HC Deb 01 July 1996 vol 280 cc329-32W
Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that in-patient units whose patients include offenders with disturbed personalities have access to psychodynamic expertise. [34616]

Mr. Bowis

All patients should have access to an appropriate range of multi-disciplinary psychological assessments, interventions and therapies. These need to be more broadly based than the dynamic psychotherapies. Assessing and meeting the need for these different therapies is a matter for local health and social services.

Mr. Cann

To ask the Secretary of State for Health (1) what action he has taken since March(a) to review and (b) to enhance the clinical training and experience in psychodynamic and forensic aspects of psychiatry of trainees in general psychiatry; [34624]

(2) what action he has taken since March to ensure that general psychiatrists taking up consultant posts with responsibility for secure beds have had a period of training in forensic psychiatry; [34621]

(3) what action he has taken since March to ensure that all trainees in general psychiatry spend a period of training under the supervision of a forensic psychiatrist. [34623]

Mr. Bowis

The standard and content of specialist medical training in psychiatry is the responsibility of the Royal College of Psychiatrists. The Department of Health holds regular meetings with the college to discuss the content of training and areas of mutual concern.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that professional clinical assessments by staff, other than those in psychiatry and nursing, are included in case conference reports, reviews and hospital transfers in respect of restricted patients. [34628]

Mr. Bowis

It is good practice to record any multidisciplinary assessments undertaken in respect of restricted patients. It is also usual for information to be transferred to the relevant agencies when patients leave hospital.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that medical members of mental health review tribunals receive a set of summary documents with reports from professionals responsible for the patient's care and treatment. [34606]

Mr. Bowis

It is good practice for the medical member to have sight of all documents concerning a patient and this is provided for in the Mental Health Review Tribunal Rules 1983.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that offender patients are given regular interviews with responsible medical officers and clinicians. [34618]

Mr. Bowis

This is good clinical practice.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to meet the training needs of(a) existing and (b) new members of mental health review tribunals. [34622]

Mr. Bowis

The introduction last year of national induction training for all tribunal members was an important new initiative which was carried through by the tribunal training group. The group has been considering the opportunities for training for existing members, which currently takes the form of discussion at regular members' meetings. The members' handbook has also been revised and the group is looking at whether a training video could be commissioned.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that reviews of practice following major untoward events involving patients detained under the Mental Health Acts are conducted by managers without direct line responsibility for the case in question. [34630]

Mr. Bowis

It is for local managers to decide who should conduct investigations into operational procedures following an untoward event.

Mr. Cann

To ask the Secretary of State for Health what steps his Department has taken since March in consultation with relevant professional bodies to draw from the best practice in child protection and to develop an inter-agency approach to case management for mentally ill patients who are discharged into the community. [34615]

Mr. Bowis

There is already a considerable body of guidance and good practice on the case management of mentally ill patients who are discharged into the community. This includes guidance on the proper implementation of the care programme approach and inter-agency working.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that responsible medical officers seek the advice of a psychologist or other suitably qualified person, who is not a member of the clinical team responsible for the patient, in respect of behaviour modification programmes, particularly in the absence of valid patient consent. [34617]

Mr. Bowis

The Mental Health Act code of practice, which has been disseminated widely, emphasises the importance of an appropriately skilled individual supervising behaviour modification programmes. This individual may or may not be attached to the clinical team responsible for the patient.

Mr. Cann

To ask the Secretary of State for Health what discussions have taken place since March with(a) the Royal College of Psychiatrists, (b) the Royal College of Nursing and (c) other relevant bodies to plan for additional guidance to their memberships about the inquiries they should make in respect of criminal offences committed by patients detained under the Mental Health Acts. [34629]

Mr. Bowis

It is a matter for the professional organisations concerned to provide for additional guidance to their members.

Mr. Cann

To ask the Secretary of State for Health what instructions or guidance have been given to social services departments to ensure that case records are transferred with patients restricted under the Mental Health Acts. [34627]

Mr. Bowis

The Department of Health guide to arrangements for inter-agency working for the care and protection of severely mentally ill people, "Building Bridges", which was published in November 1995, includes guidance on the use and disclosure of patient information. It calls for all agencies caring for people with mental health problems, whether restricted under mental health legislation or not, to have procedures to ensure that records are transferred, or copied, according to agency procedures, quickly when a patient moves district and/or local authority. It urges authorities to set sensible targets for the transfer of records, recommending transfer within two days in urgent cases and two weeks for less urgent cases. Copies of "Building Bridges" were sent to NHS agencies and social services departments.

Mr. Cann

To ask the Secretary of State for Health what action he has taken following the House of Lords decision in Home Secretary v. Oxford regional mental health review tribunal (1988) AC120 to ensure that tribunals may adjourn an application to give time for further examination of a patient's mental health before any discharge decision is made. [34614]

Mr. Bowis

Tribunals already have powers to adjourn before a final decision on whether to discharge is taken.

Mr. Cann

To ask the Secretary of State for Health what action he has taken since March to ensure that only approved social workers are assigned the task of social supervision of restricted patients. [34609]

Mr. Bowis

Local authorities and probation services, from which social supervisors are drawn, are aware of their responsibility to ensure that only suitably qualified and experienced staff are appointed as social supervisors of restricted patients.