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Mental Health (Discrimination) Bill [HL]

Volume 732: debated on Friday 25 November 2011

Second Reading

Moved By

My Lords, in the interests of time, I shall keep my introductory remarks very short. That is quite simple because this is a simple Bill, as simple as the discrimination that it is trying to end is completely disgraceful. I am glad to report that there has been something of a conspiracy among other speakers to speak for a short amount of time and one or two people have withdrawn.

The noble Baroness, Lady Hollins, who is sitting behind me, has withdrawn because she has to leave before the end of the debate. She asked me to say that, as a past president of the Royal College of Psychiatrists, she is wholly supportive of the Bill.

The Bill has a simple purpose: to remove the last significant form of discrimination in law in our society. We can be proud of the fact that, over the past 40 or so years, the UK has taken a series of steps to end discrimination in law on gender, disability, sexuality and ethnic origin. It is astonishing to most people—although perhaps not to those who have suffered from mental health stigma—that there remain disgustingly blatant discriminations against those suffering from mental ill health. If you are an MP, school governor or company director, depending on the precise circumstances, you can be removed from your job automatically or at the will of colleagues as a result of mental health problems. I will make it clear. You can have an episode of mental ill health, fully recover—just as, happily, one recovers from most illnesses—and years later you can be forced from your job. This discrimination applies only to mental ill health. It applies to no other form of ill health. You may be so physically ill that you cannot take part in discussions on boards or in school governors’ meetings, yet such rules will not apply to you. That discrimination reflects a deep stigma of medieval proportions.

Perhaps even more shocking is the matter of jury service. If you are called for jury service, you are obliged to tick a box asking whether you have ever had mental health problems. If you have, you are automatically disqualified. Only about 2 per cent of us tick that box. The real figure should be about 10 times that—so the law is a considerable ass in the process. I will not develop my argument further. There are very easy, very low-cost ways to amend the situation, which are practised in countries as far away as Scotland.

It is as simple as that. The Bill seeks to remove the last major discriminations in law in our society. I will say two further things. Noble Lords may have received yesterday an astonishingly strong missive from the Law Society setting out,

“the substantive reasons for the Society’s unconditional support of the above Bill”.

I am also encouraged by the Government’s attitude. In February they set out their six objectives for a new mental health strategy. One of them was that,

“fewer people will experience stigma and discrimination”.

I look forward to the Minister's response. Perhaps I dare suggest that the Bill might accurately be described as implementing government strategy. I beg to move.

My Lords, I strongly commend the noble Lord for his initiative in bringing forward this practical, concise and important Bill. It was 50 years ago that Enoch Powell talked about putting a torch to the funeral pyre of the great Victorian lunatic asylums. It was also 50 years ago that Erving Goffman, the great American sociologist, talked about stigma theory: the process whereby an individual is isolated, denigrated and humiliated to make others feel more normal and safe.

In the field of mental health, discrimination and stigma have been extraordinarily persistent. It is quite wrong for reality to reinforce prejudice. As the noble Lord said, there can be no justification for singling out mental ill health, whether of a school governor, Member of Parliament, company secretary or juror, when many other forms of difficulty would make them far more objectionable in any of those roles.

My original reference to become a Member of Parliament was written by a professor of child psychiatry at the Maudsley, Lionel Hersov, with whom I worked for a long time. Like others, I made it my role in Parliament for all these years always to do what I could to promote understanding and recognition of, and better services to tackle, the problems of mental ill health. I know that the noble Lord is doing a huge amount to develop a major global initiative to promote research into the understanding of mental illness and its cures.

I recognise the Government’s work in their excellent recent paper, No Health Without Mental Health. A key feature is the intention to combat stigma and discrimination. In that context, I strongly add my voice of support to an enlightened, simple and practical Bill that can make a significant difference.

