Clause 3
Mental Health Bill [Lords]
4:45 pm
Rosie Winterton (Minister of State (Health Services), Department of Health; Doncaster Central, Labour)
I hope that as I go through the arguments I might be able to address some of those points. I understand what the hon. Gentleman is saying. If we want to guard against something happening in future, where clinicians suddenly wanted to lock people up because of their political beliefs, for example, we can say that that is an issue. However, being realistic, we have to say what such exclusions are meant to do. They are meant to be exclusions from provisions dealing with mental disorder, but as I said, the items are not considered mental disorders in the first place. As I said, the exclusions are unnecessary.
If somebody felt that they had been detained and given compulsory treatment because of their political beliefs, they would first have to get two doctors to sign up to the fact that they had a mental disorder. They would then be able to appeal to the mental health review tribunal and say, “I have been detained because these two doctors think that my belief in x, y or z is a mental disorder, but in my view it is not.” Even in the first appeal process that a patient would go through, we have built in safeguards in order to give a personthe ability to appeal if the basic criteria on which compulsion works have not been fulfilled. Somebody can say, “I do not have a mental disorder; therefore it is extraordinary that I have been detained simply because of my particular political or religious belief”. On the other side, having said why our safeguards make such exclusion unnecessary, there is immense potential to create confusion about the operation of the legislation and therefore to prevent people from getting the treatment that they need. It is not an enormous risk, yet it is there; we cannot avoid talking about that possibility.
It is also important to recognise that we particularly need to look at whether the amendments that have come from the other place contribute anything in making the Bill more effective in usage for clinicians. I understand that the Royal College of Psychiatrists has argued that it will make psychiatrists think twice. Well, I would have hoped that they were thinking twice in the beginning and that the approach was not, “Well, let’s really think this through” after the event. We have always said that psychiatrists should examine whether they are judging somebody else from their particular cultural stance; they should make sure that they understand them. If they do not agree with someone, it does not mean that that person is mentally disordered. That should be part of best clinical practice. We should not be using legislation to say to people that they must think about someone’s cultural beliefs, when that should be part of how they work.