HL Deb 07 February 1968 vol 288 cc1133-6

2.35 p.m.


My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

[The Question was as follows:

To ask Her Majesty's Government whether they are aware of the deep concern over the increasing number of patients absconding from Mental Hospitals; and what action they propose to take under Part IV of the Mental Health Act 1959.]


My Lords, the vast majority of psychiatric patients are nowadays treated without invoking the compulsory powers available under the Mental Health Act, and no question of absconding then arises. Of 189,000 patients in psychiatric hospitals at the end of 1966, 175,000 were informal patients of this kind. Other patients do abscond from time to time, and although the number of serious incidents over a period of years is small, Her Majesty's Government fully recognise the importance of protecting the public from any potential danger from mentally disturbed persons. It is not for Her Majesty's Government to take action under Part IV of the Act. The responsibility for exercising compulsion rests primarily on the doctors concerned.


My Lords, I thank the noble Lord for that reply. May I declare a non-financial interest, in that I am on the house committee of a mental hospital in the Epsom area? May I ask the noble Lord to accept an assurance that I fully concur with most of the provisions of the 1959 Act in the framing of which I myself took part. But arising from his Answer, may I put three brief supplementary questions? First, may I ask what criterion is now used with respect to classifying voluntary patients and whether this needs further looking into? Secondly, may I ask the noble Lord whether he is aware that there was a very cruel murder in one of the mental hospitals in Epsom, which was committed as I understand it, by a patient who had escaped from another hospital? Thirdly, may I ask the noble Lord whether he will ask his right honourable friend to revise the catchment areas from which these patients come in, to prevent overcrowding in places like Epsom where there is a serious shortage of staff?


My Lords, the criterion for judgment is, and must be, a medical one, and it must be exercised by the hospital doctors concerned. The murder at Epsom, to which the noble Lord referred, was, I believe, the case of a patient, Doyle, who was detained but got out and committed this tragic crime. He was subsequently sent to Broadmoor. That was one of the small and bitterly regrettable number of cases to which I alluded in my original Answer.

In regard to the question of the concentration of mental hospitals around Epsom, this is an historical fact which stems from the old days when the health authorities conceived that it was better to group mental hospitals all together. To revise that system will take time and cost money. But it is present policy that mental patients should be in hospitals as close to their homes as they can be. This is for their own sakes, but it also has an advantage to the public in spreading the population of mental hospitals more evenly.


My Lords, while accepting that it is not possible to guarantee that there will not be any cases of absconding from mental hospitals without methods of oppression which would be quite inappropriate in the conditions under which patients are now treated, would the noble Lord agree that the Government really cannot shuffle off all the responsibility by saying that it is up to the doctors? Of course it is up to the doctors. But the doctors act within the law. Would not the noble Lord agree about that?


My Lords, it is for that reason that the hospital authority at Epsom, the South-West Metropolitan Regional Hospital Board, are considering the possibility of establishing a medium-security unit, that is, a unit for patients in whose cases the maximum security of Broadmoor or Rampton is not necessary but who ought to fall into a middle stage between the purely informal patients and those subject to maximum security.


My Lords, is the noble Lord aware that some mental hospitals apparently have the custom of allowing patients out on trial for an afternoon? A few years ago such a patient from Chartham Mental Hospital came into my house, knocked over my cook—at that time, of course, I had a cook—and became very violent. It was an extremely nasty affair. I hope the noble Lord can give some assurance that before these patients are allowed out on trial they are carefully vetted.


My Lords, the actual cases must remain a matter for the hospital doctors and administration.


My Lords, may I ask my noble friend whether he is aware that in 1961 a Ministry of Health Working Party recommended that Regional Hospital Boards should provide a variety of accommodation for the treatment of psychiatric patients, including a proportion of secure accommodation, and whether he would have inquiries made as to the action that followed this recommendation?


Yes, my Lords, I was aware of that recommendation. Of course, the Boards provide a variety of accommodation of differing degrees of security.


My Lords, is the noble Lord aware that some of us think that the occasional escape of a mental patient—or, I would say, the occasional incident when a patient leaves without permission—is better than the re-application of the rigid and inelastic rules which once applied?


Yes, my Lords. We need to keep a sense of proportion about this matter. There are a very few very tragic cases, but there are a couple of hundred thousand people involved in mental treatment, the enormous majority of whom are getting cured without any restriction whatever.


My Lords, can the noble Lord give the figures of the number of murders and sexual assaults committed by men and women who have either absconded or been discharged from mental hospitals?


Not without notice, my Lords.


My Lords, finally may I ask whether the noble Lord is aware that, while the sentiments expressed by the noble Baroness, Lady Summer-skill, will command much sympathy, nevertheless in areas where there are these concentrations of mental hospitals people are worried about certain aspects of the present conditions?


My Lords, I take that very much into account. The Epsom area is a special case. It is unique in the country in having this concentration. The Regional Hospital Board is consulting with the local authority. The local authority has put certain proposals to the Home Secretary, who is considering them. The Regional Hospital Board is in touch with other local organisations about the best system to be adopted, and the Member of Parliament for those parts, Sir Peter Rawlinson, is playing an active and extremely helpful role in all the discussions.


My Lords, may I thank the noble Lord, Lord Kennet, for his very full answers?