HC Deb 13 January 1997 vol 288 cc48-74

  1. '(1) The Secretary of State shall by regulations make provision for the establishment in magistrates' courts of schemes which provide for the psychiatric examination on court premises after conviction and prior to sentence of persons who are or appear to be mentally disordered.
  2. (2) The regulations may be made so as to apply only to specified geographical areas.
  3. (3) In this section "psychiatric examination" means the examination of the mental condition of persons by a medical practitioner approved for the purposes of section 12(2) of the Mental Health Act 1983.'.—[Mr. Michael.]
Brought up, and read the First time.

Mr. Michael

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

Madam Deputy Speaker (Dame Janet Fookes)

With this, it will be convenient to discuss the following: New clause 8—Court psychiatric assessment schemes

  1. '(1) The Secretary of State shall by regulations make provision for the establishment in magistrates' courts of schemes which provide for the psychiatric examination on court premises after conviction and before sentence of persons who are or appear to be mentally disordered.
  2. (2) Regulations made under this section may be made so as to apply only in specified areas.'.
New clause 12—Court to be aware of provision in custody for mentally disordered offenders 'It shall be the duty of the Secretary of State to make available to any court passing a custodial sentence upon any offender whom the court believes to be mentally disordered an assessment of the provision available in any prison or other custodial institution to which the offender is liable to be committed of facilities for providing treatment appropriate to his condition.'. Amendment No. 37, in clause 43, page 31, leave out lines 30 to 34.

Mr. Michael

The new clauses and the amendment—[Interruption.]

Madam Deputy Speaker

Order. Before the hon. Gentleman continues, I ask that there be much greater quietness in the Chamber and that hon. Members who intend to leave do so quickly and quietly.

Mr. Michael

The new clauses and amendment deal with an important issue, which is the way in which we deal with mentally ill offenders. Hon. Members will be familiar with recent horrific headlines, such as the question posed by the Daily Express: Why Was Machete Man Free? The Times of 13 December 1996 proclaims: Zito's killer wins right to sue over 'inadequate' care". The House must answer such proper questions. In the case of Christopher Clunis, who killed Jonathan Zito, there are questions about the efficacy of community care and about the system's failure to act on problems known long before the tragic offence that led to Clunis's court appearance. The introductory paragraph of the Daily Express story on Horrett Campbell states: A court knew machete maniac Horrett Campbell had mental problems months before he attacked children at a teddy bears' picnic. Such facts demonstrate why we have introduced the new clauses.

We believe that courts must have powers and systems in place to ensure that mental illness is identified and dealt with, before sentence, by the courts and, after sentence, by prison staff or by means of the disposal chosen by the courts. Far too often, prisoners have mental conditions that are known to the responsible authorities, but far too little happens and there is inadequate treatment for the problems, with the result that offenders reoffend. The heart of this debate is the need to ensure that the courts and criminal justice system are effective in nipping matters in the bud and preventing reoffending.

One cannot prevent every breakdown in the system after the commission of an offence and a diagnosis of mental illness, but I should be surprised if anyone were to say that the system is perfect and there is no need for change. There is a need in the criminal justice system for change, for great improvement and for greater effectiveness.

New clause 2 would provide for psychiatric examination on court premises after conviction and prior to sentence of persons who are or appear to be mentally disordered. It would provide courts, without delay, with the ability to satisfy themselves as to the existence of mental illness in cases in which there appears to be a problem, and with the provisions for a proper sentence.

New clause 8 would provide the Secretary of State with powers to make regulations for the establishment in magistrates' courts of schemes which provide for the psychiatric examination of offenders after conviction, and would allow for those regulations to apply only in specified areas. The two new clauses are, therefore, alternatives. New clause 8 would offer the possibility of addressing the issue over time through the introduction of specific pilot projects and experiments. If the Minister is unable to accept new clause 2, he may find that new clause 8—which would go part but not all the way to dealing with the matter—has some advantages.

Mr. Soley

Does my hon. Friend believe that, when a person who appears to be mentally ill is first brought before a court, the court might suggest that he or she should be held for observation under section 38 of the Mental Health Act 1983—which may enable the court, then or soon afterwards, to make an appropriate disposal under that Act?

Mr. Michael

I understand that point, but I think that the interface between the mental health and criminal justice systems is uneven. However, that issue goes way beyond what we want to achieve in new clause 8. We want the court, in taking its decision, to be in the best possible position to understand both the offence and the offender. New clause 12—the third new clause in the group—is extremely important in dealing with that issue. Various disposals—those not only under mental health but under criminal justice provisions—are available to the court, and, after considering reports, it may want to take one of those options. Under our proposals, the court would have the information that would allow it to do so.

In new clause 12, we want to place a duty on the Secretary of State to make available to any court passing a custodial sentence upon any offender whom the court believes to be mentally disordered an assessment of the provision available in any prison or other custodial institution to which the offender is liable to be committed of facilities for providing treatment appropriate to his condition. Therefore, authorities would have a duty to ensure that the court is aware that facilities for the treatment of mental illness are available should it impose a prison sentence on an offender who requires such treatment. Moreover, the provision would increase pressure on the Home Secretary and the Prison Service to ensure that adequate services are available to treat people with mental illness in the prison system.

Under the proposals, courts would have a choice of disposal, and they might choose the option suggested by my hon. Friend the Member for Hammersmith (Mr. Soley). However, as we know, many mentally ill offenders are simply sent to prison, and new clause 12 would ensure that appropriate treatment is available to them. The purpose of treatment is not only to deal with offenders' mental conditions but to reduce the likelihood of their reoffending. Many of those who enter the prison system and do not receive treatment for their conditions return to the streets more likely to reoffend.

My hon. Friend the Member for Knowsley, North (Mr. Howarth) and some of my colleagues on the health team have taken a strong interest in the serious issue of the overlap between the criminal justice and health systems. We cannot be happy that the two systems, individually or together, do not provide the effective services that the public and those who require mental health treatment have a right to expect. I hope that those comments answer the question of my hon. Friend the Member for Hammersmith and set in context the first two new clauses. I also hope that they demonstrate how we are attempting to improve the situation more widely within the Prison Service.

Amendment No. 37, which was tabled by the right hon. Member for Berwick-upon-Tweed (Mr. Beith) and the hon. and learned Member for Montgomery (Mr. Carlile), is grouped with the three new clauses, although I shall not deal with it now as I am sure that the hon. and learned Member for Montgomery will speak to it in his own manner. I am sure, however, that we shall be at one in attempting to make the criminal justice system more effective in tackling the problem of mental illness among offenders.

New clause 2 requires the Secretary of State to make regulations to establish court psychiatric assessment schemes in magistrates courts, to enable both accused defendants and convicted offenders to be examined psychiatrically on court premises. It is framed so that the Secretary of State could implement it on an area-by-area basis.

In the year ending 31 March 1995, 2,481 psychiatric reports were prepared on defendants remanded in custody. Prison is one of the worst possible places for someone with a mental disorder. We all know of the gloomy conditions and restrictive regimes in the older Victorian prisons, which are likely to exacerbate the mental health problems of prisoners prone to depression and those suffering from a disorder with a depressive element. Such conditions can increase the risk of suicidal self-mutilation among those prisoners and do nothing to reduce the likelihood of them being released from prison in a condition worse than that in which they started their sentence.

Medical experts have made considerable comment on the issue. A recent research study published by the British Medical Journal in December 1996 of 750 male remand prisoners in 13 adult prisons and three young offenders institutions found psychiatric disorders, which were broadly defined to include substance misuse—that is not the subject of the debate, but will be debated when we come to a new clause to be moved by my hon. Friend the Member for Knowsley, North—in 63 per cent. of inmates. Even with such a broad definition, that is an enormous proportion of the prison population with psychiatric disorders. Apart from substance abuse, diagnosed in 38 per cent. of cases, the main diagnoses were neurotic illness at 26 per cent., personality disorder at 11 per cent. and psychosis at 5 per cent.

5.30 pm

The researchers judged that 9 per cent. needed transfer to an NHS hospital. They wrote: It is government policy that prisoners on remand who have a serious mental disorder should be transferred to a psychiatric hospital but this is often not done. Even when a prisoner is transferred there are delays, during which the patient remains in prison and is at increased risk of self-harm and suicide … In addition to causing unnecessary suffering to mentally ill prisoners, this situation creates a risk to the public. I stress those last words, because we are highlighting not just the risk to the individual, but the risk to the public.

The report continues: Three recent inquiries into killings by mentally ill people described previous remands in custody during which mental disorder was recognised but not adequately managed. Some of the most difficult psychiatric patients in the country are assessed and treated entirely within prisons, which are not designed for this purpose and cannot match the standards of hospitals. I do not want to enter into the debate about where people should be placed. It is a difficult debate and professional views have been expressed on it. Some parts of the Bill are helpful, offering a more sympathetic assessment and more flexibility. However, the report makes it clear that conditions in our prisons result in people not receiving the treatment that they need.

