Severe Personality Disorders

HC Deb 15 February 1999 vol 325 cc601-14 3.30 pm

The Secretary of State for the Home Department (Mr. Jack Straw)

With permission, Madam Speaker, I should like to make a statement on new measures that my right hon. Friend the Secretary of State for Health and I are proposing in order better to protect the public from dangerous people in our society.

Up to now, we have dealt with those who are capable of committing acts of a serious sexual or violent nature in one of two ways—by conviction and imprisonment through the criminal courts, or by detention on the recommendation of doctors under powers in the Mental Health Acts. There is, however, a group of dangerous, severely personality disordered individuals from whom the public at present are not properly protected, and who are restrained effectively neither by the criminal law nor by the provisions of the Mental Health Acts.

The propensity of such people to commit the most serious sexual and violent acts may be well known and well recorded. Such people may, however, have been convicted only of crimes carrying a limited determinate sentence, and will have to be released from prison at the end of their sentence, even though, for example, they may themselves have warned prison staff of their certainty of recommitting serious offences on their release.

Because current mental health legislation prevents the detention even of a person posing the highest possible risk to the public unless doctors also certify that the condition is treatable, those people remain at large and without the benefit of any attempts at clinical intervention, unless and until they can be convicted of a further offence. In a limited number of cases, such people may not have come to the attention of the criminal justice system at all.

As successive Governments have recognised, this situation is plainly unsatisfactory. As long ago as 1975 an official committee—the Butler committee—recommended that indeterminate, reviewable sentences should be introduced for some of those individuals.

Much more recently, legislation enacted by this and the previous Administration means that increasingly effective conditions can be imposed on some offenders as they are being released from prison into the community. That includes compulsory post-release supervision for prisoners serving one year or more. In such cases, those who breach their licence conditions can be immediately recalled to prison.

Section 2 of the Crime (Sentences) Act 1997, which was passed by the previous Administration and came into force in October 1997, provides for a mandatory life sentence for those convicted of a second serious sexual or violent offence. The Crime and Disorder Act 1998 introduced extended supervision of up to an extra 10 years for sex offenders, and gave the police powers to apply for a sex offender order. However, not all these powers can apply to people who were sentenced before 1992. In recent months, dangerous offenders such as Robert Oliver and others have been released, with no conditions imposed on what they did or on where they lived.

I should therefore like to tell the House today what we are proposing for the short term, and also of our legislative proposals for the medium term. For the short term, we are putting in place an early warning system, so that local agencies and central Government have the maximum possible time to prepare for a dangerous person's re-entry to the community. Prison and probation services are being asked to provide this information to the Home Office's probation unit.

Similar arrangements are being made through the national health service with hospitals that treat patients detained under the Mental Health Act 1983. A support group in the Home Office probation unit made up of staff from the operational services will be there to assist local agencies to deal with particularly difficult cases. Those arrangements will all build on the work of the multi-agency risk panels that have already been established in many areas.

Those changes will help the system to deal with dangerous people now, but I believe that a new legislative framework for the system is long overdue. As I have explained, under the current provisions of the Mental Health Acts, only some of those severely disordered people can be detained, and then only if the treatment is likely to alleviate or prevent a deterioration of their condition". As the House well knows, there is a continuing debate about what treatments, if any, are effective in dealing with such severe personality disorder. However, the protection of the public cannot wait for the outcome of research, which may take many years to complete. Society cannot rely on a lottery in which, through no fault of the courts, some dangerous, severely personality disordered people are sent for a limited time to prison or to hospital while others remain in the community, or return to it, with no interventions whatever.

Subject, therefore, to parliamentary time, the Government propose that there should be new legal powers for the indeterminate but reviewable detention of dangerous personality disordered individuals. These powers would apply whether or not someone was before the courts for an offence. However, the new powers would themselves be exercised by the courts, and not by the Executive, and only where it could be established that the individual had a recognised severe personality disorder and that he or she posed a grave risk to the public.

Depriving individuals of their liberty in such circumstances is a very serious step. The key aim must be to protect the public while meeting the health needs of such individuals; so we will ensure that the process of ordering detention involves a robust system of checks and balances covering both legal and clinical issues. Once in detention, there will be regular, quasi-judicial reviews of the justification for detention continuing. The individuals concerned must have the best possible chance of becoming safe so as to be returned to the community, wherever that is possible. We therefore propose to establish a range of specialist programmes and a new approach to managing the detention of all those detained under the new powers. This approach would involve close operational links with the existing services.

