HC Deb 18 October 1982 vol 29 cc40-55 'Where a patient is admitted to a hospital in pursuance of an application (other than an emergency application) made under Part IV of the principal Act by his nearest relative, the managers of the hospital shall as soon as practicable give notice of that fact to the local social services authority for the area in which the patient resided immediately before his admission; and that authority shall as soon as practicable arrange for a social worker of their social services department to interview the patient and provide the managers with a report on his social circumstances. '.—[Mr. Geoffrey Finsberg.]

Brought up, and read the first time.

Mr. Deputy Speaker (Mr. Bernard Weatherill)

With this it will be convenient to take the following:

Amendment(a), to leave out from first 'application' to 'made'.

Amendment(b), to leave out 'his social circumstances' and insert 'the most appropriate way of providing care and medical treatment'. Government amendment No. 77.

The Under-Secretary of State for Health and Social Security (Mr. Geoffrey Finsberg)

I beg to move, That the clause be read a Second time.

Perhaps we can continue on the same happy note, because the new clause honours an undertaking that we gave in Committee to the hon. Member for Birmingham, Stechford (Mr. Davis). I know that he does not think that we have gone far enough, but I hope that he will agree that we have met his main point.

The new clause provides that in any case in which a patient is admitted for assessment or treatment under an application made by his nearest relative the social worker must interview the patient and provide a report for the hospital managers about the patient's social circumstances. It will ensure that a social worker is involved shortly after every admission following an application by the nearest relative, except when the application is made in a case of urgent necessity under section 29.

The hon. Member for Stechford wishes to cover section 29 applications as well. I shall tell him why we have excluded them. I hope that I can convince him. The reason was the immense practical difficulties involved. The maximum period for which a patient can be detained in hospital under an emergency application is 72 hours. It would be difficult, to say the least, for all the steps under the new clause to be completed within 72 hours and for the social worker to make a satisfactorily full report within that time. It would not be right to make provision in law for something which, in many cases, could not be done.

Let us also examine what happens at the end of the 72-hour period of detention. The patient may leave hospital or remain as an informal patient. In that case, the social worker's time would be best spent in providing support, not in writing reports. Alternatively, an approved social worker may be making an application for admission under section 25 or section 26, in which case it would be wrong to require a report under the new clause. If a further application is made by the nearest relative, new clause 5 would apply to that second application. Therefore, if the nearest relative makes an emergency application, a social worker quickly becomes involved in any case.

In amendment(b)the hon. Member for Stechford proposes that the report should be about the most appropriate way of providing care and medical treatment rather than the patient's "social circumstances". I am worried that his wording will lead to confusion. The words that he suggests appear elsewhere in the Bill, in clause 16, but that is in the context of deciding whether a patient should be admitted under the Act. New clause 5 is about patients who have already been admitted. It would be confusing to require social workers to go through the same processes as if the question of admission were still under discussion. That is the difference.

What new clause 5 seeks to ensure—which is what everyone in Committee wanted—is that as much information is available about the patient who is admitted by means of an application by his nearest relative as is available when the application is made by a social worker. After admission, it is the patient's present and future care and treatment that require the attention of the professional team looking after him. Surely there is nothing to be gained from looking again at whether he should have been admitted. If the patient has been admitted under an application by his nearest relative, information on his background, family and social circumstances may be lacking. That is the information that the professional team and perhaps the mental health review tribunal would need to help in assessing the patient's present and future needs. New clause 5 ensures that the information will be provided. It does so without the risk of confusion with other reports, which might arise through the wording suggested by the hon. Member for Stechford.

I hope that on reflection, and after the explanation that I have given, the hon. Gentleman will agree that our wording is preferable and that he will not press his amendments.

Mr. Terry Davis

I wish to press amendments(a)and(b). As the Minister said, new clause 5 is the result of an assurance that was given in Committee in relation to a group of amendments and new clauses that I moved. Those amendments and new clauses concern the involvement of an approved social worker if someone has been admitted to hospital on an application by the nearest relative without the social worker being involved. It was the intention of new clause 8, in Committee, to ensure that if the nearest relative applied for admission without a social worker having been involved, the social worker must be involved within 24 hours. 1 did not press that new clause to a vote as a result of the assurance that I was given by the Minister for Health, who said that he agreed with the intention of what I was seeking to provide.

New clause 5 provides for a social worker to be involved only if the application for admission has been made under section 25 or 26 without previous consideration by a social worker. As I said, in Committee I did not press my new clause to a vote because the Minister expressed sympathy and asked for time to consider the precise form of such a provision. New clause 5 does not satisfy either the spirit or the detailed wording of my new clause in three respects. My new clause 8 included a limit of 24 hours, but, to be fair to him, the Minister expressed reservations about that, so I do not take issue with him on that point: this afternoon. The Minister said that without giving the matter consideration he was unwilling to be tied to a period of 24 hours. However, he did not express reservations about the other two points. The wording of new clause 5 expressly excludes emergency admissions and consideration of the appropriate way to provide care and medical treatment. It would restrict the social worker to a report on social circumstances. It is significant that it is headed "Social report".

My new clause stated: In the case of an application by the nearest relative for admission of a patient for observation in the case of emergency or for admission for assessment or for treatment the hospital managers to whom such an application is addressed will refer the application within 24 hours of receipt of the application to an approved social worker who shall interview the patient and consider the most appropriate way of providing care and medical treatment. It refers specifically to: admission … for observation in … case of emergency". That is the heading of section 29 of the Mental Health Act 1959. The clear intention was to cover section 29 as well as sections 25 and 26 cases.

In our Committee debate several references were made to sections 25 and 26 cases but that was only because we had previously debated an amendment tabled by my hon. Friend the Member for Oldham, West (Mr. Meacher). But it was made absolutely clear, both by myself and by the hon. Member for Newcastle upon Tyne, East (Mr. Thomas), that my new clause included section 29 cases.