An earlier study of mentally disordered remand prisoners' carried out for the Home Office by Adrian Grounds, Susanne Dell and Katie James of the Cambridge Institute of Criminology and Graham Robertson of the Institute of Psychiatry, examined details of 952 remand prisoners in Holloway, Brixton and Risley prisons over a five to six-month period who came to the attention of prison doctors for psychiatric reasons. Only a small proportion of them had been charged with serious crimes of violence. Most had been charged with relatively minor offences, predominantly theft, public nuisance offences or criminal damage. When hospital orders were subsequently made, the subjects were routinely sent back to prison to await admission for up to 28 days.

We should pay attention to the researchers' conclusions, which showed remands in custody to be not only an inhumane, but an ineffective way of securing help and care for disturbed people. Even those who are not concerned about the inhumanity of the failure to treat conditions speedily should be concerned about the ineffectiveness of the current process.

The report goes on: For those who obtained hospital places it meant weeks or months of imprisonment, at the end of which they were admitted to beds for which they had been qualified at the outset. And for the mentally ill people who were not offered beds, the process was equally unsatisfactory. In most cases they were petty offenders without social roots, for whom magistrates had evidently ordered custodial remands in the hope that some kind of solution to their problems would be found. After weeks in prison they were generally discharged back to the situations they had come from without the courts being about to arrange for accommodation, treatment or support. Many magistrates and judges agree to a disposal in the hope not only that the person's liberty will be lost by the sentence, but that the condition that has led to, or been a contributory factor in, their offending will be addressed. It is therefore important to improve greatly the standards of both assessment and treatment. Both are addressed by our new clauses.

The study goes on: We concluded from our study that as a method of obtaining psychiatric help for mentally disordered offenders, the custodial remand has nothing to commend it: it is inhumane, expensive and ineffective. It exposes mentally disordered people to conditions and regimes which are cruelly harsh and inappropriate. It brings into prison thousands of defendants who do not need to be there and for whom penal disposals are never contemplated. Regardless of whether that general conclusion is accepted, it surely cannot be denied that there is a problem to be addressed and that our new clauses address both sides of that problem.

One important approach to tackling the problem, commended by Home Office circulars in 1990 and 1995—during the time in office of existing Ministers—is the establishment of court psychiatric assessment schemes. Some such schemes involve psychiatrists attending court on a sessional basis to carry out psychiatric assessments and to make oral reports to the courts. Others involve initial screening at court by community psychiatric nurses. Our new clauses would allow the flexibility for that initial assessment by psychiatric nurses, avoiding excessive costs falling on the system.

A study of a psychiatric liaison service at Clerkenwell magistrates court, published in 1991, reported on the impact of a scheme in which two psychiatrists attended court to examine people in custody on whom psychiatric reports had been requested and gave oral reports to the court on the same day. We all agree that speed is of the essence when deciding disposal in court and, when possible, long delays and adjournments to obtain information should be avoided. We want to help to speed up the court process.

When hospital orders were made, direct admission to the hospital from the court was arranged if possible. The authors compared the outcomes of 80 referrals to the psychiatric liaison scheme over a nine-month period with those of 50 offenders given hospital orders by London magistrates courts after being remanded to Brixton prison for reports. The psychiatrist attending Clerkenwell court recommended hospital admission in 39 of the 80 cases. For those reaching hospital through the scheme, the mean number of days from arrest to admission—the time between the arrest and something starting to happen—was 8.7. In contrast, for those remanded to Brixton, the mean time from arrest to hospital admission was 50.8 days. That is a remarkable difference.

A study of the psychiatric assessment service based at Bow Street and Marlborough Street magistrates courts was published in 1993. During the 18 months of that study, there were 201 referrals to the service. Following initial assessment, 51 people were admitted directly to hospital and 14 were admitted following a further period in custody. For the 65 hospital admissions, the average time from court assessment to admission was 10 days. A further 101 people were released after assessment. Some 58 cases were discontinued by the Crown Prosecution Service and 99 were dealt with by conditional discharge, fines or probation orders. A follow-up study of the 65 people admitted to hospital found that 77 per cent. had derived some or marked benefit from psychiatric treatment.

All that research highlights why there is such a widespread problem that needs to be addressed. It will not be addressed adequately unless our new clauses are accepted.

The interdepartmental Reed committee report of 1992 recommended that there should be nationwide provision of properly resourced court assessment and diversion schemes and that purchasers and providers of health and social services must regard the availability of assessment and diversion schemes as part of a standard service. That would draw together the expertise of the health service and the Prison Service, as we would surely want.

From 1993, the Home Office has made available funding to meet the sessional costs or fees of psychiatrists or community psychiatric nurses who attend magistrates courts. The 1996 Home Office annual report said that the total funding provided to date amounted to just over £1 million and that 53 schemes were funded.

A growing number of schemes are funded from other sources. In Committee, the Under—Secretary, the hon. Member for Bolton, West (Mr. Sackville), said that, in total, 130 schemes were in operation. He added: Further good news is the fact that the £1 million currently allocated by the Home Office for the purpose will be substantially increased—I cannot give the exact figure because it is not yet finalised, but it will be substantial. Other schemes will therefore also receive financial support. There is a powerful argument for the establishment of psychiatric assessment schemes throughout the country. I take it from the Minister's remarks that he would agree with the Opposition on that general principle.

Although no recent cost evaluation has been published, the 1991 study of the Clerkenwell scheme estimated that it was saving the Prison Service approximately £17,800 a month, which amounted to several times the cost of the two psychiatrists' attendance fees. It can therefore be realistically argued that the development of such schemes does not involve any overall increase in public expenditure. Labour was disappointed in Committee that the Under-Secretary did not accept the argument on the ground that it is not necessary to amend the Bill to achieve what those on both sides of the Committee want".—[Official Report, Standing Committee A, 10 December 1996; c. 346.] A statutory requirement to establish such schemes would, however, reinforce the trend towards their extension, promote more consistency of provision throughout the country and safeguard such schemes in future against the risk that they might be sacrificed in expenditure cuts.

In complementing such a requirement, new clause 12 would place on the Secretary of State the onus to make available an assessment of the provision available in any prison or other custodial institution". That is intended to ensure not only that the need for treatment for mental illness is identified, but that there is necessary provision in the criminal justice system for those who are transferred to a custodial institution.

The most recent study on the matter, that conducted by the British Medical Journal, showed the extent to which there was a prevalence of psychiatric disorders. It also showed that there is a need to tackle problems during a sentence, not only for humanitarian reasons—although those are essential in themselves—but because failure to do so greatly increases the risk of reoffending. In the Home Office's national prisons survey in 1991, 41 per cent. of prisoners cited drink or drugs as contributing factors when asked for their reasons for reoffending. It is clear from research that there is a link between drink and drug-related problems and psychiatric problems. Very often, one is laid on top of the other.

If we bear in mind the fact that, as I cited earlier, the BMJ stated: Some of the most difficult psychiatric patients in the country are assessed and treated entirely within prisons", we must surely do something to address the quality and nature of the treatment that they receive. By placing the onus on the Home Secretary to certify to the court the availability of provision, the new clause will ensure that there is much closer and effective oversight by the Home Secretary and the Home Office.

The combination of the new clauses ensures first that assessment is made on a proper understanding of the mental illness of any offender who comes before the court after the person has been found guilty but before the court decides the sentence, and that, secondly, for those who on the decision of the court go to prison or any other institution, the appropriate system of treatment for their mental illness is put in place.

The balance of the new clauses makes a very positive contribution, especially given the paucity and poorness of facilities in many of our prisons, which has been highlighted on a number of occasions. I commend the new clauses to the House not only because they are right but because they address the horrific headlines that identified people who went on to commit the most violent of crimes, including murder, after a court had been in possession of the facts about their mental illnesses and should therefore have been in a position to intervene.

The acceptance of the new clauses will increase the likelihood of a court, in the knowledge of a condition that requires treatment, being able to decide on the sentence and disposal on the basis of accurate information. It will also enable courts to have confidence that, during the period in which people are deprived of their liberty in prison, they will receive the psychiatric treatment that may help them to leave prison less rather than more likely to reoffend, and less likely to reoffend to the serious extent highlighted in headlines.

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Mr. Alex Carlile (Montgomery)

The three new clauses and the amendment deal with three important issues. The first is the question of gatekeeping in magistrates courts to try to ensure that those who are mentally ill are recognised as such. The second deals with the nature of the provision that is available in prisons—an important issue relating to the sentencing choice made by the court. The third, which is addressed by amendment No. 37, which stands in my name and those of my hon. Friends, relates to the question whether a person suffering from mental illness, other than those who are diagnosed as psychopaths, should fall within certain of the new provisions.

