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My concern about the Minister’s answer is that he seemed to imply that there was no way in which this measure could be properly implemented. We are not

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looking for one-size-fits-all provision. We are interested in the provision of a diversion scheme in courts and in police stations to make certain that the mentally disordered are diverted to get the treatment that they deserve and need and are not then confined unnecessarily in custody. The Mental Health Act, which the Minister quoted, offers the way ahead. The Mental Health Bill has just been through this House, and diversion schemes were mentioned during its passage. I would have thought that that was the way of taking this ahead, and I commend it to the Ministry of Justice. It must be responsible for seeing that something happens; it is responsible for the courts. I know that the Home Office is still responsible for the police, but all this joined-up government that we hear about should be able to bring that about.

Under the Mental Health Act, a requirement should be placed on local authorities. There will not necessarily be a one-size-fits-all provision, but it has to be laid down that it must happen. It must have legislative means of some kind, because if it is non-legislative that usually means that it will not happen. It has not happened up until now. When I tried to find out how many diversion schemes there were, I could only get information from the national schizophrenia society. Neither the NHS nor anyone else had a list of where the schemes were, which is unfortunate. As everyone has been paying attention to the needs of people with mental health problems, it behoves us to make certain that this provision to prevent them going into custody and to get them treatment is considered and not just put in the “too difficult” tray, when the Mental Health Act probably offers the way ahead. I beg to move.

The Lord Bishop of Worcester: My Lords, I support the amendment of the noble Lord, Lord Ramsbotham, not because I know whether the exact form of words in it is right or whether this particular method will achieve its aim, but because I want to hear from the Attorney-General what we will do to inject some very necessary urgency into the issue of mental health in the criminal justice system. It would be odd to have on the statute book an Offender Management Act that did not seek to make effective provision for a situation in which 70 per cent of those in the criminal justice system have two or more diagnosable mental illnesses.

Surely, we have to admit that we have run as a society into a position whereby the number of such people who have found themselves in the criminal justice system—I do not belittle what may have been the consequences of many of their actions—has reached such a proportion that a Bill without such a clause would attend effectively to 30 per cent of those in the criminal justice system and not the other 70 per cent. I hope that the Attorney-General has something to say to us, if she does not feel able to support the amendment.

Lord Judd: My Lords, I, too, support the amendment, very much for the reasons put forward by the right reverend Prelate. I shall make two or three brief observations. We have been reminded that the courts and the police have power. The prisons are still

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full of people who should not be there. Why do I say that? It is because the prisons and the dedicated staff who try to work with these people do not have the resources, training or qualifications to do the work necessary with people with mental problems or mental illness.

I said in Committee or at Second Reading that during my visits to prisons I have been impressed by the exasperation of some of the very best prison officers who, because of their general qualifications and insight, recognise that they are not doing any good. It is not just that they are not doing any good, but they are often aggravating the mental condition of the person in prison and increasing the likelihood of reoffending—it is not just a passive role with no impact. For that reason, the noble Lord, Lord Ramsbotham, seems absolutely right. I am glad to support him in saying that this issue urgently has to be addressed, as the right reverend Prelate said, and I hope that my noble and learned friend will have something reassuring to say.

Baroness Howe of Idlicote: My Lords, I support the amendment also. It is crucial, as the right reverend Prelate pointed out, to deal with this matter urgently. A high percentage of offenders have some form of mental illness, and this is yet another area where women suffer more than men. The degree of mental illness, often more than one type of mental illness, is higher among women offenders than men. I hope that this matter will be given the urgency it needs.

9.30 pm

Lord Wallace of Saltaire: My Lords, I do not wish to delay the House. We recognise that this issue overlaps with other legislation currently going through Parliament: the Mental Health Bill and the criminal justice Bill. The number of prisoners with mental health problems is part of the overcrowding problem. If we are to reduce prison overcrowding it must be dealt with. We would like to hear a clear message from the Minister about how the Government intend to give this much greater priority.

