My Lords, patients are detained at Ashworth under the Mental Health Act 1983. Responsibility for patient care and treatment rests with Ashworth hospital, acting in accordance with the provisions of the Act. In addition, the code of practice published by the Government in March 1999 provides guidance on how the Act should be applied and contains a chapter specifically advising on arrangements for detained patients to receive visitors. It is for Ashworth hospital to decide, in the light of the code guidance and other relevant factors, what visiting arrangements should be put in place for patients.
My Lords, I express sympathy with a much esteemed Minister for having to provide such an unsatisfactory Answer. He knows perfectly well that he knows nothing about the subject. I put it this way--such an intelligent man will understand what I am saying--is he aware that Ian Brady, who has done the most terrible things, has been a mental patient in Ashworth for a number of years? He has been in custody for over 30 years altogether. Even now he is not allowed to see his mother without some officer sitting beside him to overhear what is going on. Is that humane? Is this man to be treated as a human being, in spite of what he has done?
My Lords, I am grateful to the noble Earl for that vote of confidence. I cannot, of course, comment on an individual case and the House would not expect me to do so. However, at the hospital all visits are directly observed and supervised, with the exception of those of any legally qualified person instructed by the patient to act as his legal adviser, any Member of either House of Parliament, members of the Mental Health Act Commission, solicitors and Mental Health Act Commission visitors. Visiting policy generally is determined by the hospital having regard to guidance in the code of practice I mentioned in relation to the Mental Health Act 1983. All patients' visits are subject to the safety and security directions which apply to all patients in all of the high security hospitals. Those directions are aimed at ensuring that visiting occurs in an environment that is safe for patients, visitors and staff.
My Lords, as the noble Lord will know, the Fallon inquiry made a number of recommendations in relation to the hospital. That was followed by the Tilt inquiry into aspects of security. We are determined to ensure that the hospital is managed effectively. There has been, and will be, investment to ensure that the recommendations we accepted are implemented. The management of the hospital has proved a considerable challenge over many years and no one can be complacent. However, I am satisfied that we have the framework in place in which to take forward improvements.
My Lords, the intention at Ashworth--as at Broadmoor and Rampton--is to endeavour to integrate as many services as possible into the NHS. At Ashworth hospital arrangements are being prepared at the moment to link the wider development of secure psychiatric services in the North West to the mental illness services provided at the hospital. We are also considering the personality disorder service and the possibility of establishing a joint management approach between Ashworth and Rampton hospitals. However, I certainly accept the premise of my noble friend that as far as possible integration between the special hospital services and the NHS must be the right way forward.
My Lords, the noble Earl, Lord Longford, certainly knows his onions. I doubt whether he would have tabled this Question were there not anxiety about the treatment of this patient. Will the noble Earl therefore take care to ensure that those immediately concerned with looking after Ian Brady are given a copy of our proceedings today?
My Lords, of course the proceedings are available. I assure the noble Lord that the issues which my noble friend raised originally with the Home Office some weeks ago--which have been transferred to the Department of Health--will be considered. I have written to the chair of the special health authority involved to make sure that they are investigated.
My Lords, I hear what my noble friend says. I do not believe that it is appropriate for me to comment.
My Lords, no, I cannot say that. I shall be happy to provide that information when I have found it out.
My Lords, the Minister referred to the integration of Ashworth hospital with the broader range of NHS mental illness services, if I understood him correctly. Can he say a little more about how that matter can be taken further, in particular with regard to secure units at mental illness hospitals and the way in which those patients can be treated?
My Lords, in relation to Broadmoor hospital, that authority will be dissolved on 31st March 2001. The new West London Mental Health NHS Trust will incorporate Broadmoor hospital and the Ealing, Hammersmith and Fulham Mental Health Trust.
Rampton, too, will be dissolved on the same date. A new Nottinghamshire Healthcare NHS Trust incorporating Rampton hospital and the medium secure services within the Trent region will also become operational on 1st April 2001.
Integration arrangements in relation to Ashworth are still being considered and are tied up with a proposal that is being developed for a Mersey mental health NHS trust. We are very keen to make progress, to ensure that integration is developed where appropriate, and that personality disorder services are managed effectively.
My Lords, yes, there are a number of procedures in relation to the complaints processes. All complaints are first channelled through the complaints unit at the hospital itself.
My Lords, I do not refer to complaints. I was a member of a mental health review tribunal. It is not a complaint. It is a right of anyone, certainly in Broadmoor, to appear before a mental health review tribunal to review whether he may leave that place.
My Lords, we are talking about two specific issues. I thought that the noble Baroness referred to the complaints system. A number of patients have been admitted to Ashworth hospital from prison under the section of Mental Health Act 1983 to which I referred.
I am happy to write to the noble Baroness with further details of the operation of the mental health review tribunal. There is a complaints unit at the hospital. We are and have been concerned about how effectively it operates. We have set targets for improving the speed with which it deals with complaints.