HL Deb 05 November 1992 vol 539 cc1542-4

3.26 p.m.

Lord Mottistone asked Her Majesty's Government:

What steps have been taken to monitor the arrangements made by regional health authorities to ensure that there are a sufficient number of doctors approved under Section 12(2) of the Mental Health Act 1983 and that such doctors receive suitable training in operating the Act.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, these arrangements are monitored by the Mental Health Act Commission and I can assure my noble friend Lord Mottistone that generally they appear to be working well. However, we are always ready to take up any particular problems which authorities and the professional bodies responsible for training may discover.

Lord Mottistone

My Lords, while thanking my noble friend for her Answer, is she aware that of the three regional health authorities recently approached, two had no training programme for the doctors referred to in my Question? If that proportion of two out of three is representative of the country as a whole, that does not seem to be an acceptable position and it is not covered by my noble friend's answer.

Baroness Cumberlege

My Lords, in preparation for today I asked officials to telephone every regional health authority to ascertain the situation. No apparent problems arose, but if my noble friend would like to give me details of those regions I shall certainly take up the matter personally.

Lord Allen of Abbeydale

My Lords, from time to time persons with mental handicap—or learning disability if that phrase is preferred—will be subject to compulsory admission either because of behavioural problems or because there is mental illness as well as mental handicap. Can the Minister give an assurance that in approving doctors under Section 12, and in arranging for training, ample regard is paid to the need for expertise in problems relating to mental handicap?

Baroness Cumberlege

My Lords, I understand the point that is being made and the difference between people with learning disabilities and those who have a mental illness, but we do insist that doctors have three years' post-registration clinical experience, including the equivalent of at least six months full-time psychiatric experience in a post which forms part of a training scheme approved by the Royal College of Psychiatrists, or, indeed, are members of the Royal College or have an equivalent qualification. I believe that the situation is that they take into account also people with learning disabilities.

Lord Allen of Abbeydale

My Lords, I wonder whether qualification by instruction by psychiatrists is quite enough, but I am content to leave it to the Minister to look into that point.

Lord Carter

My Lords, will the Minister confirm that regional health authorities do not have the power to compel NHS trusts to include in their standard contract terms what are described as "matters of operational practice"? That would include things such as out-of-hours work and other matters which are required in connection with Section 12 of the Mental Health Act. Can she also confirm that there are still doctors who appear not to understand the department's guidance and that patients can be admitted to hospital under Section 12 solely in the interests of their own health and treatment—they do not have to be shown as being a danger to themselves or other people?

Baroness Cumberlege

My Lords, the Mental Health Act Commission has put in a lot of effort to ensure that doctors are aware of the recent amendment to the code. With regard to trusts, regional health authorities are still responsible in this area under the 1990 circular.

Lord Mottistone

My Lords, the answers are not quite what I would have hoped for. Can my noble friend reassure me that, apart from waiting for people like me to provide examples of where RHAs give unsatisfactory answers to the kind of questions we are talking about, she and her department will take the trouble to find out from the RHAs whether they are monitoring the position themselves so that we do not have to do it for them?

Baroness Cumberlege

My Lords, I thought I had told the House that that is the case. In the past week we have been in contact with all 14 regional health authorities to ascertain the exact position.

Lord Redesdale

My Lords, a briefing from MIND, the National Association for Mental Health, states that it is aware of only one regional health authority which runs training specifically for intending applicants. If MIND is not aware of what is going on, does the noble Baroness believe that that could be the case in the regional health authorities?

Baroness Cumberlege

My Lords, I really think that I have answered those questions fully.

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