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Transforming Rehabilitation: Mental Health

Volume 753: debated on Tuesday 6 May 2014


Asked by

To ask Her Majesty’s Government what plans they have to include mental health treatment and support in contracts for the probation services as part of the new Transforming Rehabilitation programme.

My Lords, our reforms will bring in the best of the private and voluntary sectors to work with offenders and reduce reoffending. Community rehabilitation companies will be contracted to work with low and medium-risk offenders in the community, and the National Probation Service will supervise high-risk offenders. Both will be required to deliver services for specific groups such as females and BME offenders, as well as those with mental health issues, to ensure that an offender’s treatment requirements are complied with, including in situations where a court order exists.

I thank my noble friend for that reply. I am sure that he will be aware that currently four out of every 10 people who are being supported by the probation service are actively mentally ill: that is, 39%. This underlines the range of skills and knowledge that is required today from experienced members of the probation service in managing and properly meeting the needs of these clients. Therefore, will the Minister clarify whether the new organisations now bidding for probation service contracts are specifically expected by the Ministry of Justice to include and implement mental health provision across the board—because there are not specialisms to this extent within the probation service, as far as I know—and whether this requirement will be included in the proposals? How will the quality of the proposals of the new probation service contractors and the performance of the new providers be assessed?

My noble friend, and the House, may recall that the Government lodged with both Houses of Parliament a detailed draft services agreement, which included provisions that would apply to mentally ill offenders. Clause 3 of the agreement provides that the contractor shall monitor that the treatment provider prepares a full treatment plan with details of the specific mental health needs of each allocated person, with the timescale indicated to the court at the time of the sentence. Therefore, companies will be contractually obliged to do this. They will have an obligation under the Human Rights Act and under the Equality Act. My noble friend is of course right that the skills should be preserved in relation to mental health.

Will the Minister clarify the relationship between NHS England’s responsibility for mental health and that of the Ministry of Justice, and how contracts are laid between the two, not only in the private sector but in the voluntary sector, where a number of organisations have lost contracts through this confusion? I declare an interest as a trustee of the Lucy Faithfull Foundation.

There is an obligation to treat offenders and non-offenders the same. The circumstances in which they come to be treated may be different. Those who are in prison may suffer from a number of different mental illnesses. Their treatment is the responsibility of NHS England. Of course, there are complications with the delivery of treatment in the community as well, but there is no absolute difference in the treatment that is appropriate to you when you are an offender in prison or out of prison or are an ordinary member of the public. Clearly there are matters of co-ordination that the noble Baroness would say are not sufficiently attended to.

Between 2010 and September 2012, 86% of the prison and probation-related work contracted out to the private sector by NOMS went to G4S, Serco and Sodexo. If the Minister is so confident of the performance of these contractors in this important and sensitive area, why has the Ministry of Justice refused to disclose the figures for the succeeding year, even after an FoI request from the Centre for Crime and Justice Studies? Is he aware that just three third-sector organisations accounted for two-thirds of the third-sector expenditure in the same field?

I cannot comment on the details of the noble Lord’s question, but I assure him that neither of those two organisations are part of the CRC delivery, as he may well be aware. The CRC contracts are being drawn up and will be in operation by 2015. This matter was fully debated before both Houses of Parliament and we believe that any difficulties should be capable of being found in the stress-testing that is currently being undergone.

My Lords, to follow on from my noble friend’s question about NHS England, can the Minister comment on a recent freedom of information question and answer that showed that only 5% of clinical commissioning groups were actually funding specific healthcare for probation and that 25% of the CCGs questioned did not even realise that it was their responsibility to fund medical health provision in probation?

I cannot comment on the specific freedom of information request to which the noble Lord refers but I can perhaps reassure him that the Government are particularly aware of the danger of individuals escaping the net who are suffering from mental illness—offenders who come to the attention of courts and police services. Much work is done by the liaison and diversion services, which have invested a considerable sum of money to make sure that those who are often reluctant to acknowledge that they have mental illness, when they come into contact with a court or police station, are identified by appropriate health professionals. The information about them is then passed on to the appropriate figure so that, when they go to prison or are in the hands of a CRC, that information is available. A considerable investment has been made and for altogether 22% of the population it is hoped to roll out the arrangement throughout the country so that there is much better liaison in future.