PATIENTS DISCHARGED AFTER SENTENCES OF IMPRISONMENT (Hansard, 26 October 1995)

§ Mr. Stephen Timms (Newham, North-East)
I beg to move, That the clause be read a Second time.
The new clause arises from an appalling incident in Newham on 27 July 1994, when Mr. Bryan Bennett, a constituent of my hon. Friend the Member for Newham, South (Mr. Spearing)—who is unable to be in the Chamber this afternoon—and a user of a social services day centre was tragically killed by another user, Mr. Stephen Laudat, just a few months after the latter's discharge from psychiatric treatment at Kneesworth hospital.
Mr. Laudat pleaded guilty on the ground of diminished responsibility and was committed by the central criminal court to an indefinite period of treatment in Rampton hospital in December 1994.
The district health authority and the local council jointly commissioned an independent review of the circumstances surrounding the tragedy in January 1995, under the chairmanship of Mr. Len Woodley QC. That inquiry reported last month. The Minister will be aware that the Woodley report is sharply critical of the Bill. It states: it is difficult to imagine how the proposed legislation would have enhanced Stephen Laudat's care or prevented the death of Mr. Bennett. It says that its findings do not support the enactment of the Bill and that the key lies in better resourcing of community care—a point to which I shall return if I am able to on Third Reading later today.
The new clause relates to one aspect of the Laudat case with which the Bill does not deal. There is immense concern in Newham, especially among the relatives of the man who died, naturally, about how Mr. Laudat came to be released from Kneesworth hospital in December 1993, just seven months before the killing. The Woodley report shows that the hospital had great concerns about him immediately before he was released. There was a series of difficult incidents in October and November 1993 and the ward manager wrote, prior to an after-care planning meeting on 25 November, that Mr. Laudat was subject to the potential and threat of violence to both males and females", 1157 and that he was vulnerable and a threat to himself and others". Mr. Laudat's prison sentence—the reason for his detention in the first place—meant that he could be released on 6 December 1993. At the meeting on 25 November, it was noted that there were insufficient grounds to warrant his detention beyond the end of the restriction order on 6 December and that he had, therefore, to be released.
That is the matter that has so deeply concerned myself and my hon. Friends the Members for Newham, South and for Newham, North-West (Mr. Banks) and which lead to the drafting of the new clause. Mr. Laudat was released because his prison sentence expired and not because anyone had positively concluded that he was ready to re-enter the community. The limited grounds in the Mental Health Act 1983 under which it would have been possible to detain Mr. Laudat further were felt not to have been complied with, so it was felt that there was no alternative but to release him, despite the severe misgivings of those responsible for his care. The truth is that he should not have been released.
The new clause shifts the onus, so that in such circumstances discharge could take place only on the explicit authority of a medical officer and not merely because the prison sentence had expired, as in the case described in the Woodley report. The length of the sentence clearly bore no relation to the state of Mr. Laudat's health.
Under the new clause, the patient would be released only if his doctor was positively satisfied that he was not a danger to himself or others. If it had been enacted prior to December 1993, it is likely that my hon. Friend's constituent would be alive today. I hope that the Minister will be able to accept it, to prevent similar tragic incidents.

§ Ms Tessa Jowell (Dulwich)
I commend my hon. Friends the Members for Newham, North-East (Mr. Timms) and for Newham, South (Mr. Spearing) for tabling the new clause. We believe that it should be supported.
Although such patients will be entitled, when discharged, to after-care under section 117 of the Mental Health Act 1983, there is no legal requirement in that section to consult prior to discharge and on many occasions, as my hon. Friend made clear, discharge is poorly, if at all, planned and co-ordinated. We believe that new clause 1 is a practical way of addressing those concerns.

§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
I am grateful to the hon. Member for Newham, North-East (Mr. Timms) for bringing the matter forward. The hon. Member for Newham, South (Mr. Spearing) did me the courtesy of writing to explain that he could not be here, but that his hon. Friends the Members for Newham, North-East and for Newham, North-West (Mr. Banks) would be here to support new clause 1.
I understand well the concern that lies behind new clause 1 following the Woodley inquiry into the care of Stephen Laudat. However, the present wording of the 1158 Mental Health Act 1983 already meets the aims of the new clause, while the introduction of supervised discharge will of course strengthen the provisions.
The Home Secretary may direct that a patient be transferred from prison to hospital; he may also direct that a patient should be subject to special restrictions. The patient may not then be discharged, given leave of absence or transferred to another hospital without the consent of the Home Secretary. The issue that the new clause seeks to address arises at the point when the prison sentence of a patient in hospital expires. At that point, the restrictions exercised by the Home Secretary also expire. That does not mean that the patient must then be discharged immediately. The patient remains liable to be detained for a further six months unless a positive decision is taken to discharge him or her.
At the end of the six months, the responsible medical officer must review the case and the detention may then continue if the renewal conditions in section 20 of the Mental Health Act 1983 are met. When the patient is eventually discharged, he or she is subject to section 117 in the same way as anyone else who has been detained for treatment under the Act; that is, the relevant health and local authorities are obliged to provide after-care services for as long as the patient needs them.
Under the terms of the Bill, as soon as the restriction direction has lapsed, it is open to the responsible medical officer to make a supervision application if, and only if, he or she is satisfied that the after-care arrangements are agreed and in place. New clause 1 would treat transferred prisoners differently from those admitted directly under hospital orders made by the courts. I do not think that that is desirable or necessary and I hope that the hon. Gentleman will feel able to withdraw the new clause.

§ Mr. Timms
I am disappointed that the Minister has not accepted the new clause, but I am encouraged by what he said. I hope that he is right that the arrangements will ensure that such incidents do not take place in future. In the light of what the Minister said, I shall not seek to press the new clause to a vote and I beg to ask leave to withdraw the motion.