Let me quote from our proceedings so that the House is in no doubt about our intention and about the assurance that the Minster gave. I stated: I assure the hon. Member for Newcastle upon Tyne, East (Mr. Thomas) that he has made an important point because I intend to cover section 29 cases as well. There is even less room for confusion about the intention when it comes to the social worker advising on treatment or merely on social circumstances. I stated four times in the debate that it was necessary to involve the social worker in the consideration of care and treatment. The Minister for Health referred to the issue twice. He stated: Nevertheless, there is a case in good practice and in law for the involvement and advice of an approved social worker who can consider non-medical means of treating the case as soon as is reasonably practicable. He again stated: Although that advice could not be binding upon, or overrule the professional medical opinion of a psychiatrist, it should be available and fully considered. The best treatment for a case would thus be considered on a multi-disciplinary basis rather than on that of psychiatric opinion alone."—[Official Report, Special Standing Committee, 13 May 1982; c. 284–299.] The Minister asked the Committee to allow the Government time to consider the precise form that the provision should take. He said that he was sympathetic to my points and would draft a new clause to provide for an approved social worker to be involved in emergency applications by a nearest relative under section 29 and to take into account care and medical treatment and not simply the patient's social circumstances.

4.45 pm

I am disappointed to learn this afternoon that the Government now take a different view. The Minister says that emergency cases are excluded for practical reasons, as section 29 provides only for someone to be admitted for 72 hours. But the new clause makes provision for the social worker's report to be produced as soon as practicable. I do not take issue about the 24 hours. The Minister made it clear that he was not willing to be tied to that period, but he did not mention excluding emergency cases. It may take as long as 72 hours for a social worker to consider the appropriate form of treatment for a mentally disordered patient, but the Minister cannot pretend that in Committee there was no intention to cover emergency cases. The point was made crystal clear, especially by myself and by the hon. Member for Newcastle upon Tyne, East, and the Minister did not contradict us. Indeed, the hon. Gentleman pressed him several times on whether he was giving a categoric assurance that he would adopt the provisions in my new clause with the exception of the 24 hours.

The Minister now says that it would be confusing for the approved social worker to be involved in considering appropriate care and medical treatment, but the intention has always been for the approved social worker to do that, as everyone in Committee understood. He has no grounds to say now that the understanding was that the social worker should consider only social circumstances.

The Minister says that nothing would be gained by considering whether a patient should have been admitted to hospital after he has been admitted, but from the evidence that we heard we know that many people are admitted to hospital when they should not have been. One aim of my new clause was to bring that problem into the open and to ensure that the approved social worker, in the interests of the patient, could consider the care and medical treatment, even if the patient had already been admitted to hospital. The social worker might suggest care and treatment that did not involve detention in hospital.

I am disappointed that the Government have tabled a new clause that does not satisfy the assurances given in Committee. Even at this late stage I hope that they will reconsider. I do not believe that the Minister realised that the assurance had not been fully honoured until my amendments were tabled. I hope that he will accept the two amendments. If he does not, I shall ask the House to vote on them.

Mr. David Ennals (Norwich, North)

I shall be brief because many of the arguments have been deployed by my hon. Friend the Member for Birmingham, Stechford (Mr. Davis). It is clear that certain assurances were given in Committee and accepted by both sides. One merit of the Committee was that it did not really comprise two different sides. The Minister has reneged on his assurances.

We must ensure that an emergency admission does not take place without the knowledge and involvement of a social worker. The words in new clause 5, other than an emergency application", downgrade the role of the social worker. A social worker may know a great deal about the background of someone admitted to hospital under the emergency provisions. Although a patient's social circumstances are important, the social worker may also have a professional view about how to deal with his problems. There is no logic in providing for a social report and notification to the social services department for non-emergency cases, but not for emergency cases. There is a stronger case for the involvement of a social worker in emergency cases. We need the maximum amount of knowledge to decide the necessary treatment and the place of treatment for each patient. A social worker may know the family background, which may help the doctors to decide what is best for the patient.

I hope that the Minister does not think that he will convince us on this matter. I hope that we can convince him that he is wrong. If he accepts amendments(a)and(b)he will be doing his best for the patients and also fulfilling the clear wishes of the Committee.

The social worker's report is important, as is the notification to the social services authority. The clause does not provide for the social services department to be informed immediately, which is a serious weakness. Even if the Minister does not listen to any other argument, that last argument must sway him. The wisdom of social workers can be added to the professional experience of the doctor who must decide the treatment.

Mr. Mike Thomas

I recall that the Minister gave an undertaking in Committee in the terms described by the hon. Member for Birmingham, Stechford (Mr. Davis). I said in Committee that the safeguards for patients before being admitted under section 29 might be taken further. The Minister did not agree to that, but he gave an assurance that additional safeguards would be provided. It is not reasonable for him to construe the Committee debate as supporting the term "social circumstances" which the hon. Member for Stechford proposes to replace. The hon. Gentleman's concern, which was also expressed in Committee, is that an emergency admission under section 29 could mean that a patient finds himself in the wrong place, in the wrong circumstances, with the wrong proposals for his care and treatment. Nobody seeks to supplant the medical practitioner with the social worker. However, the social worker's view is an important safeguard for the patient

I urge the Minister to accept the amendments. It would greatly facilitate the further passage of the Bill if we did not begin with a feeling that undertakings were not being honoured. There can be no serious disadvantage to anyone if the amendments are accepted, but there will be real advantage to the patient, with whom we should be concerned.

I shall ask my hon. Friends and members of the Liberal Party to support the amendments should the House divide.