I turn to the gatekeeping role—contained particularly usefully in new clause 8, which provides for pilot projects and for them to apply in selected areas. We know from statistics, which have already been cited by the hon. Member for Cardiff, South and Penarth (Mr. Michael), many articles, Home Office research and comments of prison staff that a great many prisoners, including very many who are serving short sentences for relatively minor offences, are suffering from various forms of mental illness. It is certainly correct that many who appear before magistrates courts do so when they are suffering from mental illnesses that do not put their or anybody else's life in danger. They are however suffering from mental illnesses that put the safety and security of themselves and those members of the public against whom they commit offences at risk.

It is extremely expensive and destructive to treat people with minor depressive illnesses and other conditions such as untreated but potentially treatable schizophrenia by locking them up in prison. Such treatment does little to resolve their mental illness. Despite what is sometimes said, it is quite clear that the treatment for minor psychiatric illnesses in prisons for short-term prisoners is lacking and, sometimes, verging on the pitiful, and that prisoners emerge from prison not having been treated for the mental illnesses from which they are suffering. It therefore seems entirely sensible that pilot projects should be set up for gatekeeper psychiatry to be made available in the busier magistrates courts.

I do not suppose that such problems arise very often in rural and small-town magistrates courts because generally people are much better known in those areas for their idiosyncrasies, there is often more time to deal with cases and probation officers know the defendants and their families rather better. If one talks to magistrates in the big cities—I had a conversation on the subject recently with a stipendiary magistrate in one of our great cities—one hears that a significant proportion of the people who appear before the courts do so when suffering from some discernible psychiatric condition. Although pre-sentence reports are prepared before any custodial sentences are passed, they do not offer a full opportunity for a medical assessment to be made. It seems sensible that, at the least, experienced psychiatric nurses should be made routinely available to carry out examinations so that those who are suffering from apparent mental illness can be screened into medical procedures rather than forced into an otherwise inevitable cycle of minor criminality and imprisonment which may ruin the rest of their lives and the lives of their nearest and dearest.

New clause 12 deals with the second issue. Courts are faced every day with choices on sentencing, despite some of the Government's best efforts. Sometimes judges and magistrates face a choice between an order that involves mental health provision and a sentence of imprisonment. Judges may feel that the level of culpability of the offender, despite a psychiatric condition, is high; and may feel that the appropriate sentence would be one of imprisonment with appropriate psychiatric provision during that sentence. Believe it or not—and some would not believe it—judges approach such problems responsibly and have a genuine interest in what happens to the people they sentence, especially if the offenders are suffering from psychiatric conditions that have affected their criminality.

Judges would be more ready, in some cases, to pass prison sentences if they knew that the prisoners' conditions would be treated appropriately in prison. In most such cases at present, the judge has no way of knowing what psychiatric treatment will be given in prison. Indeed, if a judge inquires, save in the most serious cases, about what will be done if he passes a sentence of imprisonment, he will receive no answer or the most general of answers. New clause 12 would resolve that situation responsibly.

I turn to amendment No. 37. Clause 43 will insert a new section 45A into the Mental Health Act 1983. It will empower courts to pass prison sentences with what are called "hospital and limitation" directions on mentally disordered offenders, and section 45A(2) will provide that that power should apply to psychopathic offenders. I have no complaint about that because those powers will be useful and will enable hospital and limitation directions to be passed on psychopathic offenders. The reason for the power is that there are often doubts about whether offenders suffering from psychopathic disorder will be receptive to treatment. Psychiatry is, if the psychiatrists will forgive me for saying so, often as much art as science, and frequently a question of trial and error. It is sometimes the case that psychiatrists will be able to treat psychopaths usefully by, for example, removing the trait—by medication or other treatment—that makes the offender a danger. After treatment, a psychopath might not be especially dangerous. Nevertheless, it is right that those who bear significant responsibility for their criminal offences, albeit that they are psychopathic, should serve their sentences of imprisonment. Clause 43 will ensure that that can happen.

The new section 45A(10), however, will enable the Secretary of State to extend the power by order to cover other categories of mentally disordered offenders, including not merely those suffering from a psychopathic condition but those suffering from a discernible and diagnosable mental illness. The Bill's explanatory and financial memorandum explains that the provision in clause 43 will be implemented in two or more phases. Presumably, subsequent phases will cover other categories of mentally disordered offenders other than psychopaths.

The Reed report of 1994 was mentioned earlier by the hon. Member for Cardiff, South and Penarth. The joint Department of Health and Home Office working group, chaired by Dr. John Reed, recommended a version of the hybrid order when it reported in 1994, but it did not recommend the version that is included in the Bill. The working group's recommendation was limited to offenders suffering from psychopathic disorders. The White Paper, in contrast, proposed to make the order available for other categories of mental disorder and mental impairment. Moreover, under the 1994 proposals by the Reed working group, the offender would be transferred back to prison only if hospital treatment were inappropriate or refused, whereas the order proposed by the Government would involve automatic return to prison even if treatment were successful.

The 1996 discussion paper issued by the Home Office and the Department of Health recognised that the development of the hybrid concept beyond the recommendations of the Reed working group could raise difficulties. In particular, the paper recognised that the uncertainties about treatability which characterise psychopathic disorder are rarely present in cases of true mental illness. In cases of diagnosable and definable mental illness, it is beneficial for rehabilitation to be managed in a flexible time frame and for there to be continuity of care if the patient is to make a successful return to the community with minimum risk to the public. There is no evidence that that could be achieved if the provisions were to be extended from psychopathy to people suffering from mental illness who then found themselves being returned to prison. The machinery simply does not exist in prison to provide the follow-through that would be needed and that is why both the Reed working group and the joint discussion paper identified that as a problem.

I do not need to repeat the protests that have arisen as a result of the proposals. Opposition in unison has come from the Royal College of Psychiatrists, the Royal College of Nursing, MIND, the Law Society, the Penal Affairs Consortium and others. I suggest to Ministers that it is not necessary to include a provision that would extend the new hospital and limitation directions beyond those who are suffering from psychopathy. There is no evidence that such powers are necessary, but there is evidence that they would be detrimental to the care of mentally ill people. Indeed, if orders are made under section 45A(10), the resulting hybrid order could increase the number of mentally disturbed offenders detained in hospital beyond the period of clinical necessity because doctors would be reluctant to remit patients to prison, either because that would be clinically unwise or because they believed that it would be medically unethical to do so. Furthermore, if hospital and limitation directions were linked with determinate sentences, some offenders might be released sooner than if they had been admitted on an indeterminate restriction order under the Mental Health Act 1983.

I urge the Minister to think again about amendment No. 37 and to leave the matter open, at least until the Bill completes its stages in another place—if that is ever to happen—so that a measure too far need not be taken.

Mr. Soley

This interesting group of amendments and new clauses gives the Government an opportunity to work with the Opposition in looking at what my hon. Friend the Member for Cardiff, South and Penarth (Mr. Michael) rightly called the interface between our criminal justice system and mental health services. The Under-Secretary of State for the Home Department will have some knowledge of this area following his previous ministerial responsibility in the Department of Health.

The one caveat that I have about the new clauses is that I do not think that we should assume that a good psychiatric assessment can be made within the confines of a court or that we can act on that assessment by making a long-term committal to a psychiatric hospital. The new clauses would not be suitable for that, although I do not think that my hon. Friend the Member for Cardiff, South and Penarth is thinking of the matter in those terms.

Mr. Michael

It is more likely that such circumstances will be identified so that appropriate action can be taken, and we claim no more than that for the amendments in dealing with the sort of cases to which my hon. Friend refers.

Mr. Soley

I am grateful to my hon. Friend for that clarification, which he also gave me when I intervened earlier. There is a real possibility here of identifying some mentally ill offenders at an early stage and of taking appropriate action.

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My hon. Friend the Member for Cardiff, South and Penarth referred to the experiment at Clerkenwell court—a court I know extremely well, as I served there for some 10 years, first as a probation officer and then as senior probation officer. I was then committed to this institution at the 1979 general election on an indeterminate sentence. There is no hope of parole here—just the steady erosion of one's personality.

In an inner-city court such as Clerkenwell—the hon. and learned Member for Montgomery (Mr. Carlile) referred to this matter—it can be difficult to deal with these cases. Clerkenwell covers two major rail terminals—King's Cross and Euston. Many of the people dealt with by the court were on the move, had shattered life styles and were mentally ill. It does not surprise me that a large proportion of such defendants are mentally ill, and the figures suggest that close to 50 per cent. have a definable mental illness. If the figures are correct, they give us advance warning and an idea of what could be achieved by better co-ordination between the criminal justice system and the NHS on mental health.

