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Mental Health: Patient Safety

Volume 684: debated on Wednesday 12 July 2006

asked Her Majesty’s Government:

When they expect to publish the National Learning and Reporting System’s report on women in National Health Service mental health units.

My Lords, we take seriously concerns raised by a National Patient Safety Agency analysis of individual reports on patient safety in mental health services. We have concerns about some information on sexual allegations and are working with the NPSA to establish the accuracy of the most serious allegations. Professor Louis Appleby is leading a review of these reports, which we shall act on. We had already intended to publish the NPSA report on completion of this review. However, as inaccurate accounts have been made public, we shall publish the latest version shortly.

My Lords, I thank the Minister for his Answer. In 1996, Mr Blair, in opposition, asked the following question about mixed-sex mental health wards:

“Is it beyond the wit of the Government and health administrators to deal with this problem?”.

Today, when 25 per cent of mental health patients record that they are held in mixed-sex wards and it has taken the Department of Health more than six months to respond to a report setting out allegations of more than 100 serious sexual offences against women, does he not think that it is time the Government responded to the report fully and quickly?

My Lords, there are two points there. As I understand it, the latest published figures show that 99 per cent of mental health trusts and PCTs that provide mental health services meet single-sex accommodation objectives. We are working closely with the remaining 1 per cent to ensure that they achieve the necessary standards as quickly as possible.

The delay in responding to the report has been caused by trying to get to the bottom of the allegations. That is what Professor Louis Appleby has been doing and will continue to do.

My Lords, I accept that the departmental returns suggest that 99 per cent of trusts now have single-sex wards, but does the Minister not accept that in reality at least 25 per cent have makeshift arrangements because they do not have the capital investment to allow them to arrange for separate wards? Those unfortunate arrangements allow daytime occupancy to be joint and rooms at night to be unlocked, often in separate wards but too close to each other to provide appropriate protection.

My Lords, we know that a very small number of patients, when admitted as an emergency, may be put in mixed-sex accommodation. It is the nature of an emergency that some action has to be taken. However, we have put a large amount of extra money into mental health services, including capital. I will look into any cases where applications have been made for capital money that has not then been granted in that area.

My Lords, the Minister said that a very high percentage of providers met an acceptable standard. What is an acceptable standard? Does that mean that women are still at risk in these units, as the report suggests? If that is the case, will he please look at it as a matter of extreme urgency?

My Lords, I will write to the noble Baroness with the definitions of standards. I think she is aware of them. I do not have time to go through the detail of them here, but I will share them with her.

As I said, there are occasions when people are admitted to a mixed-sex ward in an emergency. A small proportion of providers—1 per cent—are not meeting the standards, and we are working with them to make sure that they do so.

My Lords, does the noble Lord recall that in 1994 I sponsored and took through this House a Bill outlawing mixed-sex wards? Ever since that time—12 years ago—I have been assured by Minister after Minister, including the noble Lord himself, that such wards would indeed be phased out completely. Now I understand from the noble Baroness, Lady Barker, and others, that they have not been phased out. Surely, after 12 years, we should have eliminated mixed-sex wards entirely from the National Health Service.

My Lords, I pay tribute to the work of the noble Lord in this area. I say to him that rather more progress has been made in this area under this Government than under the previous one.

My Lords, can the Minister confirm my understanding that no organisation is specifically tasked with monitoring assaults committed by patients on other patients? Is that not quite wrong? Will the Minister consider the case for drawing up clear national guidelines for how trusts should react when one patient assaults another as there does not seem to be any consistency in this area?

My Lords, it is the responsibility of the trust that is running the facilities to ensure the safety of its patients. Where there are possible criminal assaults, it is for the trust to inform the police. Work is going on about whether more guidance is needed in this area. I am happy to write to the noble Earl about that.

My Lords, will the Government institute a robust, transparent and easily accessible reporting system for incidents of sexual assault and harassment in mental health units in general, and for women in particular? If that is to be the case, when will it occur?

My Lords, this Government introduced the National Learning and Reporting System under the NPSA, for which they have been fully commended by the National Audit Office. This leaked document is part of that work. We are continuing to get to the bottom of that. This has demonstrated that there is a more open culture in the NHS, which is for the good of patients.