§ Tim LoughtonTo ask the Secretary of State for Health whether the Mental Health Bill will place a legal obligation on health and social services authorities to honour advance statements and advance directives. [100781]
§ Jacqui SmithIt is not proposed that the Mental Health Bill should place a legal obligation on health and social services to honour advance statements and advance directives since the use of compulsory powers under the Bill is based on the concept of treatment being necessary rather than the capacity of the individual to take decisions, whether those decisions are expressed at the time or in an advance statement or directive.
As part of our consideration of the Mental Health Bill consultation responses we are, however, looking further at how best to ensure that clinical teams take notice of patients' wishes and feelings.
§ Tim LoughtonTo ask the Secretary of State for Health (1) how many investigations took place last year into patient deaths in mental health trust centres; [101069]
(2) what steps his Department is taking against mental health trusts which do not accurately report how many (a) suicides and (b) killings took place in their care; [101072]
(3) how many mental health trust centres staff are suspended regarding patient deaths; [101070]
343W(4)what discussions his Department has had with (a) mental health trust chief executives and (b) the Commission for Health Improvement regarding patient deaths in mental health trust centres. [101071]
§ Jacqui SmithThe Department does not collect data from individual mental health trusts on the number of investigations that take place into patient deaths or on staff who are suspended regarding patient deaths. All serious untoward incidents are investigated by the relevant trust and the suspension of staff is a disciplinary issue dealt with at local level. If there is a homicide by a person in the care of a mental health trust, it is obligatory to hold an independent inquiry under HSG(94)27.
The Department is not aware of any problem in the reporting of serious untoward incidents by mental health trusts. All trusts are required to report serious incidents to strategic health authorities and to the relevant Directorate of Health and Social Care/ Regional Director of Public Health and the Department of Health. In such cases, the Department works closely with all relevant organisations to ensure that advice and support is provided to enable the service to learn lessons, which can prevent further incidents occurring. The development of the new Commission for Health Audit and Inspection, and the integration within it of the Mental Health Act Commission, will ensure an even stronger focus on mental health issues for the new organisation.
The Department funds the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness to ensure that every one involved with mental health services learns and implements lessons from the factors associated with serious incidents.
The Government have also established the National Patient Safety Agency (NPSA) to improve the safety of NHS patient care by introducing a national reporting and learning system for adverse events. Guidance on the introduction of new arrangements will be issued when the system is rolled out, from summer 2003. In future, all serious service failures or dysfunction will be subject to a full root cause analysis to establish what went wrong, to learn lessons and to take appropriate action. Reports of all incidents, including those subject to a root cause analysis, will be made to the NPSA. This overview will enable the NPSA to identify trends and patterns of avoidable adverse events, learn lessons that can be fed back to the service and produce solutions to prevent further harm occurring.
§ Tim LoughtonTo ask the Secretary of State for Health what assessment he has made of whether the NHS response to the mental health needs of ex-servicemen is in accordance with(a) international best practice and (b) the international evidence. [101073]
§ Jacqui SmithThe spectrum of mental health disorders in the United Kingdom armed forces is broadly the same as in the matched civilian community. The national health service already has a commitment to an evidence-based approach in the context of individual assessment of needs.
Health authorities have a responsibility to provide services to meet the mental health needs of all those who are eligible. Decisions about treatment and care are 344W taken on the basis of an individualised assessment of needs, the patient's wishes, the evidence base for effective treatment and available resources. The general practitioner remains the first port of call for anyone suffering from mental health problems. The Department published guidance to help GPs know more about the most effective treatments in the mental health national service framework and in specific guidance on psychological therapies and counselling. These are available on our website at www.doh.qov.uk/ mentalhealth.
There is also current guidance relevant to priority treatment for war pensioners (HSG (97)31) which says:
that the referral should make specific reference to the fact that the patient is a war pensioner and requires treatment for the condition(s) for which he was awarded a pension; andthat war pensioners can use the NHS complaints system to resolve any alleged breakdowns in the arrangements for priority treatment (leading, ultimately, to the Ombudsman).
§ Tim LoughtonTo ask the Secretary of State for Health how many members of the British armed forces who served in the last Gulf war were subsequently diagnosed with mental health problems. [101081]
§ Jacqui Smith[holding answer 6 March 2003]Primary health care records for the 53,000 or so veterans of the 1990–91 Gulf Conflict are held by their doctors and are not accessible centrally for reasons of patient confidentiality.
§ Tim LoughtonTo ask the Secretary of State for Health what action he is taking to ensure the NHS can cope with increase in demand for specialist mental health services as a result of forthcoming military action in the Gulf. [101082]
§ Jacqui Smith[holding answer 6 March 2003]Contingency planning between the Department of Health, Ministry of Defence and the national health service is ongoing. The Ministry of Defence has one specialist hospital and about 15 community units providing mental health services for military personnel and hence has the capacity to meet the needs of service personnel who develop mental illness. We will use the operational flexibility we have in the system to make sure that NHS mental health services can also be made available.
§ Tim LoughtonTo ask the Secretary of State for Health if he will set up a system of specialist mental health services for returning service men and women along the lines of that in the US. [101085]
§ Jacqui Smith[holding answer 6 March 2003]Returning service men and women will still be in-service and therefore the responsibility of the Defence Medical Services. The Ministry of Defence has one specialised hospital and around 15 community units providing mental health services for military personnel. The operational flexibility we have in the system can also be used to ensure that national health service mental health services are made available.
345W
§ Mr. BurstowTo ask the Secretary of State for Health what steps his Department has taken to ensure appropriate arrangements are made to handle the transition between(a) children and adolescent and adult mental health services and (b) adult and older people mental health services. [96636]
§ Jacqui SmithEnsuring a smooth transition for people as they move from child and adolescent mental health services (CAMHS) to adult services, and from adult to older people's services has been a priority in the modernisation of mental health services.
Progress has been monitored in the last two years' annual local implementation plan process. The self-report from the 162 local implementation teams nationally has shown a steady increase in those who rated themselves as having adequate and effective transition protocols.
The transition from CAMHS to adult services is currently being considered by the CAMHS module of the children's national service framework (NSF) who will make recommendations in their report.
A key element of the NSF for older people is the need for all localities to have plans for the assessment and integration of mental health services. The implementation of the single assessment process and the care programme approach guidance will ensure that care planning in the transition between the services is smooth.