House of Commons
Tuesday 19 June 2007
The House met at half-past Two o’clock
Prayers
[Mr. Speaker in the Chair]
Oral Answers to Questions
Transport
The Secretary of State was asked—
Railways
In July the Department will publish the high level output specification, which will set out what we expect the railway industry to deliver in the years to 2014. It will be accompanied by a statement of funds available, setting out the funds that we expect to make available to the industry over the same period.
Is my right hon. Friend aware that Streatham to Mitcham Common is the longest line of track in London without a station, and that although I have been campaigning for 10 years for a station in Mitcham, the campaign for the Eastfields halt goes back to the 1930s? Does he share my delight that Network Rail intends to build a station there, and will he do everything he can to ensure that it is introduced at the earliest possible date in December?
I am fully aware of the tireless efforts of my hon. Friend in relation to a new station at Eastfields. She has a reputation in the House for her efforts on behalf of her constituents, and I know that the matter is of particular concern to a number of commuters, who are keen to see a new station on that route. She is right to recognise that ultimately a decision rests with Network Rail. I understand that there have been constructive and positive conversations with Network Rail, and I urge her to continue those conversations.
It is interesting that the Secretary of State says that the decision about a new station rests with Network Rail. Last Friday I had a meeting with Network Rail to discuss the new station in Corsham in the light of the very helpful letter that I had from the Secretary of State for Defence, who said that he was keen that the station in Corsham should open. The Network Rail people said that it was nothing to do with them—it was a matter for the Government or the regulator, but they were not quite certain which. Will the Secretary of State clarify whether he agrees with his right hon. Friend the Secretary of State for Defence that the new station in Corsham would be a good thing, and if so, who will take the decision to reopen it?
With the greatest respect to my right hon. Friend the Secretary of State for Defence, I doubt that the terms of the letter to which the hon. Gentleman refers suggest that the decision is one for the Ministry of Defence or the Secretary of State for Defence. I am happy to look at the correspondence and we will be back in touch with him.
When considering future rail investment, will my right hon. Friend take a particular look at west Yorkshire and especially the lines that run through New Pudsey, Horsforth and Guiseley in my constituency, bearing in mind the relatively low level of investment per person on transport in Yorkshire and Humberside?
I am aware of the importance of rail services not just in one region, but in every region and nation of the United Kingdom. I am happy to give the assurance that we will consider the needs of every part of England when we publish the high level output specification in due course.
Will the Secretary of State consider the service given to rail passengers on a Sunday? Does he think it is acceptable that most train companies offer appalling services on a Sunday, which take far longer than any other train journey during the rest of the week, and charge the same price for them?
Of course it has been the case historically that significant engineering work has often been undertaken on a Sunday. It is right to acknowledge that as lifestyle, retailing and leisure patterns change, there are greater expectations of the network on a Sunday than was the case in a different era. I am sure Network Rail is aware of that, and I will make sure that the point is made to it, in light of the hon. Gentleman’s contribution.
Will my right hon. Friend ensure that any moneys paid into the public purse by rail operators are ring-fenced for use within the franchise area where the moneys were raised, for further improvements to the franchise and the benefit of passengers?
There has been some misapprehension on these issues in much of the commentary. I can give my hon. Friend the assurance that she seeks, which is that the money received from the franchise is ring-fenced in the budget of the Department for Transport. It is part of the ongoing sustained investment which accounts for about £88 million per week on Britain’s railways at present.
Given the threat of climate change, is it not time the Government got serious about high-speed rail from Scotland to London to get people out of planes and into trains?
With the greatest respect to the hon. Lady, it is about time the Liberal Democrats got serious. If she was serious about looking at high speed trains, she might recognise that there is a correlation between speed and energy consumption, and therefore that the easy assumption that in every circumstance a high speed train is the pro-environment choice does not bear scrutiny. These are serious matters. We are considering them in the Department and we will bring forward our recommendations at the time of the high level output specification in the summer.
Will my right hon. Friend talk to his Treasury colleagues to ensure that the East London line extension is completed—not only phase 1 which is under construction, with the operator announced today, but phase 2 to Clapham Junction, which requires another £75 million under the comprehensive spending review?
Many Ministers are keen to speak to the Treasury this week. I am happy to pass on the point that my hon. Friend makes.
I am sure the House is aware of the reports that this is likely to be the last occasion on which the Secretary of State stands at the Dispatch Box for Transport questions. May I offer him my thanks for a constructive relationship over the past few months and wish him well for the purges that we expect on the Government Benches next week. Can he tell the House, though, whether Britain’s trains will be more or less overcrowded by 2015?
First, I know that in the rail industry as in other walks of life, forecasting is an inherently challenging and difficult business. Clearly, the hon. Gentleman is in possession of information that I am certainly not aware of as we look ahead to the events of next week.
Let me deal with the substantive point, however. We have already recognised in the high level output specification discussions the centrality and importance of greater capacity on the railways. That is why I made it clear in March that as part of that statement this summer, 1,000 extra carriages will be provided for the country’s railways. At the same time, we are looking at a range of measures on infrastructure, such as platform lengthening, for example. I can give the hon. Gentleman the assurance that capacity will be one of the central challenges that the high level output specification will address.
It is a shame that the 1,000 extra coaches will not be with us for another seven years.
The Government are receiving higher premium payments from train operators, because they in turn are passing on substantially increased fares to passengers—increases that are well above the rate of inflation. Will the Secretary of State give a commitment today that all the extra money raised from passengers in that way will be spent on tackling the overcrowding crisis on our railways?
Let me address both the points that the hon. Gentleman has raised. First, he has suggested once again that the 1,000 extra carriages will not be available for a number of years. Let me correct that misapprehension, which I am sure is inadvertent, by confirming that carriages will be available on the network by the end of next year, which is 2008 rather than 2014.
Secondly, reflecting the earlier answer that I gave, we recognise that the premium payments that came in under the franchising system form part of the rail budget. I have already made it clear that one of key priorities for the rail budget in the years ahead will be capacity.
Bus Services
Last month the Government published a draft Local Transport Bill for consultation. It includes proposals to provide the necessary powers for local authorities to improve bus services, as set out in “Putting Passengers First”.
The proposals have been broadly welcomed in south Yorkshire, even to the extent that last Friday, almost 100 bus users turned out on the wettest day for 35 years to discuss the measures with the Secretary of State. Does my hon. Friend agree with me and those bus users, however, that the measures in the Bill could be improved by giving local authorities the right to introduce the quality contract without having to go to an unaccountable body?
My hon. Friend is indeed an effective campaigner, as has been mentioned before. Indeed, I know from my right hon. Friend the Secretary of State that her work last week to promote a better deal for bus passengers by bringing them together with my right hon. Friend was extremely valuable. I congratulate Sheffield city council and the passenger transport executive on signing up to a voluntary quality partnership that will mean better bus services.
I can assure my hon. Friend that the draft Bill does indeed provide for better working partnerships between authorities and operators. It will give more powers to local authorities where needed, and it is important that where quality contracts are proposed, they are properly scrutinised, because they are for the benefit of all, and it is important that we ensure that they are in the public interest.
Does the Minister recall that on 21 May 1997, when the Prime Minister first answered Prime Minister’s questions in this Chamber, he promised the House that the Deputy Prime Minister, who then had responsibility for transport, would be carrying out a review on the question of bus regulation? Since then, we have progressed as far as having a draft Bill. During that time, however, the cost of travelling by bus has increased by 15 per cent., while the cost of travelling by car has fallen by 9 per cent. Does the Minister think that the Prime Minister should be satisfied with the progress that her Department has made in the course of the past 10 years?
I am quite sure that the Prime Minister is very pleased that we now have the biggest shake-up of buses for some 20 years and that we have a balanced package of measures in the Bill, which is basically about ensuring better services for bus passengers. In particular, I want to draw the attention of the House to the fact that, just last week, provisional figures were published showing that there has been a rise of 85 million bus and light rail passenger journeys, and that 80 million of those additional journeys are made in the English non-metropolitan areas. That shows that bus patronage is on the rise, due in part to the concessionary travel provisions introduced by the Government.
If we are serious about tackling road congestion, there needs to be a meaningful role for park-and-ride, linked into strategic and key bus services. Given that fact, what discussion is my hon. Friend’s Department having with the Greater Manchester passenger transport executive to ensure that that essential element is included in its transport innovation fund bid for Greater Manchester?
Discussions are under way on the TIF bid, which is to deal with congestion. I am sure that my hon. Friend and other hon. Members are aware that I recently had the honour of opening the new GMPTE offices in Manchester, and its commitment to improving bus services, tackling congestion and working for the people of Greater Manchester is commendable.
Will the Minister, or her successor, visit Kettering to discuss local bus services with local residents and to be briefed on the remarkable 23 per cent. increase in bus patronage in the past four years?
I am sure that I would be absolutely delighted to visit Kettering. Areas up and down the country have experienced great success in passenger growth. The Local Transport Bill is all about spreading good practice and making sure that the benefits are available, which my right hon. Friend the Secretary of State saw for himself in Oxford yesterday.
I urge my hon. Friend to make sure that the new powers in the Bill are coupled with the continuation of the Government’s kick-start programme, which in Newcastle has given us a new, high-frequency bus corridor, the X47 in the north-west of the city, that has attracted thousands of new bus passengers. Sadly, however, the Liberal Democrat council in Newcastle failed for many months to carry out its part of the deal, which was highway improvements to support the scheme.
That is disappointing, if not unsurprising, news from my hon. Friend. The important point about kick-start funding is, as I am sure that the House is aware, that bus funding has almost doubled in real terms since 1997, which includes the kick-start programme. I cannot make a commitment today, but I assure my hon. Friend that we will put the matter under review.
The Government spend much of their time demonising the deregulatory provisions of the Transport Act 1985. If those provisions are so evil, why have the Government not included re-regulation in the draft Bill?
What an interesting question. We have had an apology from the Opposition about rail privatisation, but we have had no such apology about their action on buses. The draft Local Transport Bill, which I hope that the Opposition will support, will introduce a new regime that will put passengers first and deliver better punctuality. That will mean the further development of the community transport sector and the implementation of quality contract schemes through effective partnership working. The Bill is not about returning to the 1980s; it is about looking forward and providing bus travel not only for those who do not have a choice, but for those who do.
Since rail passengers have got an effective way of complaining if they do not get good service, is there a particular reason why bus passengers do not have the same provision?
I assure my hon. Friend that we are strengthening the role of the traffic commissioners, who are also being included in the assessment of quality contracts to use their expertise and time to best effect to improve bus services.
Rail Services
I am aware that the Swindon to Kemble section is single track and that that limits the number of trains that the route can accommodate. Network Rail’s business plan 2007 states:
“Redoubling the single track between Swindon and Kemble is being evaluated as the first phase of the Swindon-Gloucester-South Wales line upgrade for delivery in 2008/09”.
However, that remains a matter for Network Rail to progress.
I am grateful to the Minister for that response, but we need to hurry up that improvement. Some 220,000 people live in Cheltenham and Gloucester alone, and many more people in the area use the trains. There is a direct train only once every one hour 52 minutes; on many trains, people have to change if they want to go to London, a journey which can take as long as two hours 36 minutes; and an open return often costs £139. That is a very poor service between an important area of the country and London, so we need that improvement. Will the Minister redouble his efforts in persuading Network Rail to take on that project?
For every Conservative Back Bencher who complains about not enough money being spent on the rail network, their Front Benchers complain that we are spending too much. I understand the hon. Gentleman’s concerns about the line but, as he will know, it is currently served by 18 trains in each direction every day—a level of service that would be envied in many other parts of the country. However, it is entirely up to Network Rail to decide if and when to spend money on the project, and how much.
As someone who has campaigned on this issue for 10 years, it is good to hear that it has now reached so-called GRIP 3, which will be known to my hon. Friend if to nobody else in the House. There is some optimism. However, I would like to know that there is a degree of transparency in the process. As the hon. Member for Tewkesbury (Mr. Robertson) says, this redoubling is greatly needed in Gloucestershire, and indeed in other parts of the region, so it would be nice to know that Network Rail will take advice from MPs and other interested parties to ensure that it gets a full view of the benefits that the upgrade could bring.
My hon. Friend is absolutely right to express concerns about the transparency of such decision making. Network Rail consults extensively throughout the industry. I would recommend that he visits its website to get the latest on the precise identity of the consultees on this particular business plan. If he wishes to write to me, I am happy to pass on his concerns to the chief executive of Network Rail.
May I add my support to my colleagues from all parties in Gloucestershire on this important proposal? The redoubling of the line from Swindon to Kemble will deliver benefits in my constituency as well as those of my neighbours. Does the Minister agree that with passenger numbers on the railway network as a whole at their highest since the 1940s, such measures to increase capacity should be given the highest priority by Network Rail?
I am grateful for the hon. Gentleman’s congratulations to the Government on their success in growing the network over the past 10 years. I would caution him and other hon. Members who have spoken on this issue by pointing out that the severe constraints on track capacity to the east of Swindon mean that although the work, if it goes ahead, will help to improve the reliability and performance of through services, it will be a much greater challenge to increase the number of services through to London.
Private Roads
Local authorities already have the power to bring unadopted roads up to the standard required for adoption. It is a matter of priorities for each individual authority to decide whether to do so, and there is no further role for central Government.
As my hon. Friend is aware, coalfield communities are disproportionately affected by unadopted roads, of which Derbyshire alone has 700. Will he agree to meet local authorities from coalfield communities to find finally some strategy to deal with that problem, which is not going away?
I certainly do know about the problem, because my hon. Friend has worked hard to ensure that Ministers are aware of it and of the specific issues. Of course, one of the ministerial team—these matters are usually dealt with by the Under-Secretary, my hon. Friend the Member for Lincoln (Gillian Merron)—will be delighted to meet her. Our ability to get involved in this is limited, but we can help to try to identify the various opportunities for funding such schemes of which my hon. Friend’s constituency can take advantage.
The Minister says that this is nothing to do with central Government. When the new town corporations handed over the overspill London new towns to local councils, many roads were not adopted, and local authorities simply do not have the money to put those roads into the state that they should be in for public use. As it was the Government’s fault when those agencies did not do their job properly, can we look into the problem again to see whether there is any central money to solve it?
Local authorities might take advantage of various sources of funding for such schemes. The Department for Communities and Local Government offers several opportunities through regeneration funding. The local authority can use its own local transport plan funding, the integrated transport block and revenue support grant. It can even consider the possibility of using private finance initiatives and neighbourhood renewal funding. There are opportunities for local authorities to deal with this. If the hon. Gentleman would like to write to us, we will enumerate them and he can get his local authority working on an opportunity to put the problem right.
Wakefield is a coalfield community with more than 200 unadopted roads. As my hon. Friend knows, the legislation that governs adoption is outmoded, requires unanimity from householders and is normally defeated because of apathy and the cost to those householders. They wish to resolve difficulties only when there are problems with sewage or street lighting. Will he liaise with Ministers in the Department for Communities and Local Government to ensure that, as we embark on a programme of house building, we do not allow any more unadopted roads to be built on private estates and that, if they are built, planning agreements cover the costs of maintaining them in perpetuity and their adoption?
I will pass on those views to my colleagues in the Department for Communities and Local Government. My hon. Friend makes a good point and any new housing developments should take such matters seriously and ensure that the problem does not get worse.
Will my hon. Friend take it from me that he cannot pass the buck in the way in which he appears to have done? It is his Department’s responsibility that many people in my constituency and in Kirklees cannot get an unadopted road made up. May we have some leadership from him on the use of recyclable aggregate, which can often be used to make up the roads economically? His comments do not sit well when I have to face a Kirklees council that is run by the Tories with Liberal Democrat support, and it has to wait for a Labour Government to get its road done up.
I am sorry that my hon. Friend is cross with me, but there is little scope for central Government in the matter. It is for local authorities to decide how best to use their resources. We can make a variety of resources available to them, including regeneration funding and neighbourhood renewal funds. I am told that some local authorities have even used the home zone scheme as a way of moving matters forward. If the Liberal Democrat or Tory-controlled council to which my hon. Friend refers genuinely intends to resolve the problem, it has the mechanisms at its disposal.
Trains (Overcrowding)
We will work to increase capacity through the franchising process and in other ways. In particular, I announced on 14 March that the high level output specification, to be published in July, will include a commitment to 1,000 extra carriages. They will be targeted at the most congested routes on the network.
Does the Secretary of State agree that, in places such as my constituency, where junction 21 of the M5 is badly congested at peak hours, it is essential to have a high quality commuter rail scheme and that, for stations such as Worle, where there is bad overcrowding, we are moving in the wrong direction, with reduced rather than increased services? Will he make a commitment to people who wait for trains at Worle station and elsewhere in north Somerset that some of the resources that he mentioned will be targeted at the severe rail congestion there?
Doughty though the hon. Gentleman is in defence of his constituents, I doubt whether he would expect me to preannounce such specific elements from the high level output specification, which will be before the House in only a few weeks.
Let me make the general point that there has been sustained investment in our railways in recent years, in contradiction to literally decades of under-investment that we previously experienced. Transport Ministers used to claim that we had the most efficient railway in Europe. I regret that, all too often, that was code for the fact that money was not spent on maintenance or capacity, and we are therefore trying to catch up. That is why there needs to be additional capacity in the fleet and why we have announced 1,000 extra carriages. That is why we want sustained investment in the network and why it is sensible to present all the proposals at the same time in July. That is exactly what we will do.
Does the Secretary of State recognise that an announcement of the funding for the Reading station upgrade in next month’s high level specification output statement would contribute significantly to reducing train overcrowding on the Great Western main line?
I know that my reply will disappoint my hon. Friend. I passed through Reading station only last night when travelling back from Oxford. Much as I would like to assure him that, on the basis of outrageous congestion that I experienced, I will make an immediate announcement, I fear that I will disappoint him because I cannot make such an announcement at this stage and the station was remarkably quiet when I passed through it.
In all seriousness, my hon. Friend has made clear to me the concerns of his constituents about the high level of usage of Reading station. He has brought a group to the House of Commons to present his concerns directly to me and I assure him that we are mindful of them as we prepare the high level output specification.
Is the Secretary of State aware that Chelmsford has a significant commuting population and that railway journeys on One railway are unacceptable in respect of overcrowding during the rush hour? What specific and detailed advice can he give about how One railway can reduce the overcrowding and ensure that my constituents can travel to work as members of the human race rather than as cattle?
Obviously, there are steps that individual train-operating companies can take, whether it be train lengthening, with additional capacity being provided by additional carriages, or platform lengthening to facilitate those additional carriages, but there are specific requirements on specific routes. I can assure the hon. Gentleman that it would not be the right response simultaneously to suggest that we can have lower fares, a higher level of investment and lower taxes. Ultimately, there are two sources of funding available for the network: one is the rail fare and the other is the taxpayer. That is why the Government have, over many years, seen sustained investment in our railway, but we recognise that more needs to be done on capacity, which will inform the high level output specifications published this summer.
But surely my right hon. Friend—like me, he is a regular traveller—will understand that there are safety implications from the overcrowding of our trains. Is it not now possible in the modern age to restrict the numbers on trains, just as we restrict the numbers travelling in cars, planes and boats? We should restrict the numbers travelling on our trains because we are now reaching the point at which it is becoming unbearable. That problem really should be addressed by restricting the numbers that are allowed on our trains.
Of course, safety on our railways is a matter that we keep under constant review and there are appropriate bodies to advise us on the technical requirements of improving the safety regime on our railways. As to my hon. Friend’s point about what other steps can be taken, I made it clear back in March that we are making provision for an extra 1,000 carriages, which will go some way towards addressing some of his concerns.
Passenger Focus Report
The spring 2007 results from the national passenger survey show that there has been a small but disappointing decline of between 1 and 2 per cent. in rail passenger satisfaction in the last year. That needs to be viewed in the context of the steady improvement in rail passenger satisfaction experienced over recent years.
I think that the Minister is being somewhat selective in looking at the Passenger Focus survey. What area of dissatisfaction is he most concerned about—dissatisfaction with delays, dissatisfaction with value for money or dissatisfaction with reliability?
The passenger survey was undertaken in the context of steadily improving performance on the rail network. The industry is committed to achieving 89.4 per cent. reliability by the end of March next year and 90 per cent. the year after. In that context, with record amounts of public money being invested in the railways, I hope that the hon. Gentleman will agree that investment and not tax cuts should be the priority for the travelling public.
Will the Minister join me in congratulating Midland Mainline on its high-quality service and on the very high levels of customer satisfaction that are recorded in the survey? Will he reassure me and others in the east midlands and south Yorkshire area who rely on Midland Mainline services that they will not be unduly disrupted and that the quality of service will not be lost as a result of the new East Midlands rail franchise?
It is, of course, the Department’s aim to ensure that when any new franchise is introduced, passenger services continue as smoothly as possible. Inevitably, there will be timetable changes every December for every franchise. The new East Midlands franchise will be in place this summer and the new timetable for the new franchise will be introduced in December 2008. I expect service levels to be an improvement on what passengers currently receive.
The Minister knows that rail passenger satisfaction has improved greatly on the C2C Fenchurch Street service over recent years, but it could be improved even more if uncertainty about the franchise renewal were removed, so that the line could get on with making more investment in rolling stock to tackle problems such as overcrowding. What is the Minister going to do to remove the uncertainty about the franchise?
There is an ongoing debate in the industry about the length of franchises; the hon. Gentleman is absolutely right to point that out. However, there is no consensus on how long a franchise should last. I am of the view that the present length of between seven and 10 years is appropriate, and that it does not serve as a disincentive to train operating companies in making the necessary investment. The idea of a 20-year franchise has been mooted, but that would not provide an incentive to improve performance, for example.
Does my hon. Friend agree that modern well-equipped railway stations contribute to improving levels of rail passenger satisfaction? Perhaps he thought that he could get through an entire Question Time without anyone mentioning New Street station, but I must ask him when he thinks we in the west midlands might get some good news on this project, which is vital for the entire region?
My hon. Friend is correct to say that the travelling experience is greatly coloured by whether the facilities at a train station are good or bad. As far as Birmingham New Street is concerned, I would love to be able to give him some cheer, but I shall have to ask him to await the announcement on possible funding for the redevelopment of the station that will be made in due course.
Did the Minister detect any customer satisfaction whatever on the state of the so-called Stansted Express? Seeing the state of our railways must be the most appalling introduction for foreigners coming to Britain. What are we going to do about that smelly, slow and unacceptable route?
The right hon. Gentleman understandably takes a close interest in these matters. His indignation would sound better, however, if he had not been complicit in the botched privatisation of the railways in 1993. The fact is that performance on our railways has gone up by 10 per cent. in the past five years, largely because of record investment by the Government in the railway network.
Cycling
The Government are committed to increasing cycling; it is a healthy, environmentally friendly transport mode. We doubled Cycling England’s budget to £10 million last year and launched Bikeability cycle training earlier this year. The six cycling demonstration towns with which Cycling England is working have increased cycle trips by about 30 per cent. in just one year.
I thank the Minister for that answer. Does he agree that one thing that helps cycling is better cycle and rail integration—and that that is not helped by the attitude of some rail operators that do not encourage cycles on trains, and of some stations that prevent cyclists from bringing their bicycles into the ticket office?
I accept my hon. Friend’s concerns. Since late 2004, the Government have funded about 2,500 new cycle parking spaces at stations. However, there will always be constraints on the ability to accommodate non-folding bikes on trains at peak times. I believe that the train operating companies are the best placed to know where and when pressure on services exists, and they must be free to impose restrictions when necessary.
I call Rob Wallace. [Interruption.] I am sorry—I have a friend called Rob Wallace. I call Rob Wilson.
Thank you, Mr. Speaker. I am sure that we will become firm friends in a short space of time.
This week I shall participate in Reading’s cycle week, but Reading has a very poor cycle network that is neither safe nor fully integrated. What central funds will the Minister provide to address that deplorable state of affairs in my constituency?
I congratulate the hon. Gentleman on trying to pin the blame for poor cycle routes on the Government. However, he will know that cycle facilities are entirely the responsibility of local government, using record levels of funds provided by this Government. I suggest that he engage with his local authority on this issue.
EU Emissions Trading Scheme
We have led the debate in Europe on this issue, and welcomed the European Union's announcement on aviation's inclusion in the EU emissions trading scheme in 2011 and 2012. However, we continue to press for an earlier introduction.
Assuming that introducing the measure would involve additional costs, may I ask the Minister to use her good offices to remind the major airline companies that they too have a responsibility to the environment, and that passing on any additional costs to the travelling public should not be an option at all, let alone the first option?
I understand my hon. Friend’s point. I know that he has a particular interest in the subject because Glasgow airport is in his constituency. Although other measures, including the offsetting of costs, are part of the mix and need to be considered, emissions trading guarantees a specific outcome in ensuring that an environmental contribution is made. We therefore believe that it is the best way forward.
Justice
The Minister of State was asked—
Prisoners
Commissioners are continuing to strive for improvements in purposeful activity across the prison estate that are achievable with the resources provided.
May I invite the Minister to join me on a visit to Reading prison, where blue-chip private sector companies are running extensive training programmes to guarantee jobs for young offenders when they complete their sentences? The programmes have cut reoffending rates from 70 per cent. to less than 7 per cent., turning lives around. Should the Government not be following that private sector-driven example of best practice, rather than allowing reoffending to cost the taxpayer up to £12 billion a year? Is that not a better idea than letting burglars and drug addicts out of prison early?
The hon. Gentleman will be pleased to learn that I visited Reading jail very recently, and saw the excellent work going on there. As he says, it is important to tackle reoffending and to ensure that as many providers as possible are available, whether they come from the voluntary, the private, or indeed the public sector. I hope he will support the Offender Management Bill, which his party is opposing as it goes through its paces in the House of Lords.
In the context of, in particular, younger prisoners who are restrained from any kind of activity, may I ask what the thinking was behind the Government’s proposal to change the rules on restraint, and whether and when we shall hear a full statement on that important proposal?
I know that my hon. Friend has taken a close interest in this issue. A statement will be made shortly, but I can say now that the purpose of the Secure Training Centre (Amendment) Rules 2007 was to prevent ambiguity. The primary legislation was very clear. We listened to what the coroner had to say to us, and changed the rules accordingly.
Does the Minister agree that one of the major barriers to giving prisoners purposeful activity is the fact that the sentences served are often so short that by the time they have been assessed, there is no point in putting them on a programme? Will he assure us that he will end the Executive early release of prisoners, to ensure that more of them are given the excellent training described by my hon. Friend the Member for Reading, East (Mr. Wilson)?
There is no Executive early release of prisoners. As the hon. Gentleman says, what we must do is cut reoffending, and we can do that by providing the right programmes to tackle it. The Prison Service is doing what it is doing and the probation service is doing whatever it can do, but reoffending rates are still far too high. One way of reducing them is through the Offender Management Bill, which the hon. Gentleman’s party is opposing.
Will the Minister join me in congratulating James Ewers and Pete Middleton, and all who took part in the Jail Guitar Doors campaign concert in Reading on Saturday? It raised more than £2,000 for the drug rehabilitation charity Turning Point, and to purchase musical instruments for some of the inmates of Reading young offenders institution.
I am happy to congratulate those who took part in the event, and wish the organisers well. Turning Point is doing a tremendous job in trying to tackle reoffending, particularly among young people. It is important for us to use every available tool to reach young people through music or the arts to try to stop them from reoffending, and we will continue to do that. I hope the whole House will support the programmes that we want to introduce.
Does the Minister not agree that although work and training, and the drugs-related programmes about which we have heard, are vital to stop criminals from reoffending, with the current overcrowding they are simply not available? If there is no purposeful activity and criminals are let out on to our streets with a “get out of jail free” card, will they not reoffend, committing crime after crime time after time?
Given the Chancellor’s refusal to fund the extra places that everyone knew were necessary for so many years, and given that the Minister of State, Ministry of Justice, the right hon. Member for Delyn (Mr. Hanson), said only the other day that there were no extra funds, did it not take some brass neck for the Chancellor to stand up today and offer money for new places? How much confidence can the public really have that he will keep them safe?
We will take no lessons from the Opposition on prison funding. We have built 20,000 places since 1997, and last year we announced that there would be a further 8,000 places. We must tackle reoffending. We all agree that end-to-end offender management is the way forward, to stop people going into prison so that we do not need so many prison places. Let me ask the hon. Gentleman a question: why does he oppose the Offender Management Bill? We will build more prison places, and the Minister of State, Ministry of Justice, my right hon. Friend the Member for Delyn will make a statement shortly.
Prison Population
The Government recently published prison population projections up to July 2012. They are to be reviewed in August 2007 and are available on the Home Office and Ministry of Justice websites.
Why does the Minister think that the Secretary of State said, when the Ministry of Justice was set up just a few weeks ago, that there would be no further early release schemes? What has gone wrong? What message does this give to those who are fighting crime?
My right hon. Friend the Secretary of State has indicated that there will be no Executive early release schemes, and I shall mention that in my statement. What message on crime does the right hon. Gentleman wish me to give people? When his party was in office, the crime rate doubled, violent crime increased by 170 per cent., the chances of being a victim trebled, convictions fell by a third and police officer numbers were cut. That was the message from his Government. Our Government have a different message.
I know that my right hon. Friend is aware that there are 45 fewer women in prison now than a year ago, but the number has still doubled over the past 10 years. What does he plan to do to bring down the number of women in prison, and does he plan to adopt Baroness Corston’s proposals?
My hon. Friend will know that Baroness Corston produced a report on the female prison population, and we are currently considering it. The Under-Secretary of State for Justice, my hon. and learned Friend the Member for Redcar (Vera Baird), will examine the recommendations, and we warmly welcome them. We want fewer women to be in prison, and I am confident that we will be able to respond to the report positively—by late autumn at the latest, I hope.
I call Elfyn Llwyd.
That’s you!
I am sorry; I thought you had another friend with a Welsh name, Mr. Speaker.
Oh, get on with it!
I will get on with it.
As the Minister will be aware, the prison population has doubled over the past 15 years. Does he believe that it will double again in the next 15 years—and if not, why not?
As the hon. Gentleman knows, I will shortly make a statement on prison population projections and what steps we intend to take. I am confident that we can take a number of measures to protect the public and put serious offenders in jail, and also look at community-based sentences and work with sentencers to ensure that we manage the sentenced population effectively. We will need to build extra prison places, and we have plans to do so. I shall say more about that in my statement. I am confident that we can build extra places, manage the prison population effectively and make sure that we protect the public from serious and dangerous offenders.
When I was first campaigning to enter the House, in the run-up to the 1992 election, our party made a great deal of the fact that the number of prisoners had gone past the 40,000 mark, which at that time was the highest per capita in Europe, with the possible exception of Turkey. It has now gone past the 80,000 mark. Does the Minister attribute that doubling to a heightened level of criminality in the British population, or to a response to evidence showing that prison works—that is unlikely—or, which is more likely, are we pandering to the middle-market tabloids of the Daily Mail and Daily Express variety, and trying to obtain yet more votes from that section of the population?
I must tell my hon. Friend that if we are pandering to the Daily Mail, it is not working. The prison population has certainly risen. Overall, crime is down, convictions are up and the Labour Government are catching more criminals because of the greater numbers of police on the streets. Irrespective of that, I recognise the problems that my hon. Friend identifies. We want there to be better use of community sentences, and stronger community sentences. The Criminal Justice Act 2003 has given 12 orders which I hope will be utilised more effectively over the next three years than they have been, with a great deal of effort, over the past three years. I am confident that we can build extra prison places, manage the prison population in an effective and productive way to prevent reoffending, and build on community sentences to ensure that people do not return to jail or to offending once they have been through the criminal justice system.
I hear what the Minister says, but given that there are now 16,000 extra prisoners in England and Wales why should anybody presume that if Labour were in power for another seven years, there would not be the same rate of increase? What is the answer to the problem that not only do we still have more prisoners per head of population than any other western European country, but we have half as many again as countries of the same size and type—Germany, France and Italy? Are the British more criminal, or has the policy failed?
The hon. Gentleman will know from the statement made on 9 May that I have a great deal of sympathy with some of the points that he makes. We need to look into focusing more on community sentences, on drug treatment and alcohol orders, and on a range of measures such as—dare I say it?—home detention and tagging, because they can help to prevent reoffending as much as prison can. We have a rising prison population, and at 3.30 I shall announce some steps to deal with those matters, but I am confident that community sentences and guidance, and work with sentencers, will be among the key drivers in helping to reduce the prison population in due course.
The Minister was asked a perfectly straight question by my right hon. Friend the Member for Bracknell (Mr. Mackay), and he has yet to answer it. He referred us to his website; I thought that we had questions and answers across the Dispatch Box, not via a website. Is the Minister not answering the question put to him because he knows very well that according to the projected figures, the prison population for the years in question will go way over 100,000 and towards 120,000, and he does not have any plans to cope with that sort of capacity?
I am grateful to the hon. and learned Gentleman for pointing out the content of my website, and I am pleased that he views it. I referred the right hon. Member for Bracknell (Mr. Mackay) to it because it is an important way of looking at the facts and figures that we have. I am happy to provide the hon. and learned Gentleman with figures on these matters. The ones that he mentions are projections, and as I said, we are planning to review those projections in August. I will shortly announce steps to be taken on prison population issues with which I suspect that he, even if not his Front-Bench colleagues such as the right hon. Member for Haltemprice and Howden (David Davis), will have some sympathy. [Interruption.] If the hon. and learned Gentleman would care to contain himself, I will report on these matters at 3.30.
Machinery of Government
Discussions between the judiciary, the Lord Chancellor and officials in the Ministry of Justice are ongoing.
We all know that this dreadful Labour Government have messed up the police service, and now they are about to do the same to the judiciary. Perhaps the Minister will tell the House whether, during those discussions with senior members of the judiciary, she has been able to reassure them that there is no constitutional problem, that their traditional independence will be preserved, and that they will not be compromised in terms of any sentencing?
There will be no messing up of the judiciary. Its independence is in statute passed by this House, under the Constitutional Reform Act 2005, and nothing is going to change that.
Was it not disgraceful that the Lord Chief Justice heard about the Ministry of Justice from the pages of The Daily Telegraph, and does my friend feel at all embarrassed that the judiciary were not properly consulted, as they should have been? Finally, has my friend read the report from the Public Administration—
Order. We will keep it to one supplementary. The hon. Gentleman has had two.
It was a short question, Mr. Speaker.
It was short, but there was more than one supplementary—that is the point that I am trying to make. Try to use good manners; it is important. The hon. Gentleman will learn something after a few years.
As soon as it was a serious proposal to go ahead with the Ministry of Justice, as my hon. Friend will know from looking at the evidence given by the Lord Chancellor to the Constitutional Affairs Select Committee on 22 May, at that point arrangements were made to have a working group of the Lord Chief Justice, at which Department for Constitutional Affairs officials engaged in discussions in preparation for the Ministry of Justice. However, the most important thing is that section 1 of the Courts Act 2003 lays out the Lord Chancellor’s responsibility to ensure that there is an “efficient and effective” courts service, and the Constitutional Reform Act 2005 ensures the independence of the judiciary. Moreover, a concordat sets out the agreement on relationships between Ministers and judges. I am sure that all those things will have the full support of this House.
As there is not even agreement with the judges on interim working arrangements, let alone a long-term solution to what the Lord Chief Justice sees as a serious constitutional problem, is the Minister prepared to allow a situation to continue in which there is a real divide between the judiciary and the Executive, even about the implementation of the concordat in the Act that she has described?
