§ 7.58 p.m.
§ Report received.
§ Clause 1 [Assessment of needs of persons discharged from hospital after treatment for schizophrenia]:
§
Lord Mottistone moved Amendment No. 1:
Page 3, line 13, leave out ("or (b) his nearest relative").
§ The noble Lord said: My Lords, I hope that I shall be brief with all my amendments. In the main they are in response to various points raised by other Members in Committee, and I hope that they will agree that they meet their needs.
§ Amendment No. 1 endeavours to meet a point relating to Clause 1(6) raised in his opening remarks on Amendment No. 12 at col. 736 of the Official Report on 10th May by the noble Lord, Lord Ennals. The amendment would prevent the nearest relative from blocking an assessment if the person being discharged wants one. That was the point made by the noble Lord. I beg to move.
209§ Lord EnnalsMy Lords, I simply respond to say that I am grateful to the noble Lord, Lord Mottistone, for meeting the points that I made in the course of our previous debate. He has totally met my concerns and I welcome the amendment.
§ On Question, amendment agreed to.
§
Lord Mottistone moved Amendment No. 2:
Page 3, line 27, after ("his") insert ("formal").
§
The noble Lord said: My Lords, with this amendment I take Amendments Nos. 4 and 5 and a new manuscript Amendment No. 5A, copies of which I have given to noble Lords who are taking part in the debate. For the benefit of noble Lords who have not seen it, the manuscript amendment reads:
Page 5, line 21, at end insert ("formally").
§ These amendments insert in the Bill the word "formal" which was incorporated at various places in the Bill in Committee and it is now necessary to make the Bill consistent where the same qualification is necessary. Arguments for this need were made at the previous stage and I shall not bore the House with them again. I beg to move.
§ On Question, amendment agreed to.
§ Clause 2 [After-care of persons discharged from hospital after treatment for schizophrenia]:
§ Lord Mottistone moved Amendment No. 3:
§
Page 4, line 29, leave out subsection (4) and insert—
("(4) A person—
may on request by that authority when it is pursuing its reasonable enquiries under subsection (3) disclose that information to it.").
§ The noble Lord said: My Lords, this amendment responds to the main thrust of Amendment No. 12 moved by the noble Lord, Lord Ennals, in Committee to which I have already referred. It reflects the fact that some relationships involve a seal of confidentiality; for example, the relationship between a schizophrenic and his doctor, his clergyman or his solicitor. If a schizophrenic wishes to disappear, his doctor may well feel, in the absence of such a provision, an obligation not to reveal his whereabouts although he thinks that the case still requires treatment.
§ The proposed redrafting of subsection (4) seeks to protect disclosure by the doctor in these circumstances. I suggest to your Lordships that the patient's interest will be served because he will have another opportunity of receiving treatment instead of perhaps sleeping rough in a cardboard box on the Embankment. The patient's privacy is protected as far as possible because the disclosure to be protected must be to the health authority alone, and then only if the health authority requests it.
210§ It was suggested in Committee that perhaps a penalty might be necessary in order to force this through, but I do not think that it is. If the doctor does not consider that disclosure is desirable, that is the end of the matter. It is difficult to conceive of circumstances where he considers disclosure is desirable and where he still does not disclose. The challenge to him in that event could always be met by his saying that he has changed his mind and no longer thinks disclosure desirable. Therefore, I hope noble Lords will feel that with this amendment we have taken the main theme put by the noble Lord, Lord Ennals, and others who supported him in Committee. I beg to move.
§ Lord EnnalsMy Lords, I again briefly intervene to say that in the amendment which I sought to move in Committee there were some major points relating to civil liberties, and I am grateful to the noble Lord for having recognised the concerns expressed by myself and others. He did exactly the right thing. He prepared a draft, discussed it with us, we agreed and he has come before the House with an amendment. I support it. My hope is that the Government will be as sensible in the whole of the Bill as the noble Lord, Lord Mottistone, has been in this part of it.
