it is euphemistically called, learning disability, and people suffering from other kinds of mental illness-- I mentioned hallucinations, for example--because nothing can be done for such people in prison, where they will merely be the sport of other prisoners. They must be put in hospitals, for life if necessary. Mental illness is sometimes curable but it is a well-established medical proposition that no form of mental handicap is curable. I have some knowledge of this because I have a daughter who is severely handicapped and I am a past president of MENCAP.
We must get this right. I hope that my noble friend will be able to assure us that, soon after the Bill comes into force, the Government will use their power to extend the application of Clause 45 to other kinds of mental disorder. However, because Clause 45 applies only to offences the sentence for which is not fixed by law, we must be very careful, especially with regard to Clause 2 under which the court has no discretion and the sentence has to be imprisonment for life.
Lord Swinfen: My Lords, I support this group of amendments so ably moved by my noble friend Lord Hacking. I also support the points mentioned by my noble friend Lord Renton. As he said, there are no facilities in prison for the treatment of those incarcerated who have a mental disorder. If they are the subject of orders under the Mental Health Act 1983 they can be treated in a secure hospital where their condition is likely to improve, as a result of which they are likely, upon final release, to be of little or no danger to the public. However, if they spend their time in gaol, their condition is likely to deteriorate. It certainly will not improve and they are likely, when they finally come out, to be of similar if not greater danger to the public.
Speaking about mentally disordered offenders, sentencing and discharge arrangements, the Royal College of Psychiatrists, in a response to the Home Office and Department of Health discussion paper in 1996, said about mentally disturbed offenders being transferred back from hospital to gaol:
- "Many clinicians will be unhappy about transferring such individuals back to prison because of the risks to mental health which follow such a transfer ... It makes no clinical sense for
- prisoner-patients to be transferred back to prison prior to release into the community; this will be entirely detrimental to their rehabilitation".
One of the reasons for gaoling offenders is to rehabilitate them. Therefore, I feel that we should take every step with mentally disordered offenders to ensure that rehabilitation takes place and is not destroyed by the way in which they are incarcerated.
7 p.m.
Lord Pearson of Rannoch: My Lords, I too should like to support the amendments. I do so as president of the National Society for Mentally Handicapped People in Residential Care and as the father of a mentally handicapped daughter. Therefore, I speak more on behalf of the 156,000 mentally handicapped people in this country than for the people who suffer from the other forms of mental disorder covered by the amendment.
I say to my noble friend on the Front Bench that the proposals in the Bill once again go directly against stated government policy. The Home Office/Department of Health guidance accompanying Home Office Circular 12/95 states that:
- "those suffering from mental disorder who require specialist medical treatment or social support should receive it from the health and social services".
- "Detention in prison is likely to be damaging to the mental health of a mentally disordered person, and the Prison Service is not equipped to provide treatment equivalent to that available in hospital".
Quite so. I have to say to my noble friend that the Government now appear less concerned with providing appropriate care and treatment but instead seek to hold all mentally disordered offenders fully legally culpable and responsible for their actions by imposing mandatory sentences.
The combined effect of Clause 2(2) and Schedule 4 paragraph 12(1) as drafted means that the court has no discretion to consider whether detention and treatment under the Mental Health Act, with or without restrictions, may be a more appropriate disposal. The court must impose a life sentence unless there are "exceptional circumstances". The definition of mental disorder under the Mental Health Act clearly includes mental illness, mental impairment and severe mental impairment, which I take to mean mentally handicapped people.
I have to agree with the comment of the Law Society and the Royal College of Psychiatrists referred to by my noble friend Lord Hacking when he so ably moved the amendment that the imposition of a punitive element into the treatment of people with learning disabilities or mental handicap is morally repugnant and contrary to the values of a humane society.
As other noble Lords mentioned, the Government have argued that some of those concerns will be met by the introduction of the new hospital direction set out in Clause 45 of the Bill, which empowers the court, when imposing a prison sentence on an offender suffering from psychopathic disorder, to direct that the offender should first be detained in hospital. But as the Bill is
drafted, the hospital direction will apply only to people with psychopathic disorder, with the effect that only those offenders for whom the benefits of treatment are doubtful will get the chance to be treated. Other offenders with mental illness or learning disabilities will automatically be sentenced to imprisonment.Further to what my noble friend Lord Renton so wisely said about the limitations of Section 45A, I refer my noble friend on the Front Bench to Section 45A(2)(c), where it is a condition of the offender being sent to hospital that the treatment:
- "is likely to alleviate or prevent a deterioration of his condition".
As my noble friend Lord Renton said, that cannot possibly apply to the mentally handicapped, who are, by definition, incurable.
Summing up, the Government's proposals are certain to lead to a huge increase in the number of mentally disordered offenders, inappropriately placed in prison, making enormous demands on the Prison Service. As I mentioned at Committee stage, that very unfortunate situation is certain to be made still worse by the Government's community care policy, under which it is evicting mentally handicapped people from the long-stay institutions and forcing them to live, sometimes inappropriately, in an ordinary house in an ordinary street. Indeed, there are now only some 11,000 mentally handicapped people left in long-stay institutions, where they are waiting to be evicted and now, as this Bill is drafted, waiting to be sent to prison.
Lord Annaly: My Lords, I rise to support the amendment of my noble friend Lord Hacking. I speak with particular reference to the deaf. I have an interest to declare, in that I have a younger sister in her thirties who is totally deaf. The problem, whether it was deafness, brain damage or whatever, was not established until she was 10 years of age and went to various experts. It turned out to be deafness. On the strength of that, before he died my father and my stepmother started a charity, of which I am now a trustee. It is called SIGN and campaigns for deaf people and people with mental health problems. I am certainly no expert on this subject but I have had a little to do with it. We have started a number of small residential units in Manchester and London--at Balham, where we have taken over an old church. The ground floor houses a psychiatric unit, which is literally in the street. That all came out of Springfield Hospital. Upstairs is residential. People who have had problems perhaps go into the psychiatric unit on a day basis or a residential basis but there are long-term residents upstairs. We are also involved with deaf clubs.
That leads me to ask the Minister a question. I do not know whether she will be able to answer it. Understandably, people who are totally deaf have behavioural difficulties. They become very frustrated and do things out of sheer frustration. One might say that that is not a mental health problem but perhaps we can all relate to it. Through frustration, those people may end up doing something which would be caught by the present Bill. If somebody fell into that category, can the Minister say whether they would be sent to prison
for committing such an offence? I should sincerely hope not, because it would do no good. There would be no facilities for dealing with the deaf, who need specific treatment, medication and the relevant psychiatrists to help them. So I am greatly concerned that they might fall into that particular sphere.
Often, deaf people who have never heard a word, like my sister--and there must be many thousands of others--cannot speak either. They rely totally on sign language. In the deaf world there are two schools of thought: whether to lip read or whether to use sign language. But I know that there is a great shortage of people who are qualified at the top level to sign. When somebody who is totally deaf gets into difficulties and the police are involved, they have to find a qualified sign language expert to communicate with the deaf person, who is probably distressed, to find out what the problem is. There is a great shortage of those experts, which is just another problem. Perhaps the Minister could say whether deaf people come within the amendment.
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