There are interim working arrangements in place. The courts are working and the judges are ensuring that justice is done in the courts. The Lord Chancellor and the Ministry of Justice are ensuring that the court system is operating. Of course there are operational issues that the judiciary raised with the Lord Chancellor’s Department and are now raising with our Department, and those are being considered. I have seen the evidence that was taken by the right hon. Gentleman’s Select Committee, and obviously there will always be discussions between the judiciary and the Ministry of Justice, but I cannot see any point in adding to the situation through hyperbole.
I welcome, of course, the assurances given by the Minister of State about the importance of the independence of the judiciary, and it is, of course, protected by statute. Following the evidence given to the Select Committee, has the Lord Chancellor spoken to the Lord Chief Justice about this issue, because Committee members felt strongly that that personal contact between them would break this logjam?
I can reassure my right hon. Friend and the House that the Lord Chancellor is in weekly, sometimes daily, contact with the Lord Chief Justice. They have regular discussions, and that will continue to be the case.
The Lord Chief Justice and his colleagues also gave evidence to the Select Committee to the effect that if there were to be any meaningful assurance of judicial independence, there should at the very least be a ring-fenced courts budget. Can the Minister and her colleagues assure us that we will have that vital safeguard, as requested by the Lord Chief Justice?
There are two separate issues here. One is the resourcing of the courts budget within the Ministry of Justice. The courts budget is some £1 billion, compared with the legal aid budget of £2 billion, to which is added the prison budget of some £2 billion. Obviously, it is the responsibility of the Lord Chancellor, under section 1 of the Courts Act, to ensure that there is an efficient and effective system to support the carrying out of the business of the courts, and that resources are dedicated to that. As for the independence of the judiciary, that too is enshrined in statute and underpinned by the concordat.
Prisoners
Defining and assessing dependency is not straightforward, and records are not kept on the numbers leaving prison with drug or alcohol dependency. A comprehensive treatment framework is in place to support prisoners with a drug problem, with a range of services available for those with an alcohol problem.
It is a shame that the Government are not able to provide those statistics, because one in five people going into prison have a drug dependency problem. Many of them then have treatment in prison—detox and rehab. They start their treatment regime and then, when they leave prison, they go to the back of the queue and lose out on all the benefits that they might have experienced if they had been able to continue their treatment. If we are to tackle recidivism, is it not important that we ensure continuity of treatment for those people?
My hon. Friend makes an important point, and I appreciate the work that he does in his community to try to tackle drug use. He will know that prisoner health care has been transferred to the national health service through the primary care trusts, and there are now end-to-end programmes for people with drug problems. We have also seen a 997 per cent. increase in spending on drug problems.
May I make a helpful suggestion? Too many prisoners leave prison still addicted to class A drugs, and then reoffend. What about moving prisoners coming to the end of their time in prison into an established residential drug rehab centre for the balance of their sentences? That would save money and be much more effective. It would be cheaper than prison, and cost the country much less in the long term.
Again, I appreciate the work that the hon. Gentleman does in our courts and criminal justice system. It is important that we look at what works. As I said, there has been a 997 per cent. increase in spending on drug treatment. We are trying to find the best way to stop people taking drugs, and we believe that using the NHS is an appropriate way forward. We are also looking at what providers in the voluntary sector can do, and at what is best practice in this area, but I shall be happy to consider the suggestion that the hon. Gentleman has made.
Burial Facilities
We understand the importance that many families attach to having a local cemetery. Our decision to enable the reuse of old burial grounds will provide local authorities with a further option when deciding how best to meet their communities’ needs at an affordable cost.
Does the Minister believe that West Lancashire district council should refund to its council tax payers the increased cost that they incur when burying their loved ones in cemeteries in neighbouring local authority areas? This is a tax on dying. It is being imposed on the council tax payers of West Lancashire with no regard to their ability to pay, while the local authority denies its responsibilities.
I know that my hon. Friend represents the considerable strength of feeling in her constituency of West Lancashire about the fact that local people are unable to bury loved ones in their own area. They have to incur the expense of travel, and are obliged to pay a higher price when they get to a burial ground outside their area. I know that she will continue to put pressure on West Lancashire district council. Under provisions announced in my written statement earlier this month, councils have additional options available to them, but there really is no excuse for not providing the burial services needed by local people.
Prison Population
I wish to repeat a statement made by the Lord Chancellor in another place.
The Ministry of Justice has been in existence for five weeks. I announced on 9 May my Department’s approach to penal policy. I announced that we would continue to protect the public by providing prison places for those whom the courts determine need custody, and that that would include asking the Sentencing Guidelines Council to review its guidance. I also made it clear that we should make best use of the best community sentences where evidence says that they reduce reoffending and offer more effective punishment, and that we would continue to deliver in line with the recommendations of Lord Carter’s 2003 review, including end-to-end offender management and public service reform.
Today, I wish to provide details to the House of how the Government will ensure that all those whom the courts send to prison can be accommodated. I will update the House on the detail of Lord Carter’s inquiry into prisons, announce the building of further custodial places, and set out further measures to improve the functioning of our prisons and to reduce reoffending.
We have made public protection from the most dangerous criminals a priority. We are bringing more offenders to justice than ever before—25 per cent. more than when we came into office. Those who commit violent or sexual offences can now receive an indeterminate prison sentence. The length of time for which criminals are sent to prison has increased, with the average custodial sentence in Crown courts rising by 25 per cent. between 1995-2005. As the House will know, more people are being sent to prison than ever before. That means that, overall, there are 40 per cent. more serious and violent offenders in prison than in 1997. Since 1997, the prison population has increased from 61,467 to 81,016 today, a record high.
Nationally, crime is falling. There are 5.8 million fewer offences than in 1997, but we know we need to go further. We have been working intensively with 44 of our most deprived communities, where crime and disorder are highest, to reduce crime still further. Early indications show that the work is making an impressive impact and crime is falling at twice the rate in those areas than the national average. The Government are determined that the public be protected from dangerous offenders, and that court sentences and other orders be obeyed.
In addition to those measures, we have taken steps to increase the resources spent on community punishments and interventions designed to address the causes of crime among offenders. Tough community sentences have been developed, which have proved more than successful in reducing reoffending. As I announced to the House in May, we shall, therefore, extend and expand such schemes.
We have built more than 20,000 more prison places since 1997, and we have a commitment today to build 8,000 more by 2012. We have increased expenditure on probation by 70 per cent. in real terms over the last 10 years and, as an example of our commitment to addressing the causes of crime, we have increased expenditure on drug treatment programmes in prisons from £7.2 million in 1997 to £79 million in 2007-08.
To help accommodate the current pressures, I can announce today that my right hon. Friend the Chancellor of the Exchequer has made available new money to build an additional 1,500 places over and above the 8,000 already announced. We will be starting work immediately on 500 of those extra places and the first of the additional places will come on stream in January 2008.
As I announced on 9 May 2007, I have asked Lord Carter to look at the future of the estate and we will take decisions on the optimum timing and composition of the further 1,000 places announced today in the light of Lord Carter’s final report. I am today publishing the terms of reference for his review. As the terms of reference make clear, Lord Carter will look at the long-term future of the prison estate and at both the supply and demand of prison places.
Those additional measures will bring on more prison places, which are much needed. Currently, as I mentioned, the prison estate is near to full. To ensure that we can accommodate all those sent to prison by the courts, we will continue to rely on police cells, as a temporary measure, and where necessary court cells. I am personally grateful to chief constables in England and Wales for making police cells available to us where necessary and to the Court Service for more than 100 court cells to date. The use of police cells may be necessary until the end of this year at the latest, pending the increase in capacity from some of the 8,000 prison places coming on stream and then, at the beginning of 2008, from the additional prison places I have announced today.
In addition to increased prison capacity, I have authorised the issuing of guidance to prison governors to allow them to make wider use of the prison rules provisions to authorise release on licence for offenders who are coming to the end of their sentence. [Hon. Members: “Ah.”] The guidance will authorise release on licence, in accordance with existing prison rules, up to 18 days before their release date, for those who have been sentenced to a determinate prison sentence of four years or less. This is a temporary measure.
Let me be clear for all those in the House who are concerned—[Interruption.]
Order. Members must allow the Minister to make his statement; then we shall have questions.
Let me be clear from the outset: release on licence is not the same as Executive release. Releasing people on licence means that their sentence continues. Release on licence will be granted only to those who meet the eligibility criteria set out in the guidance that I will place in the Library of the House today. The criteria specifically exclude offenders convicted of serious sexual or violent crimes, those who have broken the terms of temporary release in the past and foreign national prisoners who would be subject to deportation at the end of their sentence. Release on licence will apply only to those who are not released on home detention curfew and while on licence the offender will remain subject to his sentence and will be liable to recall. The guidance comes into effect on 29 June and I will keep its operation under review.
In addition, yesterday saw the launch of the new bail accommodation and support service, which will enable courts to make greater use of bail in appropriate cases. The accommodation will also be available for prisoners who are eligible for home detention curfew if they have suitable accommodation.
The measures I have announced today are designed to ensure that the Government will be able to accommodate all those the courts send to prison. We will respect and give effect to the orders made by the courts and we will protect the public.
I commend the statement to the House.
I begin by thanking the Minister for showing me his statement—20 minutes ago. Earlier this afternoon during questions, he was given the opportunity to tell us the projected prison population figures until 2014, but he did not—they would not have made good listening.
The Government have done nothing to plan for and provide adequate prison capacity. The Minister re-announces 1,500 new places, continued reliance on police and court cells, early release and greater use of bail. The Government know, on present rates, that there will be well over 100,000 prisoners by 2012. There are no indications that that figure is anything other than on the low side. There is no sign that the Government have done anything constructive—
Order. I say to the hon. and learned Gentleman that he should not be making a statement; he should be questioning the Minister. If he puts his case in the form of questions, it is acceptable to me.
You kindly, but not for the first time, anticipate me, Mr. Speaker. I am just about to ask the question. But let me just set that question in context.
The Minister says that the Government have built 20,000 new places, but several of these new prisons were contracted for prior to 1997, and does he really believe that the 20,000 new places will be sufficient to deal with the crisis of overcrowding? Will the Minister accept, not only that the current problem of prison overcrowding will continue, but that it has been both predictable and predicted by everyone who has thought about the issue for many years? His noble Friend Lord Carter, Anne Owers the prisons inspector, and even my right hon. Friend the shadow Home Secretary and I have warned the Government about this time after time. Did not the Home Office itself predict in 2001 that there would not be enough places for the expected numbers of offenders by the end of this decade?
Is it not clear that the only people who failed to react to what was happening and what was going to happen were the four Labour Home Secretaries and their Ministers, aided and abetted by the current Chancellor of the Exchequer, who on all the evidence, have done next to nothing? Why on earth did the Home Secretary claim last October in the House that my right hon. Friend the shadow Home Secretary
“has been making a dreadful, dreadful fuss because we are a couple of hundred short of maximum capacity”—[Official Report, 9 October 2006; Vol. 450, c. 38.]
instead of getting on with sorting out the mess?
What sort of Government demand that the courts send more offenders to prison, and for longer, but fail to provide the places to put them in? What sort of Government, after 10 years in office, look and sound surprised that the prison population has risen under their watch from under 60,000 to over 81,000, and that offenders are now having to be housed overnight in court cells, and for several nights in police station cells, and even kept in prison vans outside court while they wait for their cases to come on? And, Mr. Speaker, did you not hear this Minister say that he was pleased to announce that he was going to invite the police to do that until the end of the year?
There are prisons that have turned away prisoners because they have no more room. Why, if the Government thought it right to have 20,000 more inmates, did they not plan and build 20,000 more places?
The Home Secretary said last year that he would provide 8,000 more places by 2012. On the Government’s own projections, that will not be enough. But the Chancellor, the next Prime Minister, has not signed the cheque. Where are these places going to be, what will they cost in terms of building and staffing costs and when will they be ready?
To provide temporary accommodation, why have the Government not found the prison ship that they sold at a loss not so long ago? Why have they not made any use of redundant military camps, former secure hospitals and other available accommodation? Why did they not do these things last year or the year before that?
Watching the Government’s handling of this growing crisis has been like watching a train crash. Why have the Government been hapless bystanders and not taken decisive action? Is it because the Chancellor, driven by political rivalry, has refused successive Home Secretaries the resources needed to address the chronic lack of prison spaces? Is not the crisis that we now face a failure of design, for which the Chancellor bears responsibility? We heard today from Manchester that he will ensure extra fast-build prison places to address the problem. But why—if the Labour Chief Whip, the right hon. Member for Redditch (Jacqui Smith), would stop chattering—why, if the resources are available, were they not made available in time to prevent this predictable chaos? How much is the Chancellor providing? How many places will be built, and when will they be available? Are these not likely to be fast-fill prisons that will soon demonstrate the short-term nature of this Government’s approach?
The Government briefed the press this morning that they will release prisoners early. The Minister confirms that. Why then did the Lord Chancellor say quite the opposite over lunchtime on Sky television? The Government did that before, with tragic consequences for far too many innocent victims. In previous years, as they released inmates early from open prisons, they transferred unsuitable offenders from the secure to the open estate. Will the Minister undertake to the House in terms that he will do no such thing again?
We know that the police and the probation service, which are already overstretched, cannot keep their eyes on more released offenders. Every probation officer is already supervising between 20 and 80 offenders. Are not the public entitled to conclude that the Government’s strategic and day-to-day management of our prisons has been not just stupid, reckless and incompetent, but shamefully irresponsible? Do they not see an exhausted Government, who, as a direct result of their failure to plan and act, have increased reoffending, reduced public safety and wasted huge sums of taxpayers’ money? What do the Government offer but yet another review? Are there no limits to the Government’s inadequacies—
Order. I am sorry to interrupt the hon. and learned Gentleman, but I laid down a rule that there would be five minutes for questions and he is reaching six minutes. So, I think we will cut his comments short and let the Minister reply.
I think the Minister has got my point.
I am grateful to the hon. and learned Member for Harborough (Mr. Garnier) for raising some issues. May I put him straight on one thing? He said that I am reannouncing 1,500 prison places, but I am not: I am announcing new money—£80 million—from the Chancellor of the Exchequer for 1,500 prison places. That is over and above the 8,000 places we have already committed to for this period. [Interruption.] The hon. Member for North-East Hertfordshire (Mr. Heald) can chunter all he likes, but that is money that the Government have voted for, raised taxes for and will spend. I challenge him and the hon. and learned Member for Harborough to say where that money would come from in the context of tax cuts for the future.
The hon. and learned Gentleman is quite accurate to say that there are projections that show an increase in the prison population. I accept that. I have already indicated to him in questions that we intend to review the figure in August 2007. We have a building programme for 8,000 places already and 1,500 places have been announced today. We are committed to raising the number of prison places, but we are also committed to things that I know that—deep down, secretly—he supports, such as looking at better community sentences, ensuring that we get people out of prison by reducing reoffending, and looking at people who have under 12 months to serve to see whether we can make sure that they do not reoffend in the future. I know that he believes in that, although the right hon. Member for Haltemprice and Howden (David Davis) takes a different view. I hope that the hon. and learned Member for Harborough will support us, not just in building the necessary prison places now, but in looking at the issues related to preventing reoffending in the long term.
The hon. and learned Gentleman helpfully suggested we consider prison ships or redundant Army camps—as if they were things that the Government had never thought of, examined and tried to do. The issues are difficult. We have looked at the ideas and they are not practicable in the short or long term. What is practicable is building proper prison places, putting in, in effect, extra prison resources, and looking at sentencing and community-based sentences.
The hon. and learned Gentleman mentioned the Lord Chancellor. The Lord Chancellor has ruled out early release; he has ruled out Executive early release. Pressure has been put on us to take that step, but we are not undertaking Executive early release. Early release is letting people out. They are not under licence and we do not have control over them. For a small number of people, we have put in temporary transitional licence arrangements to bring them home in the last few days of their sentences. Those people do not include serious and dangerous offenders. I hope that the hon. and learned Gentleman will support that.
Can the hon. and learned Gentleman recall May 2005, when his party fought an election on a manifesto committed to the James review, which contained £35 billion of spending cuts? That was not a question of resources going to deal with issues in our communities. He needs to remember that.
Given the pressures on the prison population, the measures that my right hon. Friend has announced are clearly a sensible and balanced package, but we need to look at the longer term. He spoke about the 25 per cent. increase in the length of sentences passed by the courts over the last few years—often against the wishes of Home Secretaries and Lord Chief Justices. In many cases, those sentences are for crimes where there is no evidence that the increase produces better public protection or a bigger reduction in offending. What discussions are taking place with the Sentencing Guidelines Council to make sure that judges are using the punishment of imprisonment correctly and, secondly, that we make greater use of restorative justice—
Order. I am sorry to interrupt the right hon. Gentleman, but I have told another hon. Member that one supplementary question is enough.
My right hon. Friend makes several important points. As he will know, my right hon. Friend the Lord Chancellor has already written to the Sentencing Guidelines Council to ask it to examine several matters relating to long-term sentencing. We certainly need to examine how we can mange supply and demand in the longer term through sentencing policy. Such a complicated and difficult issue requires serious consideration. We are willing and able to undertake that with the judiciary in due course.
My right hon. Friend mentioned restorative justice, and the Ministry of Justice has already undertaken several pilot projects. I know from my experience in my previous job in Northern Ireland that that can have a significant impact on reducing reoffending. One of the Ministry of Justice’s purposes is to examine sentencing across the board and the variety of penalties that might arise from other Departments’ legislation. We are acutely aware that extra legislation can often put pressure on prison places. We will continue to look at that and I hope that we are making progress.
I thank the Minister for his statement. He will know that several of his announcements for the future are welcome, but as a new Minister in a newly created Department, does he accept that today’s announcement was the absolutely predictable end to a sorry story of failed policy over the past 10 years, that the situation is an embarrassment to the departing Prime Minister and undermines the criminal justice system, and that the announcement will do nothing of itself to prevent reoffending, or to reduce the number of offenders? Does he accept that each of the four Home Secretaries saw this coming, but clearly did not take adequate action to prevent it?
Does the Minister agree that we need to address now the categories of people who are in prison, but should not be there? Is the number of foreign prisoners going down quickly, either at the end of sentence, or by agreement? Will we have secure places for the mentally ill—not just the 1,500 places that exist in mental hospitals—in which people will be treated for a mental illness instead of being locked up in a prison that does nothing? Will he implement Jean Corston’s proposals on women who do not need to be in prison so that such women can be placed somewhere they can support families and be rehabilitated? Will there be a speedy increase in the number of places for people with drug problems who would do better in secure rehabilitation centres instead of crowding our prisons? Given that we know that the numbers are approaching record levels, will we have from today a change to the crazy policy that has seen prison numbers and reoffending going through the roof and a realisation that unless we bring prison numbers down, rather than building more prisons, we will not be giving the public what they want: less crime and, above all, less reoffending?
I am grateful to the hon. Gentleman, who has a thoughtful approach to such issues. One of the Ministry of Justice’s prime jobs is to try to prevent reoffending. We need to examine several long-term solutions, such as how we can have an impact on drugs and alcohol treatment, how we can work in the community, and how we can invest more in giving additional treatment to people in prison. However, I cannot get away from the fact that the public need to be protected from the growing number of serious and dangerous offenders. We are examining how we can build extra prison places. Our strategy involves building prison places and examining the wider issues of community sentencing and the way in which to prevent reoffending.
There is work to do on foreign national prisoners, whom the hon. Gentleman mentioned. There are still people in prison who need to be deported back to their home countries, or transferred to the immigration estate. The Ministry of Justice needs to work with its colleagues in the Foreign Office and other Departments to make progress because the small yet significant issue needs to be addressed.
The hon. Gentleman mentioned the report by my right hon. Friend Baroness Corston. I said during Justice questions that my right hon. Friend the Lord Chancellor and I welcome the Corston report, which we intend to examine in detail. The Lord Chancellor has tasked the Under-Secretary of State for Justice, my hon. and learned Friend the Member for Redcar (Vera Baird), with looking at the details of the report to determine not how to reject the recommendations, but how and when we can implement them. It is our objective that there should be fewer women in prison. With the benefit of that report, we can achieve that over time, with difficulty, with resources and by examining the prison estate as a whole as part of Lord Carter’s review. I have already said that I expect the Government to respond to that report by late autumn at the latest, and I very much hope that we can do that.
Finally, in the Criminal Justice Act 2003 we put in place drug treatment orders and alcohol orders, which we need to examine more imaginatively and use again in the future.
The only area in which our views do not chime with those of the hon. Gentleman are his views about my right hon. Friends who have previously held positions in the Home Office. They were faced with difficult issues and had to make difficult decisions in respect of not only the prison estate, but terrorism and other matters. They did the best job they could in difficult circumstances. As the Ministry of Justice, we have assessed those issues, targeted a way forward and got the resources from the current Prime Minister and the future Prime Minister to see those proposals through, and I commend them to the House.
My right hon. Friend says that the issue of foreign prisoners is small but significant, but may I suggest that it is quite large? Will he confirm that about one in seven of the prison population is of foreign origin? Cannot more be done to arrange for them to serve their sentences in their countries of origin?
I accept what my hon. Friend says. In answer to the hon. Member for North Southwark and Bermondsey (Simon Hughes), I was referring to foreign prisoners who have served their sentence and are awaiting deportation. There are a small but significant number of those. I fully accept what my hon. Friend says in relation to the number of foreign prisoners in jails in England and Wales. We need to look imaginatively at how we can get those people to serve sentences in their home countries, and we need to take action on that to reduce that number of individuals. I have been in post five weeks. We have looked at a number of key significant issues, and that is one to which we need to return. I am sure that my hon. Friend’s contribution to that debate will be of great help.
As the crisis was both foreseeable and foreseen, can the Minister confirm that each of the past four Home Secretaries to whom he has just paid tribute asked the Chancellor of the Exchequer for the money required to provide the additional prison places that were necessary, but that the Chancellor of the Exchequer turned a deaf ear to those requests and refused to make the money available?
There are continuing demands on public expenditure, as the right hon. and learned Gentleman will recognise. My right hon. Friend the Chancellor of the Exchequer has already committed to a building programme for an additional 8,000 places. He has committed today to a further 1,500 places, 500 by January. We have dramatically increased the resource spent on the probation service. Since the right hon. and learned Gentleman was Home Secretary we have increased the resource spent on drug treatment, alcohol treatment, young people’s offending and other issues in the community. It is brass cheek for the right hon. and learned Gentleman, who went into an election committed to a manifesto to cut spending on the Home Office and put it into education and health through the James review, to come to the House and tell me to spend more money on prisons and prison services. While we are speaking of the right hon. and learned Gentleman, in his last year in office, 1,100 people absconded from prison—
Order. The Minister is in order to speak about the history of a Government Department. He was not in order when he was talking about a manifesto. Does he want to continue?
No, Mr. Speaker.
Will my right hon. Friend go into a little more detail on his comments about extending and expanding tough community sentences and their success in reducing offending?
As my hon. Friend knows, under the 2003 Act there are 12 community-based sentences that we can use, including alcohol treatment, home detention curfews, measures related to drug treatment and other sentences. I need to ensure that we expand the public understanding of the benefit of those schemes. They are tough schemes that prevent reoffending, often much more effectively than does prison. As I am trying to do, I need to visit the probation service, sentencers and the Prison Service and promote the idea that community sentencing has a value. In many cases, particularly for low sentences, it is much better at reducing reoffending and it makes community pay-back visible to people in the community. I want to ensure that we promote the benefits of community sentences both to the offender and to the community, for the simple reason that they prevent reoffending. That means, ultimately, that somebody’s garden shed will not have been broken into; somebody will not have been robbed on the street or mugged; and that some event will not have happened that would have caused crime to rise. I support the general drift of the approach that I think my hon. Friend would wish me to take.
The Minister mentioned this matter in his statement. The hon. Member for Sunderland, South (Mr. Mullin) said that one in seven prisoners were of foreign origin, and it is estimated that up to 25 per cent. of prisoners currently being held should not be there—low-level repeat offenders, people with medical problems, dysfunctional people and people who are not a danger to the community. Will the Minister’s Department undertake an urgent audit to see what kind of numbers can safely be released on to the street?
We are very aware of the foreign prisoner issue, which my hon. Friend the Member for Sunderland, South (Mr. Mullin) mentioned. We have an ongoing review that is trying to get people repatriated to their country of origin. The over-stayers issue is equally important; it is a small but significant issue that I mentioned earlier. I certainly want greater emphasis on the point that the hon. Gentleman has made. We need to look at people on sentences of less than 12 months. Although prison can work, for some people who serve two, four, six, eight or 10 weeks, the level of intervention that can take place in prison cannot particularly help in getting on to the path of reduced reoffending. What we can often do through community sentences is bring people face to face with their crime and its consequences, and give community payback, which is also proved to have greater success in reducing reoffending in due course. I hope that the hon. Gentleman will support us in pursuing those objectives.
Has the Minister had an opportunity to read the written evidence given by no fewer than 43 different organisations to the inquiry of the Select Committee on Home Affairs, entitled “Towards Effective Sentencing”, much of which argued that there is a range of sensible, workable alternatives to prison that will not put the public in danger?
My hon. Friend raises a very important point. I appeared before the Committee—two weeks ago, I think—to give evidence on behalf of the Government, and I am returning at the end of the inquiry to give further evidence. One of the matters on which I gave evidence was the need to put in prison people who are dangerous, violent or sexual offenders, so that the public can be protected from them. Equally, I emphasised the need for an examination of strong community sentences. We already have in place a very large number of community sentences. I think that we should increase that number if we possibly can and encourage sentencers to do so, not because such sentences reduce the prison population, although being honest, they do, but because they reduce reoffending, which is the most important consideration in bringing forward those ideas.
The Prison Service is full of young men, three quarters of whom have serious alcohol and drug addiction problems; about 60 per cent. of whom come from broken homes; and many of whom have the reading age and numeracy age of a child of 11. What this is really all about is the fact that the Government have known all along that that pool of people has been getting bigger and bigger, and it is therefore no surprise that the prison population has been rocketing, because the Government have done nothing about mending that.
I respect the right hon. Gentleman very much, and I respect his contribution to the debate on tackling some of the causes of crime, such as poverty, social exclusion and dysfunctionality, which very often are contributors to crime issues, but I have to say that I disagree as to how we should approach the matter. I happen to believe that public investment in tackling some of those issues is key and should be increased and looked at in the round. I happen to believe—we can debate this to the ninth degree—that ultimately the Conservative party will continue to reduce public expenditure, which will have a knock-on effect in dealing with some of those issues and in tackling crime.
I understand where the right hon. Gentleman is coming from. He and I know that we need to tackle dysfunctionality, social exclusion and long-term drug issues in particular. We can do that outside the criminal justice system in social policy, and we can do it, in my view effectively, in the criminal justice system through prison. Particularly, we can do it through some of the 2003 criminal justice orders, which will help in the community.
With prisons bursting at the seams and a new Department in charge, this is a watershed at which certain fundamental principles can be re-evaluated. Will the Minister say whether he intends to examine the key performance indicators within which the Prison Service is required to operate, because in the past organisations such as the Prison Reform Trust have criticised the KPIs, arguing that they do not measure whether the needs of the prison population are being met in respect of the distance that prisoners are kept from home and time spent out of cells? Will he revisit that matter, which will respond to sensitive involvement by the new ministerial team?
As my hon. Friend will know, I have been in post for five weeks. I need to examine a number of issues with the Under-Secretary of State for Justice, my hon. Friend the Member for Bradford, South (Mr. Sutcliffe), who has done a good job in the past year. We will examine the performance of the Prison Service with Phil Wheatley and the Prison Service and the National Offender Management Service. The Prison Service is doing a good job of meeting the objectives set by the key performance indicators. We need to keep the matter under review, and I will certainly consider some of the issues that my hon. Friend has mentioned.
Does the Minister accept that in the past 10 years four Home Secretaries have responded to media pressure by taking away discretion on sentencing from the courts and putting them under pressure, which has dramatically increased the prison population to almost double what it was when I was Home Secretary, without paying the slightest heed to the inevitable moment when they would hit the buffers and there was no accommodation? Although I do not know what the new Ministry of Justice is for, except perhaps to make the Minister an innocent victim—he has made a statement about a fiasco for which he is plainly not responsible—will the new Department produce a change of culture in which the platitudes about community sentences and making prison only for those who need it are turned into reality by returning proper discretion to the courts and ensuring that prisons are used only for violent, dangerous and recidivist criminals in conditions in which there is some hope that some of them will be rehabilitated?
I am grateful for the right hon. and learned Gentleman’s concern for my innocent victimhood. I do not regard those ideas as platitudes. I believe in community sentencing and considering how we can prevent reoffending in the long term. We are doing a considerable amount of work and putting extra resources into drug treatment orders, which is much more than what happened when the right hon. and learned Gentleman was in office. There is a big problem with drugs in the United Kingdom today, and we need to examine imaginative ways to deal with it. Drug treatment orders are important.
We are doing a great deal of work on the type of person who is likely to become an offender. When people enter the criminal justice system, they have often gone too far down the line to get them out of it. Perhaps we can achieve a cross-party consensus on some of those issues, and I hope that the right hon. and learned Gentleman uses his influence on the liberal tendency in his party to make that happen. We can make a difference, and I hope that we will.
As one who does not read the Daily Mail and who views the prospect of 100,000 of my fellow citizens being incarcerated more as a source of national regret than a symbol of political virility, may I compliment my right hon. Friend on having discussed the alternatives? May I draw his attention to the problem of secure accommodation and bail hostels, particularly in west London, where there are no vacant places today. I appreciate that the Minister launched a programme yesterday, but what hope can he give to those justices of the peace who want to place people in bail hostels but who are unable to do so?
My hon. Friend has raised an important point. As he has mentioned, yesterday the Under-Secretary of State for Justice, my hon. Friend the Member for Bradford, South, announced an increase in the number of bail hostels in the course of this year. The bail hostel places programme will provide approximately 1,000 extra places in the course of this year, and I hope that we can examine the pressures in areas such as west London and make that figure a reality. Those 1,000 places are not cheap, and they are paid for through taxation. We make that our priority; other parties may not.
Is the Minister aware of the contribution to prison overcrowding made by the growing length of time spent in prison by unconvicted remand prisoners? In particular, there has been a big growth in the population of young offenders institutions since 2001. The issue is not more prison places, but more efficient courts.
There is a range of issues. I accept that many people are held on remand, in some cases for very long periods. Again, I cannot generalise. Some people are held on remand because they may ultimately be convicted of serious violent and sexual offences, and the public need that element of protection during the course of the trial process, which can be very long. I hope that in many cases the Ministry of Justice can serve an important function in considering the criminal justice system in terms of the supply side of prisons and community sentences, and in the efficient management of the Courts Service, so that we help to reduce some of the delays that mean that people spend a long time on remand before their conviction or acquittal.
Last week, my constituent, Kenneth Milburn of Enderby, was jailed for five years for illegal possession of handguns. The judge said that the crime did not merit a jail sentence and that he jailed him with “great sadness”. That was the result of poor legislation passed by this House. Mr. Milburn threatened or harmed nobody, and he is unlikely to reoffend. Will the Minister look at that case so that perhaps we can free up a place in prison for a burglar and let out Mr. Milburn, who is unlikely to harm anybody, and who is deaf, 63 and in ill health?
I hope that the hon. Gentleman will accept that I am unable to comment on individual cases that he may bring up. I do not know the details of the case or the circumstances in which the judge considered it. However, the gun legislation is in place for a positive reason—to help to reduce gun crime and its impact. If the hon. Gentleman wishes to write to me with the details of the case, I will look at them and respond as positively as I can.
Does the Minister agree with staff at Dorchester prison, which I recently visited, whose assessment is that one of the main points of entry into prisons of illegal drugs and other contraband is through abuse of the release on licence system? In effect, what happens is that somebody who is released on licence loads themselves up with drugs in every available orifice, commits another offence, and then goes back into the prison having been used as a camel so that the drug material gets in there. I was told that that is the main means by which drugs are now getting into Dorchester prison. In that case, why is the Minister extending the system?
I accept the hon. Gentleman’s point. We need to tackle drug trafficking into prisons, perhaps through a range of measures given the variety of means whereby those drugs get in. Under the current system, 405,259 releases on temporary licence took place in 2005, of which only 339 are failures. The modest extension of the scheme that I announced today will involve about 1,400 individuals. I take the hon. Gentleman’s point very seriously. We need to tackle drugs in prison, and there is a range of ways in which we can undertake that. The Under-Secretary, my hon. Friend the Member for Bradford, South, is working hard with the Prison Service to do so. If the hon. Gentleman wishes me to, I will certainly look at some of the evidence regarding the prison in his constituency.
Given that more than 60 per cent. of the 12,000-plus people in our young offenders institutions suffer from speech, language and communication problems that prevent them from accessing education courses, and that the reoffending rate in that category is approximately 80 per cent., will the Minister display real courage and vision in agreeing that every such institution in the country should employ a speech and language therapist so that we can tackle the problem whereby people go into and come out of prison uncommunicative, uneducated, untrained, unqualified, unreformed and unemployed?
The hon. Gentleman makes an exceptional point. A large element among the people who are in prison today face the problems that he mentions. Through his all-party group on speech and language difficulties, he is doing significant work to raise those issues in Parliament. My hon. Friend the Under-Secretary and I have given him a commitment to consider the matter in detail. It is important that we raise the basic literacy and numeracy levels of people entering prison. We need to create, as I hope we will, greater employability for them on their release, because employability, confidence, literacy and numeracy are the keys to preventing reoffending.
Is this not yet one more blow to honesty in sentencing—the relationship between the nominal sentence and the time spent in prison? For example, how long will someone who receives a sentence of six months’ imprisonment spend in prison if they are released either under the provisions that the Minister announced or home detention curfew?
Again, I cannot go into the details. The reply depends on many factors, including a risk assessment that the prison governor undertakes and the crime that the individual committed. The statement made it clear that serious and dangerous offenders and a range of others will not qualify for any scheme. We will ensure that, when possible, individuals who are reaching the end of their sentence and can return home earlier under licence can also, if recalled in the event of any breaches, be helped to reintegrate into the community at the end of their sentence to help with some of the pressures that we face in the Prison Service and that they face in their daily lives. I cannot comment on the particulars but, if the hon. Gentleman examines the scheme in detail, he will realise that it is effective, operates already and will not pose the danger to the public that many people believe.
Iran (Detention of Naval Personnel)
On 16 April I announced that the Chief of the Defence Staff had appointed Lieutenant-General Sir Rob Fulton of the Royal Marines, currently the Governor and Commander-in-Chief of Gibraltar, to lead an inquiry into the operational circumstances surrounding the seizure of 15 of our personnel on 23 March. I also announced an independent review of the media handling of the incident and its aftermath, and subsequently confirmed that it would be led by Mr. Tony Hall, chief executive of the Royal Opera house and formerly the BBC’s director of news and current affairs. I am grateful to General Fulton and Tony Hall, who have both completed their respective reports to tight deadlines with all the professionalism and candour that was expected of them. I am now informing the House of their findings, as I undertook to do.
I begin by stressing that the two reports are very different in nature and therefore require different handling. Mr. Hall’s review is a public document, which is today placed in the Library of the House and published on the MOD website. As I made clear in April, General Fulton’s report is classified, because it addresses operational and tactical issues, which cannot be discussed in public without increasing the risks to our forces. Nevertheless, those events and the issues that they raise are legitimate subjects of parliamentary and public concern. To balance those factors, I decided that I would give a broad outline of General Fulton’s findings to the House, but that the full report would be given to the Defence Committee. That has been done; I leave it to the Chairman and members of that Committee to comment today as they see fit.
General Fulton highlights the complex and dynamic nature of the northern Gulf as an operating environment. We are there as part of a coalition maritime force carrying out a variety of demanding tasks against a backdrop of wider and rapidly evolving international issues. His report is impressively thorough. It has looked at every aspect of the incident, and others that may hold valuable lessons. To complete the report, he has carried out lengthy interviews with all the people involved and at every level of the chain of command.
