Orders of the Day — Mental Health (Patients in the Community) Bill [Lords]

Part of the debate – in the House of Commons at 4:59 pm on 20th June 1995.

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Photo of Mr Kevin Hughes Mr Kevin Hughes , Doncaster North 4:59 pm, 20th June 1995

I give a qualified welcome to the Government's decision to take some action over the increasing crisis of confidence in mental health services. We know that public confidence has been shaken by the number of tragedies and deaths, including one in Doncaster, which resulted in the tragic killing of a 12-year-old girl, Emma Brodie. I am sure that the Minister is well aware of that case, so I shall not go into the details now.

My concern with the Bill is that the Government are reacting to the crisis of public confidence in mental health services rather than to the crisis in those services. It seems to me that the Bill fails to address many of the fundamental problems in mental health care. Much of what is proposed already exists, for example, in guardianship. The only thing that is truly new is the power to take and convey to places of treatment people with mental illness.

The switch from hospital-based care to community-based care has replaced one set of problems with another, and now we are faced with a shortage of psychiatric beds for those who really need them. People can be pushed out of hospital because of pressure on those beds, before adequate services and support in the community are available. That seems to be the key issue.

Patients' health will suffer. They will become revolving-door patients, making no long-term progress in the community. We must recognise that patients will need access to an income, suitable housing and activities to suit their needs if there is to be a sustained improvement in their mental health. Without those, they cannot seriously be expected to prosper in the community.

The Bill does not try to improve the health of the patient. Rather, it is a reaction to the failure of current services and treatments. The power to take and to convey is a reaction to a deterioration in the health of the patient. It is a reaction to the failure of community services. It is for that reason that we need to ensure better organisation and resourcing of those community services.

The Royal College of Psychiatrists has pointed to the danger of the Government skewing resources and paying attention to one group of patients at the expense of the less severely mentally ill. It said that, in most parts of the country, there would need to be a substantial increase in services provided if the after-care provisions of the Bill are to be met.

The Government's claim that the Bill is essentially resource-neutral is difficult to sustain. The claim ignores the problem of staff training and appropriate work loads for community psychiatric nurses, whom both the Royal College of Nursing and the Royal College of Psychiatrists identified.

If the Government are serious about tackling these problems, they should consider reviewing the Mental Health Act 1983 as a starting point. The Act should be revised to help it to address the community emphasis that is now placed on care and treatment following the introduction of community care. Instead, the Government have brought before the House a measure that could undermine the professional relationships between carers and patients, and which fails to address the real problem in mental health care: service provision and resources.

I hope that the Government will think hard about more long-term solutions, particularly when the Bill is in Standing Committee, and act to secure service improvements that will benefit those with mental health problems and the public at large. The issue is too important to be left to the quick fix that we all too often see from the Government.