I have outlined for the House what the Government believe is needed, but, because of the complexity of this area, and the seriousness of creating the kind of detention powers that I have described, it will be important for us to consult more widely. This will enable us to ensure both that we have not overlooked any options and that the action we take is effective and measured, commands broad support and is compatible with our obligations under the European convention. My right hon. Friend the Secretary of State for Health and I therefore propose to publish in the spring a consultative document that will outline in more detail the nature of the problem and the options for the new framework within which these powers will operate. In the light of responses to that document, we will take final decisions later this year.

We need to find out also why some people develop severe personality disorders and how that can be prevented. We are therefore funding further research, of nearly £1 million over three years. But we know already that severe personality disorder is often associated with large, broken families where abuse has been rife and where children may have been taken into local authority care or have received community-based mental health treatment before then embarking on drug abuse and criminal careers. Those problems will need to be dealt with in any event.

A number of hon. Members on both sides of the House have had to deal with the consequences in their own constituencies of the release of such dangerous, severe personality disordered offenders. I am extremely grateful to them and to local police, probation and health services for the sensitive and responsible way in which they have handled cases in their constituencies involving offenders to whom these measures relate, often in the face of serious and alarmed public concern. I very much hope that this constructive all-party approach will continue and that the proposals that I have outlined will receive wide support inside and outside the House.

Sir Norman Fowler (Sutton Coldfield)

In judging these proposals, should not our paramount concern be the safety of the public, and especially the safety of children? It cannot be right to have dangerous people in the community when there is a real belief that they may commit serious crimes, particularly when, as in the case of Michael Stone, the person himself seeks secure treatment.

It is clear that there is a range of issues to be decided when it comes to the Government's proposals. That being so, I ask the Home Secretary two particular questions. First, what will be the standard of proof when deciding whether an individual has a recognised severe personality disorder and is a grave risk to the public? Secondly, the right hon. Gentleman refers to regular quasi-judicial reviews of detention and the person's detention. How frequent will such reviews be? If a system can be devised, which is both fair and protects the public, I, for one, would support that.

Let me put an additional point to the Home Secretary. He has rightly talked about sex offenders, but is there not a bigger problem here? Not just the unconvicted are involved; convicted sex offenders, some of whom have served longish sentences, are released from prison into the community in the near certainty that they will offend again. The result is that persistent sexual abusers—who, during their lifetime, can have dozens of victims—have their career of abuse interrupted by prison, but not halted by it.

Is not one way forward to give the courts more power in sentencing and, in particular, to make possible the wider use of life sentences for sex offenders, in some circumstances? Would that not have the advantage that an offender would not be released until there was some confidence that he would not reoffend? An offender could be released on licence, and could be recalled. He could be made subject of a positive requirement—for example, that he should continue to have treatment. He would be subject to those conditions for the whole of his lifetime.

Does the Home Secretary agree that, if we are properly to protect the public, there should be extra provisions—for the unconvicted, but also for convicted sex offenders who, all too often, are released into the community and then offend again?

Mr. Straw

I am grateful to the right hon. Gentleman for the support in principle that he has offered to the proposals. I understand that he will want to comment in detail when he sees the consultative document.

The right hon. Gentleman asks about the standard of proof. That will be dealt with in the document, but we are looking for a standard of proof similar to that which applies within the mental health provisions—one that is bespoke for judging those matters and, above all, as he rightly said, for establishing whether a serious personality disorder poses a grave risk to the public. The protection of the public must be the paramount consideration when the courts are judging whether to make an order of this kind. The period, too, will be the subject of consultation. The Butler committee proposed that these reviewable sentences should be subject to review every two years. That will be one of the options raised.

The right hon. Gentleman asks whether I agree that these powers ought to be available to the courts in respect of those who are being convicted of offences as well as those who are not before the courts for any sentence. The answer is yes. As I made clear in my statement, these powers would apply whether someone was before the courts for an offence or not. If someone is before the courts for an offence—no matter what the nature of the offence is and even if it does not normally carry a heavy penalty—it would be open to the courts, subject to the criteria being met, to impose one of these indeterminate, but reviewable, sentences.