Hon. Members urged that specific matters should be considered, and I would like to tackle some of those points to the extent that I can do that, consistent with the constraints of operational security that I mentioned.
First, General Fulton considered the events on the Shatt al-Arab waterway in June 2004. He concluded that, although there were some broad similarities in the circumstances, the events were different, and that the requisite lessons of the time were learned and applied. Secondly, he considered the rules of engagement and confirmed that they were entirely appropriate for the task and remain so today. Thirdly, his report is clear that the event was not the result of equipment or resource issues, including helicopter availability, the size and suitability of the Cornwall or the size and armament of the boarding party’s boats. The coalition force commander in the Gulf has reiterated that he is content with the capabilities deployed by the UK but, as ever, we keep that under review. Finally, General Fulton confirmed that the presence of the BBC on HMS Cornwall was not a factor in any of the operational decisions taken on 23 March.
General Fulton has, however, identified some shortcomings. This was a coalition operation—hon. Members will not need me to spell out the merits of that—but clearly there is a cost in terms of added complexity. Despite that, it is vital that the procedures that we all share can adapt rapidly to change in such a complex strategic environment. General Fulton’s report has identified some faults in that respect, and we are addressing them with our coalition partners.
General Fulton has also identified some specific national shortcomings. The central lesson is that we must improve our ability to identify and assess the risks that this complex environment generates, and to train and posture our forces accordingly. He noted the need for improvements in a range of areas: in the handling of intelligence, in communications, in doctrine and in training—both individual and collective.
On training in particular General Fulton notes—and this is worth repeating—that the Royal Navy’s generic training for operations remains world class. By the time a Royal Navy ship deploys on operations, it is well prepared for a wide range of potential roles. However, the report does identify a need to improve some training specific to particular tasks, including boarding. Furthermore, it recommends that in future we deploy specialist rather than composite teams for boarding operations—a recommendation that we have already acted on. General Fulton also recommends that we ensure that we learn quickly from the experience of other nations operating in the area and get better at sharing information with them.
Above all, General Fulton’s report concludes that the events of 23 March were not the result of a single gross failing or individual human error, but of the coming together of a series of vulnerabilities, many relatively small when viewed in isolation, which together placed our personnel in a position that could be exploited by Iran. His conclusions suggest that there is no case for disciplinary action against any of the individuals involved—[Interruption.]—but his report emphasises that many of those individuals could have done more to prevent what happened. In that respect, it identifies some failings, both collective and individual, which the Royal Navy’s chain of command will consider and deal with.
General Fulton recommends a range of actions to address the shortcomings that he has identified. An action plan has been drawn up and a number of measures have already been taken, allowing us to recommence boarding operations in April, and further measures are under way. The Select Committee on Defence has been briefed on the action plan, but as I indicated at the start, there is a limit to how much I can say to the House. I can say that I, together with the chiefs of staff, are content that General Fulton’s report and the resulting action plan will ensure that our people are properly prepared for future operations.
I turn to the Hall review, and let me say at the outset that we accept all of its recommendations. In my statement to the House on 16 April, I made it clear that the intention of the review was not to embark on a witch hunt focused on apportioning blame for the decision to allow media payments to the returning detainees. Like the Fulton report, the Hall review confirms that it would be wrong and counter-productive to focus on finding individuals to blame for these events. What was needed was a calm and dispassionate assessment of what happened in order to learn the lessons and to improve the ability of the MOD and the services to handle similar events in future.
Tony Hall makes it plain that on the question of whether payment should have been made for individual stories, there was a
“collective failure of judgement or an abstention of judgement”
within the department allowing that to happen. In my earlier statement to Parliament, I accepted that failing as my responsibility and apologised to the House.
I welcome the report’s clear recommendation that media payments to serving military or civilian personnel for talking about their work should simply not be allowed. That confirms my announcement on 9 April of an interim ban on acceptance of media payments. Work is now under way to make detailed amendments to service and MOD regulations and guidance to reflect that conclusion. The report further identifies that work is needed to establish a clearer policy on the naming of individuals and their families in such cases. That work, too, is already under way.
The report also identifies some broader themes. Perhaps most crucial is the huge change over the past 25 years in the context in which media coverage of operations takes place. Media access has increased significantly and the agenda has changed. The focus on the individual, for example, inevitably clashes with the service ethos of group first, and the desire to present instantaneous news from the heart of the action can conflict with the need for operational security. That means that, although it is clearly in the interests of the MOD and the media to co-operate, tensions exist. We need to manage those tensions better, and we need to rebuild confidence between the MOD and the media. The report also makes it clear that we need to help the media to develop a better understanding of defence issues so that they can be set in context.
The report recommends that, for the future, the lead for the media handling of such episodes should lie clearly with the MOD, rather than with a front-line command or a single service. It also recommends some strengthening of what the report notes is a relatively small central press office. The report also makes clear a number of recommendations on the need for clearer decision-making processes. I accept those entirely. Unequivocal understanding of who should sanction what is essential. The recent capability review, published in March, also highlights that, and in response we have already been looking at how we can clarify responsibilities and improve accountability within the Department.
I hope that it is clear that we have sought, wherever possible, to learn the lessons from this difficult episode, both operationally and in terms of media handling, and to be open and accountable in so doing. We have had two reviews: one independently led, and today put into the public domain; the second, of necessity, classified, but shared with the Defence Committee to ensure proper parliamentary accountability. Both are very thorough and professional. Both offer clear, detailed recommendations, all of which we accept, and many of which are already well in hand. Both are focused on the future, determined to help ensure that we do not make these mistakes again. The Chief of the Defence Staff and my permanent secretary will take the lead in implementing the recommendations. I expect the great majority to be implemented by the end of this year, and many of them sooner than that.
I will end by saying that I know that we have the best armed forces in the world. They are respected everywhere for their bravery, their professionalism and their ability to get results. Some have argued that this incident has dented their hard-won reputation, but I do not believe that to be true. Their reputation is more durable than that. These reports will help us to maintain and enhance that reputation, and I intend to ensure that we succeed.
I am grateful to the Secretary of State for his statement. He will be aware that I returned from the Falklands with the Minister of State, the right hon. Member for East Kilbride, Strathaven and Lesmahagow (Mr. Ingram), at lunchtime, and that I have therefore been unable to see a copy of the report or to have a full briefing on it. I am grateful to the Minister of State, however, for his oral briefing in the middle of last night somewhere over the Atlantic. If I stray into operational elements covered in the report, I hope that the Secretary of State will understand that that is utterly unintentional.
The seizure of our naval personnel caused great anger across the country, not least because of their subsequent treatment at the hands of the Iranians. We are not seeking to name scapegoats today, however; that would be in no one’s interests, least of all those of our forces on deployment. However, the House must know that Ministers have asked all the relevant questions and that all remedies have been undertaken to minimise the risk of such an event happening again. It is also important to avoid giving the impression that no one is to blame for what was a national embarrassment. I am sure that the Select Committee will want to consider the report in great detail in the months ahead. Over the past few days, I have had the chance to speak to a large number of Royal Navy personnel, many of whose views concurred closely with those expressed in the Fulton report.
I would like to raise a number of specific issues with the Secretary of State. It is clear that the frequency of successful and unresisted boardings produced a diminished sense of danger, so that the equipment used on the occasion that we are discussing was deemed suitable. Is he satisfied that, in an increased state of alert, we have sufficient alternative and additional equipment available? Is he convinced that the helicopter cover is now sufficient, both in platform numbers and hours allocated, for the task of boarding? On intelligence, is he satisfied that information from UK and other sources is sufficient to warn of an increased risk of attack, above and beyond a necessarily high base line, given the approach and activities of the Revolutionary Guard? He also mentioned training. Will he tell the House more about where in naval training the failures have occurred? We are pleased that, in future, specialist teams will be used for boarding. It is, after all, dangerous work, not work experience.
There is an issue that I think the whole House needs to discuss, that of embedded media. Can the Secretary of State tell us, as a matter of fact, whether the BBC crew was still on board HMS Cornwall when the seizure took place? The authors of the report clearly do not believe that the presence or otherwise of BBC personnel was a factor in our operational decisions, but what about the other side? What about the Iranians? Does not the presence of live television crews in a place where we know the Iranians are constantly considering attacks provide a potential incentive for them in the knowledge that they have a ready media audience in attendance? Does that not deserve far more attention in the future?
The whole report is scathing about the Government’s approach to media handling. The Ministry of Defence did not take control, therefore the media set the agenda. It would have been sensible to involve the Press Complaints Commission, but the Government refused the offer. There was a collective failure of judgment. Many people could have said no to the sale of individual stories, but no one did so. Ultimately, that is the Secretary of State’s job.
One final issue needs to be raised—Labour’s handling of MOD press since 1997. There are 229 people in the Government’s communications department at the MOD. This Government abolished uniformed single-service press officers in their attempt to control and politicise MOD press, and it is clear that they could not even do that competently. The Conservatives believe that the abolition of uniformed single-service press officers was a mistake, and an incoming Conservative Government will reverse it.
As I have said, I believe that the Government’s handling of the whole crisis, especially the media aspect, made a national embarrassment incomparably worse. The Secretary of State has already apologised to the House for his role in the media handling, and naturally the House accepts that; but the whole House will expect it not to be repeated. Our forces are the best in the world, and they certainly deserve better.
I think that I can deal with all the points raised by the hon. Gentleman. I do not think that any of them transgressed the border between what we can discuss in the House and what cannot be discussed for reasons of operational security.
Let me say at the outset that mistakes were made—of that there is no doubt—and I have accepted full responsibility. There are matters that must be put right, which is why I was determined that we would conduct the two reviews whose results I have announced today. I asked for the faults to be exposed and for recommendations to be made on how they could be corrected, and I believe that both General Fulton and Tony Hall have done that for us. I intend to see this through, and will see through the operational side with the supervision of the Select Committee.
The hon. Gentleman raised the issue of resources. That was addressed in the report. As I said in my statement, the report makes it clear that the incident did not result from equipment or resource issues. Indeed, the coalition maritime commander has explicitly said he is content that he has the resources required for the tasks that he is given; but, as ever, we keep resources under review. I have said many times that we will always seek to give commanders the resources they need for the job that we ask of them, and we will keep those resources under consideration as part of our continuing review.
There has been a great deal of speculation about helicopters, but the bottom line is that if the helicopter had been asked to stay at the scene, it could have done so. There is sufficient helicopter support for these operations. That issue, however, comes within the broader continuing review of resources.
Was there an intelligence failure? General Fulton’s inquiry centred on exactly that sort of question. Clearly, any failings in this regard would be operationally sensitive, but I can tell the House that there were shortcomings, which will be addressed through a plan overseen by the chiefs of staff. The Select Committee has been briefed in detail, and I do not intend to go into any further details.
The generic training given to the Navy through FOST—flag officer sea training—was considered to be world class against the test of the review, but a shortcoming was identified in relation to the need to train for specific tasks, particularly boarding. That is exactly what has been addressed, as well as the issue of there being specifically nominated boarding parties instead of the way in which they were previously put together.
The BBC was present on HMS Cornwall at the time. General Fulton’s reputation goes before him, and I am sure that all who know him know that he has done a thorough and professional job. He has come to the view that the BBC’s presence had no operational effect.
I shall now turn to the Hall report and the media—
Intelligence?
The hon. Gentleman asks about intelligence; I have already addressed that issue. There were shortcomings in respect of intelligence, which have been dealt with, but I shall not go into the detail of them in public for obvious reasons.
I realise that my reply is lengthy, but a series of questions were asked to which I should respond. At the heart of the Hall report is the judgment that the MOD, as opposed to the single service, should have taken responsibility for the media and for the media handling of the captives when they were returned. I accept that recommendation and that analysis. However, although that judgment is correct, it does have the benefit of hindsight. It was the view of those planning to receive the released captives that they should be received back into a military environment. The same analysis informs a lot of calls for us to receive injured servicemen back into a military environment, in order to enable them to recover from the trauma that they have been through. The view was taken, which I agreed with at the time, that it was right to bring these people back into a service environment. However, as the Hall report makes clear, there was at the time a media storm, and the level of media demand outstripped the ability of that environment to cope. I accept that, and I also accept that we need to make sure that that never happens again.
An offer from the PCC came on the day of the captives’ release. The Hall report recommends that there should be engagement with the PCC in developing the ability of our media shielders to support people through the early stages of such a process. I also accept that recommendation. It is entirely different from what was offered to the MOD, and which it did not respond to. The Hall report does not conclude that single-service press officers should be reinstated, but it does say that there should be more engagement of a higher level of military personnel in the MOD press centre and the communications operation. We will act on that recommendation.
I am grateful to the Secretary of State for his statement and for his briefing to colleagues last night. We should also be grateful to Tony Hall for giving us this report on the media handling. However, I still hold the view that I have held throughout: the media handling is something of a red herring.
The Secretary of State has taken responsibility, which is right because permission for the revelations could only have been given by him or in his name. I simply seek a reassurance from him that among the lessons that are learned will not be a temptation to gag military officers from talking to the press in the course of their ordinary duties. Some of them have intimated to me that they occasionally feel that that is the case.
The Secretary of State has told us that the Fulton inquiry was thorough; I have no reason to doubt that, and I entirely understand why it cannot be published. However, there are a number of unanswered questions. We gather from the statement that there was not a problem to do with equipment or lack of helicopters, that there was not a major intelligence failure and that there was not any particular serious error anywhere in the line of command. In that case, what exactly did go wrong? Did the Royal Navy simply fail to comprehend the level of threat that the Iranians posed? If so, that was in stark contrast to our land forces in Basra and on the border, who understood only too well what the threat was—and, indeed, that has been discussed many times in this House.
The Secretary of State says that lessons must be learned quickly from the experiences of our partners. Do the other nations involved in this work use constant air cover? It remains to me unfathomable that these dangerous operations could be taking place in contested waterways without a greater degree of air cover than seemed to be available within the coalition at the time.
This report seems to conclude that everyone was to blame a bit but no one was to blame a lot. Mercifully, this turned out in the end only to be a national embarrassment; it could have been a complete disaster. Who exactly will step up to the plate and accept responsibility for what happened?
I will step up to that plate, and have done. I take responsibility for what happened—that is my job and my responsibility. I do not think that we will serve any purpose by seeking to identify other individuals to blame, when a perfectly professional report, carried out by a man of integrity, has said that this set of circumstances came about because of a combination of factors.
The hon. Gentleman is absolutely right to say that the situation could have been much worse, but the fact is that it did not develop into something much worse. There is some credit to be given to those who secured the return of these 15 young people much more quickly than many informed commentators said could be done, in a situation in which the Iranians did not get the public apology that they so craved for their own propaganda purposes, and in which their own behaviour and illegal activities, exposed across the region, diminished their standing in the region among those countries whom they most tried to impress by these actions.
The hon. Gentleman asked a number of questions that I will seek to answer quickly. It is not our intention to gag the armed forces; however, they are in a difficult position. We need to find a balance between openness and risk to security. The overriding ethos of the services is the putting of the interests of the whole above those of the individual. Every single individual in the services who seeks to engage with the media takes on that challenge, which is why there is a clear and unequivocal rule that if a member of the services wishes to engage with the media, he or she requires permission so to do. Some are barred by contract from so doing, as the report reveals. This is all very sensible, but a significant degree of communication goes on between members of the armed services, the media and the public. We are not going to move back from that openness, but we will have to manage it against the various challenges, particularly those to security.
On air cover, I cannot give the hon. Gentleman details on the operating procedures of every country that operates in the Gulf, but I can tell him that they do not always board with air cover. It largely depends on where they are in the operational area, and I am not going to go into the details of that.
rose—
Order. Because of timetabled business that will follow, may I please ask that Back Benchers now ask just a single question? A brief response from the Secretary of State might ensure that more Members are called.
I thank my right hon. Friend for setting out the report before us today. As a member of the Defence Select Committee, I concur with the view that it is a thorough and professional report, to which is attached an action plan. Can he tell the House whether and how he will report on the fulfilling of the important milestones attached to that report?
I thank my hon. Friend, who is in a privileged position in the House in having had access to the Fulton report, and the other members of her Committee for taking on the responsibility of being the arm of parliamentary accountability in this unique process—unique, at least, in my experience. Exactly how we will proceed from where we are to the point of completion, at which we can draw a line underneath this issue, will be a matter for discussion between me, as the Secretary of State, and her Select Committee. However, I fully expect that the Committee will continue to play a role in ensuring that we see through the action plan that we have shared with it.
I am particularly grateful to the Secretary of State for giving me advance sight of the statement, and the Defence Committee is grateful to him for showing us in confidence the full report by General Fulton. We will need to consider that report and the Secretary of State’s statement today very carefully indeed. If we are to be able to assure the House that the lessons learned from this incident have been fully implemented, it places a great responsibility on us and on the Government. Will the Secretary of State, on behalf of the Ministry of Defence and of the Government, pledge to work with us and to give us—in confidence if need be—all the material that, in our judgment, we shall need in order to be able to give the House that assurance?
I am grateful to the right hon. Gentleman and to his Committee for taking on that onerous task, and I recognise that there will need to be a continuing relationship. He and his Committee know that where I can share information with the Committee across the range of my responsibilities, I have done so. They have always respected the confidence that the Department and I have placed in them and I welcome that relationship. I will have to consider the very specific question that the right hon. Gentleman has asked me, just as he will have to consider the terms of my statement and the report before deciding further. However, he may rest assured that that would be my aim, and if it is possible for me to do that while at the same time preserving the security of those on operations, I will see it through.
I have no doubt that the media handling of this matter was a failure and an embarrassment, but it is of secondary importance to the operational effectiveness of our forces and the security of our serving men and women in the Gulf. I welcome my right hon. Friend’s decision to share the Fulton report with the Defence Committee. There has been much speculation that there were two areas of failure, with first, the lack of appreciation of the threat that the Iranians posed and, secondly, a failure of communications. My right hon. Friend alluded to both in his statement. Can he assure the House that the lessons learned from this will be part of the training regime for all those who are now to be deployed in the Gulf?
I can give my right hon. Friend an unequivocal assurance on that point, and I thank him for his support.
Is the Secretary of State aware that the armed forces personnel clearly needed training and instruction that they did not have, and that the rules of engagement were clearly wrong? Is he aware that this feeble and evasive statement cannot be the end of the matter? I, for one, as a former Chairman of the Committee that considered what became the Armed Forces Act 2006 and a member of the Defence Committee, prefer not to be excluded from consideration of this issue and intend to find ways to pursue the matter elsewhere.
I of course respect the hon. Gentleman’s position as a Member of this House. In handling this report in this way, I sought to square the issue of confidentiality and the secrecy that was necessary to protect operational security with parliamentary accountability, but I recognise that I do not have the last word in relation to that. I agree with the hon. Gentleman about training, but I fundamentally disagree with him about the rules of engagement. The Fulton report contains no criticism of the rules of engagement, nor does it suggest that they were inappropriate for the operation that was being carried out. In fact, it says the contrary.
I believe that it is important to remind people that nobody died and that 15 young people came back alive. The Secretary of State has acknowledged, as he has on previous occasions, that there were mistakes and shortcomings. Surely what we need now is to draw a line under this and to implement the recommendations. Can my right hon. Friend refute the suggestion, made by an Opposition Member from a sedentary position, that we have a Mickey Mouse navy? We have nothing of the sort and that view is not shared on this side of the House.
I have no hesitation in accepting my right hon. Friend’s invitation to confirm the view—which almost every hon. Member and many across the world share—that the Royal Navy rightly enjoys a world class reputation. No matter how much damage anybody thinks that this one incident has done, I do not think they believe that it has changed that reputation.
The Secretary of State must agree that this incident was a very serious operational failure indeed. If the captain of one of Her Majesty’s ships were to run it aground on a sand bank, he would be arraigned before a court martial. It seems astonishing to me that the right hon. Gentleman can come to the House with a report by General Fulton—which clearly has been staffed to death by the Royal Navy—and say that the affair is over and that we should draw a line under it. Does he accept that that shows a woeful and shameful lack of leadership and grip on his part and on the part of his Department? Will he tell the CDS that he has better things to do than take part in ill judged public relations stunts that involved welcoming back from the disaster a crew who should have spent two days at home and then been sent straight back to their ships?
I have no doubt that the hon. Gentleman’s words will be heard by the CDS and others, and no doubt either that his plan is that they should be. I have complete faith in General Fulton’s integrity—
So do we.
With respect to the hon. Gentleman, it did not sound like it. I have complete faith in General Fulton’s integrity. He prepared and owns the report, and no one else sought to influence or shape it. It comes to the honest conclusion that a combination of factors led to the unfortunate and terrible circumstances of an event that I accept ought to have been avoided. We should look forward to make sure that it never happens again, but the House must accept that, for decades and generations, we have been asking young people to do very dangerous things in very dangerous and difficult circumstances, and that sometimes things go wrong.
The families of the hostages from Plymouth were very appreciative of the welfare and emotional support that they received during the crisis, but there was a view that the people offering that support did not have the necessary media training. If a similar event were to happen, will my right hon. Friend ensure that family members and others are shielded from the media by people who understand the media? My constituents are also grateful for the offer from the PCC.
We will consider the PCC training recommendation with a view to acting on it, but I know from the reports about the families that have come back to me how grateful they were for the support that they received during the crisis. When their family members were returned, many said unequivocally that they had been well supported by the generic help that the MOD had been able to offer in facilitating help from the services. The report reveals that, when it came to helping the families, we sought to have in place an officer representing the service and a person acting as a media shield. It may be that both should operate in the same chain of command, and be given support with their media skills. That seems to be the recommendation made by Hall, and I intend to see it through.
When I used to serve, a long time ago, the operational chain of command was always clear. I hope that it is still clear now, as it meant that people in command took responsibility when something went wrong. With respect to the Secretary of State, I maintain that we cannot move on until the people who made the mistakes in this instance are seen to take responsibility for them. I urge the right hon. Gentleman not to pretend that he can defend them. The people in the operational chain of command know what they were up against. If they have failed, they should take the responsibility for doing so.
Those in the operational chain of command know their responsibilities, but I am sure that they will take on board the rehearsal of those responsibilities by the right hon. Gentleman.
My right hon. Friend has made a calm, dignified and comprehensive statement to the House. Rightly, it was apologetic in parts, and I think that all reasonable people will thank him for that. However, when the smoke has cleared and we have moved on from issues to do with matelots and iPods, some questions will remain. Is my right hon. Friend entirely convinced in his own mind that the information that we had at the time about the map co-ordinates was correct, and that the Coventry’s landing craft were not operating in Iranian waters?
It was HMS Cornwall.
Cornwall—I beg the House’s pardon.
I thank my hon. Friend for his support. There is no doubt that HMS Cornwall was operating in Iraqi waters and that the incident itself took place in Iraqi waters. Indeed, people will recollect that in the early days the Iranians provided us with a set of co-ordinates, and asserted that was where the event took place, but when we told them the co-ordinates were in Iraqi waters they changed that set and found one in their own waters. I do not think that even they sustain the position that the incident took place anywhere other than in Iraqi waters.
The Secretary of State rightly pointed out that the Navy is renowned for generic training and multi-skilling, which, of course, underpins the lean manning of warships. Does he accept that the headlong rush towards lean manning of warships is in part responsible for the lack of specialist skills that General Fulton identified?
With respect to the hon. Gentleman, I do not accept that. Boarding parties have always been made up of people with other specialist skills, specifically trained for that job. If there is a failure of training, it was in the specific training of nominated people for boarding, who would in any event have had other specialist skills. I know of no Navy in the world that carries boarding parties who are specialists only in that; I do not think they exist.
I commend my right hon. Friend for the “buck stops here” attitude he has shown. Will he assure me that the witch hunt sought by some Members will not happen and that our servicemen and women will be supported not only by him but by the MOD in ensuring that their jobs are safe and that they can get on with the job they are being paid for—putting their lives on the line for their country, as they do? They should be commended for everything they do.
I thank my hon. Friend for his comments. Because the CDS instructed the report from General Fulton in operational terms, I did not seek to put any qualification on that. In relation to the media-handling side, I was adamant to the House that I was not instructing a review that was intended to be a witch hunt. It was intended to identify what happened, the lessons that needed to be learned and how we could move forward, which is exactly what I intend to do. It is a coincidence that the Fulton report comes to a similar conclusion in that regard, but General Fulton supports the conclusion in his report with an analysis of the facts.
I welcome the fact that there was no equipment failure, the commitment to learning from mistakes and my right hon. Friend’s assertion that the rules of engagement were right for the task. I spent several years in the nuclear industry, in a communications department, where I witnessed press officers working in difficult circumstances. The best press officers have media experience and a media background, as I hope my right hon. Friend will agree, so will he assure me that he will consider people with a press background when looking for media support in the future?
I welcome my hon. Friend’s advice but, with respect, I do not think it would be appropriate for me to give her that assurance from the Dispatch Box, or we may end up before an industrial tribunal in future in relation to applicants for other jobs.
There are different ways of getting experience in dealing with the media. Given the society we live in, people who never thought the media would intrude in their way of life find increasingly that they need the skills to deal with the media. As I understand it, in relation to augmenting the press part of our Department, the principal lesson from the Hall report suggests that we need people with a degree of service experience and I intend to act on that.
Does the Secretary of State believe that the report has implications and lessons for our coalition partners, and will he ensure that they are fully briefed with the details of the report?
One of the interesting aspects of the operational report—the Fulton report—is its recognition that it is important always to bear in mind the fact that we are operating as part of a coalition. It is our intention to share the lessons with our coalition partners and, indeed, we have already taken steps to do so at CDS level.
The poor training and discipline of the boarding party have been admitted—this work is to be undertaken in future by expert teams—but by stepping up to the line, the Secretary of State has done no service to the Navy. It is frankly unbelievable that he has not told the House who was responsible for that poor training, what rank they held and whether they are serving at home or abroad. Will he now give us that information?
I know that the hon. Lady is an assiduous student of issues in relation to defence, and particularly the security of our operations and the safety of our armed forces. I commend her for the work that she does in that regard, but she may well have misunderstood the information that I have given the House.
On training, the recommendation is that we continue to do the world-class generic training that we do for the crew of ships as we deploy them, on the basis that ships are deployed for nine months, that they are quite often diverted to do quite diverse things when they are on deployment, and that the generic training has served us well for a long period. However, that ought to be augmented by some specific training, particularly in relation to boarding, if that is likely to be part of the function of a ship when it is deployed. There is no question of chasing responsibility for someone not having done that in the past.
I do not accept that there was a failure of discipline. I am not going to sit here on these green Benches or stand here at this Dispatch Box and judge these young people on their behaviour in circumstances that I have not experienced. The last time I came to the Dispatch Box, I said that experts in interrogation assured me that their behaviour was well within the bounds of what was permissible and acceptable in relation to their responsibilities. I can do no more than repeat that to the House.
Will the Secretary of State take it from me that those of us on the Defence Committee will not be party to a whitewash, that we have heard the anger in the House, and that we are aware of the mockery to which the Royal Navy has been subjected by sea shanties being updated? Will he undertake to ensure that there will be no attempt by the MOD to prevent senior serving officers from appearing before our Committee?
I assure the hon. Gentleman that there will be no attempt by my Department to prevent the Select Committee from carrying out the task which they have agreed to accept, and to a degree which I have charged them with.
Points of Order
On a point of order, Madam Deputy Speaker. You may have seen that Mr. Ijaz-ul-Haq, the religious affairs Minister of Pakistan, is reported to have said the following about the award of a knighthood to Salman Rushdie:
“If someone exploded a bomb on his body he would be right to do so, unless the British Government…withdraws the ‘sir’ title.”
The Minister then went on to praise suicide bombing.
The House will of course be mindful of the horror of the loss of life experienced on 7/7. Mr. Ijaz-ul-Haq’s remarks can reasonably be read—
I am wondering where the point of order is in the hon. Member’s comments to which I can respond.
The point of order is this, Madam Deputy Speaker. Those remarks can reasonably be read as incitement to terrorism in Britain. Have you had any notice that Ministers are prepared to come before the House to say whether they have demanded that the Government of Pakistan disassociate themselves from Mr. Ijaz-ul-Haq’s pro-terror remarks, and have condemned them unreservedly?
I have had no such notice and the matter raised is not a point of order for the Chair.
On a point of order, Madam Deputy Speaker, about ministerial accountability to Parliament. On 15 May, the Minister for Employment and Welfare Reform sent me a letter stating that he proposed to close the Christchurch Jobcentre Plus office, to enable his Department to provide a “better service” to the residents of Christchurch than it had been able to provide up to now. I then tabled a priority written question for answer on 23 May, asking the Minister to explain how closing the jobcentre would provide a better service. I received a holding reply. I was concerned about the delay in getting a substantive response. My office phoned the Minister’s office and was told that the answer had been on the Minister’s desk and that he had sent it back so that a fuller and more helpful response could be given. That response is now available, but it does not answer the question one iota.
The Minister told me in a letter that closing my local jobcentre will improve life for my constituents, but, when I asked him, he said that this was a matter for the chief executive of Jobcentre Plus and that he does not accept any ministerial responsibility. How can we hold such a Minister to account in the House?
The occupant of the Chair has many responsibilities in the House, but Ministers’ responses to Back Benchers are not one of them. If the hon. Gentleman, who is experienced, is having some difficulty, I suggest he go to the Table Office to get advice from the staff there.
On a point of order, Madam Deputy Speaker. I know that staff in the Speaker’s Office and other officials in the House have for some time been trying to address the blight of the encampment outside Carriage Gates. I shall not address that situation directly, but it has been put to me that, on several occasions, megaphones have been used outside Carriages Gates to broadcast foul and abusive language when young children have been present. I have asked the police in the Palace whether they wish to take action and I have been informed that they have asked the Metropolitan police from outside the House to attend—[Interruption.] This is a very serious issue. These people are addressing young people—whom we want to encourage to visit the House—using foul and abusive language and the police have refused to attend to deal with the situation. I wonder whether the House can make a representation to the Metropolitan police to ensure that, if people break the law outside the House, all action is taken against them.
I suggest that the hon. Gentleman put his criticisms and comments in writing to Mr. Speaker, who will no doubt investigate the matter further.
Council Housing (Direct Investment)
I beg to move,
That leave be given to bring in a Bill to promote the improvement of all council homes and estates; to provide for the building of new council housing; to promote equal financial treatment between local authorities and registered social landlords in the provision of affordable housing; to reserve certain rents and capital receipts for direct investment in council housing; to provide for the protection of rights to life-long secure tenancies and of tenants from involuntary changes of ownership and management; to further regulate and make requirements of registered social landlords; and for connected purposes.
Next Wednesday, the present Chancellor of the Exchequer will take over as our new party and national leader. He told the Amicus conference yesterday that he plans to review housing policies, and I hope that my modest measure will help to inform that process. Our nation faces growing housing problems that can be met only by building new, and improving existing, council housing, and by having a fair financial balance between local authorities and housing associations in the provision of affordable housing.
Since 1997, fewer than 1,800 council houses have been built in total—in contrast to an average figure of well over 180,000 each year in the decades following the election of the Attlee Government. Despite a great cost to the taxpayer and an enormous loss of accountability, the private sector, including registered social landlords, has built at an annual rate of only 15,000 homes in the past 10 years. It has proved to be incapable of dealing with the increasing overcrowding and homelessness in many parts of our land; only a renaissance in public sector construction can do that.
There is a strong national consensus on the matter. Some 3 million tenants, 1.6 million households on waiting lists, trade unions and councillors of all parties are agreed. The six candidates for the Labour party deputy leadership have said that we must have a new housing policy and three successive party conferences have voted to encourage and finance direct investment in council housing—the fourth option. It is the purpose of the Bill to provide a legal framework for that fourth option so that it can be an addition to, or a replacement for, the current three options, which are all seriously defective.
The option promoted most enthusiastically is stock transfer to a registered social landlord, which, in law and practice, is privatisation disguised under the thinnest of veneers. Legally, housing associations are private companies and they borrow directly from the private market. RSL board members are often paid, banks are in the driving seat, and executives are on inflated pay scales, funded by soaring rents from hard-pressed tenants. Councils that are trying to coerce or bully their tenants into stock transfer will claim that the Government’s rent convergence formula ensures that rents will increase by the same amount whether tenants transfer or not, but in reality that formula is worthless. New tenants can be pitchforked up to the target rent immediately, service charges are not included and the valuation method can and will be manipulated to generate much higher rents.
My Bill would aim to protect tenants’ rights to lifelong secure tenancies, which are sacrificed following a stock transfer. The assured tenancy on offer is not the same thing at all because a promise by a new registered social landlord not to use its greater powers in law, for example on eviction, is nothing like comparable to the statutory rights that secure tenants have at the moment. Although we are told that transfers will be made to “community based” organisations, that often does not last because landlords can get into a financial mess and be taken over by remote businesses, or can become caught up in the merger mania that is fuelled by the Housing Corporation’s drive for mega RSL groupings. We should not forget that tenants have no vote on such takeovers and mergers and that the new owners of the housing have no obligation to deliver on old promises made by others.
The Bill would protect tenants from the scandals that we see when unscrupulous and uncaring councils use large-scale funding that comes from the pockets of local taxpayers to run misleading and unbalanced campaigns to frighten tenants into voting for stock transfers. Together with so-called independent consultants and advisers, they produce dubious glossy propaganda booklets that, in essence, say to tenants, “You have no alternative but to vote yes to transfer.” That is an outrage. We need no crystal ball to point to the cracks and stains on the rosy pictures painted by those who are hellbent on flogging off, at a knock-down price, public assets that were built by and for successive generations of tenants and taxpayers.
The track record of stock transfers is often pretty dreadful. Shelter found that homelessness worsened in areas with stock transfers, while the National Audit Office said that it cost thousands more to improve each home after transfer than would be the case if councils were just given the money to do the work themselves, which the Bill proposes. Any genuine consultation on the future of publicly owned housing must, as a minimum, ensure that tenants hear all the arguments, that there is equal access to public funds for both sides of the case to be put, and that there is a formal ballot on any change. As that is just what the Bill spells out, I urge a moratorium on any further ballots until the new Prime Minister’s housing policy becomes clearer.
May I turn to my Bill’s proposals to ring-fence rents and capital receipts for direct investment and to require equal financial treatment in the provision of affordable homes for local authorities, and for housing associations and other RSLs? The argument of the ancien régime about to leave office is that we simply cannot afford the level of investment in publicly owned housing that is brought in by private finance. There are two fatal fundamental flaws in that approach: first, the theory that there is no cost to the taxpayer in the options for privatisation when there most definitely is; and, secondly, the theory that there is a huge increase in public expenditure with direct investment when there most certainly is not. Tenants are right to demand a level building site for councils on which the fourth option can be constructed, as opposed to the three privatisation options. The same amount of public funds spent on subsidising stock transfers, arm’s length management organisations and the private finance initiative should be available in the growing number of cases when council housing is retained.
The Joseph Rowntree Foundation estimates that right to buy sales have yielded almost £50 billion, but that just a quarter has been recycled into improving public housing. The moonlight robbery campaign points out that tenants pay an average of £800 per year more in rents than they get back in management, maintenance and major repairs. That represents a national annual total of more than £1.5 billion. It is unacceptable that money is being leeched from council housing and council tenants in such huge volumes to subsidise private developers who are building houses that are still priced way out of the reach of ordinary, hard-working families.
The unequal financial treatment between unaccountable and often remote housing associations and democratically elected local housing authorities defies belief. For example, making debt write-off conditional on stock transfer is a form of blackmail, and my Bill would bring that to an end. The Auditor General has stated that that form of debt repayment has no net effect on the Exchequer, so why is it denied to local housing authorities, but doled out to RSLs?