For example, I wish to refer to section 38 of the Mental Health Act 1983, which allows for detention in an NHS hospital for a period of observation. There is no doubt that many people who end up in magistrates courts are on the edge of mental illness, and are facing an incipient breakdown or perhaps full mental illness. Having the section 38 procedure readily available to a court—because a psychiatrist is present—could be of great benefit not only to the court and the offender, but to the community.

When I was a probation officer at Clerkenwell, people who one knew to be psychiatrically ill—and who the magistrates knew to be ill from their general judgment of the defendant's demeanour and behaviour—were nevertheless released into the community immediately because one could not justify a custodial sentence or a remanding in custody except in special circumstances; he or she might be a danger to other people, for example. The defendant would be released again and could possibly break down within the community. If we could do more to focus our attention on people when they first come before magistrates courts, it would be beneficial in terms of spotting the mentally ill.

I emphasise the importance of the care in the community procedures. I am a great supporter of care in the community in principle, but without the proper resources care in the community is a disaster, as has been demonstrated by the Zito case and others. The tragedy—as many hon. Members will be aware from their postbags—is that many people are not getting the degree of care in the community that they need to prevent a collapse into a full psychotic state, perhaps because they are not taking a course of drugs. It is possible—although it is important to remember that this occurs only in a minority of cases—that they will resort to some sort of dangerous and violent offending behaviour.

The idea of having a psychiatrist present or available to a court is useful. I do not pretend that a psychiatrist should be present in every court in the land, but my hon. Friend the Member for Cardiff, South and Penarth has hit on a good point in saying that it would be an advantage in a number of areas. It would enable us to spot those people who are supposed to be getting care in the community but are not getting it, and who are, as a result, offending. At the moment, such a person appears in court—more often than not for a petty offence—and is either remanded on bail or in custody for a psychiatric report. Three or four weeks later, he or she comes back to court and is disposed of by the court—perhaps by way of a mental health order, but more likely by a custodial or non-custodial sentence of a conventional type. There may be no effective follow-up to the sentence unless psychiatric and probation reports indicate the direction that the court should take on the level of psychiatric or probationary supervision.

The Minister must address an issue that the Minister of State failed to address on the previous occasion that I spoke on this matter. The issue is relevant to the group of amendments and deals with the way in which we treat mentally ill people who murder. As I stated previously, we persist in having a full inquiry when someone who is mentally ill murders, although no such inquiry takes place when a sane person murders. I am not sure what the point of that is. These inquiries cost hundreds of thousands of pounds, and we must consider carefully whether the system should continue. I do not expect an immediate answer, but we must look at whether it is sensible to have full and expensive inquiries every time a mentally ill person murders. Perhaps we should have an assessment of the causes and the background of the murder which might apply to the sane and the insane.

It is bizarre that we spend vast amounts of money on inquiries—some of which produce useful conclusions, some of which do not. But the present system suggests that a murder committed by a mentally ill person is more fearful or terrifying than a conventional murder. Frankly, if one has been murdered, it does not matter too much whether the person who did it was mentally ill or not. That is a serious point, and we should assess more effectively the background to murder rather than the background of those who murder and who are psychiatrically ill. This is a complex area that I know the Department has thought about from time to time. I will give the Minister time to respond to the matter before I leave for an appointment that I must keep. But if I am not here when he replies, I assure him that I will look carefully at his comments in Hansard.

My final point deals with the issue of psychopathy, which was raised by the hon. and learned Member for Montgomery. Most psychiatrists agree that psychopathy is not a treatable condition, and that is why it is not described as such in the Mental Health Act 1983. It is true that some drugs and other forms of treatment can help, but we are on a slippery slope if we start giving drug treatments to people who are not defined as mentally ill under the Mental Health Act. Some special units have been set up to deal with people who have a psychopathic personality, as it has been labelled—frankly, that is a bit of a dustbin label. We must concede that there is no known method of treatment that guarantees any form of advantage, but there are ways of treating and constraining such people that one can have reasonable confidence are helpful.

We should give more attention to such people who come before the courts and need treatment, as the general public's image of a psychopath is of a raving lunatic who is out to kill. In fact, the vast majority of psychopaths—as they are labelled—are rather inadequate and pathetic individuals who repeat their offences over and over again. They do not seem to learn from their behaviour, and generally are not liked by anyone. They are often very isolated individuals as well.

In all seriousness, there is a problem because we write people off with a dustbin label and talk about psychiatric treatment, which in most cases is not relevant, appropriate or effective. There are treatments, such as group therapy and other treatments in a residential setting, which can help such people. If we want to stop the persistent minor offenders who are a menace to everyone and whose behaviour in public causes discomfort to most people, we might do better to focus on such treatments rather than on drug treatments, which have certainly not been proven to offer any advantage and can have dangerous outcomes.

Mr. Denis MacShane (Rotherham)

The concerns about these matters have been brought home to me in at least two serious constituency cases in the past couple of years, in which crimes were committed by people who were not given adequate psychiatric counselling or assessment before release.

This is an example of a matter on which Parliament should work at its best. The new clauses are practical and sensible and have been tabled by Opposition Members of considerable experience. My hon. Friend the Member for Cardiff, South and Penarth (Mr. Michael) is a Justice of the Peace, the hon. and learned Member for Montgomery (Mr. Carlile) is a Queen's counsel and my hon. Friend the Member for Hammersmith (Mr. Soley) has deep experience of the probation service.

The public will ask why the Government refuse to accept new clauses that suggest experiments, are modest in their reach and would none the less contribute to people feeling a little more secure about the process of sentencing in magistrates courts. The underlying philosophy is simple: an ounce of prevention or of knowledge is worth more than a ton of cure or retribution.

I shall refer the Minister, perhaps after the debate, to a wonderful book by a leading Rotherham criminal solicitor, Mr. Stephen Smith, who works in the local magistrates courts. The book contains true-life stories of the past 20 years of his life as a professional solicitor. Time and again, he has had to defend the most inadequate and pathetic characters, who make great copy for a book but who have not been given a helping hand. They do not need an overdose of counselling, but they merely need a helping hand in terms of assessment, to allow the criminal justice system to treat them with due respect as citizens and human beings.

The hon. and learned Member for Montgomery mentioned the useful role of the probation service. In South Yorkshire, the probation service faces both cuts and a redefinition of its role that will take away the knowledge and training available to it and its ability to intervene adequately in such cases.

I do not suppose that the Minister will accept the new clauses at this stage, given the nature of our system of government, in which no amount of common sense or intervention can make any difference once the steamroller has been set in motion, but perhaps, if time allows, more serious and mature consideration can be given to the proposals in another place.

The Parliamentary Under-Secretary of State for the Home Department (Mr. Tom Sackville)

This has been an interesting and thoughtful debate about a subject that has to be addressed: the appropriateness of sentencing and disposals for some people who may be mentally disordered and who in the past may often have been remanded to prison inappropriately.

The value of mental health assessment at magistrates courts is fully accepted and the Home Office has been active in encouraging the development of such schemes. Guidance was issued, as the hon. Member for Cardiff, South and Penarth (Mr. Michael) said, in 1990 and 1995, and funds were made available to assist with the costs of medical staff attending court. Support has been increased from £0.5 million in 1993 to more than £1 million this year, and substantial additional funding is expected to be available from the next financial year.

In 1990, there were only a handful of such local arrangements; now there are about 130 schemes in operation, some of which cover more than one court. In addition, some courts have access to a panel of mental health care professionals away from the court; the Home Office is helping to pay for 53 of those this year, but many more are funded from local resources. I do not regard Home Office central funding as the main way in which such schemes should be financed, but such funding is available because we are extremely keen to encourage them.

6.15 pm

It is important not to be prescriptive about how such schemes should operate; they are local initiatives and it would be unhelpful to tie the hands of the local agencies involved, which are best placed to devise the right response to local needs and to make the most effective use of the available resources.

The hon. Member for Hammersmith (Mr. Soley) talked about flexibility. I am not sure whether the new clauses would achieve that. Two points of detail may illustrate the point. First, the new clauses appear to limit those who can run the schemes to doctors, as defined by the Mental Health Act 1983, when in fact teams of community psychiatric nurses and others would be, and are, involved.

Secondly, it would be a step back to restrict assessment to the pre-sentence stage, as that would limit examination to those who had been convicted and exclude those on remand. A major benefit of any assessment scheme would be the early identification of mental disorder and the availability of advice to the court at first hearings, to avoid unnecessary remands to prison.