Mr. Stan Thorne (Preston, South)

I am sorry that I was not in the Chamber to hear the Minister's statement when he moved new clause 5. My remarks may appear puzzling if he dealt with my points in his statement. The purpose of the new clause is to ensure that there is a report on the social circumstances of a patient. I support amendment(b)tabled by my hon. Friend the Member for Birmingham, Stechford (Mr. Davis), which widens the whole purpose of obtaining reports about patients prior to their treatment. The amendment refers to the most appropriate way of providing care and medical treatment". Is the Minister concerned only with social circumstances and not with the most appropriate means of providing care and medical treatment? If so, why has he included new clause 5? It contradicts matters that we shall discuss later about consultation with other professions and people concerned with the treatment of the mentally ill. In new clause 5 the Government are prepared to consider obtaining reports about social circumstances from social service departments. However, they do not appear to want the involvement of other professions in a multi-disciplinary consultation about patients and they seek to delete a clause in the Bill to provide such consultation.

I find it difficult to accept new clause 5. I hope that my hon. Friend the Member for Stechford will press amendment(b). It is of tremendous importance in protecting the interests of patients.

Mr. Geoffrey Finsberg

I do not think that I can help the hon. Member for Birmingham, Stechford (Mr. Davis). I listened carefully to his remarks and tried to align them with what my hon. Friend the Minister for Health said in Committee. He said: The Government are not unsympathetic to the proposal, which has much to recommend it. He asked for time to consider the precise form that the provision should take. He also spoke of the need for consultation and said: In the light of that consultation, having found out what would work we could produce a final version. Most important, he said: Perhaps the Opposition would agree not to press the amendments… in exchange for the Government's assurance that they recognise the mood of the Committee and will try to meet its wishes in principle after consultation and polishing up."—[Official Report, Special Standing Committee, 13 May 1982; c. 285–6.]

Mr. Ennals

What consultation took place? Was there consultation with local authority social service departments and those who represent them or with the British Association of Social Workers, which is obviously infinitely involved? It would be helpful to know the nature of the consultations that led the hon. Gentleman to reach a conclusion different from that of his hon. and learned Friend.

5 pm

Mr. Finsberg

I shall deal with that point in a moment. My hon. and learned Friend's assurance to consider the points that were made has, I believe, been met by new clause 5. It was not possible to agree to everything that was proposed in Committee because of the various difficulties of which I have spoken.

Let us examine the position of social workers in this context. I cannot see what else they could do other than to give their report on the social circumstances. It is for the responsible medical officer and others to decide what sort of treatment there should be. That is not a matter for the social workers.

Mr. Terry Davis

The Minister quoted the phrase "polishing up" which was used by his hon. and learned Friend. Will he please give the column reference?

Mr. Finsberg

Column 285 talks about the precise form the provision should take, and the last sentence in paragraph 4 of column 286 refers to "a final version". "Polishing up" can be found at the end of paragraph .5 in column 286.

This matter was discussed with the ACC, the local authority association, which did not raise any objections to what we have put forward in the new clause.

Mr. Mike Thomas

That reply is not good enough. To consult only one of the three local authority organisations—after all, they may have to find the extra cash for the social workers involved—is hardly an impartial consultation. The British Association of Social Workers, the British Medical Association and even the psychologists and psychiatrists might also have a view.

Mr. Finsberg

This highlights the position of a Special Standing Committee. We had preliminary hearings and received a mass of information. We then proceeded to go through the Bill to try to take account of the views that had been put to us. The organisations that made representations were surely in a position to say whether or not they were happy with what we proposed. We did not undertake formal consultations yet again, but the ACC in particular said that it had no worry at all about the proposals. I do not believe that we could have done more, short of going through a second round of detailed consultations. In the circumstances, I do not think that would have been appropriate.

Through various means, the BASW had more than one representative present at the Committee and it knew exactly what was happening. I cannot go further than that. I do not believe that the new clause resiles from the undertaking that my hon. and learned Friend gave, which is followed in the new clause.

Mr. Mike Thomas rose—

Mr. Deputy Speaker

Order. We are now on Report, and the hon. Gentleman can speak only once.

Mr. Terry Davis rose—

Mr. Deputy Speaker

The hon. Gentleman may speak again only with the, leave of the House.

Mr. Davis

With the leave of the House, I should like to speak again to the two amendments that I have tabled.

I do not accept what the Minister has said. It is my considered opinion, which I shall try to prove with the aid of Committee quotations, that the Government have resiled from their undertaking which was accepted in good faith by the Committee.

