Mental Health Act 1983 (Hansard, 6 July 1993)

§ 3. Mr. Clifton-Brown
To ask the Secretary of State for Health if she will make a statement on the working of section 2 of the Mental Health Act 1983.

§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
Section 2 of the Mental Health Act 1983 provides for a patient suffering from mental disorder to be compulsorily admitted to hospital for assessment for a maximum of 28 days. We have been reviewing the general adequacy of the Act's provisions in relation to vulnerable or potentially dangerous psychiatric patients and my right hon. Friend the Secretary of State will announce her conclusions on this shortly.

§ Mr. Clifton-Brown
I have given previous notice of three cases to my hon. Friend. The first involved a patient who was detained on inconclusive evidence, with subsequent devasting damage to the patient's family. The second case involved a patient whom two doctors had certified should be detained. The social worker refused to detain the patient, who then went outside and bopped the social worker on the head. The patient had to be brought inside and detained. In the third case, the patient could not get any evidence—

§ Madam Speaker
The hon. Gentleman is trying the patience of the House. Will he come to his question to the Minister?

§ Mr. Clifton-Brown
I am grateful for your advice, Madam Speaker. In view of the abuses of the current system, will my hon. Friend consider reviewing the system whereby a mental health tribunal takes 21 days to settle such cases? Will my hon. Friend set up a quicker conciliation procedure?

§ Mr. Bowis
I am grateful to my hon. Friend for giving me notes of the cases to which he referred. As he said, some of the cases were referred too quickly and others were not referred quickly enough. I am seeking comments from the authorities involved about the cases raised. Section 2 requires a tribunal to act within seven days, not 21. Under the 1983 Act, the Mental Health Act Commission acts on behalf of my right hon. Friend the Secretary of State in keeping the working of the Act under review. That can include any aspect of the Act.

§ Ms Lynne
Can the Minister explain how it can be right that people detained under section 2 of the Mental Health Act 1983 have no statutory right to after-care under section 117? Will he ask the Secretary of State for Health to use her powers to direct health authorities, local authorities and NHS trusts to have some minimum standard of after-care, thus preventing mental health patients or ex-patients who recognise that they need treatment going for help and being turned away?

§ Mr. Bowis
It is our wish that everyone who needs treatment and after-care should receive it. That is why we have put in place the care programme approach, which ensures that everyone who leaves institutional care has a programme of treatment and social welfare and a key worker to assist. The mental health task force under David King is travelling around the country ensuring that social services departments are better able to receive such people and, indeed, to look after them while they are in the community.

§ Mrs. Browning
Is my hon. Friend aware that, for example, in rural communities, schizophrenic patients who from time to time have to be sectioned find that when housing is found for them they are housed in a large urban conurbation? That exacerbates their problem because they are away from the area where they are known by the local community and the area with which they are familiar. Will my hon. Friend examine that issue? It is a particular problem in rural constituencies such as mine.

§ Mr. Bowis
I accept entirely that the point that my hon. Friend raises is important. The programme for housing between the health authority and the relevant local authority social services department should be put in place before the patient is returned to the community. Certainly, the wishes and needs of the patient as well as of the patient's carers will be taken into account. I am sure that needs will be met in the way that my hon. Friend wishes.

§ Mr. Hinchliffe
Is the Minister aware of the widespread concern that the Government's only apparent response to the increasing lack of public confidence in community care is to amend the mental health legislation and strengthen its provisions? Is not it astonishing that the Government admitted in the last oral Health questions, that they did not have the least idea where thousands of psychiatric patients who had been discharged while the Government have been in power had gone?
When will the Government start on the basics of community care: guaranteed after-care and support, proper accommodation, and care plans that are agreed when patients leave hospital and regularly reviewed when they are in the community? When will the Government realise that community care must be much more than simply closing hospitals and saving public expenditure?

§ Mr. Bowis
I wonder whether it is not time that the hon. Gentleman understood that it is our policy that everyone who has a mental health problem should be considered carefully and have his or her interests taken into account. It is not the case that beds are closed and people are thrown out into the community; bed closures must be set against a much wider range of provision in the community for former long-stay patients.
If the hon. Gentleman wishes to exchange facts, why does not he explain the real fact about funding mental health provision in Britain at the rate of £2 billion every year; the real fact about trebling the number of community psychiatric nurses; the real fact about trebling independent sector residential places; the real fact that funding for local authority services for the mentally ill has been increased by 86 per cent. in real terms; and the fact that mental health specific grant has increased this year by £13 million to £34.4 million, including £250,000 to the hon. Gentleman's borough?