My Lords, I have many reasons for wishing to speak in support of this vital Bill, and I am very grateful to the noble Lord, Lord Stevenson, for introducing it. I know very well the noble Lord's commitment to this area, and I must acknowledge my esteem for his honesty, openness and integrity in trying to ensure that this issue is not lost or ignored any further.

I am no stranger to the impact of discrimination for people suffering mental illness. As a former chairman of the Mental Health Act Commission, I was made aware on a daily basis of the pain and injustice that people experienced by virtue of having a problem that affects more than one in four of us at some time. It is also my firm belief that this issue can be truly understood only from the perspective of the person affected. The voices of service users and those experiencing mental health problems are essential to our understanding of the issues. It was for this reason that I sought to have a mental health service user join the board of the Mental Health Act Commission. I am thankful that that was not illegal or prohibited.

We were fortunate to gain the expertise and insight of a remarkable woman, Kay Sheldon. Kay was in many respects an unusual choice. She was not the usual type of person to apply to be on a board, and she clearly made her views known at the interview. As someone who had experienced detention several times under the Mental Health Act, she said she would consistently stand up for the rights of service users and be a voice for those who have direct experience of mental health problems. We could not have had a more excellent advocate of service-user rights, and that, in essence, was our core function: to ensure the protection of those very rights. Kay is now a member of the Care Quality Commission, and I know that she remains firmly and completely committed to the rights of people using health services and continues to ensure that the voices of service users are at the forefront of decisions about healthcare.

It is from my personal knowledge of Kay and the many others with mental health problems who have made an immense contribution over the years, particularly to public services, that I wish to speak in very firm support of this Bill. I hope that the Minister will agree with me that it is crucial to have people like Kay who bring their personal experience to the strategy and decision-making of public boards.

I also strongly support this Bill because of the message it sends about ending discrimination. I was very fortunate this week to meet a remarkable young man, Danniel Bennett. Danniel was in a very serious accident earlier this year which almost cost him his life. He was bleeding badly from his head after suffering an injury while playing football, and his father, who was there, had to give him CPR before the ambulance arrived. It was a very serious injury and the young boy's life was in the balance. He was only 13 years old. Danniel is from the Romany Gypsy community and a health worker who happened to be at the scene—a professional whose job is to save lives—refused to help the father give CPR. Her attitude was, “He’s a Gypsy, let him die”. He did not die, thanks to his father's knowledge of CPR, but he needed to go to hospital and needed treatment for his serious head injury. That should have been simple and unquestioned, but he was not admitted to hospital and did not receive a CAT scan. While anxiously waiting in the A&E department, his father was told that his son would not be admitted because, and I quote, “Your kind always turn up in droves”, and that he “should be grateful you are getting any treatment at all anyway”. It was the family GP who, when he saw Danniel the following day, immediately called 999 and had Danniel admitted for a CAT scan which revealed that he had two haematomas on his brain. Danniel survived, but he is still experiencing problems and he can remember hearing that his life was not worth saving because of who he is, a Romany Gypsy. It is a shocking story and hard to believe, yet I know that this kind of discrimination goes on even in the heart of our most trusted public services. We cannot separate our values from the framework of our laws. Our laws set the standards of behaviour we expect, and must themselves never be the cause of unjustified and unreasonable discrimination.

I want to end by reading a short extract from one of the many poems that this 13 year-old boy has written. It sums up what this Bill is all about.

“I challenge you Mr Government

To walk a mile in my shoes

I will start

By taking away your freedom

And then your choices too

And when your soul is destroyed

And you can feel no more pain

I will set you free and give you back your name

So that you can sit back

And feel what it's like to be me

And hopefully your heart and head

Will be filled with shame”.

I hope that today there is no need for shame and that the House will put an end to at least one injustice of discrimination: that against people who experience mental health problems. People like Kay and Danniel deserve our full support. I wish we had a thousand more like them on our school boards, in Parliament, running companies and serving on our juries. I urge noble Lords to support this Bill and put an end to this discrimination.

