HL Deb 25 July 2002 vol 638 cc527-9

Lord Hylton asked Her Majesty's Government:

How many places in secure psychiatric wards of hospitals they expect to provide in the coming three years; and how this compares with the numbers of mentally ill offenders in prisons.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)

My Lords, at present, local commissioners and providers plan to increase secure psychiatric beds by 1,091 between 2002–03 and 2005–06. Although these plans may be subject to amendment to reflect changing circumstances, they take into account the likely needs of severely mentally ill prisoners who may require transfer to such beds.

Lord Hylton

My Lords, I thank the Minister for that Answer. Are the Government fully seized of the seriousness of the situation now, given that there are at least. 500 cases of acute mental illness among prisoners, that probably two-thirds or more of all prisoners have some kind of mental disorder, and that suicides are running at a rate of about 80 per year? Will the noble Lord's department consult urgently with the Home Office, not only for the good of individuals but to achieve easier and better prison management?

Lord Hunt of Kings Heath

My Lords, our estimate is that 90 per cent of prisoners suffer from at least one of the five main categories of mental disorder, although the numbers who require transfer to an NHS bed is not on that scale. I agree with the substance of the noble Lord's question. We need to do much more, in co-operation with the Home Office and the NHS, to provide appropriate mental health services. The NHS can provide a great deal of support to the prison health service. I particularly commend the intensive mental health teams that we are now putting together to help the prison healthcare service in those areas.

Lord Janner of Braunstone

My Lords, is my noble friend taking any steps to extend appropriate treatment for non-violent offenders with mental problems so that sentencers will have an alternative to sending them to prison, where many of them should never be?

Lord Hunt of Kings Heath

My Lords, my noble friends who have responsibility for prison services have made clear that in many instances community sentences may be more appropriate. I agree that if NHS mental health services are available for such people, they can often provide a great deal of support and help. That has to be seen in the overall context of the NHS improving its mental health services. We have published a national service framework and we are investing more resources in mental health services. I am sure that that will provide the kind of support my noble friend requests.

Lord Hurd of Westwell

My Lords, perhaps I may press the Minister on the issue of resources. I recognise that this goes beyond his own department. We have a fairly desperate situation at the moment with 4,000 more prisoners than a year ago, some of them being forced into police cells and others being shunted around the country every evening as the court s close in a desperate search for a prison with space to hold them. This must all be unbudgeted expenditure. Will the Minister do his best to ensure that this expenditure is not at the expense of the treatment of mentally ill prisoners or the training and education programmes in prisons which are so crucial?

Lord Hunt of Kings Heath

My Lords, I am not in a position to answer for the Home Office in relation to the specific budget of the Prison Service. I understand the point made by the noble Lord. Certainly in respect of health services the NHS is determined to give as much support as it can to the prison healthcare service to ensure that the appropriate services are provided to prisoners. Joint assessments of the health needs of prisoners are now undertaken by individual prisons and the local NHS. We are hopeful that as a result of those assessments and the additional resources being put in by both the Home Office and the Department of Health, we will provide much enhanced health services for prisoners.

Lord Avebury

My Lords, does the Minister agree that the protocol agreed between the Department of Health and the Prison Service, while helpful as far as it goes, does nothing to eliminate the delays which occur prior to the clinician in the receiving establishment accepting the prisoner and that much of the delay occurs earlier in the process of assessment? Will the regional prison health task force have power to commission surveys such as the one conducted by the West Midlands Forensic Psychiatric Service last year, in which it was shown that 32 per cent of the in-patients in prison would benefit from a transfer to psychiatric hospitals? Does he agree that if that survey were extended to the whole country and the results were repeated, it would show that there has been no improvement in the situation since John Reed gave evidence to the Select Committee in another place in April 2000?

Lord Hunt of Kings Heath

My Lords, I agree that we need to look carefully at survey figures. I am not sure that I agree necessarily with the conclusions of the survey to which the noble Lord referred. The whole point of the prison and the local health service carrying out an assessment is to get much more precise information about the health needs of prisoners. I agree that there is a problem with prisoners awaiting an NHS mental health assessment. My understanding of the latest statistics for March this year is that 142 prisoners were awaiting an NHS mental health assessment. We need to take action to ensure that waiting is kept to a minimum. As to prisoners waiting for transfer, the figure for March was again 142. Of those, 39 had been waiting for more than three months. This is where the protocol comes into play because it focuses attention on prisoners waiting for more than three months. We are determined to take action to ensure that those waits are kept to a minimum.

Lord Clement-Jones

My Lords, the provisions of the mental health Bill are extremely controversial, not least in the way they affect prisoners with mental disorders. Will the Minister recommend to his right honourable friend the Secretary of State and the usual channels that there should be proper pre-legislative scrutiny of the mental health Bill via a Joint Standing Committee of both Houses?

Lord Hunt of Kings Heath

My Lords, I recognise the importance of the effective scrutiny of any mental health Bill that is brought before Parliament. The noble Lord will know that we have published a draft Bill in order to secure comments over the next two to three months for that very reason. If in due course a Bill is brought to Parliament, it will need particularly close scrutiny. I am sure that your Lordships' House will play a very important part in that. I shall of course pass on the noble Lord's comments to the usual channels.

Baroness Gibson of Market Rasen

My Lords, in the figures to which my noble friend referred, how many relate to women prisoners and how many relate to men?

Lord Hunt of Kings Heath

My Lords, we do not have the figures for the exact number of women who are part of the 142 waiting for assessment or the 142 waiting for transfer. However, most of the prisoners waiting for a transfer are men.

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