Rental income must be ring-fenced in the national housing revenue account and the pooling of local rents for national distribution needs an overhaul. Housing support for hard-up areas should come from the taxpayer, not the tenant. The rigging of write-offs and gap-funding subsidies to make RSL business plans stack up is a stitch-up. A fresh approach that is rooted in real, unforced choice for tenants, and fair financial deals for councils, with the availability of debt write-off and gap funding, would benefit millions of people throughout the land. Waiting lists will shorten, overcrowding will lessen and living conditions will improve. Council estates can again be the stable and mixed communities in which many in the House, like me, have lived. I was proud to stand in the 2005 election on a manifesto that stated:
“By 2010 we will ensure that all social tenants benefit from a decent, warm home with modern facilities.”
We have three years to make good on that pledge.
In the Government’s response to Kate Barker’s review of the supply of housing was a promise, as part of the 2007 comprehensive spending review, to respond
“with an ambitious plan for increasing social housing supply, with new investment alongside further efficiencies and innovation in provision”.
Option 4 is indeed a policy whose time has come.
We must defend and extend council housing. No wonder so many people are putting up their hands for it. There is a strong business case for direct investment. There is a powerful social case for constructing council housing to tackle the affordable housing crisis, and there will be a political dividend from reaffirming a core value that council housing is not some obsolete policy from a bygone era, but a key economic activity that adds to our national wealth, promotes social inclusion and is a robust, high value and sustainable solution for one of the most pressing problems that face a new Administration planning their priorities for the next three years.
I am sure that that Administration will recognise that council housing is cheaper to build, manage and maintain than all the alternatives and, most importantly, is more accountable. I hope sincerely that this Bill is a suitable foundation for an overdue and much needed new direction in affordable housing both in theory and in practice, and I commend it to the House.
Question put and agreed to.
Bill ordered to be brought in by David Taylor, Mr. Jim Cunningham, Frank Dobson, Paul Flynn, Dr. Ian Gibson, Kelvin Hopkins, Dr. Brian Iddon, Lynne Jones, Andrew Mackinlay, Paul Rowen, Bob Russell and Mr. Phil Willis.
Council Housing (direct Investment)
David Taylor accordingly presented a Bill to promote the improvement of all council homes and estates; to provide for the building of new council housing; to promote equal financial treatment between local authorities and registered social landlords in the provision of affordable housing; to reserve certain rents and capital receipts for direct investment in council housing; to provide for the protection of rights to life-long secure tenancies and of tenants from involuntary changes of ownership and management; to further regulate and make requirements of registered social landlords; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 19 October, and to be printed [Bill 127].
Orders of the Day
Mental Health Bill [Lords]
[2nd allotted day]
As amended in the Public Bill Committee, further considered.
Clause 7
Change in definition of “medical treatment”
I beg to move amendment No. 1, page 4, line 16, leave out
‘In section 145(1) of the 1983 Act (interpretation)’
and insert—
‘(1) Section 145 of the 1983 Act (interpretation) is amended as follows.
(2) In subsection (1)’.
With this it will be convenient to discuss the following amendments:
No. 2, page 4, line 18, after ‘care’ insert—
‘(but see also subsection (4) below)’.
No. 3, page 4, line 18, at end insert—
‘(3) After subsection (3) insert—
“(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.”.’.
The amendments are in my name and that of all the Back-Bench Labour members of the Committee—I hope the Minister is aware of that—and some Conservative and Liberal Democrat Members. The three amendments tie together rather oddly, so for clarity I should explain that they would have the effect of rendering section 145(1) of the Mental Health Act 1983 as:
“‘medical treatment’ includes nursing, psychological intervention and specialist mental health habilitation, rehabilitation and care (but see also subsection (4) below).
(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.”
The British Medical Association has written to all Members of the House, I think, to say:
“This is the central clinical and ethical issue in relation to the legislation…the BMA strongly advocates the inclusion of a requirement that the use of the legislation must provide therapeutic benefit and could support the amendment subject to firm assurances that ‘manifestations’ referred to are clearly linked to underlying clinical conditions.”
The BMA is not the only organisation that is urging the Government to accept the amendment. Mind, the mental health charity, for which I ran the marathon earlier this year, has written to say:
“We also welcome the amendment tabled by Chris Bryant MP”
and other Members
“which would re-introduce a requirement to the 1983 Act that compulsory treatment must be of therapeutic benefit.”
Likewise, Hafal, the mental charity in Wales, has also supported the three amendments. The Mental Health Coalition, the new combination of organisations including Unite, which is my trade union, Unison, the Royal College of Nursing, the College of Occupational Therapists, the British Psychological Society and the British Association of Occupational Therapists, has also written to say:
“We are supportive of this amendment and have made this clear to the Minister, we are urging her to accept it and would encourage MPs to support the amendment.”
Finally, the Mental Health Alliance has written to say that it welcomes the amendment, although it has some concerns about the concept of manifestations and would want ministerial assurances that what it refers to is clearly part of the mental disorder.
It is perhaps important to stress some of the context in which the amendment comes before us. Ever since 1324, we have had in statute some provision to detain people solely by virtue of their mental ill health, although I apologise for the terms in which the legislation was couched in 1324, when the royal prerogative asserted that the king had jurisdiction over the persons and property of “idiots” and those who happened to “fail of” their “Wit”. Obviously, legislation moved substantially, and in the Vagrancy Act 1714, we had the first articulation of how we should be able to detain somebody purely by virtue of their mental ill health. That subsequently translated into the Mental Health Act 1959 and then the 1983 Act, which made clear the requirement for a therapeutic environment.
The principles that I feel are important in this issue are pretty straightforward. First, no psychiatric unit can be a prison by another name; it must be a therapeutic environment. Secondly, any person, whatever their mental condition, whether or not it is a condition that we currently believe is curable, must have the right to appropriate treatment and we cannot simply wash our hands of them.
Will my hon. Friend confirm that the amendment would certainly enable people with personality disorders to be treated in a therapeutic environment? My concern is that people with such disorders have in the past been refused treatment on the grounds that they are untreatable according to a very rigid interpretation of the terms “alleviate”, “likely to alleviate” or “not worsening” symptoms.
I believe that there have been instances since 1983, and that there were certainly instances before, in which people believed that the treatability test was actually a curability test, and that because one could not cure somebody of a personality disorder, one should not therefore bother to treat them. That view is certainly not held now among most psychiatrists, most consultants working in hospitals and most of those working in mental health services today. I hope that, in future, as science advances in this area, we will be able to provide many more treatments. Who knows? Perhaps in the distant future, we will be able to get closer to curing some of these personality disorders.
Will my hon. Friend comment on the situation of one of my constituents, who murdered a man? The murderer, my constituent, had been in and out of Homerton hospital in my constituency for two years to be treated for schizophrenia prior to the day release on which the murder took place. He was sent immediately to Broadmoor, where he spent 10 months being assessed. At the point of conviction, in trial, the judge was told that he could not send the man to Broadmoor under sentence and could send him only to a mainstream prison, because under current mental health legislation, he could not be treated. Does my hon. Friend believe that the amendment will capture such situations, and will he join me in urging the Government to take note of what is being laid down today?
I am grateful to my hon. Friend, who has made a valid point. We should consider not only people who might commit a homicide, but, far more significantly, those who might be considering suicide. As last year’s report on avoidable deaths by the university of Manchester pointed out, some 1,300 people who had been through mental health services committed suicide last year in the United Kingdom compared with some 30 homicides. It may be that when some people’s minds are very disturbed, the dividing line between homicide and suicide is not as clear as it might be for others. We should consider the rights and needs of the patient, which is an important principle.
I am a little concerned by something that the hon. Gentleman has said. Will he accept—I declare an interest as a member of the BMA medical ethics committee—that treatment is more than just intervention? Treatment is something that has a chance and that has been shown to be effective in having a chance, although not in every case, of alleviating the condition in some way. That is different from intervening or placing someone in a therapeutic environment. If the concern is to protect the public, it should not be done under a notion of treatability when it simply involves intervention or detention. Will the hon. Gentleman give me that assurance about his amendment?
I return to the first principle that I articulated, namely that no psychiatric unit should be a prison by another name. However pleasantly it might be arranged, we cannot detain people just for the purpose of detaining them, and there must be some kind of therapeutic benefit. That is the purpose of the amendment.
We also need to adhere to two other important principles. First, the public have a right to protection. Historically, mental health legislation has always allowed for the protection of the public. Originally, the legislation addressed the protection of the King, but it was subsequently extended to cover all members of the public.
I know from personal experience in my family that families, friends and carers of those who have significant mental health problems sometimes want mental health services to have the right to detain and sometimes feel that mental health services were too hesitant in detaining somebody, because they consequently saw that person travel further and further down the route towards significant mental ill health in a way that they think is irretrievable.
Having said that, it is important to bear in mind that I do not believe that the Bill will balance the rights of the patient, the rights of the public and the rights of families and friends on the security of society and the rights and freedoms of the individual without some kind of treatability test. The treatability test in section 3(2)(b) of the 1983 Act specifies that
“in the case of psychopathic disorder or mental impairment, such treatment is likely to alleviate or prevent a deterioration of his condition”.
That is clear, but it refers only to those with a psychopathic disorder or mental impairment and not to those with other mental disorders. Because of the way in which we are changing the 1983 Act, any treatability test that we introduce tonight will apply to not only the historical definition of “psychopathic disorder”, but anybody who might be detained for any mental disorder.
As I am sure that all hon. Members know, the Lords insisted that there should be a treatability test and inserted one almost identical to that in the 1983 Act, before the Commons Committee—I see that most of its members are here this afternoon—removed it. However, I believe that there is a need to insert a form of treatability test if we are to get the balance right. The Lords version of the treatability test sets too high a hurdle because it insists on the word “likely ”, as in a treatment being
“likely to alleviate or prevent a deterioration in his condition.”
Likelihood is a very high hurdle. Is it more than 50 per cent. likely—that is what “likely” means in most dictionary definitions—that the treatment will produce one of those two outcomes? That is difficult to argue. It is also difficult to argue at the beginning of an individual’s treatment under detention that their condition will be alleviated or will not deteriorate further, because the process of detention or of starting treatment may itself bring about a deterioration in the condition.
On top of that, most medical treatment is not subject to a “likelihood” clause—that is not the hurdle that we set. Many treatments are provided where there is only a one in four or a one in three chance of alleviating the condition. That is why we should move towards the purpose of the treatment being the most important element.
I support the general direction in which the hon. Gentleman is going but remain a little concerned. Sometimes people are treated with a small chance of success because they are consenting autonomously and are not being forced into it. Moreover, they are able to carry out a risk-benefit calculation that may well fall on the side of benefit even if the treatment is not likely to be effective. In this case, we are talking about depriving someone of their liberty, so there is good reason for the hurdle to be high. I hope that the hon. Gentleman accepts that, and I am interested to hear him develop his point.
I will go on to articulate more about why the concept of purpose embodies an element of likelihood. It would be wrong to say that we should provide treatment where we know that there is no likelihood of any alleviation or prevention of deterioration in the condition; that would be unethical, wrong and counter-logical. However, the Lords phrased the amendment in such a way as to create a very high hurdle.
The hon. Gentleman is making a powerful case. Does he agree—I think that this is helpful to his argument—that the concept of purpose in relation to medical procedures was imported at a late stage into the Mental Capacity Bill in the context of making it clear that euthanasia was not acceptable, and that that was done for precisely the reason that he is adducing—as part of the scope of the doctor’s considerations in making the intervention?
As is so often the case, the hon. Gentleman is absolutely right. It is a simple matter of logic that if someone says that they intend or propose to do something, and then set about doing it in a way that one could reasonably expect to have no likelihood of success, they cannot genuinely have intended or proposed to do it. Therefore, if the purpose of the treatment is
“to alleviate or prevent a deterioration in his condition”
one must believe that there is some likelihood of success. That is why I suggest to the hon. Member for Oxford, West and Abingdon (Dr. Harris) that the hurdle is not as low as he may fear.
During the debate in the House of Lords, Earl Howe spoke against a compromise amendment that was remarkably similar to the one that I proposed but spoke of symptoms and effects instead of symptoms and manifestations. He said:
“The effect of someone’s mental disorder may consist of alarm or affront on the part of the public because his behaviour has been violent and disruptive. Treatment that has the purpose of alleviating that effect—and no more than that—could consist of nothing more than locking the person up in a therapeutic surrounding away from the public view.”—[Official Report, House of Lords, 19 February 2007; Vol. 689, c. 928.]
I believe that he was stretching a point and deliberately misconstruing what the word “effect” might mean, but let us be generous to him and say that there was some ambiguity in the word. Clearly, it is not right to detain somebody solely to prevent somebody else from being fearful of that person’s mental condition. I do not believe that that is what “effect” meant, and that it referred to the condition itself. However, that is why I have suggested “manifestation” instead of “effect”.
I also believe that Lord Carlile was wrong when he said in the debate in the House of Lords that somebody could be detained purely to treat that person’s Tourette’s syndrome. He appeared to ignore the fact that not only one but three tests must be fulfilled to detain someone because of their mental disorder. We should add a fourth, namely the availability of treatment. It is important that detention cannot happen unless the person is suffering from a mental disorder of a nature or to an extent that warrants that. On top of that, he should be detained in the interests of his health and safety or with a view to the protection of other persons. Given that all those tests must be met, Lord Carlile’s concerns about detention to treat Tourette’s syndrome are not valid arguments.
I have insisted on the phrase “symptoms and manifestations” in amendment No. 3 because I believe that the manifestation of an element of a mental disorder must have a direct relationship with that disorder. The relationship cannot be indirect; the manifestation must, by definition, be an element of the condition. The reason for the word “manifestation” is that it has a direct route into the mental disorder. Let me give an example. Somebody who is schizophrenic might suffer and be extremely angry because he has just split up with his partner. He might be furious with her. However, we should not be allowed to detain somebody solely to treat that anger unless the perhaps violent anger is a direct manifestation of the mental disorder from which he suffers. That is important.
Why did the hon. Gentleman use “manifestation” instead of “sign”, which is commonly used in the medical field?
I am grateful to the hon. Lady because she has enticed me into my next paragraph. I know that many clinicians say that it is standard clinical practice to differentiate symptoms and signs. Using that term in the Bill therefore appears nice and clear. A symptom is something that patients can articulate or feel to be part of the condition. A sign is what the clinician can objectively perceive. Those definitions are generally accepted, although some clinicians use “sign” differently, to mean either what a clinician can perceive through understanding of the clinical condition or what any person could perceive. That introduces an element of ambiguity.
More significantly, the word “sign” may have a clinical meaning but it has no clear legal meaning and consequently confuses the issue. The word “manifestation”, which has no clinical meaning, provides much greater clarity in the Bill because there must be a direct relationship between the manifestation and the condition.
On that basis, I hope that my right hon. Friend the Minister will share my understanding of “manifestation” and make that clear. All the organisations that have written to me and to her, asked for meetings with her and lobbied her as ferociously as me—our last meeting was this afternoon; I hope that we never have to discuss the Bill again after today, much as I like her—support that. I hope that she can put on record her precise understanding of “manifestation” and that she will say that the Government are prepared—perhaps uniquely—to accept an amendment from a Government Back Bencher.
I end by saying that we cannot always prevent suicide. I know from my own family and my constituents that there are cases in which it feels like suicide is likely to be the almost inevitable outcome of someone’s mental disorder. However, we should not wash our hands of people in that situation. Neither should we encourage the culture of blame, which all too often attends mental health services when somebody takes either their own or somebody else’s life. All too often when that happens, the newspapers will demand, “Let’s find the psychiatrist who let this person out.” We cannot completely eliminate risk and we have to be cautious about both detaining and releasing people. Furthermore, we should not give up seeking treatment for those who have personality disorders just because we have believed that the treatment was not very effective in the past.
A compromise is available here—a compromise between the extremely high hurdle that the Lords insisted on, which made no reference to symptoms or manifestations of the condition and stressed the likelihood of the treatment having a particular effect, and the version that the Government originally wanted. It is undoubtedly a compromise, but when the Minister rises to her feet, I hope that she will not just accept the amendment grudgingly. I hope that she will not feel that she is simply backing down. I hope, rather, that she will ardently embrace the amendment, because it will leave her with a better Bill.
I will speak briefly, because I want the Minister to have the opportunity of explaining why she is backing the amendment—ungrudgingly, as I am sure she will. We are very pleased, as are the vast majority of those who served on the Committee, to support the amendments tabled by the hon. Member for Rhondda (Chris Bryant). He made a forceful, intelligent and well balanced case this evening, as he did in Committee, which is why we said we were strangely endeared to his proposals. We thought then that they had a scintilla—or chinchilla, as I believe he reinterpreted it in Committee—of therapeutic benefit, which we believe is so crucial to the whole Bill and the whole principle of mental health. Throughout the Bill’s stages in the Lords and in this House we have tried to reinsert such a provision. Without it, a mental health Bill becomes a mental disorder Bill, as it threatened to do.
I shall repeat again the comments of those who were responsible for the Mental Health Act 1983: at its core was the point that it was essential that people should not be admitted to detention for treatment in hospital if their condition was not treatable. To do so, as the hon. Member for Rhondda said, is to make hospitals prisons by another name. We know that the number of people who have been subject to sectioning has gone up considerably, so there does not appear to be a problem under the treatability test at the moment. We need to retain some form of that treatability test. To remove the treatability requirement, whatever the Government’s intentions, is to permit indefinite preventive detention and to change the law from a health measure to one of social control, of which we have been fearful all along.
Does my hon. Friend agree that ensuring the adequacy and attention of therapeutic treatments and intervention is, in fact, the best way of securing the safety of the public in almost all cases, and that the approach should be grounded in that and not focused at the control end of the spectrum?
Absolutely. Various members of the Committee have acknowledged time and again that the relationship between a mental health practitioner and a patient is a particularly sensitive one, which relies on trust perhaps more than in any other part of the national health service where people seek treatment.
If the Government back the amendment, as I hope they will, they will have moved substantially towards reintroducing a form of the therapeutic benefit treatability test, which is to be greatly welcomed. I very much welcome the language used by the hon. Member for Rhondda. I entirely agree with him that a treatability test is not a curability test; it is about being able to provide some therapeutic benefit, some alleviation of conditions or whatever for the person concerned. The hon. Gentleman made that quite clear when he first proposed a version of the amendment in Committee. We wholeheartedly support the amendment.
I have a few questions for the Minister, and I would like her to give the House some assurances. We query the use of the word “manifestations”. I gather that the parliamentary draftsmen had a problem with the term “signs”. I think that we have reached a suitable compromise on the semantics of the definitions, but it would be useful if the Minister confirmed that the word “manifestations” is intended to cover the same ground, and no more, than the term “signs”, which was the term that we originally suggested. “Signs” is a medical term used in connection with symptoms, meaning the evidence about the patient’s condition that is elicited by observation of the patient by the doctor. The symptoms are what the patient complains of. Will the Minister tell us what would be covered by the term “manifestations” that would not be covered by “signs”? The code of practice refers to symptoms, manifestations and behaviours arising from the disorder. I assume that behaviours are now not covered, and that the code of practice will be amended accordingly.
As the amendment relates to the definition clause, will the Minister make it clear—if she is going to accept it—that it will operate as a criterion for compulsion? In other words, will she confirm that a person may not be detained unless there is medical treatment available to him, the purpose of which is to alleviate, or prevent a worsening of, the disorder?
A point that I raised in Committee was that the purpose needs to have an evidence base; it should not be simply the subjective view of the clinician. We have now exchanged the term “likelihood” for “purpose”, and the purpose to treat someone has to be based on evidence that the treatment should achieve the purpose, and therefore has a more than 50 per cent. likelihood of success, as the hon. Member for Rhondda has said.
The hon. Gentleman might recall that, in Committee, I originally suggested that we use the word “intent” rather than “purpose”. As I understand it, in law, the word “purpose” is much stronger in insisting on an element of likelihood than “intent” would have been, which is why I used it.
I follow the hon. Gentleman’s argument about a more than 50 per cent. likelihood. I simply want the Minister to acknowledge at the Dispatch Box that this is the right understanding of the wording. On that basis, we shall be happy to add our support to the amendment. I hope that the Minister will, ungrudgingly, say that this is a sensible compromise and congratulate the hon. Member for Rhondda on introducing it into this important part of the Bill. This is an important principle underlying mental health law.
The House owes the hon. Member for Rhondda (Chris Bryant) a deep debt of gratitude for providing a solution to the core problem of the Bill. It is an ethical principle of medicine that its objective is to benefit patients, although it does not always do so. Detention by the NHS, as opposed to detention by Her Majesty’s prisons, has—save in rare cases of epidemic control—the goal of doing some real good to the patient. Indeed, the 1983 Act allows for the detention of seriously ill and at-risk patients, provided that there is a treatment likely to alleviate or prevent deterioration of their condition. That is the treatability test that, as the hon. Gentleman pointed out, applied to no one other than psychopaths and the mentally impaired. The treatability test left us with the problem of those with an untreatable personality disorder, which was dealt with without conclusion by the Joint Committee, and for which our Committee did not find a solution either. Some said that such people should be released, and I think that the hon. Member for Daventry (Mr. Boswell) said that they should be interned.
In Committee, the Government made some entirely reasonable points. One was that existing legislation could be used to ignore and duck hard-to-treat personality disorder cases. I accept that that is a problem. They also pointed out that a consistent and deliberate refusal of treatment by an aggressive psychopath, for example, could engineer his dismissal by establishing, quite reasonably, that he was not treatable. The Government therefore initially favoured the definition of treatability that stated that appropriate medical treatment was available. They pointed out, quite reasonably, that not all medical treatment goes beyond palliative treatment, and that chronic conditions are often dealt with by the management of symptoms rather than by an outright cure. The Lords, fearing that the proposals involved simple imprisonment under another name, defined “appropriate available treatment” in the old way, as treatment that was likely to alleviate or prevent deterioration of the condition, and we were back to square one.
The Rhondda amendment, if I can call it that, is an attempt to bridge the gap. It removes the word “likely”, and defines “medical treatment” as having the purpose of alleviating, or preventing the worsening of, mental disorder and its manifestations. It recognises that psychiatry is a relatively young science, and that remedies are not sureties or even always probabilities.
Even if it will not always prove successful, detaining desperately and seriously ill people who are at risk—which, as the hon. Member for Rhondda explained, is what we are talking about—with a therapeutic purpose seems to me to be generally justifiable, subject to the normal rules on advocacy, appeals, tribunals and so on. I believe that the amendment can and should be supported, provided that the Government and those who tabled it make it clear that by “manifestation” they mean symptoms rather than the public impact made by a person’s behaviour. Mental provision should not be about hiding people away and ignoring their conditions.
I rise only to express my delight and amazement that the impassioned speech I had prepared to support this vital amendment is not necessary, and to try to allay the anxiety about the word “sign”. The full description is “physical sign”, meaning that which is found on physical examination of the patient. I am afraid I know very few psychiatrists who still possess stethoscopes, and I rather doubt that many of them actually examine patients. I entirely agree that “manifestation” is far the most sensible word.
I congratulate my hon. Friend the Member for Rhondda (Chris Bryant) on assembling such a powerful coalition against me. There is not a grudge in sight.
My hon. Friend set out very clearly all the ways in which he had tried to address this difficult issue. Let me remind the House what the Government hoped to achieve by removing the treatability test in the 1983 Act and replacing it with an “appropriate medical treatment” test. I am sure that Members, especially those who served on the Committee, will know that—as I think everyone has now acknowledged—the treatability test did more harm than good. As my hon. Friend said, it required clinicians to predict that treatment would be likely to work before certain patients could be detained. As he also said, on occasion it has been misinterpreted as meaning that patients could be detained only if they could be cured, rather than treated. That led to a culture in which, too often, patients with personality disorders were turned away from services on the grounds that they were supposedly untreatable. My hon. Friend the Member for Hackney, South and Shoreditch (Meg Hillier) gave the example of a particularly disturbing incident in her constituency.
That culture was bad not only for public safety reasons but because of the trauma that it caused to patients, their families and their carers. It also held back the development of services for people with personality disorders, despite the clinical advances being made. I believe that as a result of our removal of the treatability test, such development will be enabled rather than frustrated by legislation.
The wording of the test has given some patients a perverse incentive to refuse to engage with treatment, in the hope of arguing that they cannot be detained because the treatment is not likely to work. I have been told of disturbing cases in high-security hospitals where patients have been advised by lawyers not to engage with treatment because it would lead to release. I know that all members of the Committee were concerned about that.
The new “appropriate medical treatment” test requires a patient’s medical treatment to be
“appropriate in his case, taking into account the nature and degree of the mental disorder from which he is suffering and all other circumstances of his case.”
That is much more than the treatability test currently requires. Nothing in that test requires medical treatment to be appropriate to the patient as an individual, and, unlike the treatability test, this test applies regardless of diagnosis.
Accusations were made that the new test would require detention without proper treatment. That is not the case, and is not what was intended. As my hon. Friend said, an amendment made in the other place would effectively have reinstated the treatability test, and in some cases would have made it worse by extending it to all areas of mental disorder. We removed that amendment in Committee because of the problems that it would have created.
I accept that there have been doubts and concerns about the effect of the new test. Genuine worries have been expressed by a number of organisations. That was raised by my hon. Friend when he tabled his amendment in Committee. I agreed to consider it then, but in the meantime my hon. Friend discussed it with a number of organisations, clinicians and others.
The amendment that we are discussing today has considerable support from Members in all parts of the House. I have given it serious consideration, and have met representatives of several organisations. I recently met members of the British Medical Association, who urged me to support the amendment provided that it was clear that “manifestations” were linked to an underlying mental disorder. My hon. Friend rightly explained that manifestations of a mental disorder were the way in which the disorder was manifested. Clearly a disorder can manifest itself only in the thoughts and actions of the person who has the disorder, not in the reactions of others. The crucial difference is that this amendment describes the purpose of the medical treatment; it does not turn on the likelihood of treatments achieving that purpose.
The hon. Member for East Worthing and Shoreham (Tim Loughton) asked about the difference between signs and manifestations, as did the hon. Members for Southport (Dr. Pugh) and for Wyre Forest (Dr. Taylor). We believe that “manifestations” is better than “signs” because the latter can be interpreted more restrictively as only the things that clinicians observe in a clinical setting. The hon. Member for Wyre Forest was getting at that with his stethoscope point. Some clinicians use “signs” to mean only what a clinician can observe through examination at a specific time, which would exclude, for example, reports by third parties of self-harm or suicide attempts. The examination would, therefore, be confined to what was happening there and then. That is why we believe that “manifestations” is a better word to use than “signs”.
My hon. Friend the Member for Rhondda, with the support of Committee members, and latterly of the Opposition parties, has certainly—[Interruption.] I carefully looked at the signatories to the amendment, and I am glad that the Opposition parties support it; I do not wish to give the impression that I begrudge that. My hon. Friend and the Opposition parties have proposed this measure and it is a good compromise. I assume that the Opposition parties had discussions with my hon. Friend, and I am glad that they wish to support his amendment. In light of everything that he has said—and of our meeting this morning when we discussed the “manifestations” issue and the fact that many organisations have backed his amendment—I am glad to say that the Government will agree to the amendment.
Amendment agreed to.
Amendments made: No. 2, page 4, line 18, after ‘care’ insert—
‘(but see also subsection (4) below)’.
No. 3, page 4, line 18, at end insert—
‘(3) After subsection (3) insert—
“(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.”.’.—[Chris Bryant.]
New Clause 12
Impaired decision making
‘( ) The 1983 Act is amended as follows.
( ) In section 3 (admission for treatment) after subsection 2(a) insert—
“(aa) that because of his mental disorder, his ability to make decisions about the provision of medical treatment is significantly impaired.”.’.—[Tim Loughton.]
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
My speech will take a little longer than the Minister just took in eventually forcing herself to say that she supported the last amendment we discussed. I hope that she will take a little less time to reach the same denouement on new clause 12. It should come as no surprise to her, as it mirrors amendments tabled in the Lords which she promptly savaged in Committee on very poor grounds. I hope that she has reconsidered and consulted experts, and will admit the error of her ways by now agreeing to restore this rightful amendment to the Bill, whose provisions were originally added to it in the Lords.
New clause 12 represents a basic principle of mental health law: that patients should be involved in, and informed about, their treatment. People with mental illness are unpredictable. That is not something that just happens and goes away; it can come back, and people might live with many episodes of mental illness over many years. As a result, many people with mental illness develop a great knowledge of what works best for them when the illness flairs up; they develop coping mechanisms. They will therefore have their own views on the long-term use of what are powerful and potentially harmful drugs. Such drugs might be deeply unpalatable for some; we have addressed side effects in the past, such as weight gain, diabetes and disabling, embarrassing and at times painful movement disorders.
It is essential that patients are involved in, and informed about, their treatment, and where they retain capacity, as many do, their wishes should be respected. The principle that compulsion should be the last resort underlies our approach to the Bill. For people with a mental illness, the best forms of therapy involve the trust of the clinician, who has the power to prescribe powerful—mind-altering or physical feature-altering—drugs. More than for any physical illness, it is essential that there is a position of trust between the patient and the clinician.
We must respect the autonomy, personal integrity and personal responsibility of the patient. That is a basic human right. In the Bill in its current form—without the impaired decision-making amendments, as added in the Lords—there are inconsistencies compared with how we treat physical illness. The Bill is also still stigmatising, so we have reinserted the amendment that gives an impaired decision-making test, acknowledging that if someone suffers from a mental disorder, it does not automatically mean that they are not fully able to make decisions. That should help to reduce stigma and enhance personal autonomy and responsibility. I would hope that the Minister—along with all the other people and organisations who are interested in mental health—supports that.
The addition of the impaired decision-making provision also makes the grounds for non-consensual medical interventions for people with a mental disorder similar to those for people with a physical disorder, thereby helping to reduce stigma and discrimination. I think that all Members agree that far too much stigma is still attached to mental illness. We have a lot more to do to reach a position where somebody going for treatment for a mental illness is viewed no differently from somebody going to a hospital for treatment for an illness such as cancer or heart disease. We are still a long way from achieving that. At the basis of our perceptions on this subject and how we can change them is the way we configure our laws on how people with mental illness are treated. That is why an impaired decision-making test is essential.
There is something I do not understand. We are talking about a situation in which two clinicians have already established that a person is suffering from a mental disorder and needs to be compulsorily admitted for treatment. Part and parcel of such a mental disorder is some degree of thought disorder—in a sense, that is the manifestation of the disorder. How does the hon. Gentleman’s extra condition of judgment being “significantly impaired” help the clinician who has already made the judgment that that person has a serious mental disorder?
The hon. Lady debated that with us in Committee, and I shall respond to her points later. However, it is important to recognise that many people with mental illness retain capacity and should therefore have the right to influence their treatment.
Does my hon. Friend agree that when we think about people who are detained, we may forget the spectrum of conditions for which people are sectioned? Some are voluntary admissions but many are in crisis, and it is often the sections made under crisis that we think about. However, I have known many cases in which people being sectioned were calm and rational through the admission process, so there is a spectrum of conditions.
That is absolutely right and reflects the point that I was making. It is an unpredictable process, and people go through highs and lows. Of the 47,000 sections last year, some 20,000 occurred after voluntary admission. Surely we want to encourage more people to engage with mental health services as early as possible, so that their condition is treated before it becomes more extreme and they have to have more extreme treatment, and might then be subject to compulsory sectioning. We are trying to encourage best practice and trust in the clinician, and to encourage people voluntarily to engage with mental health services.
I congratulate the hon. Gentleman on the point that he is making and the way in which he is making it. Does he accept that part of the stigma associated with mental illness is the presumption—the caricature, almost—that it inevitably involves total and enduring lack of capacity? That is simply not the case. It is a far more mixed bag, and I point out through the hon. Gentleman to the hon. Member for Stockport (Ann Coffey) that it is not inevitable that lack of capacity occurs, as recent case law confirms.
The hon. Gentleman, who has great experience of these matters through his own medical background, is right. We need to appreciate, respect and publicise, as part of the image and stigma problems—
Will the hon. Gentleman give way?
Hold on. I am trying to answer the hon. Member for Oxford, West and Abingdon (Dr. Harris). Of course I will give way generously, as I always try to do, to the hon. Lady, if I may first finish my sentence—which I have now forgotten, so I give way.
I thank the hon. Gentleman very much. I was simply going to point something out, through him, to the hon. Member for Oxford, West and Abingdon (Dr. Harris). He is talking about capacity, but my point is, what will the phrase “significantly impaired” add to a clinician’s judgment? “Capacity” is a readily understandable term.
In order to make some progress, perhaps the hon. Lady and the hon. Member for Oxford, West and Abingdon would like to go outside and talk about this issue, or both contribute to this debate—if there is any time left after I have made my opening comments—rather than our holding this three-way conversation.
It is important to remember that if a patient with depression has a potentially fatal physical illness such as heart disease or cancer, they may be treated for it only if they give capacitor’s consent, or if they lack capacity and such treatment is in their best interests. In other words, the law permits that patient, if they retain decision-making capacity, to refuse treatment for an illness such as heart disease, but not for an illness such as depression. That is surely inconsistent and wholly illogical, and we are trying to achieve some consistency in the way that this legislation is framed. I make no apologies for returning to this very important principle in the Bill.
The General Medical Council said the following in response to the Government’s criticisms of our approach:
“We do not share the Government’s concerns that people who pose a risk to themselves or others could be excluded from the provisions of the Act because of this amendment. In determining whether a person is able to make a decision about medical treatment for their mental disorder, doctors would need to follow a process which assesses whether:
a. the person is able to understand that they have a mental disorder, what treatment is proposed and why the doctor believes it is necessary
b. they can retain and weigh up this information and make a reasoned decision whether to accept or refuse the treatment
c. their understanding or reasoning is distorted or impaired by their mental disorder.
We envisage that following this process would lead, in practice, to the conclusion that although a person who is suicidal or poses a risk to others may still have some capacity to make decisions, their ability to make decisions about medical treatment for their mental disorder is impaired and they are, therefore, able to be detained under the Mental Health Act, provided the other conditions under the Act are met.”
That counters the point that the Minister has made before in arguing that our proposals would in some way put at risk a large body of people.
Does not the Mental Health (Care and Treatment) (Scotland) Act 2003 include a proposal such as this new clause, which applies to assessment as well as treatment? There have been no reports so far from clinicians or social workers that the measure is not working within that Act.
My hon. Friend is right on both counts, and I will touch on that issue briefly in a minute. As the Minister is always keen to refer to that Act when it suits her, perhaps she will acknowledge that point now—when it suits us, for a change—so that we can draw on that experience, limited in time scale though it is so far.
Genevra Richardson’s expert committee on the 1983 Act recommended an approach to compulsion based on capacity. In her submission to the Public Bill Committee, she said:
“Patients should not be subjected to compulsory treatment against their capable wishes simply in the interests of their own health or for the avoidance of annoyance to others. To do so would be to discriminate unjustifiably against mental, as opposed to physical, ill health…I would therefore urge the retention of clause 4”—
on impaired decision making, which we are trying to restore—
“in its amended form. The presence of impaired decision making as a condition for the use of compulsory powers is essential if we are to apply the recognised principles of health care equally across mental and physical disorder. It will help significantly to reduce both the discrimination reflected in the Mental Health Act 1983 and the stigma which feeds on it. In the years since the publication of our Report our understanding of the nature and extent of the stigma attaching to those with mental disorder has greatly improved…and it is clear that the retention of the impaired decision making amendment would mark a significant step in the battle to combat it. Far from seeking to deny treatment to those who need it, the impaired decision making condition would place mental and physical disorder on an equal footing and would begin to break down those barriers which deter people from seeking the help they need.”