I tabled two new clauses in Committee. The first suggested that an approved social worker should determine the most appropriate way of providing care and medical treatment. As a result of discussion in the Corridors, it became clear that the Government would oppose that new clause on the ground that they felt it suggested that a social worker should overrule a psychiatrist. They objected to the word "determine". At no time was it conveyed to me that the Government objected to the suggestion that the social worker should be involved in considering the most appropriate way of providing care and medical treatment". I subsequently withdrew my original new clause and tabled another. To meet the Government's objections, I specifically provided that the approved social worker should "consider" the most appropriate way to provide care and medical treatment". During our discussion in Committee I made the intention of the new clause absolutely clear. I said: New clause 8 seeks to provide for a case where someone is admitted compulsorily to a hospital under sections 25 and 26 and has had no consideration by an approved social worker. In such a case, hospital managers must, within 24 hours, refer the application to an approved social worker who shall interview the patient and consider the most appropriate way to provide care and medical treatment. I proceeded to explain why I had dropped the word "determine" and substituted the word "consider". I then added: It is now clear that the approved social worker would 'consider' the most appropriate way to provide care and medical treatment and would then report the results of his consideration. That does not mean that the responsible medical officer has to do what the social worker suggests, but it does mean that the views and results of consideration by the approved social worker will be available to him, which I consider wholly desirable". I went on to state: In new clause 8, I have sought to provide that the hospital managers will ask a social worker to consider the most appropriate way to provide care and medical treatment only when the application has come from a nearest relative rather than an approved social worker."—[Official Report, Special Standing Committee, 13 May 1982; c. 281–82.] In his reply, the Minister for Health said: I shall make my understanding of the proposal now before us clear, because I shall ask to be allowed to draft a form of words to meet the hon. Gentleman's requirements. I understand"— that is, the Minister for Health understands— that the present suggestion is that in the case of a patient who has been admitted on the application of a nearest relative alone, without the involvement of a social worker, the advice and opinion of a social worker should be obtained as soon as is reasonably practicable thereafter. Although that advice could not be binding upon or overrule the professional medical opinion of a psychiatrist, it should be available and fully considered. The best treatment for a case would thus be considered on a multi-disciplinary basis rather than on that of psychiatric opinion alone. The Government are not unsympathetic to the proposal, which has much to recommend it. I ask the Committee to allow us time to consider the precise form that the provision should take. First, there are drafting problems. The hon. Member for Stechford has refined and polished up the wording over the past few days"— the Minister is referring to the decision to drop "determine" and to substitute "consider"— but I do not believe that he has it exactly right yet. Some points of practice also remain to be considered. Later in that speech the Minister explained why he objected to the 24-hour period. I accept that. He made it clear that he had reservations about any time limit of 24 hours. He went on to say: I have given an undertaking that the Government will consider the amendment". He said that he would consult the directors of social services, the British Association of Social Workers, the Royal College of Psychiatrists and all who would have to put the provision into practice. The Minister has not told us this afternoon that any of those bodies has objected to the suggestion that an approved social worker should consider the most appropriate way of providing care and medical treatment". The Minister for Health went on to say: Perhaps the Opposition would agree not to press the amendments and the new clauses in exchange for the Governments assurance that theyrecognise the mood of the Committee and will try to meet its wishes in principle after consultation and polishing up."—[Official Report, Special Standing Committee, 13 May 1982; c. 285–86.] I have no objection to consultation and polishing up. However, let us be absolutely clear. The Minister for Health gave an undertaking to the Committee to polish up a requirement that an approved social worker should consider the most appropriate way of providing care and medical treatment". This afternoon the Government have tabled an entirely different new clause which will restrict the involvement of an approved social worker to considering the "social circumstances" of the patient. That is not the same thing.

Mr. Mike Thomas

Before the hon. Gentleman leaves the question of consultation, let us be clear what the British Association of Social Workers says. Although it welcomes the improvements in the arrangements for patients admitted under sections 25 and 26, it says that the new clause does not meet the British Association of Social Workers' demand for a full psychiatric and social assessment to be made at the time of every compulsory admission to hospital".

Mr. Davis

There is some difference between the hon. Member for Newcastle upon Tyne, East (Mr. Thomas) and myself about the extent to which a social worker should be involved. We discussed that matter in great detail in Committee and we take different views. On that point I am inclined to agree with the Government that there should not be a veto by an approved social worker on admissions to hospital. I do not believe that an approved social worker should be able to block an application for admission by a near relative.

The British Association of Social Workers seemed to have made it clear that it does not object to social workers being asked to consider the most appropriate way of providing care and medical treatment". Nor have we been told that the Royal College of Psychiatrists objects to that role by approved social workers. I am clear in my own mind, and I believe that it is clear to others, that this afternoon the Government have resiled from their undertaking.

Mr. Ennals

Does my hon. Friend recall that when he withdrew his first and second new clauses the Government said that they would leave emergency applications out and that all but emergencies would be covered?

5.15 pm
Mr. Davis

Indeed, it is the opposite. In response to a question by the hon. Member for Newcastle upon Tyne, East, whether the new clause would cover emergency admissions, I made it clear that that was my intention. The debate had concentrated upon sections 25 and 26—applications for admission. That was because we debated the issue against the background of a previous sitting, when we had discussed sections 25 and 26 and the involvement of social workers, and there had been a difference between the hon. Gentleman and myself. Therefore, we explained why this new clause was different but important. The hon. Gentleman pressed for an assurance that I did intend to include emergency applications, and that I did. It was clear from the wording of that new clause, which referred to emergency applications. It specifically used the language in the Act. It was the heading of section 29. That was quite deliberate. There could be no doubt.

There are three points of difference. The first concerned the period of 24 hours. The Government were clear about that, and I have not complained this afternoon. The Minister for Health told the Committee that he did not want to go along with the period of 24 hours. He made that crystal clear in the undertaking that he gave. However, the Minister did not say that he did not agree that an approved social worker should be involved in an application for an emergency admission. Nor did he say that an approved social worker should not consider the most appropriate way of providing care and medical treatment". Had he objected to either of those, there were several opportunities in Committee for him to say so. He did not say anything of the sort. We pressed him time after time, and he gave an assurance that he was with us in spirit. He did not want to be tied to a period of 24 hours, but on everything else he sympathised with what we were trying to achieve.

Frankly, I am amazed that any Minister should try to wriggle out of that undertaking. I regard it as wriggling out of and going back on an undertaking that was given to and accepted by the Committee. If we had known that the Government intended to do that, I am sure that we would have pressed it to a vote on that occasion. We might have won, because there was another amendment grouped with it on which the Government were defeated. That was amendment No. 8(a)which was added to the Bill against the Government's wishes because a Conservative Member voted with the Opposition in Committee. We would have pressed this issue to the vote, in the hope of winning, if we had known that the Government did not mean what they said.