On new clause 12, existing arrangements for sentencing mentally disordered offenders already require the court to consider the offender's condition and the treatment available for it before passing a custodial sentence. When there is evidence of a treatable mental disorder, the court can make a hospital order in most cases. If the offender is psychopathically disordered, the court will have the option under clause 43 of attaching a hospital direction to a custodial sentence. Our aim is to extend the hospital direction to other mental disorders.

If, having considered the offender's mental state, the court has not selected one of those options, the question of the availability of treatment in the custodial setting is unlikely to serve any purpose and should not be a major part of the sentencing decision.

It may be argued that information about treatment facilities would allow the court to express a view about where the offender should serve his or her sentence—that is clearly part of the thrust of new clause 12—but I do not think that it is either sensible or appropriate to predict at the time of sentencing where a sentence will be served, and it is not part of the court's function to direct offenders to specific Prison Service establishments. That decision is for the Prison Service, which will keep the offender's placement under review, considering a wide range of factors, including the prisoner's response to different prison regimes and the appropriateness and availability of specific programmes and treatment during the sentence.

I recognise that there may be prisoners whose mental condition at the time of sentence may not be such as to justify imposing a hospital order or a hospital direction, but that need not prevent treatment from being provided. The Prison Service has procedures in place to identify prisoners who are suffering from recognised categories of mental disorder. The identification can be on first reception into prison after sentence or, for those who develop such disorders, during the course of a term of imprisonment.

Where a prisoner is suffering from mental disorder so severe that he or she needs treatment in a psychiatric hospital, the prison doctor will seek to arrange his or her transfer to such a facility, using procedures provided in section 47 of the Mental Health Act 1983. The number of sentenced prisoners transferred to hospitals by direction of the Home Secretary under that provision has increased significantly in recent years, from 87 in 1985, to 145 in 1990, to 251 in 1995. There are already arrangements in place to identify offenders suffering from mental disorder who would be better held and treated in hospital. If an offender appears to be mentally disordered, the court will have considered evidence about his or her need for treatment before sentencing. If the offender needs treatment in hospital, he or she should be sent to hospital either by the court on sentencing or by warrant of the Home Secretary. It is not clear what the courts would be expected to do with the information that new clause 12 proposes that they should have.

Mr. Alex Carlile

If he will forgive me for saying so, the Minister is to some extent ducking the question. The real question is not about people who are so ill that they are sent to mental hospitals for treatment, but about people suffering from relatively minor psychiatric illnesses, such as depression or incipient schizophrenia. Surely he would agree that in the real world, the Prison Service fails to give people the treatment that would, in many cases, prevent them from offending in future. Do the Government have any proposals to deal with that large-scale problem?

Mr. Sackville

The hon. and learned Gentleman may feel that the medical services available in prison are inadequate, but it is not clear what new clause 12 would do to improve them. The courts can pass hospital orders. Prisons can use section 47 transfers to refer prisoners for mental treatment outside. The mechanisms are there; he is making a statement about how they are working.

Mr. Michael

It is clear that the Minister did not understand the intervention of the hon. and learned Member for Montgomery (Mr. Carlile). As the Minister may by now have received more advice, I ask him to consider seriously the question that he was asked. He also said that the facilities in prison are inadequate. There is overwhelming research and other information from his own Department to show that the situation in prison is seriously inadequate. Does he accept the seriousness of the problem?

Mr. Sackville

I believe that there may be room for improvement in prison medical services, but there is nothing in new clause 12 that would achieve it. Doctors are available to prison medical services and there are contracts between prisons and local community mental health services. All those services are in place. The hon. and learned Member for Montgomery (Mr. Carlile) simply said that he believes that they are inadequate. We are dealing with an amendment about hospital direction, which provides further flexibility on how mental services can be offered.

Mr. Carlile

Will the Minister give way on that point?

Mr. Sackville

If I may continue, I was just going to deal with amendment No. 37, which was tabled by the hon. and learned Gentleman. It would prevent the hospital direction that is introduced by the Bill from being extended beyond people who are deemed to be psychopathic. We believe that it is reasonable that there should be an order-making power to extend the hospital direction beyond such people. There may often be cases where prisoners appear to be mentally ill and in need of treatment at the time of sentence, but cannot be deemed to be psychopathic. There may be many instances where they need treatment and, having been treated, need to be remanded back to prison. If someone was deemed sufficiently dangerous to be given a long sentence—perhaps a large importer of drugs, who merited a sentence of 10 years or more—but appeared to need mental treatment at the time of sentence, it would be wrong for the court not to have the flexibility to allow that treatment to be given, with the prisoner then being remanded back to prison. I think that the hon. and learned Gentleman will agree that to do otherwise would mean that the public were not adequately protected from the behaviour of that individual.

I do not think that there is disagreement about the value of assessing prisoners before sentence or in the early stages of the process, but the best that I can say for the new clauses is that they provide a statutory framework for a process that is already happening apace in our system: the extension of psychiatric assessment at all stages of the sentencing process. I cannot advise the House to accept the new clauses.

Mr. Michael

The Minister's response was disappointing. Some of his points were simply wrong. I suggest that he looks again at the report of the Reed committee, and especially at the advice given by solicitors, who deal with their clients in the courts but are not directly involved in the Prison Service or the health service. The evidence from the Law Society about the experimental or pilot projects involving duty court psychiatrists or other such liaison schemes that are in operation was specific. The Minister was wrong to say that our new clauses would limit the involvement of medical practitioners to doctors. We specifically drafted one of the new clauses to allow the use of psychiatric nurses. That was one of the practicalities that we noted in considering amendments that might help the Bill.

When discussing such schemes, the Law Society said that one of the advantages reported to it was psychiatric reports that could be quickly identified and acted upon. That is an important requirement. As I said earlier, it is far too easy for the need for professional help or specialist advice to lead to delays in the criminal justice system. I have always thought that justice delayed is justice denied, and we have frequently tabled amendments to address that point of principle. Psychiatric reports are one of the advantages identified by solicitors who, in my experience, are not always identified with the avoidance of delay.

The Reed report praises the involvement of all relevant agencies, which assists co-operation and the speedy arrangement of services. It points out that the availability of local facilities can be made known to the court so that it has the knowledge with which to address the point of my hon. Friend the Member for Hammersmith (Mr. Soley) about courts targeting their sentencing decisions and knowing that their intentions can be followed through properly.

The solicitors also found that procedural difficulties can be overcome to avoid unnecessary and lengthy remands in custody. Remands in custody are not only bad in principle but extremely expensive, so in the general public interest that should surely be encouraged. Earlier, I mentioned the cost savings that have been identified in the available research, but the whole-hearted support of the Law Society for the nationwide provision of such schemes should be noted because it is argued on very positive grounds.

One of the other points in the Law Society's evidence is that boundary disputes between different authorities are a source of constant frustration for solicitors trying to ensure placement and service for mentally disordered offenders. The need for collaboration between probation officers, people involved in court and people involved in sentencing is clear, but that does not mean that we should just say to people in the health service authorities, psychiatric services and the criminal justice system, "It would be nice if you would talk to each other." It is the Government's responsibility to create the framework and to ensure that the two facilities deal with people who are at the point of interface—people who are in the criminal justice system but who perhaps should be in an institution that deals with mental health, or who are in prison and require psychiatric treatment. The Minister should accept our new clauses on the ground that they would help to create the right structures for that overlap between the health service and the criminal justice system.

6.30 pm

The Law Society also underlined the need for more reliable information on the need and potential demand for community services for mentally disordered offenders. I have referred to the Zito case and others where a failure to ensure that appropriate community-based services were available for people with psychiatric problems led to offences that were far more serious than those that first brought those individuals to the attention of the court.

The Law Society comments that many mentally disordered and vulnerable people are currently being cared for by their families without any contact with the psychiatric health or social services, and that without the provision of adequate support and services, those arrangements are likely to break down. That is true. The breakdown of such arrangements can be dramatic and serious. I shall give a simple example. I am sure that many of my hon. Friends could give examples from their constituencies, and that my hon. Friend the Member for Hammersmith has professional experience that he could draw on.

A young man sought help from a mental hospital that was treating him because he felt that things were getting out of hand and that he might offend due to the development of his illness and the pressures on him. He asked for help and to be taken in. His mother said that she was seriously concerned that something would go wrong unless treatment was made available. It was known that he needed help, but he was not given it and the result was a victim, a violent offence, a criminal record and great expense to the public purse. There was little that was positive in the outcome, but a massive negative outcome, the cost of which was borne by the criminal justice system and, ultimately, by the public purse.