The hon. Gentleman is arguing a fine line. The plain fact remains that many families have lost loved ones who committed suicide; they clearly needed to be treated, but were turned away and did not get that treatment. If the new clause is accepted, the number of such people might increase, and I cannot vote for the hon. Gentleman’s new clause knowing that that might be the case. What does he have to say to the families who have lost loved ones through suicide who did not get the mental health service treatment that they should have received?
I would say to them that it is a tragedy, and that if suitable services had been available for their loved ones, some of those suicides—never all—might have been avoided. I would also say that is not the job of legislation to make up for the poor availability of services or for inappropriate services. Moreover, there is no evidence that the inclusion of an impaired decision-making clause would reduce or increase the number of people under compulsory treatment in any case. The hon. Gentleman must also consider how the legislation is currently framed, and the fear that patients who retain some capacity might have in presenting to services if they think that they are then much more likely to be subject to sectioning and to have their own wishes, knowledge and experience overridden. They might not present to those services at all, and would therefore not get any help from them. Their condition might fester under the clinical radar and, as a result, they could be even more likely to commit suicide or to commit some harm against members of the public.
The hon. Gentleman has no evidence to back up the prognosis he is putting forward—[Interruption]—just as I have no evidence otherwise, as the Minister rightly says. It is a fine line, but surely the point is that it is better to encourage and entice people to engage with those services. Offering a framework that respects their integrity and their wishes when they retain the capacity to have sensible wishes is surely more desirable than saying that their wishes will be overridden, simply because the legislation does not accommodate them.
Will the hon. Gentleman also accept that it is all very well to say that the person should engage with the services on a voluntary basis, but the trouble is that in practice the services are often not available at the moment of crisis, such as in the middle of the night or at the weekend?
If the services are not available at the moment of crisis, having a piece of legislation that says that the person’s wishes can be overridden will not make any difference. It is the services that make the difference, and the person may think that it is not worth engaging with the services, or they may be deterred from or frightened of doing so—perhaps because they have had long experience of mental health services or bad reactions to drugs that were forced on them against their better judgment. They might decide that they would rather suffer than run the risk of being dictated to by a psychiatrist who might be acting in their best interests, but who overrides their wishes even if they retain their capacity. The danger of those people slipping under the clinical radar is as dangerous, if not more dangerous, than the scenario the hon. Gentleman suggests.
If the scenario is a crisis in the middle of the night, at which point help is being sought from the medical profession, the chances are that the decision making of the person involved is impaired.
That is the point that I have tried to make. If somebody has reached such a traumatic point in their life that they are contemplating suicide, they will, in most cases, have impaired decision-making capability and, therefore, the system and the legislation could pick them up. We covered that point in Committee, and if the hon. Member for Bolton, South-East (Dr. Iddon) will not acknowledge that, we will have to agree to disagree. He does not have empirical evidence for his view, as I do not, so I am siding with giving some credence to the decision-making capacity of the patient.
If the hon. Gentleman will forgive me, I wish to make some progress. We could get very hung up on this point, and it has taken some time already.
There is clear recognition of the importance of an impaired judgment standard in statements from the Joint Committee on Human Rights, whose Chairman is not in his place at the moment, although I am sure he will join us later, and in international standards. They include statements by the World Psychiatric Association, the World Health Organisation, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment and the UN General Assembly.
The Joint Scrutiny Committee, of which I was a member, said in its report:
“A large proportion of the evidence received by our Committee favoured a capacity-based approach as the starting point for a new Act, although some proposals were more radical than others. We believe that compulsory powers should only ever be used as a last resort when people are very seriously ill, and we do not agree that a person will become too seriously ill before an impaired decision-making criterion is met.”
Many professional bodies in the alliance have publicly supported that test, including the British Psychological Society, which the Minister has been praying in aid more than any other organisation to try to counter arguments being made in Committee. As has been said, the mental health legislation in Scotland has the same criteria as this new clause, albeit for the assessment stage as well as the treatment order. Anecdotal evidence from psychiatrists and social workers in Scotland suggests that it is not causing dilemmas for clinicians. The principle has been recommended for Northern Ireland, and it is a criterion for admission in other jurisdictions, including Ireland, New South Wales, North Carolina—where the famous Dr. Swartz hails from—Israel and Saskatchewan.
As the hon. Gentleman knows, I have much sympathy with the amendment and I agree with the argument that he is making. How would the new clause deal with the problem of fluctuating capacity?
That is a fair point, because people’s conditions do fluctuate. That point was addressed in Committee and in some of the submissions made to it. The new clause would not remove the discretion of clinicians to make a judgment on how someone’s condition varies.
The General Medical Council also said:
“The requirement that a person’s decision-making ability must be significantly impaired before they can be detained and treated without their consent is consistent with the guidance the GMC issues to doctors, in which we make clear that doctors are expected to respect the wishes of patients who have capacity to make their own decision about treatment or care or disclosures of confidential information, and to act in the best interests of patients who lack such capacity. Those are fundamental principles of good medical practice which we would expect to see applied to decisions involving patients with mental disorders in the same way as those suffering from physical disorders.”
This is not some hare-brained scheme plucked out of the air. This principle, wording and concept are used in other countries and jurisdictions and are backed by a raft of respectable medical professional bodies.
My hon. Friend has not yet referred to the Disability Rights Commission. Has he met representatives of that organisation? It supports new clause 12 because it says that if the new clause is not accepted, the Bill will be highly discriminatory. If the Minister is unwise and does not accept the new clause, does my hon. Friend feel that that decision will be subject to legal challenge?
I have not met the commission recently, but I have read its submission. Its members have every reason to be concerned if the new clause is not accepted, because they feel that if their views are overridden—
Will the hon. Gentleman give way?
The hon. Lady is very keen. I will give way to her in a moment, when I have finished replying to the previous intervention. The commission’s members are concerned that if their judgment and decisions are overridden, they will be deterred from engaging with mental health services in the first place.
The hon. Gentleman still has not addressed the point that I made earlier. Other parts of the Bill refer to the “capacity” of patients to make decisions. The new clause talks about the ability to make decisions being “significantly impaired”. I have asked him to explain how that extra test will add to the ability of the clinician to make a judgment about whether someone should be compulsorily detained. Is he applying a different test to mental capacity? If so, is it a higher test that the mental capacity test or a lower one? [Interruption.] If it is the same test, why does he not talk about capacity, instead of significant impairment of judgment? He has said that it is not our job to make clinicians’ decisions, but it is our job to put comprehensible legislation on the statute book.
Game show like, my colleagues shout, “Lower”, because it is a lower test—[Interruption.] You don’t get anything for a pair on this show, either. That is the answer—[Interruption.] Well, the civil servants are usually in the Box—
Order. I remind hon. Members that there should be no reference to Strangers in any of the Galleries.
Thank you, Madam Deputy Speaker. I have lost my place, but I will try to plough on.
I hope to be helpful to my hon. Friend by pointing out that within the context of mental health legislation, clinicians regularly work with two tests that are interrelated. For example, they regularly work with the concept of capacity to consent to treatment as well as notions of insight into illness. That is not unusual, and that is probably what the hon. Member for Stockport (Ann Coffey) is alluding to when she says that there are two tests. That is true, and it is not unique.
I am grateful to my hon. Friend. Rather than going through that conversation again, I shall give way to my hon. Friend the Member for Rochford and Southend, East (James Duddridge).
The proposed test is a lower one, but my understanding is that the word “capacity” is used to refer to brain damage, which can be physical as well as mental. In contrast, an “impairment” is purely mental. Does my hon. Friend agree that the word “capacity” extends to people who have suffered a physical disruption to the brain in road traffic accidents?
That could be part of it, but the matter is not so straightforward.
I am trying to understand the point made by the hon. Member for Stockport (Ann Coffey). I was not a member of the Committee, although I accept that she was and that she has explored the matter in detail. She said that the existing legislation contains a clear capacity test, but I do not think that it does. Essentially, a doctor or an appropriate clinician judges that a person is suffering from a mental disorder and should be detained. That is not a blatant capacity test, so it is appropriate to introduce an impaired judgment test to capture the point that the hon. Member for East Worthing and Shoreham (Tim Loughton) has made.
rose—
I shall not give way for a while, as several conversations seem to be going on at the same time. Those hon. Members who want to make a contribution to the debate should do so before the Minister accepts the new clause.
The breadth of the law as its stands contrasts with the provisions in most countries, where the seriousness of a condition, or the harm that might be caused, are essential criteria for detention. We consider that the criterion of impaired decision making provides a preferable alternative to the seriousness criterion in the 2004 Bill, because it is more specific and directs the clinician to the correct issue of patient choice and autonomy.
The vast majority of people with a mental illness, like those with a physical illness, retain in full their ability to make their own decisions throughout. They are treated by GPs or psychiatrists without being detained. Of those who are detained under the Mental Health Act 1983 some, as I have said, will also retain their capacity. A recent study found that 15 per cent. of detained patients, especially those who had been detained on a previous occasion, retained their capacity.
The authors of that report also found that a capacity test worked with a high level of reliability, which answers part of the point raised by the hon. Member for Stockport (Ann Coffey). The IDM test imposes a lower threshold, and does not apply to section 2 patients. If it were passed into law, I believe it would lower the percentage of detained patients who retain their capacity.
What are the consequences of failing to take account of decisions taken by a person who has insight into his condition and is fully capable of making a choice? I think that there are four. First, patients with full capacity come to resent their psychiatrists. As I said earlier, they tend to avoid their services for fear of being forced to have treatment that they do not want and which they believe may be harmful to them physically. That in turn can lead to them becoming more ill, with some slipping below the clinical radar or being deterred from presenting in the first place.
Secondly, patient outcomes may be damaged if personal decisions are not taken into account. Thirdly, patients may be harmed by treatment that may be unnecessary, and fourthly—and most importantly—stigma is increased. Failing to take account of vulnerable people’s decisions can, and does, destroy their trust in the medical profession, on whose members they rely for mental and physical health.
Inevitably, detention in hospital is a major disruption to a person’s life. In the context of the blame culture, in which every tragedy caused by a patient can potentially be attributed to misjudgments by a psychiatrist, psychiatrists often feel required to section patients against their better judgement or the best interests of those patients.
The predictable consequence of the present law is that people with full capacity can stay away from the psychiatrist because they can justify an irrational fear of being detained. In that sense, the law is totally counter-productive: as I have said before, we need patients to engage early.
Tony Zigmond, vice-president of the Royal College of Psychiatrists, has followed our proceedings very closely and I am sure that he is doing so at the moment. He has said:
“Enabling people to feel able to seek help early, to talk about their fears and difficulties, without fearing scorn, humiliation or loss of status, freedom, job and friends is the best way to bring about improvement in their health”.
As in other areas of medicine, the best outcomes are achieved when patients engage early, take a full and active role in their treatment and have trust in their psychiatrist or other professional. In that connection, the NICE guidelines on anxiety state:
“involving individuals in an effective partnership with healthcare professionals, with all decision making being shared, improves outcomes”.
Another aspect of the problem is the stigma felt by members of the black and minority ethnic community. They strongly support the new clause, and feel deeply stigmatised by the present law. The figures for the disproportionate detention and sectioning of people from the BME community bear out those fears.
Will the hon. Gentleman give way?
If the hon. Lady does not mind, I was going to end there. I wanted to make a number of other points but am conscious of the time, and I am also aware that she wants to make some comments of her own in support of the new clause. To ensure that she is not squeezed out, I shall finish my remarks now, save to say that the new clause should be added to the Bill as it is fundamental to our view of mental health legislation and to the need to respect people with a mental illness who retain capacity. I very much hope that the Minister will have a last-minute conversion and accept it.
I want to expand a little on the point I was making earlier, as I do not think I got a very satisfactory response.
I did not get a chance.
I gave the hon. Gentleman every chance: he just did not manage a satisfactory response.
The second set of provisions in chapter 3 is entitled “Consent to treatment”. Clause 27 deals with electroconvulsive therapy, for example, which can be administered only if an “approved clinician” has
“certified in writing…that the patient is not capable of understanding the nature, purpose and likely effects of the treatment”.
It is important that the same tests are applied in all parts of the Bill. The new clause would insert the new test
“that because of his”—
that is, the patient’s—
“mental disorder, his ability to make decisions about the provision of medical treatment is significantly impaired.”
That is different from the test used elsewhere in the Bill, which is based on the phrase “capable of understanding”. When challenged about whether the new test was the same or different, higher or lower, the hon. Member for East Worthing and Shoreham (Tim Loughton)—having being prompted by his colleagues in the Gallery—explained that it was a lower test.
That is not very satisfactory. The proposed additional test would be applied at a very important and significant moment in a patient’s life, and in the lives of his friends and carers. As a result of it, the patient would be compulsorily admitted to hospital for treatment of an underlying mental disorder that might be putting him or others at risk. It is not satisfactory for the hon. Member for East Worthing and Shoreham to be unable to say whether the test was higher or lower—
I said it was lower.
I am sorry, the hon. Gentleman did say that the test was lower. Will he say, then, by how much it is lower? How is it different from the test used elsewhere in the Bill? It is no use him looking at the Gallery, as I do not think that the people there will help.
Perhaps I can help my hon. Friend. The proposed test is different, as the term “capacity” relates to cognitive ability. The Scottish legislation deals with the matter adequately, holding that the concept of impaired decision making is separate from incapacity. The further factors that should be taken into account are set out in the Scottish provisions, with a patient’s impairment being measured, for example, by his ability to retain information concerning care and treatment, and to make decisions accordingly.
I thank my hon. Friend for that intervention, but the Scottish provisions are as yet untested. When the hon. Member for East Worthing and Shoreham introduced his proposal, he said that he had no evidence about whether it would work. Parliament has a responsibility to put good legislation on to the statute book, so I simply point out that his proposal is messy because there is no satisfactory explanation to show that it would operate any differently from tests in other parts of the mental health legislation.
In that case, why did the hon. Lady support community treatment orders yesterday? There is no evidence for their efficacy. She needs to be consistent.
The hon. Gentleman is proposing the new clause so it is his responsibility to explain what it means, instead of referring to some other aspect of the legislation.
I pointed out that a number of states already have an impaired decision-making test that has worked perfectly satisfactorily. There is no evidence that a capacity criterion would reduce the number of people under compulsory treatment, as the Minister claims it would. The Government object that the new clause might leave out people who need treatment. That might be true, but it is alarming to think that the state has reached the point that everyone deemed to need treatment should be detained if they disagree, which is what the Minister is trying to say.
I am sorry, but other countries have other mental health legislation; I am talking about the hon. Gentleman’s new clause. He has given no explanation of exactly what the test is and how it differs from the capability test in other parts of the legislation. Why should we adopt one test to judge whether a patient is capable of understanding the nature and purpose of the likely effects of electroconvulsive therapy, but an entirely different one when they are to be admitted to hospital under a compulsory order? It is the hon. Gentleman’s responsibility to explain that but he has not done so satisfactorily, so he does not deserve support for the new clause.
Unlike the hon. Member for Stockport (Ann Coffey), I support new clause 12, which is well reasoned. In previous debates in Committee, I would have been minded to support the Minister’s arguments if mental health problems were indeed static for a period of time. I know that the Minister holds in great respect Patrick Geoghegan, the chief executive of my local mental health partnership. He told me about a schizophrenic patient who could hold a rational discussion at one meeting but at the next would be kicking and screaming and making a mess of the office. It was deemed that the patient could make decisions about her future treatment and she voluntarily accepted treatment. As it was recognised that she had capacity to make decisions because she allowed herself to be admitted to hospital for treatment, logically she should be allowed to decide which treatment she did not want. She might know her own needs and her own body—for example, that a drug did not work well—much better than the clinician.
That is exactly the point. The patient the hon. Gentleman describes had allowed herself to be admitted to hospital. She had decision-making capacity even though she was very ill, and she entered hospital voluntarily. The problem would be if a person with the same medical condition, who had retained capacity and decided that they did not want to be treated, posed a danger to themselves or other people. Under the proposal the hon. Gentleman supports, that person could not receive treatment.
I understand the Minister’s point, but if a mental health patient has a different view about the effects of treatment and says that they do not want ECT or a particular type of drug—even if at a later stage a doctor or a second doctor says they should have such treatment—they should be treated exactly the same as someone with a more medical problem.
The hon. Gentleman needs to differentiate a patient’s ability to contribute towards decisions about their treatment, which they can still do under compulsion. We have made it clear that we want the Act to work in that way, but in the case he describes the person could not be detained under the Act and receive treatment because they would have retained their decision-making ability. They would not have impaired judgment, so they could not be detained under the Act to receive treatment. That is exactly the problem.
If the patient subsequently lost the ability to make a judgment, would doctors have to take their original decisions—made when they had full capacity—into account, even if they did not feel the decisions were in the patient’s best interests? Perhaps the Minister will clarify that point in her comments.
In an intervention on my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) I mentioned the Disability Rights Commission, which strongly supports the new clause and believes that if it is not accepted the Bill will be “highly discriminatory”. Has the Minister taken advice about the likelihood of legal challenges that the Bill is discriminatory?
We are talking about the status quo. Does the hon. Gentleman know of any cases brought by the DRC against existing legislation?
I was not able to meet the commission, which is why I asked other Members whether they had done so, and I do not have that information. However, the DRC says that the Bill is highly discriminatory. Those are strong words, which concern me, and I shall be further concerned if the Minister has not taken legal advice or discussed whether there is likely to be a legal challenge.
Finally, the British Psychological Society’s code of ethics and conduct requires psychologists to respect people’s right to self-determination. What will happen if the legislation requires health professionals to override the valid choice of a person with capacity? There is clearly a conflict of interest between the BPS code and the law we are trying to enact.
This is a serious issue. My hon. Friend the Member for Stockport (Ann Coffey) is concerned that we should have good legislation, but all the professionals who will have to implement the measure support the new clause. In fact, they would go further. The proposal applies only to section 3, not section 2, which covers initial admission for assessment. To some extent, I would prefer that the new clause applied to both sections.
All the professionals are familiar with the concepts involved, including fluctuation. Dr. George Szmukler’s memorandum to the Committee refers to the sustained resumption of capacity. One could envisage a scenario where someone who may have lost decision-making ability is admitted to hospital, gets well and recovers a degree of capacity. All those things can be taken into account, but the state of impaired decision making must not fluctuate. Similar provisions are in the Scottish measure, so I see no reason why they cannot work perfectly well, although I realise that there are issues relating to suicide, patient safety and public protection, which I shall address later in my speech.
Does my hon. Friend agree with the hon. Member for East Worthing and Shoreham (Tim Loughton) that this is a lower test than the test that is in the consent to treatment?
In one sense it is different, because if a person lacks capacity, it is a more or less permanent condition—such as in the case of a person with learning difficulties—whereas a person who may have a mental health condition can fluctuate between having impaired judgment to understanding and full capacity. It will be for medical professionals to make that judgment. They are well able to do so, and are willing and want to be able to apply this test.
I have listened to the explanations given by my hon. Friend and the hon. Member for East Worthing and Shoreham (Tim Loughton), and I am still very confused about the differences between the test of capability and this new test of impaired decision making. Even having heard my hon. Friend, I am still unsure. Does she agree that there would be quite a lot of confusion if two different tests were introduced, which might be tested in courts of law?
The professionals involved do not think that there is confusion, and there are briefings that explain it perfectly reasonably. I cannot find the exact page; I suppose I could read it out, but my hon. Friend has access to the briefings from the professionals involved, and I think that they are right. They are very comfortable with the new clause and the consequences that would flow from it.
As I am sure the Minister will argue in rejecting the new clause, if this test is introduced many of the people who are at risk of harming themselves or others may not receive the treatments they need. The original proposal came from the expert group, chaired by Genevra Richardson. We have her evidence to the Public Bill Committee, which the hon. Member for East Worthing and Shoreham read out. All this arose because the expert committee recommended a much wider definition of mental disorder, which we shall discuss later. One quid pro quo was that, while we had a wide definition, it would be narrowed in terms of invoking the concept of capacity—the concept of impaired decision making. That was the basis of Genevra Richardson’s recommendation. It was a fundamental principle that was crucial in relation to the stigmatisation of people with mental health problems, so before I return to the issue of protection of the individual or the public, I want to spend a few moments considering that.
Stigma against people with mental health problems is so endemic in our society that people are ashamed of admitting that they might have a mental health problem. I have recently been involved with the all-party group on ME, and people will bend over backwards to avoid any idea that they could have a condition that might have a psychiatric element, because of the stigma associated with it. The social exclusion unit pointed out that six out of 10 employers would not employ someone who had a mental health problem.
The stigma is endemic in our society. I know, because my father suffered from schizophrenia, and when I was growing up it was something that one was ashamed of. I could never tell my friends that my father had schizophrenia. I could not take people home, because of his behaviour. People will not talk about mental illness. The situation is getting better, but the stigma is still endemic in our society.
We have been talking about public protection, and about preventing people from committing suicide. The most important thing that could be done to help us achieve public protection and protection of the individual would be to remove the stigma associated with mental ill health, which prevents people from coming forward because they do not want to admit their feeling that they may have a mental health problem. That, to me, is a crucial aspect of the Bill. A lot of the discrimination that would appear to be in the system, and the greater use of compulsion for people from black minority ethnic backgrounds, can be attributed to the fact that the stigma is even greater in some of our ethnic communities. In fact, when relatives do eventually refer a family member for help, they usually refer them to the police rather than to mental health services, such is the stigma associated with mental ill health. Genevra Richardson put it much more effectively than I can when she explained why she recommended that a judgment should be made about impaired decision making.
The Minister has given examples where she thinks that people who are suicidal may be deemed not to have impaired judgment, and therefore may not receive the compulsory treatment that they need—for example, if they are very seriously depressed. There is some difference amongst clinicians. Some clinicians say that as a result of the impaired decision-making requirement a very few people may not receive treatment; but the General Medical Council says that although a person who is suicidal may have capacity to make decisions, their ability to make decisions about medical treatment for their mental disorder is impaired because of their express desire to commit suicide, or the concern that they may do so.
I have to disagree with my right hon. Friend the Minister. In my opinion, someone who is suicidal because of a mental health problem—not perhaps someone who wants to commit suicide because they are terminally ill; I would distinguish between the two—does display seriously impaired judgment, and I believe that most clinicians would take the view that such a person had impaired judgment and would require them to have treatment.
The expert committee recommended that an exception be made for people who may be a danger to the community. The Minister correctly points out that that situation is not catered for in the new clause, but I say to her, so crucial is this in relation to the need to combat stigma that I hope she will accept the amendment as currently worded, but seek to make appropriate modifications in another place that could take into account the recommendation of the expert committee.
In most of the cases where homicides have been committed by people with a mental health problem, the issue of impaired judgment would not have made any difference. Some were already subject to treatment; I cannot recall specific names, but there were people who were already under restriction orders, and their risk was inadequately assessed when they were released. The question did not relate to capacity; they were known to be dangerous. In many other cases, the failure of mental health services and the lack of co-ordination between different teams, and between social and health services, in providing for those patients led to the tragedies.
The acceptance of the new clause will not mean that the public are less protected or that there is likely to be a greater risk of suicide among people with mental health problems. On the contrary, if we can combat stigma—and this is part of the necessary process involved—we could have much better mental health services and people could be much more willing to receive treatment, because they know that when their judgment is not impaired, they will be listened to.
There are many other measures in the Bill—particularly now that amendments have been made—that improve the current legislation. That is particularly true of advanced statements. Under the code of practice, practitioners will have to have regard to a patient’s wishes when the patient does not have impaired judgment. However, if my right hon. Friend the Minister accepts the new clause and, if necessary, introduces any further refinements to take on board the recommendations of the expert committee, the Bill will be even better.
I am going to try to simplify things. The Mental Health Act 1983 laid down two conditions for detention: severe mental illness, and being a danger to oneself or others. Severe mental illness was defined as
“illness severe enough to require hospital treatment”.
That is a slightly unsatisfactory definition because it is culturally relative and in 1983 there were not the same alternatives to hospital treatment as there are now. None the less, the common law understanding and interpretation for more than 34 years has been that sectioning or detention requires a person to be severely mentally ill—no one can seriously doubt that. The second requirement is that one is a risk to oneself—the obvious example is suicide—or a risk to others, up to and including homicide. There is no doubt about that either.
The new clause—following the amendment in the Lords—adds a further criterion: impaired judgment. Initially, that sounds attractive, on the sound legal principle that people without impaired judgment ought not to be detained against their will unless they have done some provable wrong. However, that leaves us with the crunch question: what happens to people who are severely mentally ill, suicidal or homicidal, but who have unimpaired judgment? Several answers have been given. One answer given repeatedly is that there are no such people; it is a null class. Mentally ill people who are suicidal or homicidal necessarily have impaired judgment. That is a good answer, but it renders the new clause entirely redundant, because anyone who meets the original criteria for detention—someone who has a severe mental illness and suicidal or homicidal tendencies—meets the impaired judgment test as well. The new clause would therefore be logically superfluous, if cosmetically attractive.
Is my hon. Friend certain that the criterion is that someone is suicidal or homicidal? He is using shorthand. The threshold is somewhat less than that. He should not presume that all cases will use that criterion, rather than some lesser criterion of potential risk to oneself through neglect, for example.
Yes, but nobody would get sectioned because they did not wash themselves well or something like that. People normally get sectioned only when they face a serious emergency and the physician feels that action must be taken.
I have come to the conclusion that for the case for the new clause to be maintained, we must believe that there are some severely mentally ill people who are a risk to themselves or others, but who have completely unimpaired judgment, or, at any rate, do not have significantly impaired judgment. It might be asked: who are they, how many of them are there, and how easy are they to single out given the lack of a universal or legal understanding of the impaired judgment criterion? Nothing I have heard today has satisfied me that we are using a particularly clear criterion or that we have a general agreement about it.
It also might be reasonably argued that letting people who are suicidal commit suicide if we think that they have unimpaired judgment is a fair price to pay for allowing them to retain the civil rights that we allow to all people who have unimpaired judgment. I call that the heroic civil liberties argument. That argument has been put and I respect and understand it, although I do not share it.
Further reflection has led me in a different direction. While I was trying to figure out who was in the category of mentally disordered, potentially suicidal people with unimpaired judgment, it was suggested to me by one of the measure’s proponents outside the Chamber that a mentally ill person might be suicidal because of unconnected things such as bankruptcy or terminal illness—the kind of things that would make a rational person consider suicide. However, we are talking about people who have a severe mental illness—an illness that haunts the mind, infects every mood, for most people permeates every waking moment, and spreads its dark shadow over all their actions. We are talking about people who are, in general, being ripped apart by their emotions. That is why they get themselves sectioned in the first place. I simply asked myself whether such a person could dispassionately and rationally evaluate the state of their finances or their health prognosis—or anything of that major nature—uncoloured and unimpaired by, and immune from, the emotional storms within them.
To believe in such people seems almost to ignore the depths of suffering and confusion found among people who get themselves sectioned. It fails to recognise what those people are dealing with. Catholics such as me are supposed to believe six impossible things before breakfast, according to Chesterton, but I cannot summon up sufficient credulity to believe in this state of affairs. It defies my imagination and exceeds my current grasp. Even if we accept that a seriously mentally ill person who is a danger to themselves and has unimpaired judgment is a logical possibility, their existence is highly improbable and we are very unlikely to meet any such person.
I thus conclude—this may be a charitable conclusion that pleases everybody—the same thing that Baroness Murphy concluded in the Lords: whether the new clause is passed or rejected will make no real difference to the practice of psychiatry. We can relax.
In supporting the new clause, and following on from the hon. Gentleman’s question about who the people who retain capacity are, I want to put on the record that a study published in The British Journal of Psychiatry in 2005 identified that 15 per cent. of patients detained under the Mental Health Act retained their capacity. That was particularly true of those who had been detained previously. Ignoring that group of people has real consequences. One of them was identified by the hon. Member for Birmingham, Selly Oak (Lynne Jones), who has great expertise in this subject. Stigma will be increased. There is also an effect on the relationship between the patient and clinician. Patients’ outcomes are damaged. All that would be addressed by the new clause.
I want to come on to some of the issues raised by the hon. Member for Stockport (Ann Coffey) a little later. I had real concerns about this aspect of the Bill right at the beginning, not least because of some of the examples that the Minister used on Second Reading and other occasions, and the consequences that have been touched on by other Members tonight, particularly in respect of those who might be potentially suicidal or a danger to others. I was particularly concerned about those who fall into the category of potentially suicidal, because, at one point, the argument appeared to be that, if they had capacity and it was their decision not to be treated, they should be told to go on their way, with the obvious catastrophic consequences. However, I have to tell the Minister that having made a particular effort to satisfy myself on this point, I now believe that that would not be the case because I do not think that any clinician would stand by and allow a person to commit suicide, or to be a danger to others. A person’s wish to die would be a consequence of a mental disorder, so in such circumstances, the clinician—
indicated dissent.
The Minister shakes her head, but surely clinicians must make such decisions every day when dealing with potential suicides. Of course, potential suicides are not only people who are crying out that they wish to end their lives. People who are deadly earnest about taking their lives—I am not putting people who choose to end their lives because of a terminal illness in this category—and are determined to do so often deploy all sorts of devices to try to conceal the decision that they have made. Clinicians have to make judgments today about whether such complicated people are intent on taking their lives. I see no reason to go along with the Minister’s suggestion that new clause 12 would deny clinicians the ability to make a judgment. If a person was considered to be a danger to others because he or she wished to kill someone else, that intent would be a symptom that the person was seriously unwell. The medical profession makes clinical judgments about such matters today, so I do not understand why new clause 12 would affect the situation.
When the Minister objected to such a measure in the past, she prayed in aid the example of an anorexic patient. However, clinicians tell us that someone with anorexia who believes that she is fat clearly has disordered thinking and thus has an impaired decision-making ability. I am satisfied that the concerns about the consequences of such a measure that the Minister outlined on Second Reading have been addressed. Patients in the situations that she described would be sufficiently protected.
This is a difficult area, especially with regard to the terminology used. We have discussed the difference between significantly impaired decision making and capacity or incapacity. The hon. Member for Birmingham, Selly Oak said that that had been outlined succinctly and thus denied herself the opportunity of sharing it with the House. I hope that you will indulge me, Mr. Deputy Speaker, if I share with the House the Scottish Executive’s code of practice on the Mental Health (Care and Treatment) (Scotland) Act 2003, which deals with this exact point. That Act is already in force and is being used every day.
The code of practice states that the concept of “significantly impaired decision-making” is
“separate to that of ‘incapacity’…However, when assessing a person’s decision-making ability, it is likely that similar factors will be considered to those taken into account when assessing incapacity. Such factors could involve consideration of the extent to which the person’s mental disorder might adversely affect their ability to believe, understand and retain information concerning their care and treatment, to make decisions based on that information, and to communicate those decisions to others…One difference between incapacity and significantly impaired decision-making ability”—
the subject of new clause 12—
“arguably is that the latter is primarily a disorder of the mind in which a decision is made…on the basis of reasoning coloured by a mental disorder. Incapacity, by contrast, broadly involves a disorder of brain and cognition which implies actual impairments or deficits which prevent or disrupt the decision-making process”,
which is something that the hon. Member for Birmingham, Selly Oak referred to. These are nuances—some might say that this is dancing on the head of the pin—but I think that the Scottish code of practice sets things out clearly.
Does not the hon. Lady agree that it would be better if the same terminology was used throughout the Bill? She has gone to a lot of trouble to try to explain slight differences between what phrases might mean. However, confusion would be created by accepting a new clause that used an entirely different phrase. That would be important, given that the Bill will be interpreted by the courts.
This is my fifth year of studying the reform of the Mental Health Act 1983. I served on the scrutiny Committee and, like the hon. Lady, on the Public Bill Committee. I and many others have urged the Minister to use the Scottish Act as a blueprint for the legislation for England and Wales. If she had done so, we might not be dealing with such differences today. We could simply have lifted a lot from the Scottish Act and put it into our legislation, including the principles in the Bill. However, for an extraordinary reason that I still do not understand, the Minister and her team rejected that proposal, and the Bill is the poorer for it.
I will take only a few minutes because I understand that the Minister will want time to respond to the debate. However, I want to deal with a couple of points that were raised. I realise that I was not a member of the Public Bill Committee. Many hon. Members who have participated in the debate have taken a great deal of interest in the Bill and have spoken about its details with knowledge. I speak for no one but myself.
The hon. Member for Stockport (Ann Coffey) claims that given that there is a definition relating to capacity in clause 27—she said that that measure related to consent to treatment, but it is actually on electroconvulsive therapy—any other definition in the Bill relating to capacity should use the same wording for the sake of consistency. However, that would be wrong, because it would mean that the test for admission would be the same as the test for ECT. As she probably knows better than me, given that she has followed the Bill’s passage, the architecture of the Bill is such that ECT has a higher threshold of incapacity than mere sectioning because anyone who was sectioned could otherwise have ECT administered to them. Although there might be merit in pure consistency, the example that she cited did not work because her point would undermine the separate threshold for ECT that exists for not only historical reasons, but clinical ones.
Is it the hon. Gentleman’s understanding that the impaired judgment test would use a lower threshold? If that is the case, will he kindly explain how low the threshold is?
The threshold is lower because I do not think that the supporters of new clause 12 would want people sectioned under the Mental Health Act 1983 to qualify automatically for ECT. Although the hon. Lady might not agree with me, I hope that she has received an explanation of her point from this side of the House.
Let me deal with the interesting challenge that the Minister gave the hon. Member for Rochford and Southend, East (James Duddridge). He deflected the challenge somewhat, but I am happy to meet it head on. I think that the hon. Member for Birmingham, Selly Oak (Lynne Jones), who spoke superbly, as she always does on such matters, also would have done so. The matter was dealt with eruditely and logically by my hon. Friend the Member for Southport (Dr. Pugh), who has a PhD in logic.
The point to make is that it is possible to want to end one’s life or to have one’s life ended without necessarily having impaired judgment. It is also possible to have a mental illness as well. I shall describe two scenarios. If someone is terminally ill, they may reject immediately life-saving heroic treatment because they know that they are going to die and they want to exercise their autonomy and be allowed to die, not to have their life saved if they know they are going to die or suffer. Indeed, they may seek something that is unlawful in this country at present—assisted dying, which has never been opposed on the grounds of being irrational. It has been opposed for other reasons, which we cannot discuss now.
That is one scenario. It is possible in that scenario for the person to be depressed as a result of their terminal illness, and/or it is possible for the person to have a serious mental illness anyway, whether or not it is depression. Just because someone rejects non-mental treatment because they wish to die or end their life, which may be considered suicidal, does not mean that they should be sectioned. That is why a test such as the one proposed in the new clause in that small minority of cases would add extra confidence and insurance against what otherwise might be deemed to follow automatically—that is, sectioning—because the person is suffering from a mental illness, which makes it appropriate for them to receive mental treatment in a hospital for that illness, and to protect them from taking actions that might end their life. There is a case that the Minister must address, which the new clause seeks to do.
There is also the case—for reasons of brevity the hon. Member for Birmingham, Selly Oak did not go into it in as much depth as she might have done—about non-discrimination. People who refuse treatment that is life-saving and who are not terminally ill are entitled to do so if they retain capacity to do that. So a patient might, without not having capacity, refuse to have a big operation that a doctor would recommend and that would be life-saving. That does not mean that they are being irrational, that they do not have capacity or that their judgment is impaired. We do not force such physical treatment on them for their physical ailment.
As for people with a mental illness, although we must take care that we act in their best interests and I recognise the difficult judgments to be made, we should not presume—it goes to the stigma—that they have impaired judgment if they are not looking after themselves or have an intention that their life should end sooner rather than later.