Such a sentence would be passed not as punishment in respect of the offence, but properly to protect the public and to deal with a situation that has rightly alarmed hon. Members on both sides of the House. A known sex offender who has been convicted of only a relatively minor offence that by no stretch of the imagination could reasonably carry a life sentence, and who is about to be released, could tell prison staff that he knows that he cannot control himself and will commit further offences. At the moment, however, nothing can be done to prevent the release of such a person, if he were sentenced before 1992.

I believe that the current range of life sentences available to the courts is broadly satisfactory. It is being reviewed in the context of the sex offender review, which the Minister of State, Home Office, my hon. Friend the Member for Brent, South (Mr. Boateng), recently announced. That availability, however, depends on the severity of the crime, whereas I am seeking to ensure that there is no longer a lottery—a matter of chance—in respect of whether someone who plainly poses a grave risk to the public is or is not detained. If such people pose that grave risk, and they suffer from a severe personality disorder, and whether or not they are before the court for an offence, and regardless of what kind of offence it is, they ought to be the subject of this kind of order.

Mr. Chris Mullin (Sunderland, South)

As the Home Secretary acknowledged, this is an extremely grave step, designed to address an extremely grave problem. I am glad to hear that he will consult widely. May I ask just two questions? First, what estimate does he have of the number of people likely to be affected by the measure? Secondly, can he assure the House that people will not be written off as untreatable simply because facilities for treating them are inadequate or do not exist?

Mr. Straw

The estimates of the total number of people suffering from such severe personality disorders and who are currently at large vary considerably. The best estimates that I have been given are that the number currently at large—not in the hospital or prison system—is between 300 and 600 and that the total number of people who suffer from such disorders, the vast majority of whom are, thankfully, detained under the Mental Health Acts or in prison, is some 2,700. However, those are only estimates.

I accept entirely my hon. Friend's second point—that people should not be written off as untreatable. Somebody may be deemed untreatable by a particular group of psychiatrists, but be susceptible to treatment by clinical psychologists, psychoanalysts or psychotherapists, or just within a therapeutic community. We should not write anybody off. Above all, the root of our concern must be the risk that such people pose to the public.

Mr. Simon Hughes (Southwark, North and Bermondsey)

For this significant but very small group of people, the prospect of having a careful consultation is welcome because it is important to get the balance right. Does the Home Secretary agree that, in protecting an individual's liberty when that individual has not been convicted of an offence, the state has a duty to ensure that the test of what evidence is sufficient is met only if the most widely agreed, sufficiently high and tightly defined definition justifies that loss of liberty when set against personal or public safety? If that view is shared across the Floor of the House, will the Home Secretary assure us that an individual or his advocate will always be able to trigger a review, that reviews will not occur only at the instigation of other authorities, and that that will be reviewable by the courts?

Does the Home Secretary agree that this reform exercise can be done properly only in the context of the Mental Health Acts? We must take the opportunity of breaking down the barrier between the prison medical service and the national health service, so that those with illness or personality disorders, whether offenders or not, are looked after by the same professionals. We shall therefore have a consistent assessment of need and risk.

Mr. Straw

I accept what the hon. Gentleman says—of course, the criteria must be clearly defined. We are talking about taking away the liberty of individuals who have not been convicted of a proportionate criminal offence. It is a very grave step to take. None of us should be under any illusions about that. It would be preposterous if we were to treat such a matter lightly.

By way of reassurance, I should like to tell the hon. Gentleman that the medical profession and mental health tribunals already have substantial experience of depriving people of their liberty where individuals with severe personality disorders are also classified as treatable; thus, this is not an area where there is no experience, and we shall seek to build on the experience that exists. I agree that an individual must be able to trigger a review—it would be unacceptable if they were not—but on a periodic basis.

I take the hon. Gentleman's point about the prison health service working more closely with the national health service. My right hon. Friend the Secretary of State for Health and I are working on plans, which we shall announce to the House in due course, to achieve that end.