I understand—I do not think that the Minister acknowledged this adequately—the health service's fears about becoming an adjunct of the Prison Service. Personally, I have much sympathy for the combination order, which allows more flexible movement between one and the other. The answer is not greater separation, but greater co-operation. The basic principle, as put by my hon. Friend the Member for Stockport (Ms Coffey) when we discussed these issues earlier, is that it is important that people with a mental illness of the sort that responds to treatment should receive that treatment wherever they are held.

There should be facilities for treating people and maintaining treatment programmes in prison, and for transferring people to hospitals for short-term and long-term treatment, whichever is the more suitable. We are talking not about additional costs, but about the appropriate targeting of treatment and the matching of the individual to the treatment that he needs.

In making that point, my hon. Friend the Member for Stockport made the crucial point that, if facilities in prisons are poor, special hospitals will be chock-a-block with prison transfers, not because they provide a more appropriate environment, but simply because there is a lack of facilities in prisons. That point is surely relevant to some of the Bill. That would inhibit the special hospitals' ability to deliver treatment regimes for non-offenders. One way forward would be for the prison services to utilise special hospital skills in the prison environment through an outreach service, but the real answer is to improve the targeted service in prisons.

There is a pass-the-parcel approach and no real clarity of purpose—I suspect because prisons have difficulty coping with the bizarre and challenging behaviour of some mentally ill prisoners. Some offenders have profound personality disorders that are not treatable on a medical model. My hon. Friend the Member for Knowsley, North (Mr. Howarth) recently visited Ashworth hospital, which has separated that group out and deals with it differently. That expertise and approach is transferable from hospital to prison. It is important that special hospitals are not used as a dumping ground, but they will continue to be used in that way as long as they can be used in that way and as long as there are poor facilities in prisons.

On the other side of that equation, the Home Office and the Prison Service will not be under pressure to improve mental health facilities in prison. The attachment of the mental illness label to all sorts of behaviour is not helpful, particularly to people who are genuinely mentally ill. The key is proper assessment at the time of sentence and proper assessment of the right disposal, taking into consideration both the offence and the clinical judgment about the offender of people in the mental health service.

This should not be a bureaucratic issue of managing beds in the hospital system or prison cells in the prison system. That is why our new clauses both address the assessment, giving full information to the court and allowing it to be able to use properly the disposals available to it, including the disposals proposed elsewhere in the Bill, and to ensure that the facilities are available to people in prison. I have said on a number of occasions that there is a great cost to the public purse, in terms both of the criminal justice system and of the mental health system, in failing to address these issues adequately.

The Minister said that our new clauses would destroy local flexibility and—I quote him directly—that it would be "unhelpful to tie the hands" of people who can voluntarily make those arrangements at local level. This is a fine time for the Government to discover, suddenly, that it is a good thing to have local flexibility, and for a Minister to say that the Government do not want to tie the hands of people to do things for the public benefit at local level. Is the Minister saying that the requirement of a high standard set at a central level necessarily involves bureaucratic interference by Government Departments? The answer to that is yes under the Conservatives, but no if it is done properly.

These things must be done with sensitivity and balance. We should set the standards and then allow flexibility for local delivery of those standards, and for the courts to be able to take decisions on the basis of the right framework having been put in place. I underline again that flexibility on the use of psychiatric nurses—and not just doctors—is allowed, at least in the initial assessment, by the way in which we have approached this issue.

The Minister suggested that we should have concentrated on the remand element rather than on post conviction. I take his point about the identification of people who need mental treatment before the case has gone through. I commented on that in my earlier remarks, but we have concentrated particularly on the point that, if someone has been found guilty, the court, in deciding its disposal, should have a full analysis of the offender's condition, as well as knowledge of the offence. I remind the Minister that this is, after all, the Crime (Sentences) Bill: so it is sensible for us to concentrate on sentencing. It was the Government's choice that we should concentrate on sentencing; that is why our new clauses and my remarks in this short debate have concentrated on sentence, rather than on remand.

The Minister suggests that the outcome is uncertain—that it is not certain what the court is to do with the information made available to it. It is not prescribed, but that is not the same as its being uncertain. It is not prescribed in the sense of slot-machine justice, whereby a piece of information is fed in and a disposal pops out, although I know that some Ministers are enamoured of that approach. We are trying to ensure that the court has the appropriate information to enable it to make the right decision—a decision that might, in certain circumstances, be tough, but which includes appropriate psychiatric treatment for the offender, whether through a hospital order, a combination order or a prison sentence. What is required is that the court uses the information made available to it to do the job that it is there to do—to exercise common sense in its application of the law. That is perfectly clear and not uncertain at all.

I also found it most odd that the Minister did not respond in detail to the serious intervention from the hon. and learned Member for Montgomery (Mr. Carlile). During that exchange, the most the Minister would acknowledge was that there may be room for improvement in the services available in prison. I tell him that it is not conditional and that "may be" is not the right term—there is room for improvement in the psychiatric treatment available in prison.

Mr. George Howarth

There is room for a quantum leap.

Mr. Michael

As my hon. Friend says, there is room for a quantum leap of improvement in standards of psychiatric care in prisons. I would put it more strongly: there is a crying and desperate need for major improvements in prison psychiatric treatment and in the liaison between the criminal justice system, especially the Prison Service, and the national health service in respect of the treatment of mentally ill prisoners.

Mr. Alex Carlile

Does the hon. Gentleman agree that it is simply not good enough for the Government to say that contracts are being entered into with individual psychiatrists and groups of psychiatrists to provide services in prison? Is he aware that the psychiatrists who provide services in many of the busier prisons say that under their contracts, which are part-time and limited, they are able only to stem the tide and deal with the most serious cases?

Mr. Michael

I am grateful to the hon. and learned Gentleman for making that point which, with his knowledge of the criminal justice system, he does with great authority. He confirms my suspicions that we are seeing the Elastoplast approach to mental health, just as we are seeing the Elastoplast approach to the health service and the criminal justice system in general. He makes the point effectively and I agree whole-heartedly with him.

Sir Ivan Lawrence (Burton)

I have listened carefully to the hon. Gentleman. He has spoken a great deal of common sense, which I applaud, but is he prepared to make a commitment on behalf of his party to make the massive expenditure that would be required to bring the treatment of mentally ill offenders up to the standard that he seeks?

Mr. Michael

I am not sure how long ago it was that the hon. and learned Gentleman wandered into the Chamber but, despite his compliment on the common sense of my remarks, I have to say that I am surprised that he claims to have been paying close attention to my speech. I have already dealt explicitly with the matter he raises, twice in my opening speech and once in my current speech.

A great burden is placed on the public purse by, first, the failure properly to identify the need for psychiatric treatment and, secondly, the failure to give psychiatric treatment where it is needed, especially to those in prison. The hon. and learned Gentleman does not seem to understand the point, so I shall repeat it slowly for his benefit: it is costing us an enormous amount of money to be ineffective, and much of that cost could be saved by better liaison, by better targeting of activity and by ensuring that the work of the Prison Service and the health service is properly co-ordinated and that each does its job properly. The expenditure is not additional, but comes from dealing with the waste of money that results from the ineffective identification of those who need help and the ineffective way of providing that help.

The Secretary of State for the Home Department (Mr. Michael Howard)


Mr. Michael

It is such a clear and simple point that it requires the Home Secretary to come to the defence of his junior Ministers.

Mr. Howard

The junior Ministers are doing extremely well. What needs to be clarified is the novel approach to public expenditure commitments being advanced by the hon. Member. He knows perfectly well that the explanation—if that is the right word—that he has just given could be used to justify additional public spending on any subject under the sun. Has he cleared the words that he has just used with the shadow Chief Secretary or the shadow Chancellor?

Mr. Michael

That intervention demonstrates that it is inadvisable for the Home Secretary to wander into the Chamber, pick up on one sentence and try to criticise the Opposition. If he had paid attention to the whole of my speech, he would have heard me quoting evidence from his own Department about the money to be saved by proper identification and targeting. It is a pity that he does not appear to have read the research that he publishes.

Mr. Soley

Is not this the same Home Secretary who told the country that he will build a couple of dozen new prisons, without any regard to expense? It all falls on the taxpayer. That is another case of failure.

6.45 pm
Mr. Michael

This is also the Home Secretary who has managed to cut £700 million from the funding available to the victims of violent crime. I do not think that we need any lessons from the abacus of the Home Secretary—our point is that he is wasting money. The money available within the Home Office, the criminal justice system and the health service is being wasted. That waste is not necessary and could be avoided by the sort of measures proposed in the new clauses.

I hope that the Home Secretary will take the trouble to read the whole of this debate in Hansard and not just a little bit of it; he will see how silly he looked making that intervention and asking a question that had already been adequately answered much earlier in the debate.

Mr. Howard

Will the hon. Gentleman give way?

Mr. Michael

Of course. I am delighted that the Home Secretary is coming back—more, more.