It is vital that we ensure that people who have a severe mental illness and as a result of that are suicidal, are able to access treatment. I am satisfied, as I think my hon. Friend the Member for Southport was, that the new clause would not prevent that. It may help cope with stigma and raise doubts in the minds of people who might otherwise automatically seek to impose compulsory treatment on people with mental illness. It represents an extra test that might prevent unnecessary restrictions of liberty where that is not appropriate.
I know plenty of people who have rightly been sectioned, who are not suicidal but who are self-neglecting to the point of infestation and to the point of malnutrition, who have a severe mental illness. I have sought in my medical practice to have them sectioned. A test of suicidal intent is not required. That was the point that I made to my hon. Friend the Member for Southport during his important contribution.
For reasons of addressing stigma and of identifying a group of people who, if the new clause were not in the Bill, might be compulsorily detained for treatment, who need not be detained and for whom it would be inappropriate, and in order to ensure that we as a House recognise the need not to discriminate—discrimination law is changing all the time and the Government have just proposed consultation on discrimination law, and if the Bill goes through unamended in this place that will put the Government on the wrong side of that case—I will support new clause 12 in the Lobby tonight.
With the new clause we are back on familiar territory. An amendment was inserted originally in the other place, which we took out in Committee, and it has been reintroduced today by the Opposition. It will not surprise them to know that I do not agree with the proposal in the new clause. I understand many of the points that have been made during the debate. I know that we are dealing with a sensitive issue. I listened carefully, as always, to my hon. Friend the Member for Birmingham, Selly Oak (Lynne Jones). I shall reiterate what we are trying to achieve through the Act, which is a sensitive piece of legislation because it affects extremely vulnerable people. It deals with their protection and the protection of others.
The primary purpose of the Mental Health Act is to provide an effective, properly safeguarded mechanism by which clinicians can intervene to protect people from the risks of mental disorder, where that is necessary. There are clear criteria for detention under section 3: first, that the patient has a mental disorder which makes medical treatment in hospital appropriate; secondly, that such treatment is necessary for the patient’s own health or safety or the protection of others; thirdly, that detention is the only way to ensure that the patient gets the treatment; and, thanks to the Bill, that appropriate medical treatment is available. We discussed that earlier today when I accepted the compromise amendment.
The new clause would introduce a new test which would subordinate issues of necessity and risk to the question of the patient’s decision-making ability. It builds on provisions that we have been working with since 1983. Detention should be based on whether the patient is at serious risk of harming themselves or others. What the new test would mean is uncertain, as it is unprecedented in English law. [Interruption.] I remind hon. Members that we are in an English jurisdiction.
I understand that the supporters of the new clause argue that if the patient understands that they have a mental disorder which can be treated, and understands the treatment on offer but decides to refuse it, as long as their decision has not been distorted by their mental disorder there can be no compulsory intervention, whatever the risk to the patient or anyone else. We must be clear that that is the intent of the new clause. It has been interesting to hear the debate today about whether that would mean that some people could not be treated. I am clear that some people who are treated now would not be treated under the proposal, because their decision to leave themselves or other people at risk would take precedence.
That is the intention of the new clause. What are the reasons behind that? Let us consider some of the statements that have been made by the Opposition. I shall read into the record what has been said about the new clause. In the other place the Front-Bench spokesperson for the Conservative party said:
“My view is that if the risk they pose is to themselves, the law and the state have no business interfering in their lives; and if the risk they pose is to others, they are or should be the province of the criminal law.”—[Official Report, House of Lords, 10 January 2007; Vol. 688, c. 233.]
That was the view expressed in the other place—that the state has no business to interfere. This goes back to arguments that the hon. Member for Oxford, West and Abingdon (Dr. Harris) made in asking why there is a distinction between what would happen with a physical illness and what would happen with a mental illness. There is a clear distinction. First, the person must have a mental disorder in order to be detained. Secondly, they must be a risk either to themselves or to others. Thirdly, detention has to be necessary and appropriate medical treatment has to be available. That is why there is a difference. We are talking about an individual who is going to commit self-harm or suicide, or harm others.
I must remind the hon. Member for East Worthing and Shoreham (Tim Loughton) of what he said yesterday when we considered the Government’s victims rights amendments:
“The biggest tribute we can pay to victims and, we hope, to avoid there being more of them in future, is to make sure we do everything possible to stop perpetrators before they commit such ghastly acts.”—[Official Report, 18 June 2007; Vol. 461, c. 1121.]
As I said, his spokesperson in the Lords said that
“if the risk they pose is to others, they are or should be the province of the criminal law.”
In other words, we should wait until people have committed a crime before we can intervene. That would be the effect of what is being proposed.
I have a lot of respect for Earl Howe, but I do not tie myself to what he said. I agree with what the hon. Member for Birmingham, Selly Oak (Lynne Jones) said. It can never be rational to desire to inflict harm on others outside the boxing ring or the battlefield. If the Minister were to agree with the hon. Member for Birmingham, Selly Oak and say that the Government would table an amendment in another place that excluded that side of things from the test, which is otiose in such circumstances, I would accept that position. I ask the Minister please not to label those of us who take such views with words, whether or not they are correctly extracted, from a peer in another place—I can speak only for myself, but I suspect there are others.
So the hon. Gentleman is now saying that he accepts that we should not allow people to harm others, but that we should allow people to harm themselves. That is the obvious logic of what he has just said.
I shall certainly give way to the hon. Gentleman if he can tell me why he feels that it is okay to prevent people from harming others, but not to prevent them from harming themselves.
The reasons are the same as those for which we do not impose physical treatment on patients who have capacity and do not have impaired judgment, but who reject physical treatment, even when it might save their lives. There will be very few patients with mental illness who do not have impaired judgment—I accept that point—but there will be some, and why should they be treated differently? We have to act proportionately, and I think that the proposed arrangement would give a fair balance in the case of self-harm.
Okay, we are now down to saying, “Let’s treat it in the same way as we treat physical illness.” The hon. Gentleman therefore wants a new threshold, and he has now accepted that there will be people who will not be treated if the House agrees to what is proposed. Effectively, we would be saying that we did not want such people to harm others, but that it was fine that they could go away and commit suicide, even though they had a mental disorder and were a risk to themselves. It is sometimes quite difficult to work out whether somebody is a risk to themselves or to others; most clinicians will say that it is difficult to make the distinction. The hon. Gentleman is therefore introducing a difference between two groups, but I would say that that is quite difficult to do. We would be saying that, although appropriate medical treatment was available, a new test meant that people would be excluded from treatment. We need to be clear that that is what the House is now considering and what would be brought about.
The Minister has not identified who those people are. How will she predict who will be a serious risk to themselves or to others? She is not able to do that. In the definitions that I gave yesterday in respect of victims’ rights, the point that I was making absolutely clearly was that we should do everything we can to make sure that people do not get into such a desperate state that they commit ghastly acts to others or themselves. The point of the new clause is to ensure that they are not discouraged from presenting early so that they can get the help voluntarily or compulsorily to ensure that they do not reach that desperate stage.
Once again, the hon. Gentleman needs to look at the amendments that he is tabling. There is nothing in what he proposes that would bring people forward for treatment earlier. I would like to pick him up on that point. I think that the hon. Member for Tiverton and Honiton (Angela Browning) was hoping to avoid future criticism by saying that there would be sufficient protection to ensure that everybody who was covered at the moment would be covered in future.
If the hon. Lady is not saying that, that is fine; I shall give way to her.
The point that I was making is that these matters come down to judgments on the part of clinicians. They will have those difficulties with or without the proposals. As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) was saying, the idea of predicting with absolute certainty that, for example, somebody is going to go out and commit a homicide, having not done so before, is not credible. The Minister knows the figures; she has heard them from the Royal College of Psychiatrists. We would have to lock up and detain 5,000 people even to come close to finding one who just might do it.
But the hon. Lady knows that we already detain people.
Not on that scale.
No, not on that test, because the test does not exist at the moment. The hon. Lady would be introducing a new test ensuring that people who get treatment at the moment will not do so in future. She must accept that.
Let me cite what the hon. Member for East Worthing and Shoreham said earlier in this debate. He said that very large numbers would have impaired decision making. He then said that some people would retain capacity, and quoted a study that said that 15 per cent. of people under detention retained capacity. He then said that the IDM test is a lower percentage, so there would be much lower numbers who could not be detained as a result of the proposal. [Interruption.] He said that the IDM test is a lower percentage, so let us look at the percentages. Let us look, say, at what would happen if 10, 5 or 2 per cent. of people could not be detained, and at what we are talking about in figures—real people who would not get treatment in future. There were some 22,500 detentions in England for treatment under section 3 in 2005-06. If 10 per cent. of those were ruled out, 2,250 people would not get treatment; 5 per cent. would be 1,125 people; and 1 per cent. would be 225. Those are real people who would not get treatment under the hon. Gentleman’s proposals.
They are not real people. Those are completely hypothetical figures that the Minister is characteristically using to try to caricature the case that is being put to her. I referred to a lower threshold. I also said that there is no evidence that she can produce that the numbers subject to compulsion will be higher or lower as a result of the proposal. What I did say is that people will be less deterred from presenting to receive the help and support of services, which we want to encourage them to do.
I am afraid that the hon. Gentleman needs to look at the record tomorrow, because he said that the percentage would therefore be lower. The percentage who would qualify under the impaired decision-making test for not being detained is shown in the figures that I have given. He must accept that. [Interruption.] What percentage of people does he think would not be detained? Given that he says that large numbers would have impaired decision making, how many people does he think it acceptable not to give treatment to?
It is about not imposing treatment.
Yes. We are talking about compulsory treatment. That is exactly the point that the hon. Member for East Worthing and Shoreham was making. He believes that if an impaired decision-making test were introduced, some people would not get treatment. In that case, I ask Conservative Members how many people is an acceptable number to be turned away from treatment. Such people would be either suicidal or a danger to others. What number would be acceptable?
That is scaremongering and disingenuous argument of the worst kind. Which bit of the statement “There is no evidence to suggest that the number subject to compulsion would be higher or lower under an impaired decision-making test” does the Minister not understand? On which bit of that statement is she trying to misrepresent me?
Order. The hon. Gentleman should not use such terminology in the House. Perhaps he will withdraw that remark.
I will, of course, withdraw “misrepresent”, but there is still some confusion about what I have said, which I would like the Minister to explain.
I am confused, because the hon. Gentleman has distanced himself from the points made by the Conservative spokesperson in the Lords. If he is distancing himself from what was said in the House of Lords, that is fine, but earlier he said that a very large number would have impaired decision making and therefore admitted that some would not have impaired decision making.
The hon. Gentleman asked about the evidence on whether some people would not be treated.
Will the Minister give way?
I want to address some of the submissions about who would or would not get treatment. As I have said, it is important to admit that there are people who would not get treatment.
I have received a letter, which I know the hon. Gentleman will reject, signed by a number of eminent psychiatrists. It states:
“It is not possible to say that because a patient has a particular condition, they necessarily will (or will not) have impaired decision-making. People differ. Their circumstances differ. Even the fact that two people are diagnosed as having the same mental disorder does not mean they will experience or be affected by it in the same way. While impaired thinking is a common feature of mental disorder, impairment of the ability to make treatment decisions specifically is not, of itself, a criterion for diagnosing mental disorder, or any particular mental disorder. For example:
Patients with a long-standing diagnosis of schizophrenia or severe depression, with a history of detention at times of acute illness resulting in high risk. These patients will usually have impaired decision making when in relapse but as they recover this may no longer be the case. They may, however, not be prepared to accept that they have been ill or to accept the need for treatment. As a result, if we had an impaired judgment test, the psychiatrist would be unable to use Mental Health Act powers to continue treatment—until a further relapse occurred.
Patients with borderline personality disorder who do not have impaired decision-making, but who have a high risk of serious self-harm at certain times, and for whom the psychiatrist may well think that hospitalisation is needed during a crisis. Those patients may well understand the treatment that is being offered and the consequences of refusing it, and they may talk in a clear-headed way about committing suicide. If we had an impaired judgment test, the psychiatrist would be unable to intervene.”
We know that young women with borderline personality disorders who have a history of abuse, whether sexual, physical or emotional, want to commit suicide at times of crisis, but they understand the options. The hon. Gentleman’s new clause means that we, as a society, would say, “We are not going to treat you under the Mental Health Act.” There is absolutely no doubt that that would happen.
The British Psychological Society is in favour of an impaired decision-making test:
“We recognise that this approach may mean that a very small number of people believed to be at risk of self-harm or suicide would be permitted to refuse treatment if their decision-making was not considered to be significantly impaired.”
It has said that the new clause would allow some people to go out and commit suicide, which Labour Members find unacceptable.
I hope that the hon. Gentleman will tell me how many people whom we treat now it is acceptable not to treat.
Does the Minister think it acceptable that 1,300 people commit suicide now? If it is all so rosy under her proposals, why are 1,300 not being prevented from committing suicide now?
That is a ridiculous argument. The hon. Gentleman has said that we should prevent people from committing suicide, but he has tabled a new clause that would increase the likelihood of its happening. His policy is to accept this Government’s suicide prevention strategy, which includes measures in this Bill to ensure that we can get treatment to people when they need it. He has admitted that the new clause would allow people who are a risk to others to go out into the community in unsafe circumstances, because it does not discriminate between people who are a danger to others or a danger to themselves, as my hon. Friend the Member for Birmingham, Selly Oak has said.
We cannot accept the new clause, because it would lead to more people being allowed to go out and commit suicide, more people not getting treatment and a greater danger to the public, too. I urge my hon. Friends to reject the new clause.
The Minister has used her usual tactics of trying to confuse the Opposition into submission. Why is it that the Royal College of Psychiatrists, the BMA, Dr. Genevra Richardson, the British Psychological Society, the pre-legislative scrutiny committee, black and minority ethnic groups and the Disability Rights Commission are wrong and she is right?
It being two and a half hours after commencement of proceedings on the motion, Mr. Deputy Speaker put forthwith the Question already proposed from the Chair, pursuant to Order [18 June].
Question put, That the clause be read a Second time:—
New Clause 11
Warrant to search for and remove patients
‘(1) Section 135 of the 1983 Act is amended as follows.
(2) In subsection 1(a) leave out “for neglected or kept otherwise than under proper control” and substitute “and neglected”.
(3) After subsection 1(b) insert “or (c) may be in need of treatment or care for his mental disorder and is living in any such place, and, access to that place is necessary for the purpose of establishing whether or not he is in need of treatment or care, and it has not been possible to gain such access without a warrant.”.’.—[Tim Loughton.]
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
With this it will be convenient to discuss amendment No. 88, page 39, line 20, in clause 41, at end insert—
‘(4) In section 135(6) for the words from “means” to the end of that subsection substitute—
“(a) (i) residential accommodation provided by a local social services authority under Part III of the National Assistance Act 1948 (c. 29),
(ii) a hospital as defined by this Act,
(iii) an independent hospital or care home for mentally disordered persons,
(iv) any other suitable place the occupier of which is willing temporarily to receive the patient or, if, in the circumstances of the case it is impracticable to use any of these places,
(b) a police station”.
(5) In section 136 (Mentally disordered persons found in public places) of the 1983 Act after subsection (2) insert—
“(3) Where a police station is used as the place of safety the person may not be detained there for a period longer than 24 hours.”’.
We have only a little time left to consider the final groups of amendments, and I am sure hon. Members who wish to participate are especially keen to comment on the exclusions from mental disorder provisions in the second raft of amendments. I shall therefore speak only briefly about the first raft, and mainly about new clause 11. My hon. Friend the Member for Broxbourne (Mr. Walker) is keen to catch your eye, Mr. Deputy Speaker, to discuss amendment No. 88.
The British Association of Social Workers has supported and provided briefing notes for the new clause, which covers warrants to search for and remove patients. It would update the 1983 Act, which is out of date and causes some problems. Section 135 of the 1983 Act allows magistrates, on the application of an approved social worker, to issue a warrant when it is necessary to gain access to private premises to assess someone for possible admission under the Act. Warrants are requested far more often than they were.
In addition, court procedures have been tightened up, and the approved social worker now needs to make a formal application to the court, supported by written evidence. That has served to highlight the shortcomings of section 135, which does not reflect the whole range of circumstances in which warrants are needed and, indeed, issued, forcing approved social workers and magistrates to bend the law to ensure that access can always be gained to someone who is in urgent need of admission to hospital. The reason is that the section basically dates from the Lunacy Act 1890 and the Mental Deficiency Act 1913. It has never been updated to conform with modern needs and circumstances.
The section provides for a warrant to be issued in only two circumstances: when the person lives alone and is unable to care for themselves, and when the person does not live alone but is being
“ill-treated, neglected or kept otherwise than under proper control.”
It covers only whether the person is cared for, not whether that person needs treatment or is a danger to themselves or others. That is because, back in 1890, there was no treatment. If there was a danger to self or others, it was assumed that the police would use common law to gain entry. However, their common law powers are greatly circumscribed by section 17 of the Police and Criminal Evidence Act 1984, which allows them to enter only in dire emergency
“for the purpose of saving life or limb.”
If, therefore, someone who lives alone harbours paranoid beliefs about their neighbours but can still care for themselves, the professionals have no power to gain access to them to assess the need for admission. They must effectively wait until an assault has been committed and that person can then be arrested. By the same token, a warrant cannot be obtained when the person is living with someone else who does not neglect or ill treat them, even if that someone else is a child, infirm or unable to allow access. In some cases, family members, far from ill treating or neglecting the mentally disordered person, are concerned about them and desperate for them to receive treatment but are too frightened of them to let the police and the professionals into the house against their wishes. A high proportion of cases in which access is plainly justified do not fulfil the existing criteria, forcing approved social workers to misrepresent circumstances to obtain a warrant.
We have modified the new clause since it was first debated in the Lords to tackle a valid objection by the Minister in the other place that it deleted an existing power to obtain access to someone who needed care other than for mental disorder. The new clause now retains existing powers but deletes the stigmatising phrase “not under proper control”. As a witness to the Joint Scrutiny Committee put it, inclusion of the phrase made it sound as though we were talking about dogs.
The new clause now provides for access to be gained in any circumstances in which it is necessary for the professional to carry out an assessment for possible admission under the 1983 Act. However, it also imposes a new restriction that a warrant can be granted only when it has not been possible to gain access without one. That is designed to prevent the widespread misuse of the current system whereby the police insist on obtaining a warrant even when access has not been denied or it is not certain that that will be the case.
We believe that the restriction would require the approved mental health professional to demonstrate to the magistrates that all reasonable efforts had already been made to gain access by non-forcible means. It is therefore likely that the new clause would reduce rather than increase the number of warrants issued. Lest there is a concern about increasing the range of circumstances in which the police can enter private property, it should be noted that clause 228 of the 2004 draft Mental Health Bill—may it rest in peace—which the Government abandoned more than a year ago, contained much greater powers for the police to enter private property by force without a warrant, and purely at the request of an AMHP in circumstances in which a person was in urgent need of care and control to prevent him from causing serious harm to himself or others. Even the extension of police powers that the new clause proposes would not extend as far as that, as a case for forcible access would always have to be made in the magistrates court.
The new clause is slightly technical but the law is clearly out of line with current practice and I hope that the Minister will accept it in the constructive and positive way in which I move it.
I rise to move amendment No. 88. I have never moved an amendment in the House before and I cannot think of a better one with which to start. [Interruption.] Am I not speaking about amendment No. 88? Am I not on the right track? I appear to be causing hilarity.
Order. The hon. Gentleman may speak about amendment No. 88, but he is not moving it at this time. At the moment, only new clause 11 is being moved. If and when there is any question of a vote on amendment No. 88, the hon. Gentleman may move it formally.
Thank you, Mr. Deputy Speaker, for your guidance. In my excitement, I was getting ahead of myself. I shall try to stay within the bounds of parliamentary protocol.
Amendment No. 88 is designed to change the definition of a place of safety so that, as far as possible, it is not a police cell. Too often, people who have a mental episode that results in a disturbance or act of violence end up in a police cell. As far as possible, we would like to ensure that a place of safety is actually in a therapeutic environment. If that is not possible, however, we would hope that within 24 hours of someone being placed in a police cell after an episode of mental illness, they would be found a place in a therapeutic environment where they could receive appropriate care.
I believe that the amendment is hugely important because it sends out a message about how we regard mental illness, which is not a crime. In certain cases, it may drive people to commit acts that could be perceived to be criminal or, indeed, are criminal, but mental illness in itself is not a crime.
I have personal experience of being around people who have had extremely violent and aggressive episodes of mental illness, and I have to say that it is very frightening, but I can say now, with hindsight, that a police cell is not what these very ill and sick people need. It really is not. The police are not trained to be the jailers of the mentally ill; it is outside their range of competence. They are not skilled at managing the symptoms. The police are not clinically trained. I would have thought that locking someone up in a police cell could only add to the trauma and make that sick person even sicker.
If we do not progress with the amendment, I hope that the Minister and others will look further into the way that mental illness is approached in the community, particularly by the police, and try to find ways of ensuring that when the police are confronted with a violent mentally ill person, they can recognise the situation and call on the help of clinical experts to help them to manage it—[Interruption.] I suspect that my hon. Friend the Member for Buckingham (John Bercow) is getting agitated, so I shall give way.
Does my hon. Friend agree that warm words, though very welcome if forthcoming from the Minister, will not on this occasion suffice? We need some sort of formal commitment that mentally ill people will speedily be put in a place of safety other than a police cell. Very often, they will not be able to give voice to their own anxieties. They look to this House to protect them—and protect them we must, otherwise there is a real danger of what I would call careless and accidental incarceration or careless cruelty. We have a responsibility to avoid that.
My hon. Friend makes an excellent point in his usual eloquent way. The amendment would allow the House to send a message to people who are mentally ill that we care about their welfare and about alleviating their troubles and that we want to ensure that, in as many cases as possible, they are in places that best meet their needs as ill people—as patients.
I recall describing in Committee something that happened in my constituency, but I shall not go into it in detail again. It concerned a young girl of about 14 who was having a violent episode. I was with the police on that occasion and we were called to the house. It sounded as though there were about 30 people in that house, throwing things, screaming and yelling, but it was actually just one tiny 14-year-old girl. This little girl was walked out in between two policemen. I cannot remember whether she was handcuffed—I hope she was not—but she was put in a police car and taken to a police station. I, a totally untrained observer, could recognise that the girl was mentally ill. What was happening to her was completely and utterly not in her interests. It was a moving experience for me. By accepting this amendment, I hope that we can ensure that such circumstances are kept to the absolute minimum in future.
In providing a therapeutic environment, we must strike the right balance between having beds and community facilities. I know that there is a big move to close beds and move services, particularly day services, into the community, but in many cases we still need beds and secure places for such young people.
Is there not another practical point? We heard from the Ministry of Justice today that police cells are going to be used for criminals because there are not enough places in our prisons. If we have a Ministry of Truth in a few days’ time, perhaps it will be honest enough to admit that there will not be enough room in police cells for this, so we need something better.
I understand where my right hon. Friend is coming from. It is just not right to take people who are mentally ill and put them in police stations and in police cells next to criminals. If we are serious about ending the stigma attached to mental health, this is one practice that we should stop as soon as possible.
Does the hon. Gentleman recognise that the police would have great difficulty if they arrested a drug addict who was also mentally ill? The police would probably see the drug addiction beyond the mental illness. Does that not create a problem for the amendment?
I appreciate that there will be difficulties of interpretation at the margins, but I come back to the 14-year-old girl. It was not difficult to interpret that decision. What happened to her was clearly wrong and could not be justified in any society that claimed to be civilised in its approach to people with mental illness. I accept the hon. Gentleman’s point, but we are here to navigate our way through these difficult issues and I am sure that there is a way forward. I know that the Minister will have something to say about it. Briefly, then, we must ensure that there are facilities and beds within the community.
I was heartened by what the Minister said yesterday about age-appropriate facilities. The most important people we need to look after and remove from police cells are the young. Everyone is important, but Rome was not built in a day. If we could get more age-appropriate facilities in the community, near people’s homes—it does not have to be next door; we accept that there will be resource issues—it would be a fantastic and positive step forward. Thank you, Mr. Deputy Speaker, for allowing me to speak to this important amendment.
May I say that I understand the sentiments behind both these amending provisions, but that for reasons I shall set out, it is difficult to accept them? I intend to set out what we are trying to do in respect of the issues covered by amendment No. 88 and to discuss some changes in the Bill that impinge on them.
New clause 11 is designed to amend section 135(1) of the 1983 Act. Let me explain that the purpose of that subsection is to protect a person who may have a mental disorder from ill treatment, neglect or an inability to care for themselves and to ensure that they receive any care or treatment that they need. Obviously, the use of that subsection is quite a serious step, which can involve considerable interference in the person’s home and family life, so we have to be very careful when we talk about making changes to it.
New clause 11 amends that section so that it would apply to virtually anyone with a mental disorder who might need care or treatment. That brings us back to the concern that the hon. Member for Broxbourne (Mr. Walker) himself raised in pointing out that there had been rather a large presence when the person concerned was a young vulnerable girl.
Social workers have raised the issue of getting a warrant more quickly and easily, but we must try to ensure that every effort is made to gain entry in a voluntary manner before resorting to obtaining a warrant. Obviously this does not always work, as was illustrated by the circumstances that the hon. Gentleman outlined. It is feared that opening up new clause 11 in this way would extend those rather intrusive powers. That is why we have a problem with it, and why it is unacceptable. Concerns have been expressed by social workers about this issue, but we have looked at the matter carefully and want to make improvements to the present arrangements at local level between, for example, mental health workers and the police, without taking the rather intrusive powers proposed in the new clause.
Amendment No. 88 was splendidly moved by the hon. Member for Broxbourne, no doubt building on the experience that he gained in Committee. I recognise that concern has, quite rightly, been expressed about the use of police stations for the detention of mentally disordered people. I have recently met representatives of the Police Federation to discuss their concerns about the issue. We also debated this in Committee, where we went over a number of the arguments. I said that I agreed that a police station was not the ideal place to detain such people, and that a hospital-based facility was more likely to be suitable in almost all circumstances.
That is what we are aiming for, but we need to recognise that there will sometimes be occasions when a police station has to be used; my hon. Friend the Member for Bolton, South-East (Dr. Iddon) outlined an example. There could also be circumstances in remote rural areas in which this might have to happen. I am glad that the amendment goes some way towards recognising that, and that it does not try to limit the circumstances in which a police station may be used.
It is true that 72 hours is a long time for someone with a mental disorder to be detained at a police station. It is important to remember, however, that that is the upper limit. Recent data produced, I think, by the Independent Police Complaints Commission showed that the average length of time spent in police custody under section 36 of the 1983 Act was 10 hours, and that the vast majority of people left within 18 hours. In 2005-06, only about 5 per cent. of the people detained remained in custody for more than 24 hours. That is reassuring, but we still need to do better, because it is also clear from the figures that some people are detained for longer than that. The amendment would make it impossible for such people to be detained, which causes real practical problems in regard to our accepting it.
Would it be possible for the Minister to take away the more sensible words that she has used in the House this evening and ask the draftsmen to incorporate them in a suitable change to the Bill? What she has said is rather better than what is in the Bill.
I have been setting out what is in the Bill at the moment, but amendment No. 88 seeks to change some of that. When this was debated in the other place, where it was also a matter of concern, we tabled amendments to sections 135 and 136 of the 1983 Act to allow people to be transferred from one place of safety to another. That will enable a person who has initially been taken to a police station to be moved to another, more suitable, place of safety when appropriate. That was not possible under the current Bill, so we have changed the legislation so that a person with a mental disorder may be moved from a police cell to another place of safety. That will help to reduce the amount of time that some people spend at a police station.
We are backing up this strategy with money: £42 million has been made available to improve the mental health estate, and £58 million this year. Some of that money will facilitate an increase in hospital-based places of safety, which will also reduce the amount of time that some people spend in police stations. In the new code of practice for England, we also intend to reinforce the aim for police stations to be used as a place of safety only as a last resort—for example, only if nowhere more suitable is available. I am sure that hon. Members will appreciate that the code will have some force, particularly in legal cases.
The Minister has spoken eloquently about the period of time that a person might spend in a prison cell. I have heard anecdotal evidence that there is an additional concern about the same individuals repeatedly being taken to a place of safety, usually a police cell, having been pulled off the street perhaps several times a month. What research has the Department undertaken into people with mental health problems who are repeatedly taken into police cells, even if only for short periods of time?
We have held discussions with representatives of the Police Federation and, if my memory serves me correctly, they produced some figures from a particular area. We said to them that it would be helpful to look at best practice and to determine where the relationship between the health services and the police worked well, with a view to getting people into a hospital-based place of safety as quickly as possible. That is why they were pleased about the changes that we have made in the Bill. We also hope that some of the wider measures that we are taking through our amending Bill, such as introducing supervised community treatment, will prevent the kind of revolving-door syndrome that the hon. Gentleman has described, whereby people are discharged from hospital, become ill and are taken in again.
I cannot agree to the new clause or the amendment, but I must reiterate that I understand some of the feelings behind them. If the hon. Member for Broxbourne would be interested in seeing how we are changing the code of practice, I would be more than happy to engage him in that process. I hope that that will offer him some reassurance that we are determined to improve the situation.
I am grateful for the Minister’s response. I am particularly grateful for her invitation to my hon. Friend the Member for Broxbourne to visit her for coffee and biscuits and a full and frank discussion of the code of conduct, an invitation that my hon. Friend will no doubt accept.
I said I did not want to linger on new clause 11 and amendment No. 88 because we wanted to proceed to the final group of amendments, and our proposals may well be taken up in another place. On that basis, I beg to ask leave to withdraw the motion.
Motion and clause, by leave, withdrawn.
Clause 3
Changes to exclusions from operation of 1983 Act
I beg to move amendment No. 91, page 2, line 24, leave out from ‘Act)’ to end of line 26 and insert ‘after subsection (2B) insert—
“(2) Nothing in this section shall be construed to cover paedophilia.
(3) For the purposes of subsection (2) above a person shall not be considered to have a mental disorder as defined in this section solely on the grounds of the following—
(a) his substance misuse (including dependence upon, or use of, alcohol or drugs);
(b) his sexual preference or gender identity;
(c) his commission, or likely commission, of illegal or disorderly acts;
(d) his cultural, religious or political beliefs.”.’.
With this it will be convenient to discuss the following amendment:
No. 69, page 2 , leave out lines 25 and 26 and insert—
‘(3) A person shall not be considered to be suffering from a mental disorder for the purposes of this Act solely on the grounds of—
(a) his substance misuse (including dependence on alcohol or drugs);
(b) his sexual orientation or gender reassignment;
(c) his commission or likely commission of illegal or disorderly acts; or
(d) his cultural, religious or political beliefs.’.
I shall try to be brief, because I know that others wish to speak—although the hon. Member for Hendon (Mr. Dismore), Chairman of the Joint Committee on Human Rights, who tabled amendment No. 69, does not appear to be present, so perhaps we have a little more time than we thought.
Let me begin by putting on record something rather distasteful. Apparently, the Sunday Mirror—not a paper that I read regularly—published an article entitled “Tories to block new paedo law”, which claimed
“The MPs want to water down a new Mental Health Bill allowing dangerous patients to be detained and forced to have treatment. At the moment dangerous patients and perverts can walk the streets simply because they have an ‘untreatable’ condition. . . But Tory MPs will claim the Bill breaches human rights in the Commons tomorrow. They want to exempt ‘sexual deviants’, which could lead to paedophiles claiming they are just ‘deviants’ and should not be locked up.”
What an ill-informed, shoddy bit of journalism and scaremongering from someone who is supposed to be the political editor of the Sunday Mirror, not that I think that that amounts to much of a job. If that article is not scaremongering—misinformed scaremongering—I do not know what is.
It is not only shoddy and ill-informed. My hon. Friend is right about that, but he expressed himself with the characteristic understatement for which he is renowned in all parts of the House. It is also a piece of scurrilous, vicious journalism—precisely the kind of journalism that has the effect of making life worse for very vulnerable people. The editor of that newspaper ought to be ashamed.
I entirely agree. There was a slightly watered-down version of the same attack in the Sunday People, which I believe is a sister newspaper. I use the term “newspaper” loosely. It quoted the Minister, who I hope will disassociate herself entirely from that article and the misrepresenting comments contained in it. I should be happy to hand it over to her. It does no one any justice: it certainly does no justice to the newspaper, and—as my hon. Friend rightly and articulately said—it does no justice to the people whom we are here to help and whom the Bill is intended to help. We have spent a great deal of time trying to achieve that.
Amendment No. 91 is an updated version of an amendment that was passed with a heavy majority by members of the House of Lords in all parties. Its purpose is to provide some exclusions from what has now become a much-extended definition of mental disorder. It would replace the exclusion for dependence on alcohol and drugs with a more appropriately worded exclusion to cover a state of acute intoxication falling short of dependence, reinstate the exclusion clause in the 1983 to cover sexual preferences, substitute for the existing exclusion for immoral conduct a more generic clause to prevent mental health law from being used as a form of social control, and respond to the evidence that people from ethic communities, particularly black communities, are disproportionately subjected to the Act by providing a specific exclusion to help address the problem.
When we have discussed this proposal in the past, the Minister has suggested that it would be a lawyers’ charter and that it would not address the issue of paedophilia, which is obviously of serious concern. The fear has been expressed that paedophiles would escape through a loophole. That is why subsection (2) states
“Nothing in this section shall be construed to cover paedophilia.”
We have made the position much clearer than it needs to be in order to explain it in language that is clear to everyone, which even the political editor of the Sunday Mirror—if he bothered to check his facts properly—might comprehend and take on board, perhaps even apologising for his scurrilous claims next Sunday.
In my experience, newspapers apologise only if we force them to do so by means of the law.
Having spoken to every psychiatrist I know—and I now seem to know a great number of them—I think they would say it is extremely rare for paedophilia to enter a psychiatrist’s domain, except through forensic psychiatry. It nearly always enters that domain through the criminal law rather than the Mental Health Act.
I accept the hon. Gentleman’s point, but we do not want to create a loophole that might allow paedophiles to escape.
We have proposed this measure to be helpful by addressing the specific concern that the Minister raised. She also raised the concern that it might be a lawyers’ bonanza. I can tell her that there have been four reported challenges to the current exceptions since 1983; they are all on sexual deviancy. It is not bad going that there have been only four in the past 24 years. In Victoria and New South Wales in Australia there is a long list of exceptions, including on political opinions and religious beliefs. In New South Wales, there have been no challenges to this law since it was introduced in 1990, and in Victoria there have been very few, if any. Therefore, there should be no cause for concern that this measure might be a lawyers’ charter.
The Richardson expert committee and the Joint Committee on the Draft Mental Health Bill agree that the broad definition of mental disorder introduced in the Bill, which we support, must be balanced by a set of exclusions. The Joint Committee, of which I was a member, said:
“We conclude that a broad definition of mental disorder in the draft Bill must be accompanied by explicit and specific exclusions which safeguard against the legislation being used inappropriately as a means of social control.”
The Bill defines mental disorder very broadly as any disorder or disability of the mind. There is now only one exclusion, for dependence on alcohol and drugs. It is instructive to compare the amended 1983 Act with mental health legislation in other common law countries, all of which have narrower definitions of mental disorder and broader exclusions.
Dr. Metcalfe of Justice has said:
“The European Court of Human Rights has given a clear judgment stating that the definition of mental disorder must be very clear in order for exercise of detention powers to be lawful. The use of exclusions is a standard feature of most common law jurisdictions in meeting that requirement. They meet the requirements of legal certainty, of guaranteeing individual autonomy and of ensuring that the powers of detention are used no more than strictly necessary.”