I am not accusing the Minister of bad faith. I am sure that in Committee he did agree with us and did intend to do what he said. It is only now that we find that the clause, drafted by civil servants, does not meet the undertaking that he gave to the Committee. Having had it proved to him this afternoon, I am amazed that he does not stand up and accept amendments(a)and ((b). We shall certainly press them to a Division if he does not.

Mr. Christopher Price (Lewisham, West)

I did not enter into the debate in Committee but I have listened to the whole of this debate. Even at this late stage, I would urge the Minister to think carefully about this matter. It is important that our parliamentary procedures should work properly and that pledges given in Committee should be redeemed on Report. If that is not done, we cannot legislate in an orderly fashion.

There was an incident last year in which the hon. Member for Louth (Mr. Brotherton) was involved. Because he felt so strongly he voted against the Government on the Contempt of Court Act in the previous Session. That was right. When Ministers say in Committee that they will do something they should redeem their promises.

I should like to make a suggestion. I may not get a response from the Minister, although I am sure that the House would give the Minister leave to speak again. The Bill is not finished with. These new clauses must go to another place. I appeal to the Minister to think, even at this late stage, about his pledges. I see him re-reading them with enormous assiduity on the Front Bench. I ask him to think on those promises that he gave in Committee and to consider once more whether he will advise the House to help him to go back on promises which he gave.

Quite apart from the procedural issue, this is a matter of real substance. We do not want section 29 to be used as a loophole again as a way of excluding social workers. There is no doubt at all that that is what it will be used for by collusion between the various authorities who do not wish to involve social workers or any multi-disciplinary approach to this issue. I appeal to the Minister—he can even intervene if he does riot wish to seek the leave of the House to speak again—to think carefully about what he is asking the House to do. It will set a bad precedent for this and for future debates, and will harm the Government's reputation.

Mr. Kenneth Clarke

I shall intervene briefly in response to all the requests that have been made, because the undertakings that I gave in Committee are being referred to.

I am grateful to the hon. Member for Birmingham, Stechford (Mr. Davis) for making it clear that he makes no personal accusation against me. We are arguing about the way in which an undertaking has been honoured. As we shall see, the Government have honoured all the undertakings they gave in Committee. With two minor exceptions, we have accepted all the defeats that both sides of the Committee inflicted on the Government during our proceedings. The Special Standing Committee reconstructed and redrafted much of the Bill, and there has been no attempt to go back on that.

I shall not repeat the words given in my defence by my hon. Friend the Under-Secretary of State. On the text that I have before me he has marked the quotations about the form in which the undertaking was given, and they make it clear that we undertook to go away and to meet the principle of what was being suggested, but that we would have to consider the practicalities and details not only of the 24 hours—which I expressly gave as an example—but of the rest. I remind the House that I said: The Government are not unsympathetic to the proposal, which has much to recommend it. I ask the Committee to allow us time to consider the precise form that the provision should take. First, there are drafting problems … Some points of practice also remain to be considered."—[Official Report, Special Standing Committee, 13 May 1982; c. 285.] My hon. Friend the Under-Secretary has given our considered view—[Interruption.] I could cite more quotations but it will take up the time of the House. For example, one quotation in c. 287 has not yet been used. In Committee, I said: Therefore, we shall reconsider the practicalities of the issue. I hope that we shall come back to the Committee with something which meets the strongly expressed wishes of members of both sides of the Committee. The hon. Member for Newcastle upon Tyne, East (Mr. Thomas) then tried to press me about the provision relating to emergency admissions and he received a reply—which appears at the foot of c. 287—that I shall not read in full unless I am pressed. I have to confess that it is more waffle than substance, because at that stage I was not prepared off the cuff to give the precise assurance that he sought. As I said, We are dealing with the generality of cases."—[Official Report, Special Standing Committee, 13 May 1982; c. 287.]

Mr. Mike Thomas rose—

Mr. Ennals rose—

Mr. Clarke

We have sought to put into practice the views that were expressed strongly by hon. Members on both sides of the Committee. We believe that the new clause meets the undertaking given. It may be of significance and of some reassurance to Opposition Members that I have been told that the British Association of Social Workers and the Association of Directors of Social Services are content with new clause 5. Indeed, we have been consulting, as I told the Committee that we would have to do.

As my hon. Friend the Under-Secretary explained, we now think that the provision meets the wishes of the Committee and is consistent with common sense and with the practicalities involved.

Mr. Terry Davis

Perhaps the Minister will read what was said about the practicalities. I am not suggesting that it is all put on the record, because those who are interested can read what was said and form their own opinions. However, the Minister must agree that his reference to practicalities came after an assurance that was given either to his hon. Friend the Member for Abingdon (Mr. Benyon) or to his hon. Friend the Member for Basildon (Mr. Proctor) concerning the resource implications for the employment of more social workers. He said that he would want to discuss the resource implication and added: Therefore, we shall reconsider the practicalities of the issue."—[Official Report, Special Standing Committee, 13 May 1982; c. 287.] It was not a question of considering the practicalities of the report on the appropriate way of providing care and medical treatment. The Minister should not try to read that into it. I have quoted from the proceedings round the quotations given by the Under-Secretary. I believe that those who read the full text of that debate and the record of this afternoon's debate in Hansard will come to the conclusion that the Minister gave an undertaking and I am very sorry that he has adopted this attitude.

Question put and agreed to.

Clause read a Second time.

Amendment (a) proposed to the proposed clause, leave out from first 'application' to ' made '.—[Mr. Terry Davis.]

Question put,That the amendment be made:—

The House divided:Ayes 127, Noes 164.