Mr. Tony Benn (Chesterfield)

Is my right hon. Friend aware that most of what he has said could have been read in today's newspapers, and it is an insult to the House that we should read in the newspapers a statement to be made by a Minister? Although I recognise that there is a problem here, has my right hon. Friend looked at some of the precedents: internment without trial in Northern Ireland was justified on exactly the same basis—that people who had committed no offence should be kept out of the public domain without a trial? In the Soviet Union, that practice was widely followed because it can be easily abused. Will he take very seriously the arguments that have been made, namely that these matters should be dealt with under the Mental Health Acts and the Government should not take powers that allow them to put away anyone who, in their judgment, could potentially be a danger to the community—although such people no doubt exist?

Mr. Straw

I am sorry to disappoint my right hon. Friend, but I do not accept a sentence of what he has said.

There is no parallel whatever between what I am proposing and internment without trial. For a start, internment without trial was, and always will be, the result of an Executive decision, whereas we propose a very careful, judicially based process whereby people will be detained only by a court, and that will be subject to review. Internment without trial is, moreover, outwith our obligations under the European convention on human rights, whereas we are satisfied, and I am advised, that these proposals are fully within those obligations, and are entirely compatible with article 5.1, which provides for the detention of people of "unsound mind".

It is generally acknowledged that the Mental Health Acts need to be reviewed, but I do not believe that this kind of change can wait until they are reviewed. Let me say to my right hon. Friend that what is exposed by the need for this provision is an intellectual failure within the Mental Health Acts. I suspect that even he subscribes to the view that it is right to detain people who have severe personality disorders, but are treatable. If that is so, why on earth is it wrong to detain people who are regarded as untreatable, but who continue to pose exactly the same or a worse risk to the public?

Sir Brian Mawhinney (North-West Cambridgeshire)

Like most hon. Members, I welcome the right hon. Gentleman's proposals in principle. As he has reasonably said, we shall want to look at the details.

The right hon. Gentleman spoke of those who would be detained subject to occasional quasi-judicial review. Will he examine those proposals again before producing a White Paper? Depriving people of their liberty is an important and serious step, and the right hon. Gentleman might consider that, notwithstanding the Butler report, an annual review would be appropriate. He might also consider that it would help the courts if the review were conducted by an independent, mixed tribunal, consisting of both legal and health experts, which could then report independently to a court looking at an annual reflection.

I hope that the right hon. Gentleman will accept my proposals as constructive suggestions.

Mr. Straw

I accept both proposals in the constructive spirit in which they were offered. The appropriate period for review is a matter for debate, and we will canvass opinion. I hope that the right hon. Gentleman will respond to what will be a consultative document—I should make it clear that there will not be a White Paper at this stage. I think his suggestion of a mixed tribunal combining people from different disciplines is very valuable.

Mr. Gerald Bermingham (St. Helens, South)

I hope that my right hon. Friend accepts that the problem is caused, first, by deficiencies in the Mental Health Acts and, secondly, by the fact that care in the community has collapsed. There are people out there who have committed no crime but who are desperately sick, and there are not the facilities or the means to treat them. Under the Mental Health (Patients in the Community) Act 1995, we have had a series of tribunals which have worked extremely well. I hope that my right hon. Friend will bear in mind the expertise that such tribunals contain, and will allow them to continue. Those who are sick should be taken out of the community, often for their own good, and such cases should be dealt with by tribunals consisting of experts in the field.

Finally, will my right hon. Friend bear in mind the fact that, when people are taken out of the community and reviews take place, not only those people but the community as a whole should benefit? If the Mental Health Acts were amended to contain simply the word "treatable" or "containable", that might go a long way towards dealing with the psychopaths who languish in prison, to the danger of other prisoners.

Mr. Straw

My hon. Friend is right to say that part of the problem arises from what we now recognise to be deficiencies in the scheme of the Mental Health Acts, and the way in which it has been implemented in recent years. I am glad that my hon. Friend supports the changes and recognises that some of these people have to be detained.

Mrs. Angela Browning (Tiverton and Honiton)

What consideration has the Home Secretary given to existing mental health services in our prisons? I am not talking about psychiatric secure units, where one would expect to have the right level of staffing. He will know that many people who are detained and then say, as they are about to be released, that they believe that they will be a risk, will be the easiest cases to identify, but, throughout our Prison Service, there is very patchy provision of mental health services for serving prisoners. What will he do to ensure that there is proper diagnosis and intervention by appropriate staff while people who could fall into the category that he outlined are serving sentences in mainstream prisons? I must say also that I welcome his proposals.

