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Several hon. Members rose--

Mr. Speaker: Order. I remind hon. Members that one question only is to be put to the Secretary of State. Any hon. Members who have three questions will have to decide which one is the most important.

Mr. David Hinchliffe (Wakefield): I broadly welcome my right hon. Friend's statement. I have two points, rather than two questions, that I should like him to clarify.

First, there were distinctions between the recommendations of the expert committee on the reform of mental health law, and the contents of the Green Paper. Do those distinctions remain and, if so, why?

Secondly, will the Secretary of State expand on his point about the impact of human rights legislation on mental health law? I make this point because of the concern expressed by the Select Committee, when its members visited the special hospitals. We were told that 30 per cent. of the patients in Ashworth hospital could have been contained in lower-security institutions and, in some instances, in the community. We were also told that 60 per cent. of the women patients at Broadmoor could have been contained in the community under assertive outreach.

Mr. Milburn: My hon. Friend has been in politics for far too long; he knows the old trick of putting one item on the agenda with two more arising from it--we have all done that.

I am grateful to my hon. Friend for his broad welcome. On the Richardson committee, when he has an opportunity to study the proposals in the White Paper--I know that he will do so carefully--he will find that they are largely based on the committee's recommendations. I can give him that assurance.

On compliance with the European convention on human rights, my hon. Friend will be aware that the convention makes it clear that there is a right to liberty but that it is subject to express exceptions--one of which, in article 5(1)(e), is the lawful detention of persons of unsound mind. That is why we are convinced that the proposals are wholly compliant with the convention and with the Human Rights Act 1998.

My hon. Friend makes a good point about patients detained in special hospitals. Our estimate is rather lower than his; we think that about 60 patients are currently contained in the three special hospitals; they have gone through all the hoops with the Home Office and so on and could be released to a lesser form of secure intervention. We need to make more progress on that matter; we certainly need to make more progress for women patients in the hospitals. The additional investment that we are making in secure beds and other facilities will help us to do just that.

Mr. Nick Harvey (North Devon): I, too, welcome the statement and the Government's plans to amend the law. I also welcome the fact that, from a civil liberties point of view, some of the objections to the earlier proposals seem to have been met. Certainly, the wide entitlement to go to tribunal and the provision of independent advocacy should be a significant improvement.

We have not heard much about resources, however. The Secretary of State acknowledged in his statement that mental health services have been the Cinderella of the

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health service. He pointed out that some progress is being made in that regard, but is not there still a serious shortage both of psychiatrists and psychiatric nurses? If the improvements in the service envisaged in the White Paper both in secure settings and in the community are to come about, further progress will be needed--in particular, much more recruitment will be needed.

On severe personality disorders, what criteria will be used to have people considered in the first place? Will such consideration be based on a pattern of previous behaviour, or is that not to be taken into account? The Royal College of Psychiatrists points out:


What is the Secretary of State's response to that point? What approach will be taken towards people who have no previous record or pattern of behaviour, but may nevertheless fit the criteria that the Government are considering?

Mr. Milburn: I am grateful to the hon. Gentleman for his broad welcome for the proposals. He is right to point out that there are significant safeguards to deal with some of the reasonable civil liberties arguments. As I said in my statement, to take away someone's civil liberties without consent is a serious step, so it is important that safeguards are in place. The tribunal and the fact that it will regularly review the compulsory treatment order will be extremely important.

For the information of the House, I shall explain how that will work. The assessment period for someone who could be subject to compulsory treatment will take up to 28 days. After 28 days, the tribunal will meet and will take evidence from various parties--including the patient's clinical team, but also external second opinions. It will be able to make an order, in the first instance, for up to six months; then for a second period of up to six months; and after that, for periods of up to 12 months. In each of those periods, patients and their representative will be able to call for a review of that decision and they will receive a fair hearing. Those are significant safeguards to deal with the issues.

On staffing--yes, there are shortages of psychiatrists, community psychiatric nurses and other nurses in the psychiatric profession. We are making progress, however. Over the past couple of years, an extra 350 consultant psychiatrists have been working in the NHS; and 2,000 more nurses are working in mental health services in the NHS. By 2005, I expect that--from the position that we inherited--there will be a 60 per cent. increase in the number of consultant psychiatrists working in the NHS, because of the extra training places and the resources that we are making available.

As for admitting someone with a severe personality disorder, the best test of dangerousness is likely to be offending behaviour and a pattern of offending behaviour. However, there will need to be other tests, too, because we know from our constituency experiences that although there will be people out there who have offended in the past, they may not have come to the official notice of the criminal justice organisations. We must have the means

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of properly and precisely assessing those people for their dangerousness and for the risks that they pose to others in society.

Mr. Robin Corbett (Birmingham, Erdington): In welcoming my right hon. Friend's proposals, I thank him for the attention that he has paid to the Home Affairs Committee report on the issue of dangerous people with a severe personality disorder. Will he please clarify that when people are assessed, they will be held in specially built separate units?

Mr. Milburn: Yes. As the Chairman of the Home Affairs Committee, I think that my hon. Friend will be pleased with the White Paper because, in large part, it reflects what his Select Committee said--I believe unanimously--about the issue of dangerous people with a severe personality disorder. I can confirm to him absolutely that we will ensure that people with severe personality disorders will be treated and cared for in specialist units in precisely the way that he describes.

Mrs. Virginia Bottomley (South-West Surrey): May I congratulate the right hon. Gentleman on a very much more enlightened policy than that advocated by his predecessor and the Home Secretary when they last spoke in a really shockingly authoritarian manner on these matters? May I also commend Genevra Richardson again for her extremely impressive report?

In the light of the endless examples of relatives, parents and carers who feel that their calls were not heard when they knew that their close relatives were deteriorating and that professionals would not heed their advice, will the right hon. Gentleman repeat what more he will do to ensure that those people have a voice? In that light, has he recently spoken to Marjorie Wallace? At SANE, she has been a constant thorn in the flesh of Ministers of all political parties, but the funding for SANELINE is seriously at risk, as I understand it, and it would be a great tragedy if that service could not continue.

Mr. Milburn: As I understand it, we have recently made available £300,000 to SANE and we are looking at future funding. Yes, Marjorie Wallace does an extremely good job for that organisation and she has a very warm relationship with both the Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), and the Minister of State, Home Office, my right hon. Friend the Member for Brent, South (Mr. Boateng).

I do not know whether the right hon. Lady was trying to be helpful when she described me as less authoritarian than the Home Secretary; I shall have to think about that.

As for the serious point about carers, the right hon. Lady knows, as does the whole House, that carers do a brilliant job in very difficult circumstances indeed, particularly when caring for those with a severe mental illness. They are often on the receiving end of a great deal of stick from their charges, who are not easy people. Those carers do a first-class job. The White Paper contains a number of provisions to make their lives easier, I hope. In particular, I hope that the right hon. Lady will be pleased that we are now proposing that when a carer of a person with a mental illness is worried, he or she will be able to refer his or her charge to the mental health trust

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for assessment. I very much hope that that will help relieve some of the burdens that carers face day in, day out in every community.


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