The broad definition has two consequences. First, it covers all the diagnoses listed in the relevant World Health Organisation international classification of diseases, some of which even the Government acknowledge might be inappropriate in respect of compulsory powers. Secondly, it covers almost any significant deviation from a normal condition of the mind, however temporary.
In the view of the Mental Health Alliance, there must be some limits to guard against inappropriate use of a clinician’s powers of detention as a form of social control. The Mental Health Act Commission said in evidence to the Joint Committee:
“For the law to be of value—to patients, State administrators, mental health professionals, the police, the courts or the Tribunal—its meaning cannot rest upon the discretion of those working within its framework. We do not find it difficult to envisage the inappropriate use, however well meant, of mental health legislation for non-medical purposes of social control”.
We need certainty to avoid the field day for lawyers to which the Minister referred. The limits on powers are welcomed by the clinicians, the British Psychological Society—if I can get another plug in for it—the British Association of Social Workers, the Royal College of Nursing and occupational therapists. Many of them have been prayed in aid on many occasions by the Minister—and now I am praying them in aid for us.
The new definition of mental disorder—any disorder or disability of mind—could include certain mental states and states relating to certain sexual behaviours. The scope of the new definition is much broader than that in the current Act. If the numbers subject to compulsion are not to be markedly and inappropriately increased, the exclusions are necessary. This is important because the definitions in the 1983 Act are the gateway to the compulsory powers that we have been debating. It is important to protect the fundamental right to liberty.
Lord Alderdice said that
“without a serious look at understanding issues such as culture, politics, religion, breaking the law, sexual behaviour and so on, we could end up dragging into the net all sorts of people who are not suffering from mental illness in a proper sense and it becomes a question of how we deal with people who are difficult, different or deviant in our society. That is a real problem for colleagues in psychiatry, not least because of a move to diagnosis on the basis of people's behaviour and a set of symptoms, rather then necessarily understanding something more about the depth of the disorder and its likely prognosis.”
In Scotland—if we may pray in aid the Scottish again—there are the following exclusions: sexual orientation; sexual deviancy; transsexualism; transvestism; dependence on or use of alcohol or drugs; behaviour which causes, or is likely to cause, harassment, alarm or distress to any person; and acting as no prudent person would act. In New South Wales, there is a raft of exclusions, as there is in New Zealand. So again, it is the norm to have exclusions in various jurisdictions around the world.
On the specific exclusion in question, people misuse alcohol if they become drunk as a result. They misuse illicit drugs just by taking them, and other drugs by using them for non-therapeutic or non-prescribed purposes. In both cases, that includes a level of intoxication that does not cause lasting harm or dependence. Both misuse and dependence are covered by international classification of diseases 10, and are therefore classified as mental disorders. It is therefore necessary that the exclusion be worded to cover both, so that neither the binge drinker nor the casual consumer of drugs is considered a case for compulsion.
On sexual preference and gender identity, what is socially acceptable as sexual behaviour is subject to change over time, because it is embodied in religious and cultural value systems. For instance, homosexuality, as we discussed in Committee, was at one time—some time ago, fortunately—considered unacceptable and a sign of mental dysfunction. It was until recently included as a mental disorder in ICD 10. It is no longer necessary to cover sexual orientation because it is neither listed as a mental disorder nor considered in society as a disorder. Indeed, people are protected by anti-discrimination laws and by the Human Rights Act against such an approach.
The House of Lords discussed at great length all sorts of fetishes, transvestism and auto-erotic strangulation, on which they proved to be something in the way of experts. What a lot of fun they do have in the House of Lords. [Interruption.] We had sex addiction. As the Government have expressed great concern about whether this exclusion might cover paedophilia, and in the wish for a compromise, the amendment makes it clear that paedophilia is not within the scope of the exclusion.
There is a lot more that I would like to say, but I will finish as I want colleagues to be able to get in. The provision on political, cultural or religious beliefs—we had this debate in Committee—is of particular importance to members of the black and minority ethnic community. Again, it is a consideration that they have written to us about in serious terms. They feel that what are considered normal practices and beliefs for many members of that community could be construed in extreme circumstances—I am not saying that this will happen every day—as constituting a mental disorder. The perceptions of that community are perhaps more important than the number of times that the provision might in practice be used.
That is why we have brought back this amendment, which we consider very important. There have to be proper checks and balances in the Bill if we are to broaden the definition of mental disorder in the way that we all support. We want a better balance and to protect people, so that those who have other problems can be treated for them and not have them re-badged as a mental illness, and thereby suffer and run the risk that they will be taken under compulsion for something that is not a mental illness.
Order. I should point out that there is very limited time left. I hope that speeches will be brief, as the Minister should be accorded the courtesy of a reply. I call Chris Bryant.
You always say that before you call me, Mr. Deputy Speaker, and you do so with great wisdom. I shall, however, be immensely brief. Although I suspect that the amendment will pushed to a vote, I will not vote with the hon. Member for East Worthing and Shoreham (Tim Loughton), and I simply want to explain why. It is not that I believe that homosexuality is a mental disorder; that we should detain people for their cultural, religious or political beliefs; or that we should detain people because of their likely commission of illegal or disorderly acts. It is simply because the amendment as drafted is complex, in that it involves a triple negative. There have not been many challenges since 1983, because the exceptions were unnecessary in the 1983 Act and are unnecessary today. I do not believe that any of these things is a mental disorder and, therefore, it is patronising to put on the face of the Bill that we consider them not to be mental disorders.
Finally, the liberty of people is already guaranteed by the four tests that have to be met before anybody could be considered for detention under the mental health legislation.
I shall also be brief. An essential difficulty in the legislation is the open nature of the term mental disorder. It is not related to medical taxonomy or to clinical categories and it is therefore helpful to say what it is not. That is the point about most exceptions lists, and about putting principles on the face of the Bill. As has been said, many other legal systems have similar, but not identical lists.
The argument against lists is that they are restrictive and can be faulted on a case by case basis. There are obviously instances of political or religious beliefs, and cultural or sexual practices that are so alarming that, by themselves, they might be symptomatic of a deluded or deranged state, though one would look for other associated symptoms. One thinks, for example, of the political or—for that matter—religious views of someone such as David Icke, and things such as paedophilia and necrophilia. Equally, we can cite instances in which gay people, communists, religious dissenters and generally socially wayward people have been labelled improperly as mentally ill.
It is a fascinating topic, but it is essentially theoretical. In real world situations, including exceptions does no evident harm, sends out important signals about cultural and social sensitivity and tilts practice in a wholly desirable way, as do statements of principles. If we were making law in a Platonic spirit of purity, completely unhooked from practice, disconnected from context and timeless in its significance, an exceptions clause would not be included, but that is not what we usually do. We usually do a more pragmatic and mundane job and, in the current circumstances of the worldwide climate we inhabit, there is not a shred of evidence that including exceptions does any harm, and a fair presumption that it may do some good.
Once again, we return to a topic that was a matter of considerable controversy and impassioned debate throughout the passage of the Bill, and indeed during its long gestation. That is whether it is necessary to include on the face of legislation a list of matters that are not to be regarded as mental disorders. My hon. Friend the Member for Rhondda (Chris Bryant) put his finger on it—[Interruption.] Do wake up! We are all quite interested in this issue—
Clearly. At the moment, there are three exclusions in the mental health legislation as it stands. Our intention is to keep the exclusion for alcohol and drug dependence, but to abolish those for sexual deviancy and for
“promiscuity and other immoral conduct.”
The exclusion for promiscuity and immoral conduct dates back to the 1959 Act and the way mental health legislation had been misused before that to detain unmarried mothers and otherwise enforce moral codes. The exclusion has now served its purpose and is no longer needed.
The exclusion for sexual deviancy added in 1982 was probably intended to refer to homosexuality. As my hon. Friend the Member for Rhondda said, that was at that time still listed as mental disorder in the international classification of diseases. However, that exclusion was quickly associated with paedophilia and sexual offending. Its effect has been that paedophiles, for example, can be detained and treated under the Act, but only where clinicians diagnose an underlying condition, such as an antisocial personality disorder. Paedophilia—though a recognised mental disorder in itself—is excluded because of the provision on sexual deviancy, which is why we are removing it.
The amendments propose a set of new exclusions, but most of them refer to things that are not mental disorders in the first place. In other debates on these matters, in Committee and elsewhere in the House, Opposition Members have maintained that the proposals are less to do with what is happening at the moment than with what might happen if a very extreme Government were to take over—
We have that already.
We are getting close, I admit, and maybe it is not such a bad idea. However, my point is that an extreme Government might ask clinicians to start detaining people for their cultural, religious or political beliefs. The hon. Member for Daventry (Mr. Boswell) is one of those who has put the other argument—that the amendment does not have to do with UK practice or with the good faith of Ministers or the existing system but with the fact that there have been chilling experiences in other countries, where people have been singled out for mental treatment because their faces did not fit.
The points about other countries are probably valid, but we must remember that we are legislating for this country. Given that clinicians have not detained people for their political beliefs for many years, the idea that the advent of an extreme Government will mean that they will suddenly start detaining people under the Mental Health Act is a little difficult to swallow.
Is the Minister confident that all the exclusions listed in amendment No. 91 are covered specifically in other legislation, and that there is therefore no need to name them to send the message outlined by the hon. Member for Southport (Dr. Pugh)?
It would not be possible to detain people for their religious beliefs, because the Act states that people can be detained only if they have a mental disorder. A person’s religion is not a mental disorder, and neither are his political or cultural beliefs or, as my hon. Friend the Member for Rhondda pointed out, his sexual preference or identity.
The existing legislation provides an ability to appeal to the mental health review tribunal. The principles that will be put in the code were accepted when they were considered by the Lords, and they make it clear that unlawful discrimination is not allowed. The relevant criteria—that the person involved has a mental disorder and is capable of causing serious harm to himself or others, and that appropriate medical treatment is available that must be delivered in a hospital setting—have to be met. If they are not, the person involved cannot be detained.
I can understand why people feel that the amendment would be nice, but I have some concerns about it. The Mental Health Alliance has said that exclusions act as a check on clinical discretion, but I believe that we should be trying to ensure that clinicians can treat people as they need it. The amendment is seen as a safeguard, but I do not think that it is because, as I said earlier, the circumstances that it lists are not mental disorders. Legal exclusions should cover things that are mental disorders, not things that are not.
I want to make three quick points. First, the principles to which the Minister referred are not on the face of the Bill. Secondly, I agree that we are legislating for this country, now. However, does she accept that the legislation on mental health and other issues passed by this House sets an example to the world, and that other countries with Governments even less scrupulous than this one take notice? Thirdly, does she admit that our proposal in respect of paedophilia lays to rest the fears that she might have had in that respect?
I certainly accept that the hon. Gentleman has made a case for the exception of paedophilia. He says that the legislation may last for a long time, and that to prevent the actions of some future Government we need to include exceptions now, but waving the Mental Health Act at a Government who are locking people up for their political, religious or cultural beliefs is unlikely to have an effect.
The Minister has said twice that she believes there are things listed as exemptions that are not true mental disorders, but in paragraph 19 of her lengthy and helpful reply of 1 April to the Joint Committee on Human Rights, she says:
“The Government does not share the Committee’s view…that gender dysphoria and transvestic fetishism could never be regarded as true mental disorders”—
They are not in the list.
But subsection (b) of the amendment—
“his sexual preference or gender identity”—
could clearly refer to transvestic fetishism and, by definition, gender dysphoria. Can the Minister explain that?
We are not discussing that—[Interruption.] In fact, I said that most of the exceptions were not mental disorders and those are the ones that worry me.
Although there have been only a small number of challenges to the legislation, they have been worrying; for example, the Clatworthy case, in which the patient was convicted of indecent assault of two young girls and detained on grounds of psychopathic disorder. After the sexual deviancy exclusion was introduced his case went before the mental health review tribunal where it was argued that he did not meet a definition of psychopathic disorder because his only dangerous behaviour was sexually deviant and was thus excluded. The tribunal disagreed but the case went to judicial review and the judge found in favour of the patient. We must not imagine that such circumstances will not arise. There have already been four major cases and they have affected the operation of the tribunal.
Secondly, the more exclusions in the Bill covering conditions that are not mental disorders, the more the possibility of a challenge. Somebody could easily claim that they were detained because of their religious persuasion—because they said, “I have X, Y, Z powers”. A challenge could be mounted on each of the exclusions. When people are detained against their will, they will look for ways to challenge their detention. There can be reasonable grounds that a person does not have a mental disorder, but we must not confuse the issue by including a range of conditions in the Bill that an individual could use to meet a challenge against their detention.
I want to back up the point made by my hon. Friend the Member for Rhondda. He is right: it is patronising to say that we have to exclude sexual preference as a possible mental disorder, when it is clearly not a mental disorder. A similar issue arises in relation to autism. People from the National Autistic Society asked me why we were describing autism as a mental disorder, because some of them do not accept that description. If we say that sexual preference must be listed as an exclusion in the Bill because it is a mental disorder, we are sending the wrong message. That is why we cannot accept the amendment and I ask the hon. Member for East Worthing and Shoreham (Tim Loughton) to withdraw it.
The Minister’s arguments are not new and I do not accept them. The point that I made about our being a beacon of legislation to the rest of the world is particularly pertinent as we consider this very important part of the Bill. We do need to have these proper checks and balances, so I shall press the amendment to a Division and I ask hon. Members to support it.
Question put, That the amendment be made:—
The House divided: Ayes 196, Noes 282.Division No. 146][8.59 pmAYESAfriyie, AdamAinsworth, Mr. PeterAlexander, DannyAmess, Mr. DavidArbuthnot, rh Mr. JamesAtkinson, Mr. PeterBacon, Mr. RichardBaker, NormanBaldry, TonyBaron, Mr. JohnBarrett, JohnBeith, rh Mr. AlanBellingham, Mr. HenryBercow, JohnBeresford, Sir PaulBinley, Mr. BrianBone, Mr. PeterBoswell, Mr. TimBottomley, PeterBrady, Mr. GrahamBrake, TomBreed, Mr. ColinBrokenshire, JamesBrooke, AnnetteBrowne, Mr. JeremyBrowning, AngelaBruce, rh MalcolmBurns, Mr. SimonBurrowes, Mr. DavidBurstow, Mr. PaulBurt, AlistairBurt, LorelyButterfill, Sir JohnCampbell, Mr. GregoryCampbell, rh Sir MenziesCarmichael, Mr. AlistairChope, Mr. ChristopherClappison, Mr. JamesClark, GregClegg, Mr. NickCormack, Sir PatrickCox, Mr. GeoffreyCrabb, Mr. StephenDavey, Mr. EdwardDavies, David T.C. (Monmouth)Davies, Mr. QuentinDjanogly, Mr. JonathanDodds, Mr. NigelDonaldson, rh Mr. Jeffrey M.Dorrell, rh Mr. StephenDuddridge, JamesDuncan, AlanDuncan Smith, rh Mr. IainEllwood, Mr. TobiasFabricant, MichaelFallon, Mr. MichaelFarron, TimFeatherstone, LynneField, Mr. MarkFrancois, Mr. MarkGale, Mr. RogerGarnier, Mr. EdwardGauke, Mr. DavidGeorge, AndrewGibb, Mr. NickGidley, SandraGillan, Mrs. CherylGoldsworthy, JuliaGoodman, Mr. PaulGoodwill, Mr. RobertGray, Mr. JamesGreen, DamianHague, rh Mr. WilliamHancock, Mr. MikeHarper, Mr. MarkHarris, Dr. EvanHarvey, NickHeald, Mr. OliverHeath, Mr. DavidHemming, JohnHendry, CharlesHolloway, Mr. AdamHolmes, PaulHoram, Mr. JohnHorwood, MartinHowarth, DavidHughes, SimonHuhne, ChrisHunt, Mr. JeremyJack, rh Mr. MichaelJackson, Mr. StewartJenkin, Mr. BernardJones, Mr. DavidKawczynski, DanielKeetch, Mr. PaulKennedy, rh Mr. CharlesKey, RobertKirkbride, Miss JulieKnight, rh Mr. GregKramer, SusanLaing, Mrs. EleanorLait, Mrs. JacquiLamb, NormanLansley, Mr. AndrewLaws, Mr. DavidLeech, Mr. JohnLeigh, Mr. EdwardLetwin, rh Mr. OliverLewis, Dr. JulianLiddell-Grainger, Mr. IanLidington, Mr. DavidLilley, rh Mr. PeterLoughton, TimLuff, PeterMackay, rh Mr. AndrewMain, AnneMalins, Mr. HumfreyMates, rh Mr. MichaelMcCrea, Dr. William McIntosh, Miss AnneMcLoughlin, rh Mr. PatrickMiller, Mrs. MariaMilton, AnneMoore, Mr. MichaelMoss, Mr. MalcolmMulholland, GregMurrison, Dr. AndrewNeill, RobertOaten, Mr. MarkÖpik, LembitOttaway, RichardPaice, Mr. JamesPaterson, Mr. OwenPelling, Mr. AndrewPenning, MikePenrose, JohnPickles, Mr. EricPrisk, Mr. MarkPritchard, MarkPugh, Dr. JohnRandall, Mr. JohnRedwood, rh Mr. JohnReid, Mr. AlanRennie, WillieRobathan, Mr. AndrewRobertson, HughRobertson, Mr. LaurenceRogerson, Mr. DanRosindell, AndrewRowen, PaulRussell, BobScott, Mr. LeeSelous, AndrewShapps, GrantShepherd, Mr. RichardSimmonds, MarkSimpson, DavidSimpson, Mr. KeithSmith, Sir RobertSpelman, Mrs. CarolineSpicer, Sir MichaelSpink, BobStanley, rh Sir JohnStreeter, Mr. GaryStunell, AndrewSwayne, Mr. DesmondSwinson, JoSyms, Mr. RobertTaylor, Mr. IanTaylor, MatthewTaylor, Dr. RichardTeather, SarahThurso, JohnTyrie, Mr. AndrewVara, Mr. ShaileshViggers, PeterWalker, Mr. CharlesWallace, Mr. BenWaterson, Mr. NigelWatkinson, AngelaWebb, SteveWiddecombe, rh Miss AnnWiggin, BillWilletts, Mr. DavidWilliams, HywelWilliams, MarkWilliams, Mr. RogerWilliams, StephenWillott, JennyWilshire, Mr. DavidWilson, Mr. RobWinterton, Sir NicholasWright, JeremyYeo, Mr. TimYoung, rh Sir GeorgeYounger-Ross, RichardTellers for the Ayes:Mr. David Evennett andMr. Mark LancasterNOESAbbott, Ms DianeAinger, NickAinsworth, rh Mr. BobAlexander, rh Mr. DouglasAllen, Mr. GrahamAustin, Mr. IanAustin, JohnBailey, Mr. AdrianBaird, VeraBalls, EdBanks, GordonBarlow, Ms CeliaBarron, rh Mr. KevinBattle, rh JohnBayley, HughBell, Sir StuartBenn, rh HilaryBenton, Mr. JoeBerry, RogerBetts, Mr. CliveBlunkett, rh Mr. DavidBrennan, KevinBrown, LynBrown, rh Mr. NicholasBrown, Mr. RussellBrowne, rh DesBryant, ChrisBuck, Ms KarenBurden, RichardBurgon, ColinBurnham, AndyButler, Ms DawnByers, rh Mr. StephenByrne, Mr. LiamCaborn, rh Mr. RichardCairns, DavidCampbell, Mr. AlanCampbell, Mr. RonnieCaton, Mr. MartinCawsey, Mr. IanChallen, ColinChapman, BenChaytor, Mr. DavidClapham, Mr. MichaelClark, PaulClarke, rh Mr. CharlesClarke, rh Mr. TomClelland, Mr. DavidClwyd, rh AnnCoaker, Mr. VernonCoffey, AnnCohen, HarryConnarty, MichaelCooper, RosieCorbyn, JeremyCousins, Jim Crausby, Mr. DavidCryer, Mrs. AnnCummings, JohnCunningham, Mr. JimCunningham, TonyDavid, Mr. WayneDavies, Mr. DaiDean, Mrs. JanetDenham, rh Mr. JohnDevine, Mr. JimDismore, Mr. AndrewDobbin, JimDobson, rh FrankDonohoe, Mr. Brian H.Doran, Mr. FrankDowd, JimDrew, Mr. DavidEagle, AngelaEagle, MariaEllman, Mrs. LouiseEnnis, JeffFitzpatrick, JimFlello, Mr. RobertFlint, CarolineFlynn, PaulFollett, BarbaraFoster, Mr. Michael (Worcester)Foster, Michael Jabez (Hastings and Rye)Francis, Dr. HywelGapes, MikeGeorge, rh Mr. BruceGerrard, Mr. NeilGibson, Dr. IanGilroy, LindaGodsiff, Mr. RogerGoggins, PaulGoodman, HelenGriffith, NiaGriffiths, NigelGrogan, Mr. JohnGwynne, AndrewHain, rh Mr. PeterHall, Mr. MikeHamilton, Mr. DavidHamilton, Mr. FabianHanson, rh Mr. DavidHarman, rh Ms HarrietHarris, Mr. TomHavard, Mr. DaiHealey, JohnHenderson, Mr. DougHendrick, Mr. MarkHepburn, Mr. StephenHermon, LadyHesford, StephenHewitt, rh Ms PatriciaHeyes, DavidHill, rh KeithHodge, rh MargaretHood, Mr. JimHoon, rh Mr. GeoffreyHope, PhilHopkins, KelvinHowarth, rh Mr. GeorgeHowells, Dr. KimHoyle, Mr. LindsayHughes, rh BeverleyHumble, Mrs. JoanHutton, rh Mr. JohnIddon, Dr. BrianIllsley, Mr. EricIrranca-Davies, HuwJames, Mrs. Siân C.Jenkins, Mr. BrianJohnson, Ms Diana R.Jones, HelenJones, Mr. KevanJones, LynneJones, Mr. MartynJoyce, Mr. EricKaufman, rh Sir GeraldKeeble, Ms SallyKeeley, BarbaraKeen, AnnKemp, Mr. FraserKennedy, rh JaneKhan, Mr. SadiqKidney, Mr. DavidKilfoyle, Mr. PeterKumar, Dr. AshokLammy, Mr. DavidLazarowicz, MarkLepper, DavidLevitt, TomLewis, Mr. IvanLloyd, TonyLove, Mr. AndrewLucas, IanMackinlay, AndrewMactaggart, FionaMalik, Mr. ShahidMallaber, JudyMann, JohnMarris, RobMarsden, Mr. GordonMarshall, Mr. DavidMarshall-Andrews, Mr. RobertMartlew, Mr. EricMcAvoy, rh Mr. ThomasMcCabe, SteveMcCafferty, ChrisMcCarthy, KerryMcCartney, rh Mr. IanMcDonagh, SiobhainMcDonnell, Dr. AlasdairMcFadden, Mr. PatMcFall, rh JohnMcGrady, Mr. EddieMcGuire, Mrs. AnneMcIsaac, ShonaMcKechin, AnnMcNulty, Mr. TonyMeacher, rh Mr. MichaelMeale, Mr. AlanMerron, GillianMichael, rh AlunMilburn, rh Mr. AlanMiliband, EdwardMiller, AndrewMitchell, Mr. AustinMoffat, AnneMoffatt, LauraMole, ChrisMoon, Mrs. MadeleineMoran, MargaretMorden, JessicaMorgan, JulieMorley, rh Mr. ElliotMullin, Mr. ChrisMunn, MegMurphy, Mr. DenisMurphy, Mr. Jim Murphy, rh Mr. Paul Naysmith, Dr. DougNorris, DanO'Brien, Mr. MikeOlner, Mr. BillOsborne, SandraOwen, AlbertPalmer, Dr. NickPearson, IanPlaskitt, Mr. JamesPound, StephenPrentice, BridgetPrentice, Mr. GordonProsser, GwynPurchase, Mr. KenPurnell, JamesRammell, BillRaynsford, rh Mr. NickReed, Mr. AndyReed, Mr. JamieRiordan, Mrs. LindaRobertson, JohnRobinson, Mr. GeoffreyRooney, Mr. TerryRoy, Mr. FrankRuane, ChrisRuddock, JoanRussell, ChristineRyan, JoanSalter, MartinSeabeck, AlisonShaw, JonathanSheerman, Mr. BarrySheridan, JimSimon, Mr. SiônSimpson, AlanSingh, Mr. MarshaSkinner, Mr. DennisSlaughter, Mr. AndySmith, rh Mr. AndrewSmith, Ms Angela C. (Sheffield, Hillsborough)Smith, Angela E. (Basildon)Smith, GeraldineSmith, rh JacquiSmith, JohnSnelgrove, AnneSoulsby, Sir PeterSpellar, rh Mr. JohnStarkey, Dr. PhyllisStoate, Dr. HowardStrang, rh Dr. GavinStraw, rh Mr. JackStringer, GrahamSutcliffe, Mr. GerryTami, MarkTaylor, Ms DariTaylor, DavidThomas, Mr. GarethTimms, rh Mr. StephenTipping, PaddyTouhig, rh Mr. DonTrickett, JonTruswell, Mr. PaulTurner, Dr. DesmondTwigg, DerekVaz, rh KeithVis, Dr. RudiWalley, JoanWaltho, LyndaWard, ClaireWareing, Mr. Robert N.Watson, Mr. TomWatts, Mr. DaveWhitehead, Dr. AlanWilliams, rh Mr. AlanWilliams, Mrs. BettyWinnick, Mr. DavidWinterton, rh Ms RosieWoodward, Mr. ShaunWoolas, Mr. PhilWright, Mr. AnthonyWright, DavidWright, Mr. IainWright, Dr. TonyWyatt, DerekTellers for the Noes:Mr. John Heppell andLiz BlackmanQuestion accordingly negatived.
It being after Nine o’clock, Mr. Deputy Speaker put forthwith the Question necessary for the disposal of the business to be concluded at that hour, pursuant to Order [18 June].
Clause 51
Commencement
Amendment made: No. 50, page 44, line 14, leave out ‘or different areas’ and insert
‘(including different provision for different areas and different provision for different descriptions of patient)’.—[Ms Rosie Winterton.]
Order for Third Reading read.
I beg to move, That the Bill be now read the Third time.
The Mental Health Act 1983—[Interruption.]
Order. I apologise for interrupting the right hon. Lady, but it is quite unfair to the Minister at the Dispatch Box if conversations are going on in the Chamber. Hon. Members should stay if they wish to listen to the debate, or depart quietly.
Thank you, Mr. Deputy Speaker.
The Mental Health Act 1983 is primarily about the circumstances in which people with a serious mental health problem can be detained and treated without their consent to protect themselves or others from harm. Not surprisingly, this is a sensitive matter, so any Bill to amend that Act is likely to provoke much debate and controversy.
It might be helpful if I set out why the Government want to update our mental health legislation. We want to ensure that people with serious mental health problems receive the treatment that they need to protect themselves and others from harm. We need to recognise that the world has moved on since 1983. Many more people can now be treated in the community, rather than in hospitals, so the use of compulsory powers should reflect that. Professional demarcation lines have changed since 1983, and functions are now being carried out by people with the right skills and experience, rather than individuals from particular professions. Again, our legislation should change to reflect that fact. We also want to strengthen patient safeguards, which includes tackling human rights incompatibilities.
The Government began their review of mental health legislation in 1998. Since then, reforming the legislation has been the subject of wide-ranging debate, which has been enormously helpful. We have listened to relevant stakeholders and made many changes as a result of discussions with them. The decision to proceed with an amendment Bill rather than the 2004 draft Bill was a response to the recommendations of the pre-legislative scrutiny Committee. I take this opportunity to thank that Committee for all the work that it did.
We have had long and helpful discussions in the House on the Bill before us. The discussions in Committee were particularly helpful—
Absolutely. I am glad that I was able to table a range of amendments on Report covering issues that were raised in the other place and in Committee. I am pleased that we were able to accept the excellent amendments from my hon. Friends the Members for Rhondda (Chris Bryant) and for Bridgend (Mrs. Moon), which were supported by many other members of the Committee. I am glad that the Opposition parties also gave their support to a number of the amendments that we tabled. I am thinking particularly of the amendments on age-appropriate accommodation and, crucially, those on victims and on advocacy.
There has been much debate on other amendments that the Government did not accept. I hope that I have been able to explain why we have not accepted them, although I am not sure that I convinced everybody on the Opposition Benches of the merits of our case.
This could be the last intervention that I make on the Bill. One of the amendments that the Minister did not accept in Committee was the request to have people with autistic spectrum disorders added to the exemptions in the Bill. The National Autistic Society, of which I am a vice-president, writes today about the Report stage, saying that people with autistic spectrum disorders continue to be detained inappropriately, and the society believes that their situation will be worsened by the Bill, not improved by it.
We discussed autism not only in Committee, where the hon. Lady tabled a number of amendments, but when I attended the all-party group on autism. In addition, in discussions that I had until Friday last week, my hon. Friend the Member for Burton (Mrs. Dean) put forward arguments from the National Autistic Society. The meeting of the all-party group showed some of the divergence of opinion, even among those representing people with autism. I am thinking particularly of one of the Opposition Members who questioned why we were even considering some of the changes that the hon. Lady suggested. It is a complicated subject but I was glad that we were able to have the debate in Committee. I am more than happy to continue to look at how we can assist on issues such as the code of practice, to make sure that services are developed appropriately. As I said, I hope that the amendments that I tabled on supervised community treatment, the conditions that can be applied and how they will be applied will give some reassurance to those who are concerned about SCT.
Where we have not been able to accept amendments, we are trying to use non-legislative means to tackle the issues raised, such as the nearest relative provisions, which were mentioned by my hon. Friend the Member for Birmingham, Selly Oak (Lynne Jones), and places of safety, which were also mentioned today. We will continue to work on those matters, although it was not necessarily right to include them in the Bill.
I thank the many organisations that have worked with us in developing some of the Government amendments. In particular, I thank YoungMinds and the children’s commissioner—an office that, as I have said, is now called 11 Million.
Sir 11 Million.
Indeed. We have also had some very constructive dialogue with the new coalition of mental health organisations, particularly about the role of the responsible clinician.
We have tried to continue to engage with Members of the other place throughout the discussions. I pay particular tribute to Lord Williamson for his help in developing the age-appropriate services. As I said, our discussions in this House have followed on from many of the discussions in the other House, which have informed our debates. I believe that although we have not been able to respond to all the concerns raised there, we have been able to respond to very many of them.
I should like quickly to mention the Making Decisions Alliance and all that it has contributed to the development of the new safeguards for those deprived of their liberty in their best interests. We sometimes forget that the Bournewood changes are a very important part of the legislation, about which I know that two Opposition Members are particularly concerned.
I should also mention all the work put into the analysis of the Bill by the Joint Committee on Human Rights and my hon. Friend the Member for Hendon (Mr. Dismore). Of course, I should also thank the officials who have supported me so effectively throughout the Bill’s passage. I hope that hon. Members would say that the officials have been open to discussion and approachable to Members of the House if they have been needed to give other information. I also thank all members of the Committee. We had an excellent debate with participation from all sides, and we were able to explore many of the issues very thoroughly.
I want to stress how much we want to continue to work with a wide range of stakeholders in implementing the Bill once it receives Royal Assent. I know that many have already been involved in developing the code of practice, and we would certainly like further input from all those with an interest, including Members of the House. Many have also been involved in drafting the secondary legislation, such as measures on new professional roles. Again, we want to work with all concerned to make sure that we get this right.
All told, I think that the Bill that we are—I hope—about to send back to the other place is a significant improvement on the one that came to this House, although we have been able to reflect some of the discussions there in the amendments that we have been considering over the past two days. I hope that Members of the other place will feel that we have taken on board their concerns and responded to the points that they made, as well as to the points made in Committee. I have no hesitation in commending the Bill to the House and wishing it a speedy completion.
I echo the Minister’s words in saying that the Bill has provoked much debate and controversy, which I think is probably something of an understatement. It has been a long haul; as she said, nine years have gone by. I think that I have been responsible for the matter on the Opposition Benches for five of those nine years, and that she has had responsibility for a little longer. [Interruption.] It feels like we have been at it for a long time on the Mental Health Bill. We have been through two draft Bills, the pre-legislative scrutiny Committee, this Bill, the Richardson expert committee and countless meetings, briefings and debates with various members of the Mental Health Alliance and others.
I pay tribute to the hon. Members on both sides of the House who have contributed. We had a lively debate in Committee—it was described as “helpful and superb”—and I also thank the Bill team, who were helpful.
The Mental Health Alliance is a big alliance that formed because of the Bill. Whether or not we agree with everything that it has said, it has had an enormous input into the Bill. We must remember the enormous amount of good work that many of the organisations that form the Mental Health Alliance do on behalf of thousands of people up and down the country every day of the week. We need a Bill that helps those organisations, because they look after some of the most vulnerable members of society.
I pay tribute to the work that was done in the Lords. I disagree with the Minister about whether this Bill is better than the one that came from the Lords. An enormous amount of professional expertise was applied to the Bill in the Lords, and I think that Members of the other place may have a few things to say when it returns to them.
I pay tribute to the many professionals who day in, day out do a difficult job looking after people with a mental illness. Again, our duty is to make their job easier and to clarify the law under which they work, which has always been our intention. I agree with the Minister that there is a need to update the legislation. The 1983 Act was largely based on the 1959 Act, so it is almost 50 years since the underlying principle of the legislation was updated.
There have been advances in mental health treatment, mental health law and the flexibility with which we deal with patients. Rightly, we must respect people’s lifestyles: we have moved away from the asylum system; the professions involved have changed; and there are human rights incompatibilities. All along, we have said that we need a Mental Health Bill, but we need the right Mental Health Bill.
I welcome the Minister’s success in getting the Government to move a substantial distance in a number of areas. She took note of the record six defeats in the Lords on substantial points of great principle. We welcome what we have seen on Report in the past two days on age-appropriate treatment. I also echo the Minister’s tribute to Lord Williamson’s amendments, which started the process.
As I have said, we have made good moves on introducing victims’ rights into the Bill. I welcome the compromise on treatability and pay tribute to the hon. Member for Rhondda (Chris Bryant) for the intelligent, balanced and assiduous way in which he introduced it. We have removed some of the more objectionable and unworkable parts of community treatment orders, not least the provision on abstaining from particular behaviours, and we have linked CTOs to medical treatment.
However, we have not gone far enough. The Bill still fails to take into account the international evidence, which the Government commissioned. It is still far too open-ended, and as such we think that it provides too much of a deterrent for people to engage with mental health services. We are still at odds with the Government about the roles of various “responsible clinicians”, which may be open to legal challenge. Furthermore, inconsistencies remain with the Mental Capacity Act 2005 and the renewal of detention following initial sectioning. We still have serious problems about the definitions and the exclusions. It is unfortunate that the debate on that was truncated, because those are substantial points of disagreement that go to the heart of the Bill.
Unfortunately, we have had no movement on impaired decision making. The new clause was meant as an antidote to the stigma that surrounds mental illness, which concerns us all. Some of the Minister’s references to high-profile cases, such as the Michael Stone case, were unfortunate. She mentioned the Michael Stone case today and in Committee.
indicated dissent.
If the Minister reads the record tomorrow, she will see that she mentioned the Michael Stone case. Without trying to single out one case, what happened in that case, as in so many other such tragic incidents, is that the system fell down—
Before I give way to the Minister, I should say that if she did not mention the Michael Stone case, I may have confused it with the John Barrett case. She has mentioned the Michael Stone case before. What is common to all those cases is that they show a failure of the system and the services in not being there to pick up those people when they needed to be picked up.
