Clause 3
Mental Health Bill [Lords]
4:30 pm
Rosie Winterton (Minister of State (Health Services), Department of Health; Doncaster Central, Labour)
I beg to move amendment No. 15, in clause 3, page 2, leave out lines 22 to 30 and insert—
‘“(3) Dependence on alcohol or drugs is not considered to bea disorder or disability of the mind for the purposes of subsection (2) above.”’.
The amendment will remove the exclusions added in the other place. Again, it might be helpful for me to give some background to the history of exclusions. The Mental Health Act 1959 contained only one exclusion, stating that nothing was to imply that anyone could be dealt with under the Act as having a mental disorder by reason only of promiscuity or other immoral conduct. Such a provision is quite understandable in the context of the times, as there was still a recent history of the law being used—or, as I am sure we all agree, misused—to detain women, in particular, not for health care reasons but for moral ones, such as having a child outside marriage.
When the 1959 Act was overhauled in 1982, two more exclusions were added—one for alcohol and drug dependence and one for sexual deviancy. The latter was agreed with virtually no debate, but we think that its main target was homosexuality. It is probably worth remembering that even as late as 1982, homosexuality still appeared in the international classification of diseases as a mental disorder. Today, of course, we do not think of it as a disorder at all, nor as sexual deviancy.
When we came to the current reform of the legislation, our starting point was that the needs of patients and the risks posed by their disorders should determine whether powers of compulsion should be used where there is no other way of getting people the treatment that they need. I am afraid that exclusions get in the way of that principle. They are essentially arbitrary and do not necessarily say anything about the needs of the individual. However, we listened carefully to what was said to us, took account of the recommendations of the Joint Scrutiny Committee and agreed that we should keep an exclusion for alcohol and drug dependence.
There is no doubt that such dependence causes a lot of harm, but we do not have a history of using mental health legislation to force treatment for dependence alone, and we were persuaded that there was no compelling case to start doing so now. By contrast, we remain convinced that the exclusion for sexual deviancy should go.