Division No. 299] [5.25 pm
AYES
Archer, Rt Hon Peter Buchan, Norman
Ashton, Joe Callaghan, Rt Hon J.
Atkinson, N.(H'gey,) Campbell-Savours, Dale
Bagier, Gordon A.T. Canavan, Dennis
Beith, A. J. Cocks, Rt Hon M.(B'stol S)
Benn, Rt Hon Tony Cowans, Harry
Bennett, Andrew(St'kp't N) Craigen, J. M.(G'gow, M'hill)
Booth, Rt Hon Albert Crowther, Stan
Bradley, Tom Cryer, Bob
Bray, Dr Jeremy Cunningham, G. (Islington S)
Cunningham, Dr J.(W'h'n) Marshall, Dr Edmund(Goole)
Dalyell, Tam Marshall, Jim(Leicester S)
Davidson, Arthur Mason, Rt Hon Roy
Davis, Clinton(Hackney C) Maynard, Miss Joan
Davis, Terry(B'ham, Stechf'd) Meacher, Michael
Dean, Joseph(Leeds West) Mikardo, Ian
Dixon, Donald Milian, Rt Hon Bruce
Dobson, Frank Miller, Dr M. S.(E Kilbride)
Dormand, Jack Morris, Rt Hon A.(W'shawe)
Douglas, Dick Morris, Rt Hon C.(O'shaw)
Duffy, A. E. P. O'Neill, Martin
Dunwoody, Hon Mrs G. Owen, Rt Hon Dr David
Eadie, Alex Palmer, Arthur
Eastham, Ken Pavitt, Laurie
Edwards, R.(W'hampt'n S E) Pitt, William Henry
Ellis, R.(NE D'bysh're) Powell, Raymond(Ogmore)
English, Michael Price, C.(Lewisham W)
Ennals, Rt Hon David Roberts, Ernest(Hackney N)
Evans, loan(Aberdare) Robertson, George
Evans, John(Newton) Rooker, J. W.
Ewing, Harry Roper, John
Flannery, Martin Ross, Ernest(Dundee West)
Foot, Rt Hon Michael Sever, John
Ford, Ben Silverman, Julius
Forrester, John Skinner, Dennis
Foulkes, George Spearing, Nigel
Freeson, Rt Hon Reginald Steel, Rt Hon David
George, Bruce Stoddart, David
Hamilton, W. W.(C'tral Fife) Stott, Roger
Hardy, Peter Thomas, Dafydd(Merioneth)
Harrison, Rt Hon Walter Thomas, Mike(Newcastle E)
Haynes, Frank Thomas, Dr R.(Carmarthen)
Homewood, William Thorne, Stan(Preston South)
Hooley, Frank Tinn, James
Howells, Geraint Torney, Tom
Hoyle, Douglas Varley, Rt Hon Eric G.
Hughes, Robert(Aberdeen N) Wainwright, E.(Dearne V)
Hughes, Roy(Newport) Wainwright, R.(Colne V)
Jenkins, Rt Hon Roy(Hillh'd) Watkins, David
Johnston, Russell(Inverness) Weetch, Ken
Jones, Barry(East Flint) Wellbeloved, James
Kerr, Russell Welsh, Michael
Lamond, James White, Frank R.
Leighton, Ronald Whitehead, Phillip
Lestor, Miss Joan Whitlock, William
Lewis, Ron(Carlisle) Wigley, Dafydd
Lofthouse, Geoffrey Wilson, William(C'try SE)
McCartney, Hugh Winnick, David
McDonald, Dr Oonagh Woolmer, Kenneth
McKay, Allen(Penistone) Wright, Sheila
McKelvey, William Young, David(Bolton E)
McNally, Thomas
McNamara, Kevin Tellers for the Ayes:
McTaggart, Robert Mr. James Hamilton and
McWilliam, John Mr. George Morton.
Marshall, D(G'gow S'ton)
NOES
Alexander, Richard Chalker, Mrs. Lynda
Alison, Rt Hon Michael Chapman, Sydney
Atkins, Rt Hon H.(S'thorne) Clark, Hon A.(Plym'th, S'n)
Atkinson, David(B'm'th,E) Clarke, Kenneth(Rushcliffe)
Baker, Nicholas(N Dorset) Cockeram, Eric
Bendall, Vivian Cope, John
Benyon, Thomas(A'don) Cormack, Patrick
Berry, Hon Anthony Costain, Sir Albert
Biggs-Davison, Sir John Cranborne, Viscount
Blackburn, John Crouch, David
Boscawen, Hon Robert Dickens, Geoffrey
Bottom ley, Peter(W'wich W) Douglas-Hamilton, Lord J.
Bright, Graham Dunn, Robert(Dartford)
Brinton, Tim Eden, Rt Hon Sir John
Brotherton, Michael Fairgrieve, Sir Russell
Brown, Michael(Brigg & Sc'n) Faith, Mrs Sheila
Browne, John(Winchester) Fell, Sir Anthony
Bruce-Gardyne, John Finsberg, Geoffrey
Buck, Antony Fookes, Miss Janet
Budgen, Nick Forman, Nigel
Burden, Sir Frederick Fowler, Rt Hon Norman
Carlisle, John(Luton West) Fry, Peter
Gardiner, George(Reigate) Morrison, Hon C.(Devizes)
Goodhart, Sir Philip Murphy, Christopher
Goodhew, Sir Victor Neale, Gerrard
Goodlad, Alastair Needham, Richard
Gorst, John Neubert, Michael
Gow, Ian Newton, Tony
Grant, Anthony(Harrow C) Page, John(Harrow, West)
Greenway, Harry Page, Richard(SW Herts)
Grieve, Percy Parris, Matthew
Griffiths, Peter Portsm'th N) Pattie, Geoffrey
Grist, Ian Percival, Sir Ian
Grylls, Michael Pollock, Alexander
Hamilton, Hon A. Price, Sir David(Eastleigh)
Hamilton, Michael(Salisbury) Proctor, K. Harvey
Hampson, Dr Keith Raison, Rt Hon Timothy
Hannam, John Rathbone, Tim
Haselhurst, Alan Rees-Davies, W. R.
Heddle, John Renton, Tim
Henderson, Barry Rhys Williams, Sir Brandon
Hill, James Ridsdale, Sir Julian
Hogg, Hon Douglas(Gr'th'm) Roberts, M.(Cardiff NW)
Holland, Philip(Carlton) Rossi, Hugh
Hooson, Tom Rumbold, Mrs A. C. R.
Howell, Ralph(N Norfolk) Sainsbury, Hon Timothy
Hunt, David(Wirral) Shaw, Giles(Pudsey)
Irvine, Bryant Godman Shaw, Sir Michael(Scarb')
Jenkin, Rt Hon Patrick Shepherd, Cohn(Hereford)
Jessel, Toby Silvester, Fred
Jopling, Rt Hon Michael Sims, Roger
Kershaw, Sir Anthony Skeet, T. H. H.
King, Rt Hon Tom Smith, Tim(Beaconsfield)
Kitson, Sir Timothy Speed, Keith
Knight, Mrs Jill Speller, Tony
Lang, Ian Spicer, Jim(West Dorset)
Lawrence, Ivan Spicer, Michael(S Worcs)
Lennox-Boyd, Hon Mark Squire, Robin
Lester, Jim(Beeston) Stanbrook, Ivor
Lewis, Kenneth(Rutland) Steen, Anthony
Lloyd, Peter(Fareham) Stevens, Martin
Loveridge, John Stradling Thomas, J.
Luce, Richard Temple-Morris, Peter
Lyell, Nicholas Thomas, Rt Hon Peter
McCrindle, Robert Thompson, Donald
Macfarlane, Neil Thornton, Malcolm
MacKay, John(Argyll) Townend, John(Bridlington)
Macmillan, Rt Hon M. Trippier, David
McNair-Wilson, M.(N'bury) van Straubenzee, Sir W.
McNair-Wilson, P.(New F'st) Viggers, Peter
Madel, David Waddington, David
Major, John Waller, Gary
Marlow, Antony Ward, John
Mather, Carol Watson, John
Maude, Rt Hon Sir Angus Wells, Bowen
Mawby, Ray Wells, John(Maidstone)
Mawhinney, Dr Brian Wheeler, John
Maxwell-Hyslop, Robin Wickenden, Keith
Mayhew, Patrick Wolfson, Mark
Mellor, David Young, Sir George(Acton)
Meyer, Sir Anthony
Mills, lain(Meriden) Tellers for the Noes:
Mills, Sir Peter(West Devon) Mr. Peter Brooke and
Moate, Roger Mr. Tristan Garel-Jones.