My Lords, I thank the noble Lord, Lord Stevenson of Coddenham, for returning this House to an issue that it has previously debated—for example during the passage of the Mental Health Bill in 2006. The legislation which this Bill seeks to repeal was passed because Members of Parliament took the view that to do so was to protect the best interests of people experiencing mental distress and to protect the four institutions named in the Bill.

Since then, there have been two significant developments which make the Bill introduced by the noble Lord, Lord Stevenson of Coddenham, appropriate. First, the Mental Health Act 2007 states that,

“‘mental disorder’ means any disorder or disability of the mind”.

The effect which was intended by the Government of the day is that mental health legislation extends to a very wide range of people, including those with mild depression and those who may never think that they should be covered by mental health legislation, as well as the rest of us. They are being excluded from these specific duties and they should not be.

Secondly, the Mental Capacity Act 2005 enshrines in law the common understanding which we all have that the capacity of people with mental health problems or learning disabilities can vary from day to day. Since the 2006 legislation was passed it has become much more common for a person to take out a lasting power of attorney. In addition, people with mental health problems, such as those who are bipolar, are now, as a result of that legislation, more likely to make an advance statement. At a time when the person is well they can state that should they become ill again, they wish a nominated person to be involved in making decisions on their behalf. They can say, “It is likely that, should I become ill again, I might try to make unwise decisions. I wish at that point for those decisions to be ignored”. Those two proposals mean that a period of mental ill health is not now the inevitable catastrophe that it might have been. People with mental health problems and those who care about them can use those tools to mitigate the effects.

On juries, several jurisdictions—the noble Lord mentioned Scotland—already operate the system that would come into operation under this Bill. It is very important to note that a person who is experiencing mental distress can apply for recusal and therefore not have to serve on a jury. The chances of a major case being disrupted because a juror has ill health would be minimised.

For all those reasons, it is now less likely that the organisations in question would suffer adversely. In fact, those organisations would benefit from having people with experience of mental ill health involved. Therefore, Parliament should move with the times, move forward and pass this Bill into legislation at the earliest opportunity.

My Lords, it is because my noble friend Lord Stevenson of Coddenham is bringing this Bill before your Lordships that I am pleased to say a few words in support. I knew my noble friend when he was chairman of the Newton Aycliffe and Peterlee new town corporation in the 1970s, on which I also served. He was an enthusiastic and energetic chairman and I had no inkling that he sometimes suffered from endogenous depression. Looking at his impressive CV, one can see that it has not affected his work performance in any way.

My feeling about this Mental Health (Discrimination) Bill is that people should not be discriminated against, but that they should be fit for purpose for whatever they do if it is a public service. Should a person have had a mental health problem, they may be better equipped to understand the population as a whole. I think that about one in three people will at some time have a mental health problem.

Because of time, I cannot say much that could be said. However, I am delighted that my noble friend will have a research trust. There is not enough research into the many difficult problems of mental health, including cannabis use. We must come to some conclusion over that. I hope that the Government are ready to help this Bill become law by giving it parliamentary time.

My Lords, from these Benches I warmly thank the noble Lord, Lord Stevenson, for bringing this Bill. Many times within the course of Christian ministry in this country you come across the very distressing scenes of people in extremes of mental ill health. A number of times in parishes that I had in the north-east I saw people within the parish who were sectioned. And I saw them recover. It is very important that people understand that recovery is possible. Although this Bill allows people to take part in the political, legal, commercial and educational processes of our country, it is the signal of hope that it gives that is so important.

I should at this time hold up our own hands to say how much the churches have to learn. A very able priest who has come back into parish ministry spent many years with a mental health advocacy charity. He pointed out to me how poor the churches can be at supporting people in need. We all have to learn, and a Bill such as this is a wake-up call to everybody. I hope that it finds warm support from the Government.

My Lords, this has been an excellent, albeit brief, debate. I, too, thank the noble Lord, Lord Stevenson, for bringing the Bill to your Lordships' House.