Mr. Straw

I am grateful to the hon. Lady for what she says. She is right to say that current mental health provision is patchy. It improved under the previous Administration. We have tried to do the same. About 750 prisoners have been transferred, following proper diagnosis, from the Prison Service to the national health service while they have been detained. None the less, we accept that the system has to be improved. We have had good advice from Sir David Ramsbotham, chief inspector of prisons for England and Wales. As I said to the hon. Member for Southwark, North and Bermondsey (Mr. Hughes), that factor is one of the many reasons why we seek to ensure at every level that the prison health service and the national health service work much more closely together.

Mrs. Gwyneth Dunwoody (Crewe and Nantwich)

My right hon. Friend will accept that there are no clear clinical definitions of severe personality disorder and that many of those people will not be treatable in the normal sense. Therefore, will he not only ensure that anyone who is committed under the system undertakes more than the normal medical examination under the Mental Health Acts, but seriously consider where such a person will be confined?

The proposal is an abuse of human rights, but many of us believe that it will be justified because of the danger that those very difficult people pose to the community at large. However, before such a change in the law takes place, we must be clear that there cannot be mistakes, that there must be a ready and rapid way in which to put any problems right and, above all, that what happens to those people occurs in a context that can be easily defended and properly policed.

The categories will include not just people coming out of prison or mental health services. It is not acceptable to put extra pressures on to the medical profession, expecting it to cope with people who are not treatable.

Mr. Straw

It is becoming clear—it was obvious from the Fallon report into Ashworth hospital—that there is a substantial debate among clinicians about the nature of treatability. Some clinicians take a very narrow view of that; the trend has been towards that view. Others take a much wider view. I could quote, for example, Professor Ronald Blackburn, professor of clinical psychology at the university of Liverpool, who has said that there is insufficient evidence to support the opinion of some clinicians that nothing works with this group.

It is as wrong in psychiatric medicine to regard treatability as something that is fixed in time, as it is in any other sort of medicine, whether oncology or another specialty. As the science develops—the science not only of psychiatry, but of clinical psychology and many other disciplines—a condition that we previously regarded as wholly untreatable may become treatable. We always have to bear that in mind.

Above all, the argument for this change is that of the safety of the public. That has to be the paramount consideration.

Mr. Humfrey Malins (Woking)

May I also offer my support to the Home Secretary for what he has said? This is a difficult area.

Who will originate the proceedings: the police or others? Does the right hon. Gentleman envisage that they will be heard in a magistrates court, Crown court or any other court? Does the Home Secretary agree that they should be heard in public? Does he also agree—particularly as those who will appear, including those with no previous convictions, may be very poor—that, throughout the matter, any defendant, for want of a better word, should have full rights to legal and other representation and legal aid?

Mr. Straw

Depriving individuals of liberty in such circumstances for an indeterminate period—certainly, in most cases, it would be much more than the 12 months' total maximum that a magistrates court could impose—is a very serious matter and would have to be dealt with by the higher courts. We have to consult on whether the appropriate court is a Crown court, with all its connotations as the court in charge of criminal proceedings, or whether the matter is more appropriately dealt with under the aegis of civil courts. In the consultative document, we shall consider that matter, and the issue of who will originate proceedings; that could vary, as an inmate's propensity to reoffend might come to the attention of the Prison Service, the police, or mental health services, in the case of someone who had not committed any offence known to police but who should still be subject to such an order.

Ann Clwyd (Cynon Valley)

I am glad that my right hon. Friend is consulting widely, and also that he is supporting further research into the subject. May I tell him that I sat for many years as a lay member of a mental health tribunal, and that I found it a most difficult job to decide who was sane, who was not sane, who should be confined in hospital and who should be released? After many years of observation, I found that people who were locked up in hospital were far saner than those on the other side making the decision. It is a matter not only of treatability but of how initially we assess severe personality disorder. Among health professionals, there is an argument about making such assessments. I am concerned also, of course, about putting people in prison—locking them up—on the basis not of what they have done but of what they might do. I am sure that my right hon. Friend will agree that it is very difficult—perhaps it is the most difficult thing of all—to prove that one is not dangerous.