Question accordingly negatived.

Amendment (b)proposed to the proposed clause, leave out 'his social circumstances' and insert 'the most appropriate way of providing care and medical treatmene.—[Mr. Terry Davis.] Question put, That the amendment be made:—

The House divided:Ayes 124, Noes 160.

Division No. 300] [5.35 pm
AYES
Archer, Rt Hon Peter Benn, Rt Hon Tony
Ashton, Joe Bennett, Andrew(St'kp't N)
Atkinson, N.(H'gey,) Booth, Rt Hon Albert
Bagier, Gordon A.T. Bradley, Tom
Beith, A. J. Bray, Dr Jeremy
Buchan, Norman McWilliam, John
Callaghan, Rt Hon J. Marshall, D(G'gow S'ton)
Campbell-Savours, Dale Marshall, Jim(Leicester S)
Canavan, Dennis Mason, Rt Hon Roy
Cocks, Rt Hon M.(B'stol S) Maynard, Miss Joan
Cowans, Harry Meacher, Michael
Craigen, J. M.(G'gow, M'hill) Mikardo, Ian
Crowther, Stan Milian, Rt Hon Bruce
Cryer, Bob Miller, Dr M. S.(E Kilbride)
Cunningham, G.(Islington S) Morris, Rt Hon A.(Wrshawe)
Cunningham, Dr J.(W'h'n) Morris, Rt Hon C.(O'shaw)
Dalyell, Tam Morton, George
Davidson, Arthur O'Neill, Martin
Davis, Terry(B'ham, Stechf'd) Owen, Rt Hon Dr David
Dean, Joseph(Leeds West) Palmer, Arthur
Dixon, Donald Pavitt, Laurie
Dobson, Frank Pitt, William Henry
Dormand, Jack Powell, Raymond(Ogmore)
Douglas, Dick Price, C.(Lewisham W)
Duffy, A. E. P. Radice, Giles
Dunwoody, Hon MN G. Roberts, Ernest(Hackney N)
Eadie, Alex Robertson, George
Eastham, Ken Rooker, J. W.
Ellis, R.(NE D'bysh're) Roper, John
English, Michael Ross, Ernest(Dundee West)
Ennals, Rt Hon David Sever, John
Evans, loan(Aberdare) Silverman, Julius
Evans, John(Newton) Skinner, Dennis
Ewing, Harry Spearing, Nigel
Flannery, Martin Spriggs, Leslie
Foot, Rt Hon Michael Steel, Rt Hon David
Ford, Ben Stoddart, David
Forrester, John Stott, Roger
Freeson, Rt Hon Reginald Thomas, Dafydd(Merioneth)
George, Bruce Thomas, Mike(Newcastle E)
Hamilton, James(Bothwell) Thomas, Dr R.(Carmarthen)
Hamilton, W. W.(C'tral Fife) Thorne, Stan(Preston South)
Hardy, Peter Tinn, James
Harrison, Rt Hon Walter Torney, Tom
Homewood, William Varley, Rt Hon Eric G.
Hooley, Frank Wainwright, E.(Dearne V)
Howells, Geraint Wainwright, R.(Colne V)
Hoyle, Douglas Watkins, David
Hughes, Robert(Aberdeen N) Weetch, Ken
Hughes, Roy(Newpert) Wellbeloved, James
Johnston, Russell(Inverness) Welsh, Michael
Jones, Barry(East Flint) White, Frank R.
Kerr, Russell Whitehead, Phillip
Lamond, James Whitlock, William
Leighton, Ronald Wigley, Dafydd
Lestor, Miss Joan Wilson, William(C'try SE)
Lewis, Ron(Carlisle) Winnick, David
Lofthouse, Geoffrey Woolmer, Kenneth
McCartney, Hugh Wright, Sheila
McDonald, Dr Oonagh Young, David(Bolton E)
McKay, Allen(Penistone)
McKelvey, William Tellers for the Ayes:
McNally, Thomas Dr. Edmund Marshall and
McNamara, Kevin Mr. Frank Haynes.
NOES
Alexander, Richard Carlisle, John(Luton West)
Alison, Rt Hon Michael Chalker, Mrs. Lynda
Atkins, Rt Hon H.(S'thorne) Chapman, Sydney
Atkinson, David(B'm''h,E) Clark, Hon A.(Plym'th, S'n)
Baker, Nicholas(N Dcrset) Clarke, Kenneth(Rushcliffe)