When I was a parliamentary candidate in Yorkshire, there were two large mental hospitals in the constituency I fought. Both have now become genteel suburban housing areas. We all recognise that too much of the mental health accommodation that was there until the 1970s has gone. That is one of the reasons we have ended up with people being misclassified into prisons. We need to reverse some of that. Part of that involves greater mental health provision, which this Government have not yet invested enough in, but it partly involves what we are talking about here; that is, ensuring that people whose problems are very much matters of mental health do not go straight into the prison system.

Lord Bassam of Brighton: My Lords, the amendment from the noble Lord, Lord Ramsbotham, which we first discussed in Committee, as the noble Lord acknowledged—I am sad that the noble Lord was not here to discuss it with us, but he has retabled

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it—would require the Secretary of State to establish mental health diversion schemes to operate at all Crown Courts, magistrates’ courts and police stations. I made clear in Committee that, although we agree with much of the intent prompting this amendment, we do not agree that a legislative approach is the right way to achieve the outcome the noble Lord desires. We also desire that outcome, and other noble Lords who have contributed to the debate patently wish to see it.

I cannot agree with the noble Lord’s assertion that there is no way that the proposal can be properly implemented as it is. I shall explain why. We want to have effective court diversion schemes, and we plan to work towards improvement in this area. There can be no doubt that people who come into contact with the criminal justice system and who suffer from a mental disorder should be given the treatment they need. However, we do not believe that this should be achieved through legislation. The amendment is overly prescriptive and would not allow local arrangements to reflect local needs. With the creation of a devolved National Health Service, we moved away from a top-down, centrally prescribed system. Local communities and local NHS staff have welcomed that change. We have committed to reducing the number of central targets and have concentrated instead on providing a framework in which local arrangements can flourish and meet the needs of communities.

We fully accept that the court liaison and diversion schemes currently in operation vary in the quality of the support they can provide. There are areas of best practice, but there are also areas where schemes are failing to thrive. We also know that the better diversion services provide a range of multi-disciplinary team activities across the whole spectrum of the criminal justice system, and support the police earlier in the path to custody for those vulnerable patients who repeatedly come before them. We applaud these schemes and would wish to see more such services. However, the way to get there is not through legislation.

We are fully committed to publishing central guidance this year to the NHS and partner agencies, which support the development of local services that build on the best of what already exists. We believe that it is much more likely that schemes will develop out of this and be well supported if local benefits are clear to local commissioners, and if a strong evidence-based message is given by the centre. To be really effective, we argue, these schemes need buy-in from all the relevant agencies. We believe that the way to win hearts and minds is by demonstrating the evidence, providing examples of best practice and setting out a framework through guidance. As I said, we shall produce that guidance later this year.

We already know that the evidence from places where schemes work points to the importance of good governance, shared ownership, multidisciplinary working and schemes operating in an integrated system of offender care rather than in isolation. Factors such as multi-agency provision, financial

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stability, information-sharing protocols, effective leadership, an adequate level of staffing and clear role definition are vital.

The benefits may include support for local community safety targets, targets to reduce reoffending, improvements in the appropriateness and timeliness of treatment and earlier intervention—I sense that that was where the noble Lord, Lord Ramsbotham, was coming from on this issue. If those who actually provide services on the ground understand the benefits, the support and enthusiasm will be greater and it is more likely that the services will prosper.

Statutory arrangements are already in place to enable the courts and the police to divert people into treatment for mental disorder. I made this point in the previous debate but I will make it again. The courts already have powers under the Mental Health Act 1983 to divert offenders to hospital for treatment. Under Section 35 of that Act, they may remand an accused person to hospital for a report on their mental condition, and under Section 36 they may remand an accused person to hospital for treatment. Also, the police have the power under that Act to remove a person who appears to be suffering from mental disorder to a place of safety. This is to enable him to be examined by a doctor and interviewed by a social worker, and to allow any necessary arrangements to be made for his treatment or care.