Lord WinstanleyMy Lords, perhaps I may briefly say that I support what the noble Lord, Lord Ennals, said. I am bound to say that this kind of problem—a very real problem expressed by many people—still exists and will always exist. I do not believe that the problem concerning civil liberties in relation to disclosure of information can ever be wholly removed; but in so far as it is possible to do so, the noble Lord, Lord Mottistone, has devised a form of words which I at least regard as satisfactory and I hope others will too.
§ On Question, amendment agreed to.
§ The Deputy Speaker (Lord Murton of Lindisfarne)My Lords, perhaps it will be convenient if we take Amendments Nos. 4, 5 and 5A formally.
§
Lord Mottistone moved Amendment No. 4:
Page 5, line 16, after ("his") insert ("formal").
§ On Question, amendment agreed to.
§
Lord Mottistone moved Amendments Nos. 5 and 5A:
Page 5, line 18, at end insert ("formal").
Page 5, line 21, at end insert ("formally").
§ On Question, amendments agreed to.
§
Lord Mottistone moved Amendment No. 6:
After Clause 3, insert the following new clause:
§ ("Regulations by Secretary of State
§ .—(1) The Secretary of State may make regulations specifying one or more of the following—
- (a) the description of the authority whose duty it is to provide a type of after-care service under section 2(1), above that is to say, whether the health authority or the local authority is to provide the service;
- (b) without prejudice to section 1(4) above, the type or types of need to be taken into account when making an assessment under that subsection;
- (c) the quality and extent of a type of after-care service to be providedֵ
§ (2) The power to make regulations under this section shall be exercisable by statutory instrument; and any such regulations—
- (a) may make different provision for different cases, and
- (b) may contain such transitional, supplemental and incidental provisions as appear to the Secretary of State to be desirable, and
- (c) may create criminal offences or otherwise provide for the enforcement of obligations imposed by or under the regulations.
§ (3) A statutory instrument made under this section shall be subject to annulment in pursuance of a resolution of either House of Parliament.").
§ The noble Lord said: My Lords, this amendment endeavours to meet Amendment No. 4 tabled by my noble friend Lady Faithfull in Committee. I suggest that the new subsection (1)(a) meets paragraph (b) of my noble friend's amendment and that subsection (1)(c) meets her paragraph (a). Subsection (1)(b) of my amendment is new, as a result of my having given thought to this matter. For example, suppose that research showed that watching television was good for schizophrenics. I do not know whether it is, but it might be for some. Subsection (1)(b) of my amendment would add a provision that television sets should be considered among the possible needs. Therefore, one needs to give power to the Secretary of State to deal with that situation. This part of the amendment would also enable the list of specific needs—medical treatment and so on—to be notionally extended and gives some flexibility.
§ As regards subsections (2) and (3) of the amendment, these are fairly conventional for this sort of Bill and, indeed, have been copied from building societies Acts. I believe that they are perfectly straightforward. We also discussed this point earlier and I hope that the proposals are satisfactory to my noble friend. I beg to move.
§ Baroness FaithfullMy Lords, I too thank my noble friend for incorporating in the Bill the points that I made in Committee. I should like to make one 212 comment—I do not propose even to ask a question. At the moment the health and social services are having great difficulty throughout the country dealing with all sorts of cases, particularly with schizophrenics, because the Griffiths Report has not yet been published. I hope that my noble friend the Minister will understand how much we press for a decision on the Griffiths Report, which would ease the position and made it more easy to administer.
§ Lord HenleyMy Lords, I fully understand what my noble friend said but I regret that I cannot help her on the Griffiths Report. The Government are aware that my noble friend and others would like a response to the report as soon as possible. All I can say is that our response will come forward as soon as practicable, but it is a complicated matter.
§ Lord MottistoneMy Lords, I thank my noble friend Lady Faithfull for her kind agreement to this attempt to cover the points that she made. I wondered who would mention Griffiths; it seemed almost inevitable. I also wondered whether my noble friend on the Front Bench would respond. I only wish that he had accepted the principle of this Bill and could have an experiment to see how Griffiths might be carried out on a wider scale. However, I shall not spend more time on this. I look forward to Third Reading when we shall have an opportunity again to mention the points that have given rise to this Bill, but of course briefly.
§ On Question, amendment agreed to.