Bendall, Vivian Cockeram, Eric
Benyon, Thomas(A'don) Colvin, Michael
Berry, Hon Anthony Cope, John
Biggs-Davison, Sir John Cormack, Patrick
Blackburn, John Costain, Sir Albert
Bottomley, Peter(W'wich W) Cranborne, Viscount
Bright, Graham Crouch, David
Brinton, Tim Dickens, Geoffrey
Brotherton, Michael Douglas-Hamilton, Lord J.
Brown, Michael(Brigg & Sc'n) Dunn, Robert(Dartford)
Browne, John(Winchester) Eden, Rt Hon Sir John
Buck, Antony Fairgrieve, Sir Russell
Budgen, Nick Faith, Mrs Sheila
Burden, Sir Frederick Fell, Sir Anthony
Fookes, Miss Janet Mills, lain(Meriden)
Forman, Nigel Mills, Sir Peter(West Devon)
Fowler, Rt Hon Norman Moate, Roger
Fry, Peter Morrison, Hon C.(Devizes)
Gardiner, George(Reigate) Murphy, Christopher
Garel-Jones, Tristan Neale, Gerrard
Goodhart, Sir Philip Needham, Richard
Goodhew, Sir Victor Neubert, Michael
Goodlad, Alastair Newton, Tony
Gorst, John Page, John(Harrow, West)
Gow, Ian Page, Richard(SW Herts)
Grant, Anthony(Harrow C) Parris, Matthew
Greenway, Harry Pattie, Geoffrey
Grieve, Percy Percival, Sir Ian
Griffiths, Peter Portsm'th N) Pollock, Alexander
Grist, Ian Price, Sir David(Eastleigh)
Grylls, Michael Proctor, K. Harvey
Hamilton, Hon A. Rathbone, Tim
Hamilton, Michael(Salisbury) Rees-Davies, W. R.
Hampson, Dr Keith Renton, Tim
Hannam, John Rhys Williams, Sir Brandon
Haselhurst, Alan Ridsdale, Sir Julian
Heddle, John Roberts, M.(Cardiff NW)
Henderson, Barry Rossi, Hugh
Hill, James Rumbold, Mrs A. C. R.
Hogg, Hon Douglas(Gr'th'm) Sainsbury, Hon Timothy
Holland, Philip(Carlton) Shaw, Giles(Pudsey)
Hooson, Tom Shaw, Sir Michael(Scarb')
Howell, Ralph(N Norfolk) Shepherd, Colin(Hereford)
Hunt, David(Wirral) Sims, Roger
Irvine, Bryant Godman Skeet, T. H. H.
Jessel, Toby Smith, Tim(Beaconsfield)
Jopling, Rt Hon Michael Speed, Keith
Kershaw, Sir Anthony Speller, Tony
King, Rt Hon Tom Spicer, Jim(West Dorset)
Kitson, Sir Timothy Spicer, Michael(S Worcs)
Knight, Mrs Jill Squire, Robin
Lang, Ian Stanbrook, Ivor
Lawrence, Ivan Steen, Anthony
Lennox-Boyd, Hon Mark Stevens, Martin
Lester, Jim(Beeston) Stradling Thomas, J.
Lewis, Kenneth(Rutland) Temple-Morris, Peter
Lloyd, Peter(Fareham) Thomas, Rt Hon Peter
Loveridge, John Thompson, Donald
Luce, Richard Thornton, Malcolm
Lyell, Nicholas Townend, John(Bridlington)
McCrindle, Robert Trippier, David
Macfarlane, Neil van Straubenzee, Sir W.
MacKay, John(Argyll) Viggers, Peter
Macmillan, Rt Hon M. Waddington, David
McNair-Wilson, M.(N'bury) Waller, Gary
McNair-Wilson, P.(New F'st) Ward, John
Madel, David Watson, John
Major, John Wells, Bowen
Marlow, Antony Wells, John(Maidstone)
Mather, Carol Wheeler, John
Maude, Rt Hon Sir Angus Wickenden, Keith
Mawby, Ray Wolfson, Mark
Mawhinney, Dr Brian Young, Sir George(Acton)
Maxwell-Hyslop, Robin
Mayhew, Patrick Tellers for the Noes:
Mellor, David Mr. Peter Brooke and
Meyer, Sir Anthony Mr. Robert Boscawen.

Question accordingly negatived.

Clause added to the Bill.

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