Cabinet (Meetings)

First Minister's Question Time – in the Scottish Parliament at 12:00 pm on 9th December 2004.

Alert me about debates like this

Photo of David McLetchie David McLetchie Conservative 12:00 pm, 9th December 2004

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-1275)

Photo of Rt Hon Jack McConnell Rt Hon Jack McConnell Labour

At next week's meeting of the Scottish Cabinet, we will discuss our progress towards building a better Scotland. I hope that that progress will include joint working with the British Council. I suspect that Neil Kinnock, along with some of the rest of us, might, in the past, not have expected to be one day sitting in a Scottish Parliament. However, I am sure that he is delighted to be here today, and he is very welcome.

Photo of David McLetchie David McLetchie Conservative

I hope that the First Minister and the Cabinet will take the opportunity to review the circumstances and procedures for the authorisation of unescorted leave for patients in the state hospital at Carstairs. Can the First Minister confirm that, so far this year, according to newspaper reports, 13 releases for unescorted leave have been authorised without prior ministerial approval? What examination is being undertaken of the procedures?

Photo of Rt Hon Jack McConnell Rt Hon Jack McConnell Labour

I confirm that it is my understanding that there have been 13 such cases. Under the current procedures, as I think that Mr McLetchie is aware, permissions for the transfer of restricted patients for conditional and absolute discharge are approved personally by me. Unescorted leave of absence for those who are restricted for life and those who are sex offenders is also approved by me. However, other periods of unescorted leave of absence are currently approved by expert officials on our behalf.

Given the incidents of this week, those procedures should be reviewed. In particular, I believe that the level of information that is available to those who sign off those decisions should be reviewed. I know that I, personally, sometimes question the level of information that I receive when I have to approve discharges or transfers, or those unescorted leave-of-absence periods that I am required to approve. I certainly want to ensure that those who made the decision that led to this week's incident received appropriate information. If they did not, I want to ensure that there is appropriate information in front of all those who are making future decisions.

Photo of David McLetchie David McLetchie Conservative

Can the First Minister confirm that, in future, all such authorisations must obtain prior ministerial approval, rather than prior approval from officials in his office? Can he confirm that that is the way in which such matters will be conducted in future, with due regard to the statutory provisions in the Mental Health (Care and Treatment) Scotland Act 2003 and to the responsibility of ministers for dealing with those serious issues. I understand from what the First Minister has said that there is to be an inquiry into the procedures and that a review will be undertaken. Will he undertake, subject to the requirements of patient confidentiality, to make the findings of that review public, so that it can be a subject for debate and discussion in Parliament?

Photo of Rt Hon Jack McConnell Rt Hon Jack McConnell Labour

I shall be happy to make the review public and to ensure that the decisions that are made following that review will be subject either to questioning or to debate in the Parliament, subject to the decisions of the Parliamentary Bureau. I do not discount the possibility that the arrangements may be changed to secure prior ministerial approval for unescorted periods of leave of absence, but I also want to have a system that operates effectively. The new provisions that will come into force next year under the Mental Health (Care and Treatment) Scotland Act 2003 will move the responsibility for discharge from me to the new mental health tribunal, and there may be an opportunity at that time to review the procedures more generally.

I am content to confirm that, when we have that proper review, we shall look at the existing features of the legislation and consider whether they need to be strengthened or improved. I am particularly keen to ensure that the right level of information is available when those decisions are taken. For example, I would find it surprising if the person who made the decision to grant unescorted leave of absence would have done so if they had been aware of the police's description of the patient concerned as potentially dangerous if cornered or intoxicated. That is one of the matters that I have asked specifically to be reviewed.

Photo of Karen Gillon Karen Gillon Labour

These are delicate and difficult issues and I fully appreciate and understand that public safety is paramount. I welcome the First Minister's comments about appropriate information being available to expert panels, but can he give some reassurance that we will not have a knee-jerk reaction and move back on the progress that has been made in the support of those with mental illness? Will he ensure that those who are inappropriately placed in the Carstairs hospital for a longer period of time than they should be will not be adversely affected by the reaction to this situation?

Photo of Rt Hon Jack McConnell Rt Hon Jack McConnell Labour

This is a difficult subject and public safety must be paramount at all times, particularly when patients in the state hospital and elsewhere have been involved in violent incidents in the past. That is something that I emphasise constantly to officials and to those who have those responsibilities. At the same time, we have a responsibility as a society to ensure that those who have a mental illness are treated properly, given a proper care plan and assisted with progress back into society, but clearly only if we can be certain that they have managed to find a way of controlling their illness or improving their mental health. That is a serious challenge, even in today's enlightened society, and it is a challenge with which I believe we are making a lot of progress.

That process will be helped considerably if we have across Scotland the sort of facilities that might ensure that there is some provision between the state hospital in Carstairs and leave of absence in the community. The transition periods that people need to go through in those circumstances are particularly important, and I hope that we can create the kind of facilities that will give people a stage-by-stage approach to resuming a normal life.