The Government fully accept that more should be done in this area but believe that we should work within the existing legislative framework and seek to bring change through other means. It is far better to convince communities of the need for these services than to dictate from the centre. We should allow local health commissioners to make their own assessment of the needs of their local communities and provide the right people and services in the right configuration to meet those needs. We take very seriously the concerns of the noble Lord who moved this amendment and all those who have spoken in favour of it today. I hope that the reassurance that I have offered will provide a good reason for the noble Lord, Lord Ramsbotham, to withdraw his amendment. I was particularly surprised that—

The Lord Bishop of Worcester: My Lords, I fully accept the sincerity with which the Minister addresses us about the importance of a non-legislative approach. However, as I understand it, it will always be simpler and, from the point of view of the local community and its budget holders, cheaper to allow the custodial solution to be adopted. It will always be difficult to defend, in a local community, the provision of mental health services for offenders when they are not available for non-offenders. I therefore think that, against the Minister’s arguments against a legislative approach, is there not a case for some central setting of a direction and a real tendency to get us to move in the direction of more adequate provision in the urgent situation that we face?

Lord Bassam of Brighton: My Lords, in the first instance, I said that legislative powers were available and that those powers were there for the courts and the police to use. Secondly, we are prepared to give

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leadership and guidance in this. I made two references to the value of bringing forward guidance, and I remind the right reverend Prelate, who I know is greatly experienced in the field, that we are committed to improving that guidance during the current year.

I shall take up one of the issues raised by the noble Lord, Lord Ramsbotham. He said that he had great difficulty and had to go to the Schizophrenia Society to find out how many diversion schemes there were. The number of schemes increased during the 1990s, when some £10 million of pump-priming was provided by the Home Office. We have worked with NACRO, and the database that we have jointly put together currently shows 143 schemes. We can identify other schemes as a product of the Revolving Doors report of 2006. So there is clearly a large number of such schemes in operation, and I am sure that they are doing extremely valuable work. NACRO’s survey says that most of those schemes operate for four or five days a week. Fewer than 20 per cent operate across the spectrum of police station, court and prison, but almost 50 per cent had some joint funding arrangements in place, usually with social services. Some are provided by the voluntary sector.

So there are a lot of data there and a lot more information that I am sure can be taken from the NACRO survey. That shows that progress has been made; it shows also that there is much more to be done. It is important that we persist in developing this. We are trying to ensure that the schemes work without the need for recourse to a centralist, rather bureaucratic framework. We want to encourage them through the adoption of best practice and effective guidance, as I just said to the right reverend Prelate.

I think that I have covered all the other points that were raised during the discussion. In conclusion, I tell the noble Lord that I understand the spirit behind the amendment. Clearly, we are going in the right direction. Much good work is being undertaken; the survey demonstrates that. More can be done, more can be achieved. I certainly see the need for it to develop, but we think that the legislative straitjacket that the noble Lord suggests in his amendment is unnecessary and may inhibit the development of good schemes. For those reasons, I urge him to withdraw the amendment, but I have found this a useful debate, and the points made have been very valuable to us.

Lord Ramsbotham: My Lords, I thank the Minister for his answer. He will not expect me to agree with everything that he said and accept it, any more than he necessarily agreed with what I said. I am especially grateful to the right reverend Prelate the Bishop of Worcester for twice intervening with his habitual wisdom and understanding of the problem, and other noble Lords who have spoken, especially the noble Lord, Lord Judd.

I am not talking about how things are done but what things are done. That seems to be missing in all this. I am not after something that is legislative and bureaucratic; I am after a clear direction of what has to be done. All right, it is given to a health commissioner.

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Somebody must tell the health commissioner. They must be given guidelines and a framework. The Minister mentioned 143 schemes. How many courts are there in which there is no scheme? How many police stations are there where there is no one available on call to come to help? All that links with provision. Is there provision? Is there provision for children? Is there provision for women? What are the arrangements for that? This has been a crying need for goodness knows how many years, and it has failed through lack of overall direction. In a lot of the Bill, the Government have been keen to bring in direction on the grounds that provision has not worked, yet here they are refusing to introduce direction to something that has not worked. That is inconsistent.