Mr. Howard

Will the hon. Gentleman now answer the very simple and specific question that I put to him? The formula that he used could be used to justify any increase in public spending on anything under the sun—has he cleared the words he used with the shadow Chancellor or the shadow Chief Secretary?

Mr. Michael

I am sure that what I said could, with the twisted logic of the Conservative party, be used to justify anything—but not under the tight financial control and management that the Chancellor of an incoming Labour Government after the general election will apply, not only to spending commitments, but to the effective use of the resources that are currently available. That is the point. The Home Secretary stands condemned in this debate of not being willing to listen to advice from his own Department and his own research on how he and the Secretary of State for Health could use the resources that are currently available to them to reduce the burden of psychiatric care, to reduce offending and reoffending, to reduce the commitment to prison building and to reduce the massive expense resulting from the Home Secretary's mismanagement of the criminal justice system.

It is not good enough for the Government to try to avoid the issue by saying, "We'll tell the health and prison services to get together and that will bring about the end required by the Opposition." That is what the junior Minister said would happen and, according to the Home Secretary and his junior Minister, it does not involve extra resources. Telling the services to get on with it does not cost a penny more, but Ministers now argue that requiring them to get on with it in the way that we propose—by providing a framework that will make it easier for them to do so and that will allow money to be saved—will somehow cost more. It is just as well that the Home Secretary became a lawyer and not an accountant—he would have been drummed out of that profession long ago on the strength of the false accounting that he has tried to bring to bear this evening. The right hon. and learned Gentleman stands condemned out of his own mouth for a spurious and silly intervention.

It is not enough for the Home Secretary and the Minister to say that people involved in psychiatric services and in the Prison Service should co-ordinate their activities more effectively. It is not enough to say that provision should be made available voluntarily in the courts. It is not happening apace, as the Minister said. If it is happening apace, it is at a pace of a snail. That is not good enough.

We have tabled constructive new clauses that would tackle a significant problem and which I seriously expected the Minister to welcome, in view of the comments that he made in Committee, which I quoted back at him earlier. I regret the fact that he did not welcome our new clauses. Nevertheless, there may be enough Opposition Members—and, perhaps, Conservative Members, given that the hon. and learned Member for Burton (Sir I. Lawrence) said that there was much common sense and logic in what I said—to pass the new clause.

Question put, That the clause be read a Second time:—

The House divided: Ayes 246, Noes 297.

