My Lords, I am pleased to make a short contribution to this debate on the Queen’s Speech. I declare my interests in the register, particularly as a trustee of both the Centre for Mental Health and the Prison Reform Trust and as an honorary fellow of the Royal College of Speech and Language Therapists.
I want to focus my remarks narrowly on the proposed publication of a draft Mental Health Act reform Bill, especially the parts of such a draft Bill that relate to the interface between healthcare and the criminal justice system. First, I want to make a general comment on the proposed draft Bill, which emanates from Sir Simon Wessely’s excellent independent review of the Mental Health Act 1983. I agreed completely with the Centre for Mental Health’s view in response to the Queen’s Speech when it said:
“The Mental Health Act needs to be updated to uphold people’s rights, minimise the use of coercion, put advance choice documents on a legal footing and ensure more people get access to advocacy. It needs to curb the use of Community Treatment Orders. The bill is a chance to enshrine children’s rights more clearly within the Act and to ensure that people in prison are not forced to wait for weeks and months for an urgently needed hospital bed.”
I ask the Minister, in closing this debate, to be more precise on when the draft Bill will be published and to confirm how this House will be involved in scrutiny of it.
Turning to aspects of the relationship between policing and the Mental Health Act, Sir Simon made a number of recommendations. They included:
“By 2023/24 investment in mental health services, health-based places of safety and ambulances should allow for the removal of police cells as a place of safety in the Act, and ensure that the majority of people detained under police powers should be conveyed to places of safety by ambulance. This is subject to satisfactory and safe alternative health based places of safety being in place.”
Crucially, he recommended:
“NHS England should take over the commissioning of health services in police Custody”— a recommendation that I made in my independent report to the Government in 2009. There is no mention of these points in the commentary to the Queen’s Speech on the Bills issued by the Prime Minister, but I hope and expect that they will be included in the draft Bill for proper scrutiny.
Secondly, in relation to Sir Simon’s recommendations on patients in the criminal justice system, he made this clear:
“Prison should never be used as ‘a place of safety’ for individuals who meet the criteria for detention under the Mental Health Act.”
I agree. Again, this must be included in the draft Bill.
Further, Sir Simon recommended:
“The time from referral for a first assessment to transfer should have a statutory time limit of 28 days. We suggest that this could be split into two new, sequential, statutory time limits of 14 days each”,
“from the point of initial referral to the first psychiatric assessment” and the second
“from the first psychiatric assessment until the transfer takes place”.
This is a far more elegant proposal than the similar one I made in my report. It is pleasing to note that the Government have responded positively to this proposal but the devil will be in the detail; these and other recommendations must be fully scrutinised by this House, then debated when the Bill is introduced to Parliament.
I welcome the intention finally to introduce a draft Mental Health Act reform Bill. I echo the words of the Royal College of Speech and Language Therapists, which rightly pointed this out in supporting the reforms:
“Understanding and being understood is central to all four of the key guiding principles of the proposed reforms … Therefore, the communication needs of people accessing mental health services must be identified and supported. This must include them having access to speech and language therapy where required.”
I also echo the words of the Royal College of Psychiatrists, which stated:
“While RCPsych welcomes the proposed reforms to the Mental Health Act to improve patient care and increase safeguards, it cannot be emphasised enough that they are not deliverable without the required investment in the psychiatric workforce.”
The Government must continue to invest in stretched community services and ensure proper capital funding to fix the dilapidated, often unsafe buildings used for mental health services. They must also ensure that there are enough mental health staff to meet demand, equipped with the right skills and support. This will be the underlying challenge that the Government must face when we deliberate this proposed Bill.