Part of the problem is that ministries other than the Ministry of Justice and the Department of Health are involved. The Home Office is involved, because it controls the police. The sense of urgency that the right reverend Prelate the Bishop of Worcester rightly mentioned is needed in this area, because the problem is not going away; it is getting worse. When I went to Winson Green prison, I discovered that they had a diversion officer in the prison to pick up those who had slipped through the diversionary net to make certain that, if possible, they did not get further than the first night, for which there were special arrangements. That shows that prisons are recognising that the system is not working.

I am glad that the Government are thinking about it, but I wish and hope that the new Secretary of State for Justice will consider the matter with the urgency that it deserves. I anticipate that he will; I know that he understands the problem because I spoke to him about it when he was in his previous post. I am happy to withdraw the amendment, which is not to say that I will not return with it on Third Reading.

Amendment, by leave, withdrawn.

9.45 pm

The Earl of Listowel moved Amendment No. 37ZA:

“Children and young persons in custody(a) advise and assist that child with a view to promoting the welfare of the child;(b) provide to the custodial authorities any information necessary for safeguarding the welfare of the child; and(c) maintain contact with the child and the custodial authorities throughout the period of custody.

The noble Earl said: My Lords, this amendment places a duty on local authorities to keep in contact with children in their care who are taken into custody or young people who have spent any time in care within the past two years. I hope it may be helpful to

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your Lordships if I read from the script as it will be quicker than if I try to speak from memory.

This amendment is to some extent redundant in terms of existing statute. Its intention is to probe Her Majesty’s Government on what steps are being taken to remedy the identified flaws in co-operation between local authorities and prisons and to ask how the proposals in the recent White Paper on children in public care may influence this relationship.

I am most grateful to my noble friend Lady Howe of Idlicote for prompting the amendment and putting her name to it. Her Majesty’s Government funded the National Children’s Bureau to produce a guide for practitioners looking after children in custody. Written by Di Hart it was published last year and entitled Tell Them Not to Forget About Us. From her research Ms Hart concluded:

I welcome the recruitment of social work teams to young offender institutions. I am grateful for the replies to my Parliamentary Questions on this issue. Can the Minister provide further reassurance that information on a child’s care status is being captured and shared between social care and youth justice agencies or with the adult secure estate? I hope that the Minister can assure me that staff in both the adult and juvenile estate are adequately informed to take appropriate action. I am sure that the Minister will agree with me that looked-after children or young people who are care leavers should not feel abandoned or forgotten by outside agencies. I hope she will recognise that these children and young people value, above all, relationships and need to feel that someone is taking an interest in them. Does the Minister agree that children’s services must remain involved and be the key agency as they have first responsibility for safeguarding and promoting the welfare of children in a way that other agencies do not? I am putting several questions to the Minister and I would be happy to receive a letter in response because of the late hour and the detail required.

Has the fit between sentence plans and care/pathway plans been improved so as to avoid the sentence plans undermining the ultimate success of children in public care and care leavers? How are contacts between children and their local authority social worker maintained? What progress is being made in ensuring that the duty of local authorities to maintain contact with care leavers is delivered for young people in custody?

One of the most welcome proposals in the White Paper Care Matters, which was published last month, is the introduction of a veto by children leaving care before the age of 18 and making available foster care placements to the age of 21. What guidance is there for local authorities on how long they should keep a placement in foster care or a children’s home open for a young person who has entered custody?



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Government departments have recently been restructured. Where does the ministerial responsibility for young people from public care in custody now lie? The role of personal officers is particularly crucial to young people who have been in care as they are most likely to have an unsatisfactory family experience. The Chief Inspector of Prisons has often reported that the personal officer role is insufficiently developed. How is the Minister addressing this? Where there are 60 young people to three or so officers in the wing of a young offender institution, the personal officer role may be particularly difficult to implement. I recognise current constraints, but will the Minister be seeking to improve that ratio as soon as possible?


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