Mr. Straw

I accept the gravamen of what my hon. Friend says from her experience. There is no question but that this is a very difficult matter, and that we have a gap in provision precisely because it is so difficult. However, the result—about which there is no argument—of the gap is that there are very dangerous, personality disordered people about who, if they are not detained, will go out and commit further offences. Some of those people themselves know that they will commit further offences. Hon. Members on both sides of the House have had detailed dealings with some of the offenders and with some of those who have had to advise them. Some of the offenders themselves have begged for the security of detention, because they do not trust themselves not to commit the most serious offences.

Strangely enough, as well as owing it to the public, we owe it to those offenders to provide incarceration. At the margin, there are other offenders about whom there will be an argument. Diagnosing the condition is very difficult. That task is not made easier by the fact that many of those individuals are masters of deceit, in deceiving not only others but themselves. However, we have to use the best skills available to do the best job we can.

Mr. Robert Key (Salisbury)

I thank the Home Secretary for finding what seems to be a sensible way through a tangled web and also his officials, for the way in which they have dealt with individual cases. Certainly in the case in my own constituency and South Swindon, it was of enormous benefit that the Member of Parliament was included in the early-warning system. In the early stages, there was a serious lack of co-ordination, which was much helped by ready access by a Member of Parliament to the Home Secretary and his team.

Will the Home Secretary consider also the matter of funding and of what happens after a decision is taken? If a prisoner nearing release is instead re-detained, is it fair that the cost of keeping him or her inside an institution should be borne by the local health authority rather than by the Home Office? That is a genuine problem.

Mr. Straw

I am grateful to the hon. Gentleman for his remarks, particularly his approbation of the work of my officials, who have worked very hard indeed with local police and local probation services to ensure proper consultation with local Members. I should say that I had him, some other Conservative Members and some Labour Members in mind when I thanked hon. Members for the very responsible approach that has been taken to the matter, despite the huge public pressure in their areas and demands for extreme action, which of course could not be delivered. The hon. Gentleman raises an important point about funding. We must consider that, because I accept that the current arrangements are unsatisfactory.

Mr. Win Griffiths (Bridgend)

I welcome what my right hon. Friend has said, and I believe that he has recognised that this is an incredibly difficult area in which to come to the right solution. One issue that worries me—it has been alluded to by others—is the physical resource of the trained and qualified forensic psychiatrists and clinical psychologists in a range of services. We know that hundreds of people languishing in prison should be receiving treatment in medium or highly secure units, but that there are no places for them. What steps will be taken during the consultation to look at the skilled professionals who will be needed for the work? In Wales, what consultation will take place through the Welsh Office and, later, the Welsh Assembly?

Mr. Straw

As my hon. Friend intimates, this discrete issue is only one part of a range of necessary reforms to mental health provision in England and Wales. My hon. Friend may know that my right hon. Friends the Secretaries of State for Health and for Wales have announced expenditure of more than £700 million on improvements to mental health services in England and Wales, which will have some impact on the wider problem that my hon. Friend raises.

Mrs. Virginia Bottomley (South-West Surrey)

With others, I welcome the statement today, but I share the reservations—first, on the difficulties of cost shunting. One of the problems of severely mentally ill offenders is that they are unloved by the prison or the health authorities, and they are extremely costly to care for. Will the Home Secretary look at that issue during the consultation?

May I associate myself with those who have referred to civil liberties? The Government are known as effective followers of fashion, but this is an issue where the loophole needs to be closed. We could have a situation where an individual's civil rights were overlooked and where people were incarcerated and forgotten in the long term. At a time when legal, prison and health services are creaking under the strain of additional expectations and constrained resources, I hope that the Home Secretary will make sure that this is an area in which we deliver, and that his statement is the beginning, and not the end, of his initiative.

Mr. Straw

We will deal with cost shunting, and we are proposing a range of options in the consultation document on how the new service should operate—including whether it should be a separate service or a combined one under the health and prison services—precisely to cope with that issue. Although I made the statement today, the fact that it is a joint statement by my right hon. Friend the Secretary of State for Health and me shows our close working relationship with the Department of Health. Whatever other charge is made against me, I cannot be accused lightly of being a follower of fashion.