The hon. Gentleman is quite wrong to say that I have mentioned the Michael Stone case—I have not. I mentioned the Michael Barrett inquiry—I am sorry, the John Barrett inquiry—because one of its conclusions was that the only way that it would have been possible to ensure that John Barrett complied with treatment as an out-patient would have been through supervised community treatment, which was not available at the time. That is why we believe that supervised community treatment is important.
I entirely take the Minister’s point. I think that we are confusing Michaels and Johns; if that is my fault, I apologise. Nevertheless, whatever reference has been made to community treatment orders, there was in both cases a failure by the system in relation to somebody who tried to engage with it, and a failure by the services to provide a safety net and to move in at the appropriate time.
In the debate on impaired decision making, I was particularly concerned about the fact that the definition of “untreatable” involves people being turned away from services. That suggests that the Bill is being used as a substitute for the lack of appropriate services and deficiencies in the mental health service as it stands. It confuses availability and access to services with the need for coercion in order to ensure that patients accept services that are offered. As Dr. George Szmukler, dean of the Institute of Psychiatry has said,
“The government has objected that this amendment might leave out people who need treatment. It is alarming to think that the state has reached the point that everyone who is deemed to ‘need treatment’ should be detained if they disagree.”
Access to treatment seems to have become entirely entwined with the legislative ability to subject to section and compulsorily treat a patient. Is not that a rather terrible indictment of the state of mental health services?
The Minister has admitted that under her mental health system she would turn people away if she could not subject them to compulsory treatment. We seem to have reached a stage analogous with somebody who has heart disease, with blocked arteries, presenting at a hospital and being told, “You must either have a heart transplant or no treatment at all.” It should not be all or nothing; it should be coercion and sectioning only in the most extreme circumstances. The Minister seems to be proceeding under the highly flawed and worrying premise that if someone cannot be sectioned he will not get the treatment. That is wrong—it should not be the case under mental health law—but the Minister is labouring under that misapprehension.
It is interesting to note that the Minister dismissed out of hand the situation that will pertain, for example, in the constituency of Kirkcaldy and Cowdenbeath—that of the incoming Prime Minister. Under her assumptions and analysis, the constituents of Kirkcaldy and Cowdenbeath are being allowed to commit suicide because of impaired decision making, yet she has no evidence to support it. Has the incoming Prime Minister said, “Under impaired decision making, there is a serious problem with my constituents being more susceptible to suicide”? I very much doubt that there has been, yet the Minister is going to create a difference between mental health law on either side of the border. Clearly, Scotland has produced much more enlightened mental health legislation, and that will throw up serious differences between how patients are treated on either side of the border.
The hon. Gentleman has consistently failed to answer one question. He says that there will be people who would not need to be detained because they did not have impaired judgment, but he has never given the figure for how many people he thinks it acceptable to turn away from services saying, “We’re not going to treat you either because you are a danger to yourself or a danger to others.” What is that figure?
The Minister is trying to repeat our previous, truncated debated. Her logic and analysis imply that, in the incoming Prime Minister’s constituency, under the Mental Health (Care and Treatment) (Scotland) Act 2003, which contains impaired decision-making provisions, people are much more susceptible to suicide. There is no empirical evidence for that.
We are worried because there is a significant risk that the Bill will undo much of the good work in improving mental health services and the relationships between service users and providers. There is a genuine risk of investing in a new regime of compulsion, which will have a counter-productive effect, alienating rather than engaging with people with mental health problems and possibly increasing rather than reducing patient and public safety. Patients could well slip under the clinical radar, and we do not want that to happen. We want a Bill with which we can work, with which clinicians can work and with which patients can work and engage. We want a Bill that reassures the public that their safety is being protected, and balanced with the liberty and medical care of others.
We need a Bill that is fit for the 21st century. We are almost there, but the measure, which now returns to the Lords, still contains too much that is objectionable and will deter people from presenting. We cannot, therefore, support it as it stands. I urge my colleagues to vote against it, but in doing that, I hope that the Government will take our concerns on board, engage constrictively with the Lords and go that bit further so that we can have a Mental Health Act 2007 of which we can all be proud. I look forward to considering the measure again when the Government have taken our concerns on board and it returns from the Lords.
I agree with the Minister that we have held a series of excellent discussions on Second Reading, in Committee and yesterday and today. Every member of the Committee took part in the debate to a greater or lesser extent—I believe that that is unusual. In my admittedly limited experience, the contributions from hon. Members of all parties in Committee were of an extremely high standard.
Opposition suggestions and amendments have brought about changes and Back-Bench amendments have also been adopted. That has improved the Bill. Unlike the hon. Member for East Worthing and Shoreham (Tim Loughton), I believe that the measure is an improvement on the current position. It is not perfect and other improvements can be made, but it is better than the Bill that was introduced a few weeks ago.
The measure will return to the other place and I hope that their Lordships will at least recognise that it has not been rammed through the House—far from it. Careful consideration has been made of every point—some might say ad nauseam. I hope that their Lordships will pay some heed to that.
On a final, personal note, tonight marks the end of some five years’ involvement with scrutinising the Bill’s predecessor and serving on the Committee that considered the current measure. There is therefore a sadness, but I believe that we have produced something better than we had previously. I recognise that there has been much constructive working among many people who are in the Chamber this evening to achieve that.
After a long journey, we have reached an interesting juncture. The Bill arrived in the Commons surrounded by controversy, heavily amended and cloaked in colourful rhetoric. Some said that it was simply a Home Office measure, which was intent on coercing the mentally ill, an open charter for compulsory medication or a means of handing out psychiatric ASBOs, likely to terrify and worsen patients’ conditions. Others claimed that it was the last chance to prevent an epidemic of killing by deranged people and the only way to stop psychopaths freely walking the streets.
Some peopled the world with psychiatrists twitching to incarcerate the vulnerable, the eccentric and the politically deviant. Others spoke of a profession turning its back on the troublesome and the homicidal. However, in the Commons, the Committee stage, secluded in a Committee Room, reduced the temperature. Points were probed and some small progress was made. Subsequent off-stage meetings accelerated the process and I hope that Report has moved things on further.
Looking at our debate as a whole, a bystander might wryly note the fact that each side quotes the Scottish Act from time to time like scripture, but only the bits they really like; that each side quotes experts, but only the ones they really like and dismisses the others as “so-called”; that each side demands evidence for opposing claims, but not always for its own—as, for example, with our discussion of compulsory treatment orders; and that each side quotes opinion surveys, but only the ones that suit. Personally, I have difficulty in any case involving complex matters in believing that the majority are necessarily right. I sometimes have difficulty in believing that even the Liberal Democrats are necessarily right—[Hon. Members: “Hear, hear.”]
Suspicion about intentions and fear of professionals abusing power have been persistent traits in this debate and in the briefings, which perhaps indicates that there is more widespread paranoia around than hitherto. Unusually—the Bill has been unusual in this respect—the vast bulk of Opposition amendments tabled both in this and the other place have been skilfully drafted by a few but very influential external hands, who helpfully handed many ready-framed amendments to MPs—a kind of Blue Peter model of legislation.
As a result, we have got concessions from the Government—very welcome concessions, but possibly not enough—on children, advocacy and treatability. In other areas, the Government have stood their ground and we will have to go a little bit further. Where our arguments are good—they will be put in the other place—we would expect concessions and not stubbornness. Ultimately, this is not for any of us a political issue. It is about putting good legislation in place on a very difficult subject, which will last for decades. Whether it is done through truculence in the Lords or Socratic questioning in the Commons, we can secure better legislation—[Interruption.] Any philosophical reference will usually do for me.
The reality is that the Bill has had a poor birth and a rather troubled adolescence, but it might just mature into stable legislation.
I thank the Minister and congratulate her on two things. First, she has brought the legislation forward in an open and transparent manner. She has sought to work with people from all backgrounds who have wanted in good faith to contribute to producing a better Bill. She has done a very fine job on that. Secondly, she has done a good job by listening to Labour Back Benchers. It is very rare for the Government to accept amendments from their Back Benchers, and it is quite nerve-racking when an amendment has been tabled, but one is not sure whether the Minister is going to accept it, because it makes one think of having to vote with the Opposition against the Government.
It is an important point for parliamentary democracy and how this House works with the other place to note that it is right for the Government to seek to put things right in this House rather than wait for the other House to do business down the other end of the building. I pay an enormous tribute to the Minister and to the whole team who have contributed to that.
The Minister was right to say that the Bill team has been magnificent. I confess that I sought its advice on many occasions and it was always forthright with me. I would also like to pay tribute, as would many of my hon. Friends, to my hon. Friend the Member for Bristol, North-West (Dr. Naysmith), who over the past few years has steered many of us on the Government side in the right direction and has personally devoted a great deal of time and energy to the Bill. The quality of the Bill tonight is in no small measure due to my hon. Friend’s contribution.
I personally believe that the Mental Health Alliance, with which I have had some sturdy rows on occasion, has provided a very helpful service to the House. I have not agreed with it on everything, but I believe that it has sought to introduce amendments to improve the Bill according to their lights. We often forget that the lobbyists who come to our doors are every bit as important a part of the political and democratic process as are we who have been elected to sit here. We would simply not be able to do our work without them.
I pay a sort of tribute to Mr. Grumpy, commonly known as the hon. Member for East Worthing and Shoreham (Tim Loughton). Perhaps he should be known as Mr. John Lewis, as he is never knowingly understated. He has on occasion been non-partisan, however, as well as being conciliatory and generous to the Minister and, for those moments, I am enormously grateful to him.
Mental health and mental ill health are still barely understood by the public, and the stigma is enormous for many people. We still find it too difficult to intervene early enough to prevent some people from getting to the stage of detention; we need to do far more in that regard. I am proud that we have a Government who have put a significant amount of extra cash into mental health services so that we can start to do that, but much more needs to be done. In particular, there is a shortage of talking therapies, especially in working class constituencies around the land. We need to put that right. We also need to do more work on the relationship between the criminal justice system and the mental health system, because there are too many women and men with mental health problems in prison who should probably be receiving mental health service support.
We also need to do a great deal more to ensure that the culture of our mental health services does not exclude those who were not born in this country or whose cultural and religious references are not the traditional ones on which this country was founded. We need further to explore improving our mental health services so that they can cope with the many people arriving here who want to work, who do work and who contribute a great deal to our economy, but who sometimes find that our cultural milieu does not help their own mental health.
The hon. Member for Rhondda (Chris Bryant) paid me an entirely unmerited compliment in Committee. I should like to reciprocate by paying him an entirely merited compliment on the general tone of his comments tonight and on his perspicacity and persistence in putting through his amendment on treatability. The amendment has wide support and is a great credit to him, and I am glad that we have got that one secured.
If I do not vote for the Bill tonight, it will not be because I oppose changes in mental health legislation, but because I regard the Bill in the form in which we are now delivering it to another place as work in progress rather than work completed. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) has detailed our continuing objections to it, and I would like briefly to remind the House of them.
The first relates to people with impaired decision making, and I must point out the anomaly not only between English and Scottish law but between the treatment of physical and mental illness. The treatment of a person with a physical illness who has mental capacity and who withholds consent for treatment would, in law, constitute assault, but such treatment of a person with mental illness will be sanctioned by legislation. However strong the arguments for administering such treatment might be, this is a difficult principle to breach.
I am also concerned about the excessive scope of community treatment orders and the nature of the exclusions that we have debated over the past two days. Functionally, my concern is for the people who are not represented among those joining the debate, namely, people from different cultural and ethnic backgrounds, or with different levels of sophistication or differing abilities to stick up for themselves. The hon. Member for Rhondda touched on this issue a moment ago. Such people might find themselves enmeshed in the system. All the conventional measurements in relation to the involvement of people from black and minority ethnic—BME—backgrounds suggest that they are clearly being very badly served.
I am also worried about the absence or patchiness of treatment facilities in some parts of the country. We cannot necessarily legislate to put that right, although we have done so in relation to age-appropriate treatment. I want to pay tribute to the Minister, who made some good changes in Committee. I would not wish to caricature the Government’s position at all in this regard, but I do have those outstanding reservations.
Behind those reservations are two considerations. The first is that there is some kind of ghost in the machine that we have not yet fully eliminated. It is the ghost of control systems, as opposed to the treatment, support and protection of minorities and people with real difficulties and sensitivities in their lives. My strong feeling is that if we are worried about people with mental health problems in the community, the best way to approach the issue is positively and at source through appropriate treatment, rather than seeking to get out of the problems by saying how toughly we can control them. That is not to say that there should be no controls. Of course there should be controls, and they have been hallowed in statute for many years, but they need to be weighed very carefully in each case.
Finally, let me make an appeal to the Minister. I think I can do that on the basis of the constructive relationship that we enjoyed during the passage of the Mental Capacity Act 2005, and subsequently in the context of some its implementation. The Minister has shown an exemplary readiness for dialogue. During the passage of the 2005 Act, with which I was more intimately concerned than I am with this Bill, progress seemed impossible at one stage. There was a time constraint, there were huge differences in views, and there were passionate concerns about such issues as euthanasia. Nevertheless, we somehow managed to work ourselves into an almost complete consensus by the end. We have not yet done that with the Mental Health Bill, which is why I shall not be supporting it tonight.
I think that we are nearly there. I think that if Ministers are prepared to respond to concerns expressed in another place, to respond again when they return to us—as no doubt they will—and to iron out the remaining issues, we shall have a Bill that reflects our power to debate and, above all, our power to engage with this most sensitive group of people, to whom we all feel that we have an obligation and whom we need to serve by getting the legislation right.
I, too, congratulate the Minister. In some respects, this has been a very difficult Bill. Some of the arguments have been separated only by a thin line, which was exemplified by those that we heard today on new clause 12. It has certainly been a difficult Bill for the Minister to steer through the House, but she has done it with courage and professionalism, and has presented her arguments with great clarity.
I want to make it clear that the Committee was not full of people who were always going to agree with the Government. Some of the awkward squad were there. I include myself in that: I was prepared to challenge the Government, although on this occasion I have agreed wholeheartedly with the Government line. I am very pleased to be able to say that. I believe that the addition of the advocacy measure to the final Bill is a great step forward. I was a little surprised that it was not included initially, but I am very pleased that it is there now.
I must tell all those who have deluged me, and other Committee members, with briefings that there has just been too much of it. It has jammed my e-mail inbox, and filled my sacks of mail. I have a confession to make: I have not read it all. I think that there is a message there. Why should we receive a briefing from the Mental Health Alliance and, at the same time, briefings from all its members? I am grateful for the briefings, but I ask those who sent them please to send us a few less in future.
During the Bill’s passage, I have detected a tension between psychiatrists and psychologists. The Government are trying to build a modern mental health service in which all professionals work in harmony and to the same end—to help the patients who benefit from the service. I hope that the professionals will listen to that message.
At the beginning of the Committee stage I felt like a member of the Stasi, being accused of wanting to lock people up for having strange religious practices, political views or sexual deviancies of one kind or another. In fact, I felt—and now believe wholeheartedly—that the Minister was trying to strike a balance between liberty and human rights on the one hand, and on the other the need to recognise that there are people out there who can benefit from modernised mental health services. People with serious personality disorders, for instance, can benefit from the application of appropriate treatment, with a consequent saving of lives that might otherwise be lost as a result of both homicides and suicides.
My hon. Friend has clearly set out all the reasons why the Bill should be voted for. Does he agree that if the Opposition vote against it, they will be voting against advocacy, victims’ rights and looking after people in the community, and thereby put at risk patients’ and public safety?
The Opposition will vote against it, which is sad. As with all proposed legislation, this Bill will be proved to be successful or not when its provisions are put into practice. I hope that it will benefit the patients for whom it is intended.
I thank the Minister for her generosity in spending time with me when I have asked to see her during the course of the Bill’s proceedings. I also particularly wish to thank the Mental Health Alliance. In my view, it did not send too much material, but put a lot of work into supporting Members who were dealing with the Bill. I also thank the Royal College of Psychiatrists and the National Autistic Society for helping me with my representations on the Bill.
I look forward to working with the Minister on the code of practice. There are still problems to do with people with autistic spectrum disorders. There is a problem in that people with autism are detained inappropriately in unsuitable settings and for far too long. I hope that the code of practice will address that.
Finally, let me raise again an issue that I mentioned at the end of my speech on Second Reading, and which has not been touched on today. Early intervention with appropriate levels of resources is the answer to mental health issues. It seems incongruous to me that the Minister should suggest that by voting against the Bill the Opposition will be responsible for putting patients at risk.
indicated assent.
The Minister is nodding her head, but apparently that is okay in Scotland.
I have no trouble in supporting the Government and voting for the Bill, as it is a substantial improvement on the current legislation. I thank Members of all parties here and in the other place, as well as those who have briefed and supported us in our discussions, for their work in helping to bring about the current state of play in respect of the Bill. I particularly thank my right hon. Friend the Minister. As other Members have mentioned, she has been very open and has bent over backwards to discuss the Bill frankly. I also thank her for her attendance at meetings of the all-party group on mental health.
The Bill has been much improved since it first appeared many years ago. Much of the angst that we have experienced in the past eight or nine years could have been alleviated had greater regard been paid to the expert committee that reported in 1999 or 2000. Too much emphasis was placed on public safety as a result of some tragic cases that were in the news at that time.
I tried to intervene on the Minister on the subject of impaired decision making. If we are to protect the public and reduce the tragically high number of suicides that result from mental illness, people must receive the treatment that they need as early as possible. The effectiveness of our mental health services is judged not by the number of people who are subject to detention and sectioning, but by our effectiveness at getting services to them when they need them. I am still disappointed that the Government were unable to accept the new clause on impaired decision making.
Yesterday, there was some consternation when my hon. Friend the Member for Hackney, South and Shoreditch (Meg Hillier) suggested that there might be more mental health Bills. However, we have not been able to discuss yesterday or today new clause 1, which would give people suffering from a mental health problem a right to assessment, and we still do not have rights to a comprehensive care plan on discharge. There are issues that we need to address beyond this Bill to ensure that we get excellent services to people when they need them. The Government have done much to invest in mental health services, but I am afraid that it is still a Cinderella service. That is the—
It being Ten o’clock, Mr. Deputy Speaker put the Question already proposed from the Chair, pursuant to Order [18 June].
Question put, That the Bill be now read the Third time:—
Bill read the Third time, and passed, with amendments.
BUSINESS OF THE HOUSE
Motion made, and Question put forthwith, pursuant to Standing Order No. 15 (Exempted business),
That, at this day’s sitting, the Second Reading of the Parliament (Joint Departments) Bill [Lords], may be proceeded with, though opposed, until any hour.—[Mr. Roy.]
Question agreed to.
PARLIAMENT (JOINT DEPARTMENTS) BILL [LORDS]
Order for Second Reading read.
Motion made, and Question put forthwith, pursuant to Standing Order No. 90(5) (Second Reading Committees), That the Bill be now read a Second time.
Question agreed to.
PARLIAMENT (JOINT DEPARTMENTS) BILL [LORDS] (PROGRAMME)
Motion made, and Question put forthwith, pursuant to Standing Order No. 83A (Programme motions),
That the following provisions shall apply to the Parliament (Joint Departments) Bill [Lords]—
Committal
1. The Bill shall be committed to a Committee of the whole House.
Proceedings in Committee, on consideration and on Third Reading
2. Proceedings in Committee of the whole House, any proceedings on consideration and proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion three hours after the commencement of those proceedings.
Programming Committee
3. Standing Order No. 83B (Programming committees) shall not apply to proceedings in Committee of the whole House, any proceedings on consideration or proceedings on Third Reading.
Programming of other proceedings
4. Any other proceedings on the Bill (including any proceedings on consideration of any message from the Lords) may be programmed.—[Mr. Roy.]
Question agreed to.
CORRECTIONS TO THE OFFICIAL REPORT
Resolved,
That this House approves the Second Report of the Procedure Committee (House of Commons Paper No. 541), on Corrections to the Official Report.—[Mr. Roy.]
DELEGATED LEGISLATION
Ordered,
That the alterations in the provisions of the Highway Code proposed to be made by the Secretary of State for Transport, dated 28th March 2007, be referred to a Delegated Legislation Committee.—[ Mr. Roy.]
Chelmsford Crown Post Office
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Roy.]
I am delighted to have the opportunity to raise an issue of considerable concern to many of my constituents, especially those living in the town of Chelmsford: the Post Office’s proposal to move Chelmsford Crown post office from its current site in Exchange way to WH Smith in the High street.
Eight sub-post offices have been closed, a number of which were in the most deprived parts of my constituency. The Crown post office became the nearest post office for some local residents, even though many of them—young mothers and pensioners—were not affluent enough to afford vehicular access to it. The post office has been in Exchange way for many years; it is popular and extremely well used. What is important for wheelchair users and people with limited mobility is that it is within 50 yd of car parking for disabled people in Market road, so their access is easier.
My constituents want to know why the Post Office believes it necessary to move the Crown post office from that site, which is acceptable to local customers and the town, to the High street. We are grateful that it is to remain in the centre of the town with all the other shops, where people naturally go to do their shopping, but there are some drawbacks, the first of which is access. Motorists cannot use the roads that pass WH Smith. The front, in the High street, is pedestrianised, so it is blocked for vehicle access, and the road at the rear, where there is an entrance to the building, can be used only by buses. Even if cars could use it for access, a series of bus stops along the road would make such arrangements unfeasible or impossible.
The nearest disabled car parking spaces are about 300 yd away, and I draw the Minister’s attention to the Department of Transport’s guidelines on the location of parking bays for disabled people:
“As pedestrians, many disabled people will have a limited mobility range, and will require specially designated parking bays closer to the places they wish to visit. Whether on-street or off-street, parking bays for disabled people should not be further from major destinations (e.g. bank, post office, large store, supermarket.”
The guidelines categorise various conditions of disability and the maximum distance from car parking to building. For the visually impaired, the distance should be 150 m; for wheelchair users, 150 m; for ambulatory people without a walking aid, 100 m; and for stick users, 50 m. The disabled parking bays nearest to the WH Smith site are 300 yd away, which will create significant problems for people who need to use wheelchairs or who have limited mobility. The road layout and the siting of the building mean that the problems are insoluble.
There is another access difficulty for my constituents. If they want to enter the proposed post office at WH Smith from the pedestrianised area, that is fine because the entrance is at ground level. But if they use the rear entrance—which is adjacent to most of the bus stops, so a lot of people may use it—there are steps immediately inside the building going down to the retail area. That will cause problems.
My constituents and I find it even more staggering that the post office will be sited not on the ground floor but on the first floor of the building. The Post Office says it will ensure that WH Smith meets the requirements of the Disability Discrimination Act, and I have no doubt that it will, but there will be problems if the level of usage is similar to that of the current Crown post office. WH Smith has only one lift for disabled people, which takes a maximum of eight people. If wheelchair users use the lift, eight people will not be able to get in the lift at once. Given the level of usage, particularly at peak times such as on a Saturday, queues will form within the retail area where WH Smith is selling its own products, as people wait for the lift to the first floor.
One might also say, correctly, that there is an escalator up to the first floor at the front of the building, but there is no escalator down, so people would have to use the stairs. I have no knowledge of any proposal or commitment by the Post Office or WH Smith to put in a down escalator, and there is an argument that they will not be prepared to do that because if they do, the only way up or down would be by lift or escalator and there would be no stairs, because the building is not big enough to house a proper staircase and a down escalator, and some people do not like using escalators, or would feel that their choices were infringed upon by having to use the escalator option. If the escalators were to break down, of course, the sole option would be the conventional stair system, even though it would be on an escalator that was not moving.
My hon. Friend knows that many of my constituents will use this post office, and he may also know that the post office in Brentwood faces an identical fate, with the counter being located upstairs. My concern, and I should be grateful for my hon. Friend’s views on it, is that people with a disability, who may have difficulty walking or be in a wheelchair, or perhaps parents with prams, will bustle about downstairs waiting to use the lift. If the building has to be evacuated, such people might find themselves trapped.
I am extremely grateful to my hon. Friend because he makes an extremely important point, which to my mind strengthens the case against placing the main Crown post office services on the first floor. There is indeed the potential for safety problems if there were to be a fire or any other form of accident in the building, particularly if, as my hon. Friend says, one is dealing with people who are elderly and frail, or have a disability, or are of limited mobility. My constituents are extremely anxious and unhappy about this element of the proposal.
The Post Office has said that it might well provide a few services downstairs. We are in a consultation process, which I will come to in a minute, and it is easy to make promises such as that, but I do not think it adds up to very much. My constituents want to go into the post office, as they do now, on the ground floor, with ease of access, and they want to be able to enjoy the range of services. The tasks for which people use services range from buying stamps to dealing with car tax and benefit collection. I am not convinced that a viable limited service could be provided on the ground floor. Yet again, that would eat into the commercial viability of WH Smith, which will use the ground floor to carry on its commercial activities.
I also want to make a point about the consultation process. We are fairly cynical in Chelmsford, because there was a consultation process about the closure of the eight sub-post offices. I had some input into the consultation, as did many of my constituents, local councillors and others in the local community. The results of the consultation may have been received, but, in all eight cases, no indication was given that attention was paid to them or that they were listened to. When the consultation time ended, the precise proposals that were announced originally were pressed ahead with and implemented. We came to the conclusion that there was little point in having a consultation process, because we felt that no one was listening to the ideas, proposals and counter arguments that we put. Of course, one has to admire the Post Office: cleverly, there were no problems with the postmasters and postmistresses, because they got extremely generous financial remuneration for ending the siting of sub-post offices on their premises.
In this case, the consultation process is even trickier, because it is not about the decision to move from one building to another. That is a done deal. The Post Office has said, “This is what we’re going to do,” and I cannot have any input into a consultation process to argue why that is not in the best interests of the local community, or even possibly the Post Office—and neither can my hon. Friend the Member for Brentwood and Ongar (Mr. Pickles) or my constituents. That is not on the table.
The consultation process is on a much narrower issue: the services that will be provided inside the post office. Post offices are post offices; they provide a wide range of services and I would be amazed if the Crown post office, if it moves to WH Smith, started to cut the essential business that it provides to my constituents. If anything, I think it would like to increase the range of services that it provides, and I am all in favour of that. If the Minister believes that that is what should happen, I am 100 per cent. with him. We need to give more business to Crown post offices and sub-post offices to help them to thrive and develop in a highly competitive world.
What is the point in a consultation process in that respect, given that we all agree that it is in the interests of the post office to provide more services? I am not convinced about the consultation process, because I fear that the move is a done deal—unless at this late stage the Post Office can be persuaded that the building that houses WH Smith in Chelmsford is not suitable, because of the problems with access and the Department for Transport guidelines on the maximum distance between where cars can be parked and the building.
I had a meeting with Post Office representatives this morning, which I found useful because I had an opportunity to explain my points to them. Not unnaturally they are not intimately familiar with Chelmsford High street and its WH Smith, but they were prepared to listen and they took on board my points about vehicular access and the layout of the building. However, the Post Office has to realise that, although it is a business—I do not object to that or have a philosophical problem with it—it is also a service to the community. It has a loyal customer base that uses the Crown post office and has used it even more since the closure of one particular sub-post office. The Post Office has an obligation to its customers and an obligation to think about the social service that it provides, as well as the commercial service.
I urge the Post Office to think again, even at this late stage, because it has come up with a building that is not as suitable as it may have thought. I think that this has probably got wrapped up in the fact that the Post Office is implementing a package with several branches of WH Smith throughout the country. Of course, not all the branches have the same layouts and are in the same sorts of building. Some of the branches might work very well and be extremely suitable, but I bet that they will not be on the first floor, with difficult to access for those with disabilities.
I understand that the Minister cannot wave a wand and tell the Post Office not to behave in such a way. I do not expect him to announce that he will do that today, much as I would love him to do so. However, given his Department’s connections and dealings with the Post Office, I hope that he will be able to persuade it to reflect on the concern, anger and disappointment of my constituents. I also hope that he will ask it to think again and perhaps find a more suitable building in the centre of Chelmsford that does not have the same problems as the building it has selected.
I congratulate the hon. Member for West Chelmsford (Mr. Burns) on securing the debate. He spelled out clearly the importance of postal services to his constituents and emphasised his concerns about the future of the Crown post office in Chelmsford high street following the announcement made by Post Office Ltd on 19 April of its decision to move the branch to a nearby WH Smith store. I know that he has been lobbying hard and making strong representations on behalf of his constituents. I will try to answer the questions that he asked about Crown post offices, although I must emphasise that the Government do not have a role in detailed operational decisions such as that on the Chelmsford office, which he accepts. Nevertheless, I emphasise that the Government share the concerns of hon. Members about securing a sustainable future for the business.
The hon. Gentleman appreciates that there is a pressing need to tackle the significant losses that the network of Crown post offices is incurring. There are about 450 Crown post offices and it is estimated that they lost about £70 million last year alone. Clearly, that position is not sustainable, and the Government fully support the Post Office’s policy for reducing the losses, which includes maintaining a core network of Crown post offices while continuing to drive forward efficiencies and the franchising of branches when suitable opportunities arise. We welcome the commercial deal between Post Office Ltd and WH Smith because it will secure the retention of a main post office service in each of the 70 areas affected. Without that deal, there would have been a huge question mark hanging over the future of many Crown post offices and a question whether there might be outright closures.
Concern has been expressed about the service provided in franchised Crown branches. The evidence from the pilots with WH Smith shows that it is wrong to say to customers that franchising a post office will automatically lead to a reduction in the quality of service. Staff at franchised post offices are trained by Post Office Ltd in exactly the same way as directly managed staff. Franchisees are bound by stringent contractual requirements to ensure that service standards remain at the same high level following the transfer from the direct management of Post Office Ltd. It is important to say that franchising is not closure. Franchises and conversions do not reduce the number of post offices.
I can appreciate that customers will initially be unsure about the service implications of moving the branch from its existing location, as the hon. Gentleman outlined. Change can be unsettling—for some more so than others—but I understand that there is positive evidence from mystery shopper visits to, and focus group feedback on, the six pilot transfers to WH Smith stores that took place last year. The majority of customers welcome the pleasant environment and excellent customer service. More generally, many customers welcome the fact that there is a complementary retail offering on the same premises, as well as extended opening hours, which usually go hand in hand with the transfer to a franchise partner. Indeed, I understand that the new Chelmsford branch will offer extended opening hours of 9 am to 5.30 pm from Monday to Saturday.
Critically, the decision emphasises to customers that post office services will continue to be provided in Chelmsford town centre. Almost 14,000 post offices are already run by private businesses—individuals or franchise chains—including some 900 or so of the 1,400 large main post offices in town centres. The network has always relied on private business for the majority of its outlets.
The hon. Gentleman spelled out in detail his concerns about the consultation arrangements. It is important to stress that the local public are being consulted by Post Office Ltd. As agreed between the Post Office and Postwatch, the consumer champion, in the code of practice on post office closures and relocations, there is consultation on the service implications for each franchised office. However, it has always made clear that the decision to transfer the management of a Crown branch to a franchise partner is an operational decision for the Post Office to take.
The proposal to convert the WH Smith branch in Chelmsford went to public consultation on 30 May 2007 and runs to 11 July 2007. I would expect the important matters that the hon. Gentleman raised this evening, such as the disabled parking bays, to be addressed during the consultation. I hope that his meeting today with Post Office Ltd gives him some reassurance that it will take those matters on board. This evening’s Adjournment debate will help in that process. The current planned month of the transfer is October 2007.
Post Office Ltd has taken decisions on which branches will convert to WH Smith management based on a range of factors, including the proximity to WH Smith stores that are seen as suitable to accommodate a post office franchise, existing overheads such as the lease on properties, and what the company and WH Smith consider to be the future potential of branches. They are not a reflection on the current branch performance or on the people working in the branches.
In some stores, as in Chelmsford, the first floor provides the most suitable space to accommodate the post office facility. I understand that the existing branch has a total of 10 fortress-style counters, and the new location will also provide 10 positions, with eight of those being open-plan. As regards disability access, Post Office Ltd has given an assurance that all branches will be fully accessible to all customers, with special arrangements in place to assist customers with special access needs, for example in branches like Chelmsford, where the post office counter is not on the ground floor.
As one would expect from an established prominent high street retailer, WH Smith is also fully aware of its responsibilities under the Disability Discrimination Act 1995 and will ensure that the branch remains fully accessible for all customers, including those with mobility problems. Although I understand that the store, as the hon. Gentleman described, does not have an escalator from the first floor down to ground level, a customer lift is available in-store for customers unable to negotiate the stairs. I understand that the lift holds a maximum of 13 people at any one time and is capable of accommodating pushchairs and wheelchairs. The Post Office and WH Smith are therefore confident that this will adequately accommodate the needs of customers.
Many customers will see the products that WH Smith and the Post Office sell as complementing each other. The deal with WH Smith guarantees that that branch will be operated for a minimum period of seven years. In the extremely unlikely event that WH Smith does not want to extend the initial contract or is unable to fulfil it, the Post Office would obviously take steps to ensure that services are retained in that key location. It must be remembered that typically some 10 per cent. of the offices in the network change hands every year, so the Post Office is very experienced in managing that successfully. The deal between Post Office Ltd and WH Smith is a purely operational and commercial issue for the parties, and does not impact on the Government’s recent consultation on the network.
There are a number of challenges facing the post office network, including the need to tackle the losses of the Crown network. Although many of us and our constituents say we like our post office and value it highly, the reality is that, collectively, we do not use it as we once did. It is an undeniable fact that many people now prefer to pay their bills by direct debit or use one of the Post Office’s competitors, do their banking via the internet or use a cash point machine, renew their motor vehicle licences online, and keep in touch using emails or text messages.
Some 4 million fewer customers are using post offices each week compared with just two years ago. Although many Crown offices might still be very busy and well used, they are trading low margin products in high cost locations. In the financial year 2005-06 the post office network lost £2 million a week, as we have discussed in the Chamber on a number of occasions in the past six months at least. When the figures for the performance in the financial year 2006-07 are released, it is expected that the losses will be closer to £4 million per week.
For too long the Post Office was deprived of much needed investment. The Government have reversed that approach and invested substantial sums in supporting the network—some £2 billion since 1999. We have supported Post Office Ltd in its efforts to develop its range of financial service products, with Government’s investment having included £500 million for the Horizon project to bring computer systems into every post office throughout the UK.
The Post Office recognises the need to increase its range of services, adapt to changing shopping habits and give sub-postmasters products to sell that appeal to the needs of today’s and tomorrow’s customers. Post Office Ltd is the largest provider of foreign currency in the UK and the third largest provider of travel insurance. The Post Office is also the UK’s fifth largest fixed-line telephone service provider, and one in every 25 credit cards issued last year was from the Post Office. So new products have been introduced and more are in the pipeline.
Through the statement made by the Secretary of State for Trade and Industry last month and the £1.7 billion committed to Post Office Ltd until 2011, the Government have set out a framework to create stability for the network so that the Post Office can move forward with confidence and rise to the challenges of the 21st century.
I do not underestimate the difficulties that the hon. Gentleman has outlined on behalf of his constituents. I am convinced that Post Office Ltd will take those points on board and respond to him positively. The urban reinvention programme of several years ago did not start out as the best consultative exercise that the country has ever seen. The Post Office recognises that, as does Postwatch, and I have said on behalf of the Government that that was the case. However, the position when it finished was a lot stronger than it had been before, Postwatch is very well placed to ensure that it represents the consumer much more effectively and Post Office Ltd is becoming much more sensitive and can be expected to respond positively by Members of Parliament on behalf of their constituents. I can assure the hon. Gentleman that I will make sure that the comments that he has made tonight will be communicated to Post Office Ltd as part of the consultative exercise.
Question put and agreed to.
Adjourned accordingly at nineteen minutes to Eleven o’clock.