MENTAL HEALTH (TRIBUNALS) (Hansard, 27 June 1978)

§ Mr. Geoffrey Pattie (Chertsey and Walton)

I beg to move, That leave be given to bring in a Bill to make new provision with respect to appeals by patients to mental health review tribunals. The House, in the exercise of its role in the law-making process, has regard to the responsibilities of individual citizens and also has regard to their rights. Among the most precious and fundamental of rights is that of any citizen not to be deprived of his or her liberty without due process of law. Most schoolchildren know of the writ of habeas corpus.

There is, however, one group in our society that enjoys no such automatic rights. I refer to those who are formally admitted—that is to say, compulsorily admitted—to mental hospitals because they are mentally ill and require treatment.

Residents who are detained in hospital through short-term compulsory orders have no right to apply for a mental health review tribunal. Over 90 per cent. of those compulsorily admitted in any average year have no right to apply for a tribunal, or to any other independent body.

The House has been waiting for a long time for the Government to produce their White Paper on the working of the Mental Health Act 1959, which is the present governing statute. The wheels of bureaucracy turn slowly, and the wheels of the Department of Health and Social Security turn much more slowly than most.

It is because I think that it would be sensible to wait to see whether the Government have any any proposals in their White Paper to rectify the situation that I have outlined that I am asking the House to give me leave to introduce a Bill that is much more humble in what it seeks to achieve.

The Bill addresses itself to the remaining 10 per cent. of formally admitted patients who do have the right to apply for a tribunal. These residents are those who have been admitted pursuant to Sections 26, 60, 65, 71 and 72 of the 1959 Act, and they are compulsory longterm admissions.

1220 The House may wonder why I should single out a group of patients who have a legal right already. The answer lies in the fact that for the most recent years for which figures are available only 12 per cent. of those eligible to apply have applied for a tribunal. It should be remembered that that is 12 per cent. of a group detained against its will. Such a low take-up suggests that something is wrong.

The problem is that to get the legal process under way the onus is on the patient to initiate proceedings. When it is appreciated that the patient may be under sedation or undergoing a course of treatment, is probably under stress and may not be aware of his or her rights, the reasons for the low take-up become apparent. After a comparatively short period patients can become institutionalised and suffer isolation and withdrawal. It is also not unknown for various forms of pressure to be put on patients not to apply for tribunals.

The Bill would seek to rectify that situation by making a referral to a mental health tribunal mandatory within three months of admission. That would not cause many patients to be released who should not be released. It would merely ensure that cases are automatically reviewed early and that the review happens without the patient having to start the ball rolling. The suggestion of automatic review has already been broadly welcomed by the Government in their consultative document on the 1959 Act.

The Bill will also seek to make certain improvements in tribunal procedures. There is genuine concern among the Council on Tribunals and within the Department of Health and Social Security about some aspects of current procedures.

The representatives of applicants seem not to be given medical reports until immediately prior to the hearings. Decisions on new evidence have been taken without the representative being present. Legal aid is not available beyond the legal advice scheme green form, which covers only the first £25 of advice.

Improvements are also needed in the "requests for a public hearing" and the "reasons for a decision" procedures. Once again, a Government Department is looking at the position—this time, the Lord Chancellor's departmental review on 1221 tribunal procedures. As the DHSS, the Home Office and the Welsh Office are also involved, it could be a very long time before anything emerges.

The 1959 Act was a very good Act and has served as the model for several other Acts in other countries. Nearly 20 years later, however, the shortcomings of the Act are very apparent and reform is needed. Other countries are ahead of us. Ontario, for example, which followed our 1959 Act with one of its own in 1961, is now having a debate between psychiatrists and administrators whether the automatic review should be after 15 days or one month.

The World Health Organisation, in a recent report, surveyed mental health legislation and compared this country less favourably with many American states and all the Scandinavian countries.

The incidence of mental stress and illness is growing, and one person in ten can expect to be mentally ill at some time. Mental patients are not the most appealing members of society, but they, as much as anyone else, deserve our sympathy and compassion. Through no fault of their own, they have become ill. Basic human rights are not things to be doled out only to decent chaps. Human rights belong just as vitally to those who may often be their own worst enemies. We are responsible for the welfare of these, our fellow citizens. The House is being asked to give a little hope and encouragement to them, which I sincerely hope it will now do.