The Minister of State, Home Office (Mr. Paul Boateng)

Certainly not.

Mr. Straw

My hon. Friend the Minister, who is a follower of fashion—although he is not wearing his Ozwald Boateng suit today—says, "Hear, hear," to that.

The right hon. Lady is right: we must be conscious of individuals' civil liberties. This is a serious step that should be taken only where the gravest risk to the public is shown to be likely. Under the comprehensive spending review, substantial sums are being invested in the Prison Service to improve regimes and to improve the possibility of treatment for at least some of those people while they are incarcerated.

Mr. Tam Dalyell (Linlithgow)

May we return to the topic raised by my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) on the pressures on medical staff? In particular, will the Home Secretary clarify what he said in his statement about compulsory post-release supervision? Is it not all too easy to be lulled into complacency? Is not hindsight a very wonderful thing? What will be done to help staff who have made errors of judgment? None of us has perfect foresight, and staff can often get into great difficulty with people who do not understand the problems of such judgments. Will some help be given to medical staff in such circumstances?

Mr. Straw

I hope that such help is given. My hon. Friend is right to raise the issue. We should not condemn medical staff for trying to operate the Mental Health Acts on inadequate and flawed criteria. Having hindsight is easy. Even if the changes that I am proposing are acceptable to this House and the other place, some people will slip through the net. This is not a counsel of perfection; it is an effort to improve on the current situation. My hon. Friend is also correct to refer to supervision after release. We hope that as many individuals as possible will go back into the community under supervision when it is judged safe for them to do so.

Mr. Crispin Blunt (Reigate)

Given the warning of the hon. Member for Cynon Valley (Ann Clwyd) about the difficulty of diagnosing severe personality disorder and the fact that we have a "something must be done" society, shown by the mentality of the tabloid press, will the Home Secretary bear in mind the enormous pressure that will be put on those who have to assess whom to incarcerate in an attempt to eliminate all risk to society? One of the prices of a free society is the acceptance of risk.

Mr. Straw

That is very important. We cannot eliminate risks; we can only do our best to reduce risk. That is the purpose of the proposals.

Mr. David Winnick (Walsall, North)

No one is likely to dispute the need to defend the public against those who undoubtedly suffer from the personality disorders that my right hon. Friend has described. However, does he accept that there is bound to be unease—this has already been expressed by hon. Members on both sides of the House—over the possibility of abuses and the nightmare scenario of finding in 25 years' time that someone has been wrongfully detained from the beginning? The House should be concerned with individuals as well as with the general public. If the powers are to be taken, is it not essential that there should be sufficient safeguards to make it difficult for the mistakes that I have mentioned to occur? There must be regular reviews and people who have been detained without committing an offence must be represented. It will be difficult to be fully satisfied, but the review system should be sufficient to make us reasonable satisfied that the rights of individuals will not be abused.

Mr. Straw

My hon. Friend raises an important point. As I have said, we have to ensure that there are safeguards. The regular reviews—I have talked about them occurring every year or two—should make it impossible for someone to be wrongly detained for 25 years. An individual may protest for 25 years that he has been wrongly detained, but the decision will be for the court or tribunal, which will regularly review the situation.

Mrs. Jacqui Lait (Beckenham)

Does the right hon. Gentleman agree that a blanket condemnation of care in the community as a failure saddens and angers the many thousands in the community for whom it has been a success and the volunteers and professionals who look after them? Does he anticipate a change in the balance of care for those with severe personality disorders away from incarceration—which his statement reeked of—towards a more therapeutic community and a greater provision of secure accommodation in the health service?

Mr. Straw

I do not for a second condemn or criticise those who have the care of the mentally ill in the community, but my right hon. Friend the Secretary of State for Health has said that, in his judgment, care in the community has failed vulnerable people. I, too, have long held that view, not least from my constituency experience. The hon. Lady and I may disagree on the matter, but I do not regard current provisions as satisfactory.

On the provision of therapeutic environments, I made it clear that, although the individuals concerned are, by definition, all currently classified as "untreatable" under the Mental Health Acts, we should not write them off and every effort should be made to treat them in the best possible way and to involve not only those from the psychiatric profession but clinical psychologists and many others.