The changes in it are long overdue. Mind and other mental health organisations have long campaigned for these laws to be repealed. They are clearly discriminatory and there is widespread agreement among MPs and political parties alike that they have no place in a modern and fair society. But what is worse about their existence is that they are symptomatic of the prejudicial view that having had a mental illness makes you incapable of being a citizen with all the rights and responsibilities that that implies. They stigmatise this illness unlike any other. It puts out the message that anyone with a mental health problem is not fit to be an MP. It is a message that is picked up by all employers and is something we know is experienced by the overwhelming majority of people who have suffered mental illness.

By adopting these measures, we can send a clear message to all employers that we need to address mental health problems in the workplace and put an end to the discriminatory attitudes that prevent capable people working.

We know that the proportion of people who have mental health episodes in their life is high, as my noble friend Lord Patel highlighted. That is why it is both important and useful to have people in the other place and this House who are willing to talk about their experiences and how they came through their problems. I know that we will fully succeed in changing attitudes only when people feel able to speak openly of their own personal experiences. But we cannot expect people to be out and proud when laws that stigmatise mental illness still exist. Every time a citizen is summonsed for jury service, as I was recently, they are reminded in the most explicit terms that someone who has suffered a mental illness is a second-class citizen. How can we change attitudes when this goes on? I hope that, after today, the Minister will ensure that the Government find time to make these changes, which are long overdue.

My Lords, I was just discussing with my noble friend Lord Shutt the West Riding asylum, with its own dedicated railway siding and room for 1,200 people, which was still there, although thankfully empty, when I first stood in the Shipley constituency. We have thankfully moved a long way from the Victorian age, but there are still some issues which we have to remove from the statute book.

I can tell the House that the Government support the Bill, although we will ask for some amendments to be made in Committee. A number of the provisions put forward demonstrate a shared purpose with the objectives of this Government. They are in line with the Government’s strategy, No Health Without Mental Health. Tackling stigma and discrimination is at the heart of the Government’s mental health strategy.

This is an issue which goes way beyond the Government and the Opposition. Shifting public behaviour and attitudes requires a major and substantial social movement, including more sympathetic treatment in our mainstream media. So let me remind noble Lords that the Government have already publicly committed to the repeal of Section 141 of the Mental Health Act 1983 and that, as has already been mentioned, we stated last February that the section would be repealed when a suitable legislative vehicle became available. This Bill seems to be that suitable legislative vehicle, and we are glad to see that it is linked with similar amendments on the role of company directors, school governors and jurors. On the question of jury service, the Government have been considering the detail of what is proposed and wish to ensure that any amended provisions are fair and effective. They support the principles underlying the Bill, including Clause 2 on jury service, and propose that the clause should remain in the Bill. However, it is possible that my noble friend the Deputy Leader of the House and his colleagues at the Ministry of Justice might bring forward a government amendment at a later stage.

Given the lateness of this Second Reading in the Session, it may not be possible, even with the best of good will, for the Bill to complete all of its stages before the Session ends, let alone to take it through the Commons as well. If, however, it fails to be carried during this Session, the Government hope that it will be reintroduced at the beginning of the next Session, and can assure the House that it will have the Government’s support. We look forward to seeing it on the statute book.

My Lords, I thank everyone who has spoken. I do not know if this debate will set a record for brevity because I do not come here often enough to know, but I would lay a sizeable bet that it is. By the way, it is a very nice feeling to hear one’s own bishop speak in support of a Bill. I believe that it is a total coincidence, but it is nevertheless very nice. That provides a context in which to say that, although I cannot remember the exact title, I believe that the person responsible for educational policy in the Roman Catholic church has written a letter to the noble Lord, Lord Wallace, and myself expressing their support. I think that the House would like to know that. I thank everyone for being here.

Bill read a second time and committed to a Committee of the Whole House.

House adjourned at 3.03 pm.