Mr. Jason Mitchell: Inquiry Findings (Hansard, 22 April 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, this was a local inquiry set up by Suffolk Health Authority. I understand that the authority has agreed to invite the inquiry team back in six months' time to review progress in implementing the local recommendations.

§ Lord Harris of Greenwich
My Lords, I thank the noble Baroness for that reply. Is she aware of the very high level of public concern in relation to this question? There are a great many reports of cases of paranoid schizophrenics killing while released into the community. Is she aware that I know of nine such cases where people in that category have killed while in the community? Is she aware that many of us are concerned about the sheer repetition of such cases? I am sure that the noble Baroness will be the first to confirm the high level of public disquiet. One of the reasons for that concern is the acute shortage of community health nurses. Is she aware that only one out of every five schizophrenics in the community has a community health nurse? In that situation, is it sensible for the Government to propose closing 50 psychiatric hospitals in the next five years?

§ Baroness Cumberlege
My Lords, we are very much aware of the public disquiet. However, it is interesting to note that convictions for homicide under Section 2 of the Homicide Act 1957 and hospital orders imposed under the mental health Acts are no higher now than they were 20 years ago although of course in that time the total number of homicide convictions has increased substantially. However, we realise that there is 894 enormous public disquiet. That is why we are undertaking a major programme to provide medium-secure beds and secure beds. Indeed, for those who do not require 24-hour nursing care, we appreciate what the noble Lord says about community psychiatric nurses. It is our intention to ensure that those numbers are increased.

§ Lord Strabolgi
My Lords, may I ask the noble Baroness when the report on the independent lay assessors is likely to be published? Those outside independent people seem able to overrule the professional opinions of psychiatrists and doctors in insisting on the release of dangerous mental patients, very often with disastrous consequences.

§ Baroness Cumberlege
My Lords, yes. The noble Lord is correct that we are at present assessing the role of lay members on the mental health review tribunals. At present, nearly all members have some involvement with mental health services in either a professional or a voluntary capacity. Sometimes that experience and knowledge are of extreme value. But we appreciate that there may need to be a review of the procedures of mental health review tribunals system and that is being undertaken at the moment.

§ Baroness Cox
My Lords, is my noble friend aware that I have served on a mental health tribunal and there was great anxiety about the availability of secure beds for potentially dangerous discharged patients? Will my noble friend assure the House that that shortage is being dealt with as a matter of real urgency?

§ Baroness Cumberlege
My Lords, yes. Indeed, since 1980 we have increased the number of secure and medium-secure places by 3,500 and there will be an additional 550. Not a single bed of that nature existed in 1980. The whole development has taken place in the past 15 years.

§ Baroness Jay of Paddington
My Lords, does the Minister agree that although this report, like so many others, was the function and responsibility of an individual health authority, there are very important national questions associated with it and the fact that the Mental Health Act Commission is the only national organisation which has some responsibility for mentally ill people? In the light of the report, will the Government take a different view about extending the remit of the Mental Health Act Commission so that it covers people like Jason Mitchell who may wander the countryside? There needs to be a central register and understanding of their needs and case histories to enable them to be fully monitored. That does not happen at present.

§ Baroness Cumberlege
My Lords, this is a very interesting report. In its introduction, Louis Blom-Cooper says that among the plethora of inquiries following homicides he believes that the report is unusual in that no one individual is singled out for blame other than 895 Jason Mitchell himself. He says that the killings could not have been predicted and were not preventable, given the nature of the services supplied to Jason Mitchell. He goes on to say: Had different steps been taken at various stages from 1989 onwards, the ultimate outcome might have been avoided. But that is like saying, if I had not changed my airline booking, I would have been killed in a crash of the aircraft on which I had originally booked". Therefore, we must be realistic about this matter. We cannot always prevent such cases from happening. Nevertheless, I appreciate the view of the noble Baroness that we should try to do so whenever it is possible. Perhaps part of that task might be the review of the Mental Health Act. However, we are anxious not to undertake that yet until we have seen some of the recent developments come to fruition, particularly supervision registers and the new power for supervised discharge.

§ Lord Harris of Greenwich
My Lords, is the Minister aware that one of the reasons for public concern is that the Mitchell case is by no means an isolated example, as I indicated earlier? Is the Minister also aware that this man strangled an elderly couple and, thereafter, murdered his own father and dismembered his body? Finally, is the Minister aware that only this morning a further report was published on yet another case in this category—namely, a man called Mr. Nilesh Gadher—who murdered a woman in a west London car park? Surely the reason for public disquiet is fairly obvious. People expect government action on the matter.

§ Baroness Cumberlege
My Lords, I believe that I acknowledged to the noble Lord that there is disquiet. That is why we have put such a huge investment into providing both secure and medium-secure beds. However, I want to reiterate the fact that one cannot always prevent such things from happening. Indeed, in the most recent case of Nilesh Gadher, although the report identifies some failings in management it goes on to say that the team did not consider that a tragedy of this magnitude was predictable. The inquiry also concluded that no one person or agency is to blame for what occurred. I believe that it is unrealistic of the people of this country to think that we can always avoid such cases. Clearly we cannot; and, indeed, they are not even on the increase.