HL Deb 04 May 1988 vol 496 cc561-2

Lord Mottistone asked Her Majesty's Government:

Whether Section 133 of the Mental Health Act 1983 (information for the nearest relative about the patient's discharge) is being adequately implemented.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)

My Lords, information is not available centrally on the application of Section 133 of the Mental Health Act 1983 in respect of NHS mental illness or mental handicap hospitals, but in spite of repeated offers since the election to follow up cases only one has been forthcoming.

Lord Mottistone

My Lords, I thank my noble friend for that Answer, but it is very disappointing. Is it not a fact that in the second biennial report of the Mental Health Act Commission attention was drawn to the fact that this section had not been fulfilled as happily as one might have expected?

Lord Skelmersdale

My Lords, yes indeed, I am aware of the reference in the commission's second biennial report on this matter. All health authorities received a copy of the report, of course, and I would expect them to take note of the commission's comments.

Lord Ennals

My Lords, is the Minister aware that MIND has a great deal of evidence of failure to inform the families of discharged patients under the terms of Section 133 and that that is causing great hardship to both patients and families alike? Can the Minister say what action he can take to improve the situation and to facilitate the kind of multi-disciplinary advocacy provided for in the Disabled Persons (Services, Consultation and Representation) Act 1986?

Lord Skelmersdale

My Lords, as regards that Act the Government are pursuing its implementation. It was always made clear (was it not?) that that would depend on resource allocations and agreement between local authorities and central government? This is being pursued as vigorously as possible.

As regards the after-care of people chronically disabled by mental illness, we hope that in due course there will be guidance to health authorities. I attended a working conference in February this year organised jointly by the department and the National Unit for Psychiatric Research and Development at which a number of people from the field discussed the detailed requirements of such guidance and indeed of such a service. I understand that a report of that conference will be published shortly by the national unit and we shall take it from there.

Lord Ennals

My Lords, while thanking the Minister, would he accept that unless the information is available it is simply not possible for the multi-disciplinary advocacy to which I referred in the Disabled Persons (Services, Consultation and Representation) Act to take place? Without the information concerning when a patient is going to be discharged, how can that advocacy operation as conceived in the Act be carried out?

Lord Skelmersdale

My Lords, obviously I accept that. I regard it as very disturbing that the Mental Health Act Commission in its second biennial report felt the need to make the remarks that it did. That is why it is absolutely essential that all health authorities should get this information.

Lord Elwyn-Jones

My Lords, are the financial resources available for this important work so that it can be carried out competently?

Lord Skelmersdale

My Lords, there is no targeted fund for health authorities as regards mental illness. It is up to health authorities to judge their priorities in the light of local circumstances. Where this is being carried out properly, there is no need for them to reorder their priorities. Where it is not being carried out properly, clearly there is a need for that reordering.

Lord Mottistone

My Lords, does not my noble friend agree that the instruction within Section 133 is extremely clear? I paraphrase that section. It states that the managers of hospitals shall take such steps as are practicable to inform the person—that is, the nearest relative. Costs are not involved in this instance. It is a matter of people doing things. Does not my noble friend agree that somebody has to make sure that this is done? If the local district health or regional health authorities are not doing it, cannot the Government bring pressure to bear through them?

Lord Skelmersdale

My Lords, yes indeed they can. I should however point out that subsection (2) of Section 133 states: Subsection (1) above shall not apply if the patient or his nearest relative has requested that information about the patient's discharge should not be given under this section. There may well be a problem in this area.

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