Division No. 35] [6.49 pm
Abbott, Ms Diane Davies, Bryan (Oldham C)
Ainger, Nick Davies, Chris (Littleborough)
Ainsworth, Robert (Cov'try NE) Davis, Terry (B'ham Hodge H)
Allen, Graham Denham, John
Alton, David Dewar, Donald
Anderson, Donald (Swansea E) Dixon, Don
Anderson, Ms Janet (Ros'dale) Dobson, Frank
Armstrong, Ms Hilary Donohoe, Brian H
Ashdown, Paddy Dowd, Jim
Austin-Walker, John Dunwoody, Mrs Gwyneth
Barnes, Harry Eastham, Ken
Barron, Kevin Ennis, Jeff
Battle, John Etherington, Bill
Bayley, Hugh Evans, John (St Helens N)
Beith, A J Fatchett, Derek
Benn, Tony Faulds, Andrew
Bennett, Andrew F Reid, Frank (Birkenhead)
Bermingham, Gerald Fisher, Mark
Berry, Roger Flynn, Paul
Betts, Clive Foster, Derek
Blair, Tony Foulkes, George
Boateng, Paul Fraser, John
Bradley, Keith Fyfe, Mrs Maria
Bray, Dr Jeremy Galbraith, Sam
Brown, Gordon (Dunfermline E) Gapes, Mike
Brown, Nicholas (Newcastle E) Garrett, John
Bruce, Malcolm (Gordon) George, Bruce
Burden, Richard Gerard, Neil
Byers, Stephen Gilbert, Dr John
Caborn, Richard Golding, Mrs Llin
Callaghan, Jim Gordon, Ms Mildred
Campbell, Mrs Anne (C'bridge) Grant, Bernie (Tottenham)
Campbell, Menzies (Fife NE) Griffiths, Nigel (Edinburgh S)
Campbell, Ronnie (Blyth V) Griffiths, Win (Bridgend)
Campbell-Savours, D N Grocott, Bruce
Canavan, Dennis Gunnell, John
Cann, Jamie Hall, Mike
Carlile, Alex (Montgomery) Hanson, David
Chidgey, David Hardy, Peter
Clapham, Michael Harman, Ms Harriet
Clark, Dr David (S Shields) Harvey, Nick
Clarke, Eric (Midlothian) Henderson, Doug
Clarke, Tom (Monklands W) Heppell, John
Clelland, David Hill, Keith (Streatham)
Clwyd, Mrs Ann Hinchliffe, David
Coffey, Ms Ann Hodge, Ms Margaret
Cohen, Harry Hoey, Kate
Connarty, Michael Hogg, Norman (Cumbernauld)
Cook, Frank (Stockton N) Hood, Jimmy
Cook, Robin (Livingston) Hoon, Geoffrey
Corbett, Robin Howarth, Alan (Stratfd-on-A)
Corston, Ms Jean Howarth, George (Knowsley N)
Cousins, Jim Howells, Dr Kim
Cox, Tom Hoyle, Doug
Cummings, John Hughes, Kevin (Doncaster N)
Cunliffe, Lawrence Hughes, Robert (Ab'd'n N)
Cunningham, Jim (Cov'try SE) Hughes, Roy (Newport E)
Dalyell, Tam Hutton, John
Darling, Alistair Illsley, Eric
Davidson, Ian Ingram, Adam
Jackson, Ms Glenda (Hampst'd) Powell, Sir Raymond (Ogmore)
Jackson, Mrs Helen (Hillsborough) Prentice, Mrs B (Lewisham E)
Jamieson, David Prentice, Gordon (Pendle)
Janner, Greville Prescott, John
Jenkins, Brian D (SE Staffs) Primarolo, Ms Dawn
Jones, Barry (Alyn & D'side) Purchase, Ken
Jones, Jon Owen (Cardiff C) Radice, Giles
Jones, Dr L (B'ham Selly Oak) Randall, Stuart
Jones, Martyn (Clwyd SW) Raynsford, Nick
Jones, Nigel (Cheltenham) Reid, Dr John
Jowell, Ms Tessa Rendel, David
Kaufman, Gerald Robertson, George (Hamilton)
Keen, Alan Robinson, Geoffrey (Cov'try NW)
Kennedy, Mrs Jane (Broadgreen) Roche, Mrs Barbara
Khabra, Piara S Rogers, Allan
Kirkwood, Archy Rooker, Jeff
Lestor, Miss Joan (Eccles) Rooney, Terry
Lewis, Terry Ross, Emie (Dundee W)
Liddell, Mrs Helen Rowlands, Ted
Litherland, Robert Ruddock, Ms Joan
Livingstone, Ken Sedgemore, Brian
Lloyd, Tony (Stretf'd) Sheldon, Robert
Llwyd, Elfyn Skinner, Dennis
Loyden, Eddie Smith, Andrew (Oxford E)
Lynne, Ms Liz Smith, Llew (Blaenau Gwent)
McAvoy, Thomas Snape, Peter
McCartney, Ian (Makerfld) Soley, Clive
Macdonald, Calum Spearing, Nigel
McFall, John Spellar, John
McLeish, Henry Squire, Ms R (Dunfermline W)
McNamara, Kevin Steel, Sir David
MacShane, Denis Steinberg, Gerry
McWilliam, John Stevenson, George
Madden, Max Stott, Roger
Maddock, Mrs Diana Strang, Dr Gavin
Mahon, Mrs Alice Straw, Jack
Mandelson, Peter Sutcliffe, Gerry
Marshall, Jim (Leicester S) Taylor, Mrs Ann (Dewsbury)
Martlew, Eric Taylor, Matthew (Truro)
Meacher, Michael Thompson, Jack (Wansbeck)
Meale, Alan Thurnham, Peter
Michael, Alun Timms, Stephen
Michie, Bill (Shef'ld Heeley) Tipping, Paddy
Michie, Mrs Ray (Argyll Bute) Trickett, Jon
Milburn, Alan Turner, Dennis
Miller, Andrew Tyler, Paul
Mitchell, Austin (Gt Grimsby) Vaz, Keith
Moonie, Dr Lewis Walker, Sir Harold
Morgan, Rhodri Walley, Ms Joan
Morley, Elliot Wardell, Gareth (Gower)
Morris, John (Aberavon) Wareing, Robert N
Mudie, George Watson, Mike
Mullin, Chris Wicks, Malcolm
Murphy, Paul Wigley, Dafydd
Nicholson, Miss Emma (W Devon) Williams, Alan (Swansea W)
O'Brien, Mike (N Warks) Williams, Alan W (Carmarthen)
O'Brien, William (Normanton) Wilson, Brian
Olner, Bill Winnick, David
O'Neill, Martin Wise, Mrs Audrey
Orme, Stanley Worthington, Tony
Pearson, Ian Wright, Dr Tony
Pendry, Tom
Pickthall, Colin Tellers for the Ayes:
Pike, Peter L Ms Angela Eagle and
Pope, Greg Mr. Joe Benton.
Ainsworth, Peter (E Surrey) Atkinson, Peter (Hexham)
Aitken, Jonathan Baker, Kenneth (Mole V)
Alexander, Richard Baker, Sir Nicholas (N Dorset)
Alison, Michael (Selby) Baldry, Tony
Amess, David Banks, Matthew (Southport)
Arbuthnot, James Banks, Robert (Harrogate)
Ashby, David Bates, Michael
Atkins, Robert Batiste, Spencer
Atkinson, David (Bour'mth E) Bendall, Vivian
Beresford, Sir Paul Gale, Roger
Biffen, John Gallie, Phil
Body, Sir Richard Garel-Jones, Tristan
Bonsor, Sir Nicholas Garnier, Edward
Booth, Hartley Gill, Christopher
Boswell, Tim Gillan, Mrs Cheryl
Bottomley, Peter (Eltham) Goodlad, Alastair
Bottomley, Mrs Virginia Goodson-Wickes, Dr Charles
Bowden, Sir Andrew Gorman, Mrs Teresa
Bowis, John Grant, Sir Anthony (SW Cambs)
Boyson, Sir Rhodes Greenway, Harry (Ealing N)
Brandreth, Gyles Greenway, John (Ryedale)
Brazier, Julian Griffiths, Peter (Portsmouth N)
Bright, Sir Graham Gummer, John
Brooke, Peter Hague, William
Brown, Michael (Brigg Cl'thorpes) Hamilton, Sir Archibald
Browning, Mrs Angela Hamilton, Neil (Tatton)
Bruce, Ian (S Dorset) Hampson, Dr Keith
Budgen, Nicholas Hanley, Jeremy
Burns, Simon Hannam, Sir John
Burt, Alistair Hargreaves, Andrew
Butler, Peter Harris, David
Butterfill, John Haselhurst, Sir Alan
Carlisle, John (Luton N) Hawkins, Nick
Carlisle, Sir Kenneth (Linc'n) Hawksley, Warren
Carrington, Matthew Hayes, Jerry
Carttiss, Michael Heald, Oliver
Cash, William Heathcoat-Amory, David
Chapman, Sir Sydney Hendry, Charles
Churchill, Mr Heseltine, Michael
Clappison, James Hicks, Sir Robert
Clark, Dr Michael (Rochf'd) Higgins, Sir Terence
Clarke, Kenneth (Rushcliffe) Hill, Sir James (Southampton Test)
Clifton-Brown, Geoffrey Hogg, Douglas (Grantham)
Coe, Sebastian Horam, John
Colvin, Michael Hordern, Sir Peter
Congdon, David Howard, Michael
Conway, Derek Howell, David (Guildf'd)
Coombs, Anthony (Wyre F) Howell, Sir Ralph (N Norfolk)
Coombs, Simon (Swindon) Hughes, Robert G (Harrow W)
Cope, Sir John Hunt, Sir John (Ravensb'ne)
Cormack, Sir Patrick Hunter, Andrew
Couchman, James Hurd, Douglas
Currie, Mrs Edwina Jack, Michael
Curry, David Jackson, Robert (Wantage)
Davies, Quentin (Stamf'd) Jenkin, Bemard (Colchester N)
Davis, David (Boothferry) Jessel, Toby
Day, Stephen Johnson Smith, Sir Geoffrey
Deva, Nirj Joseph Jones, Gwilym (Cardiff N)
Devlin, Tim Jones, Robert B (W Herts)
Dorrell, Stephen Jopling, Michael
Douglas-Hamilton, Lord James Kellett-Bowman, Dame Elaine
Duncan Smith, Iain Key, Robert
Dunn, Bob King, Tom
Dykes, Hugh Kirkhope, Timothy
Elletson, Harold Knight, Mrs Angela (Erewash)
Emery, Sir Peter Knight, Greg (Derby N)
Evans, David (Welwyn Hatf'ld) Knight, Dame Jill (Edgbaston)
Evans, Jonathan (Brecon) Knox, Sir David
Evans, Nigel (Ribble V) Kynoch, George
Evans, Roger (Monmouth) Lait, Mrs Jacqui
Evennett, David Lamont, Norman
Faber, David Lawrence, Sir Ivan
Fabricant, Michael Legg, Barry
Fenner, Dame Peggy Leigh, Edward
Field, Barry (Isle of Wight) Lennox-Boyd, Sir Mark
Fishburn, Dudley Lester, Sir Jim (Broxtowe)
Forman, Nigel Lidington, David
Forsyth, Michael (Stirling) Lilley, Peter
Forth, Eric Lord, Michael
Fowler, Sir Norman Luff, Peter
Fox, Dr Liam (Woodspring) Lyell, Sir Nicholas
Fox, Sir Marcus (Shipley) MacGregor, John
Freeman, Roger MacKay, Andrew
French, Douglas Maclean, David
Fry, Sir Peter McLoughlin, Patrick
McNair-Wilson, Sir Patrick Skeet, Sir Trevor
Madel, Sir David Smith, Sir Dudley (Warwick)
Maitland, Lady Olga Smith, Tim (Beaconsf'ld)
Malone, Gerald Smyth, Rev Martin (Belfast S)
Mans, Keith Soames, Nicholas
Marland, Paul Speed, Sir Keith
Marlow, Tony Spencer, Sir Derek
Marshall, John (Hendon S) Spicer, Sir Jim (W Dorset)
Marshall, Sir Michael (Arundel) Spicer, Sir Michael (S Worcs)
Mawhinney, Dr Brian Spink, Dr Robert
Merchant, Piers Spring, Richard
Mills, Iain Sproat, Iain
Mitchell, Andrew (Gedling) Stanley, Sir John
Mitchell, Sir David (NW Hants) Steen, Anthony
Moate, Sir Roger Stephen, Michael
Molyneaux, Sir James Stem, Michael;
Monro, Sir Hector Stewart, Allan
Montgomery, Sir Fergus Streeter, Gary
Moss, Malcolm Sumberg, David
Nelson, Anthony Sweeney, Walter
Neubert, Sir Michael Tapsell, Sir Peter
Newton, Tony Taylor, Ian (Esher)
Nicholls, Patrick Taylor, John M (Solihull)
Nicholson, David (Taunton) Temple-Morris, Peter
Norris, Steve Thomason, Roy
Onslow, Sir Cranley Thompson, Sir Donald (Calder V)
Oppenheim, Phillip Thompson, Patrick (Norwich N)
Ottaway, Richard Thornton, Sir Malcolm
Page Richard Townend, John (Bridlington)
Paice, James Townsend, Sir Cyril (Bexl'yh'th)
Patnick, Sir Irvine Tracey, Richard
Patten, John Tredinnick, David
Pattie, Sir Geoffrey Trend, Michael
Pawsey, James Trotter, Neville
Peacock Mrs Elizabeth Twinn, Dr Ian
Pickles, Eric Vaughan, Sir Gerard
Porter, David Viggers, Peter
Portillo, Michael Walden, George
Powell, William (Corby) Walker, Bill (N Tayside)
Rathbone, Tim Waller, Gary
Redwood, John Ward, John
Renton, Tim Wardle, Charles (Bexhill)
Richards, Rod Waterson, Nigel
Rifkind, Malcolm Watts, John
Robathan, Andrew Whitney, Sir Raymond
Roberts, Sir Wyn Whittingdale, John
Robertson, Raymond S (Ab'd'n S) Widdecombe, Miss Ann
Robinson, Mark (Somerton) Wiggin, Sir Jerry
Roe, Mrs Marion Wilkinson, John
Rowe, Andrew Willetts, David
Rumbold, Dame Angela Wilshire, David
Sackville, Tom Winterton, Mrs Ann (Congleton)
Sainsbury, Sir Timothy Wolfson, Mark
Scott, Sir Nicholas Wood, Timothy
Shaw, David (Dover) Yeo, Tim
Shaw, Sir Giles (Pudsey) Young, Sir George
Shephard, Mrs Gillian
Shepherd, Sir Colin (Heref'd) Tellers for the Noes:
Shersby, Sir Michael Mr. Bowen Wells and
Sims, Sir Roger Mr. Roger Knapman.

Question accordingly negatived.

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