HL Deb 07 March 1990 vol 516 cc1168-70

2.58 p.m.

Lord Mottistone asked Her Majesty's Government:

What progress has been made, since the publication of the 1987 DHSS-Home Office report on mentally disturbed offenders in the prison system, towards a comprehensive secure programme for those who are detainable under the Mental Health Act and for whom the regional secure unit programme was not designed.

Baroness Blatch

My Lords, the Government welcomed the report of this working group and accepted all 16 recommendations that it made. Ten of the recommendations have been implemented and work on a further three is nearing completion. The remaining recommendations call for continuing attention over time.

With regard to my noble friend's second point, regional health authorities are generally satisfied that the present level of regional secure unit provision is adequate, at least in terms of the programme's original remit. But there may be a need to review the range of secure facilities of which regional secure units form part. There is evidence of some shortfall in longer term, medium secure provision.

Lord Mottistone

My Lords, I thank my noble friend for her very full reply. Can she add to it by indicating how many district health authorities do not have secure facilities and who, in each authority, is responsible for providing and planning these facilities? Can she also say whether progress in this area is regularly monitored by my right honourable friend the Secretary of State?

Baroness Blatch

My Lords, we do not routinely collect information centrally about the location of secure facilities other than those related to regional forensic services. However, we intend to do so as part of a forthcoming comprehensive review of secure provisions. It is for each district authority to determine the levels and patterns of local services in the light of national and regional policies and guidelines. It is for the regional health authorities to ensure that districts are planning to provide a full range of psychiatric services including secure facilities. The department plans to discuss with the regions the development of local secure provision.

Lord Molloy

My Lords, can the department also look at the position of male nurses employed in such establishments for the mentally disturbed, both from a legal point of view and their terms of employment?

Baroness Blatch

My Lords, I am certainly prepared to bring that aspect to the attention of my right honourable friend; but I am not absolutely certain of the point of the question.

Lord Ennals

My Lords, I too welcome the statement made by the Minister. However, at a time when there is increasing evidence of inappropriate placing of people with psychiatric illness in the criminal justice system, where so few treatment facilities exist, how is it that, first, so little progress has been made by the Home Office in developing psychiatric bail hostels? Secondly, why does the number of psychiatric probation orders seem to be going down? That is obviously the Home Office side of the joint working party's recommendations. Can the Minister answer those questions?

Baroness Blatch

My Lords, the department and the Home Office seek to ensure that mentally disordered offenders receive the most appropriate treatment—certainly we must all agree with that—and timely placement. Our common aim is to ensure that where possible such offenders are dealt with without resort to the courts or, failing that, without resort to the penal system. We recognise that there is scope to increase the level of diversion. That can best be done by increasing local awareness of non-custodial options and encouraging closer and more effective working relationships between all the professional agencies and individuals involved. Guidance has been drafted by the Home Office. It is being discussed with the Lord Chancellor's Department and other bodies. I understand that the guidance is likely to be issued soon.

Baroness Seear

My Lords, has the Minister any information on how many mentally ill people are being held in prison simply because there is no other accommodation for them? Is it planned that when secure units are available within the health service the health service will be required to accept such people? At present, if there is no place for offenders to go, the prisons cannot refuse them, even though it is known that prison is a totally unsuitable place for them.

Baroness Blatch

My Lords, the noble Baroness raises an important point. We know that at any one time a relatively small number of prisoners—about 330, I understand—is likely to meet the criteria for detention under the provisions of the Mental Health Act. We know also that there is widespread concern about a possibly much larger group which is thought to suffer from a lesser form of mental disorder.

There is a lack of sound information on this subject, but there can be little doubt that a number of offenders could be dealt with in more satisfactory ways than imprisonment. Research commissioned by the prison service itself to assist the development of its policies will help and shed light on the scale of the problem. The point made by the noble Baroness is that flexibility should be the order of the day and that appropriate provision is important.

Lord Hunt

My Lords, is the noble Baroness aware that a call for the adequate provision of secure units by the regional health authorities for mentally disturbed offenders was made by the House of Commons Expenditure Committee as long ago as 1978? The May Committee on the prison system endorsed that call in very strong terms in 1979. The all-party Penal Affairs Group reinforced both those recommendations in 1980. In view of the numbers of mentally disturbed offenders inappropriately held in our prisons, is it not high time that this pressing need was met?

Baroness Blatch

My Lords, I understand the frustration behind the noble Lord's question; that much has been done but over a long period of time. We must not detract from the achievements so far made and nor must we detract from the incredible push given by this House in making sure that a proper service is delivered. Concern has been expressed, for example, about the closing down of the larger institutions and the way in which appropriate provision has been made on the discharge of a person but without the proper follow-up aftercare.

In the general sense, all I can say is that there is much in the pipeline. There is a real sense of urgency on the part of the Government to resolve this problem, to have a much more flexible approach to provision for such people and to make sure that the provision is, in every sense, appropriate.