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Earl Haig: I thank my noble friend for that helpful reply and look forward to hearing at Report stage how she intends to plan the future. With those words, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 54 to 65 not moved.]

Clause 1 agreed to.

Lord Carter moved Amendment No. 66:


After Clause 1, insert the following new clause:

("After-care: housing")

. For the avoidance of doubt, a person to whom a duty is owed under section 117 of the Mental Health Act 1983 shall be deemed vulnerable as a result of mental illness under section 59(1) (c) of the Housing Act 1985 (Priority need for accommodation)").

The noble Lord said: The purpose of the amendment is entirely clear from its wording. It states:

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    "a person to whom a duty is owed under section 117 of the Mental Health Act 1983 shall be deemed vulnerable as a result of mental illness under section 59(1) (c) of the Housing Act 1985 (Priority need for accommodation)"

It seeks to ensure that a person who is subject to aftercare under supervision and any other person who has been detained for treatment under the Mental Health Act 1983 but is discharged, meets one of the qualifications for housing by the local housing authority.

We can all agree that there is a link between homelessness and mental illness in certain circumstances. We are not clear whether that is cause or effect but there is certainly a link. Some research indicates that many people are detained in hospital for longer than necessary because they do not have accommodation. The amendment places a duty on housing authorities, which may or may not be the same as the local social services authority, to provide accommodation for someone who has been detained in hospital.

The Government are slowly and reluctantly accepting the proposition which for most people is common sense; that is, that there is a link between social conditions and health, and stress is certainly a factor in this. Poor housing is related to poor health and mentally ill patients who are prone to stress will be further disadvantaged with poor housing, having to fight for accommodation or will be bed-blocked in hospital because of lack of accommodation.

For those reasons we felt that there should be a duty on the local authority to provide housing in that situation. We discussed earlier the right of the social services authority to refuse to accept a supervision discharge order. We agreed that it was not clear what would happen if the order was refused. It was recognised that housing, or the lack of it, may be a reason for such refusal.

For all those reasons we feel that the patients we are discussing are vulnerable in the true sense of the word and as a result there should be a duty on the housing authority to provide them with housing on their discharge. I beg to move.

The Earl of Mar and Kellie: I agree with the noble Lord, Lord Carter, that Amendment No. 66 would provide a useful buttress in establishing a successful community supervision order. It would clarify that this group of citizens are vulnerable and entitled to special care by housing authorities.

Baroness Cumberlege: The accommodation available to, or to be provided for, a mentally disordered patient leaving hospital must be a fundamental consideration in planning for his or her welfare and the aftercare services that are to be provided. Providing safe and secure accommodation is an essential part of caring for mentally ill people in the community. The Government are doing all they can to encourage local agencies to work together to provide this. But it must be for local agencies to determine the best use of the housing that is available. I think it would be wrong for the Government to stipulate that all people for whom the health and local authority has a duty under Section 117 to provide services must be treated as vulnerable

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under the Housing Act. That Act in Section 59(1) (c) says that those with mental illness are to be treated as priority cases. What this amendment seeks to do is to increase the scope of the provision by particular reference to aftercare under supervision.

Patients being discharged from detention or liability to detention will not all be vulnerable and will have differing needs. It must be for local agencies to determine what those needs are. I hope the noble Lord will not press the amendment.

7.15 p.m.

Baroness Farrington of Ribbleton: I find the response of the Minister astounding. The special meeting held stressed that we are dealing with an exceptionally vulnerable group of people. We are dealing with people to whom the noble Baroness referred in a previous answer as people who may need to be conveyed, against their will, to a place of training, education or residence. It is a group of people whom the Bill as it stands assumes need protecting at all stages.

Sadly, in my view, we are not dealing with an amendment that would make it a requirement that all those in desperate need of housing, for whatever cause, should get it. But the amendment deals with a particularly vulnerable group of people. It does not seem logical for the Minister to say that they are so vulnerable that it is necessary for someone to convey them to their residence to ensure that they are safe, yet it is not equally important to ensure that that residence is there, safe, suitable and provided as a matter of priority.

I was tempted, but it would be unforgiveable so close to the dinner break, to make the comment that some of the Minister's friends appear to be prepared, when it comes to other groups such as single parents, to interfere with local authority priority lists; but it would be inadvisable and unsuitable to raise that matter now.

Lord Carter: My noble friend put the case extremely well. If ever there was a predictable answer from the Minister, we certainly received it. We shall not leave the matter. It is important.

I take the Minister's point about being a little more specific. I should like to think about the matter, perhaps redraft the amendment and make the application rather more specific to define the vulnerability more closely. I take the point made by my noble friend that these are people who, above all, fit the definition of vulnerability. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 2 [Absence without leave]

Baroness Cumberlege moved Amendment No. 67:


Page 15, line 43, leave out ("or placed under guardianship by a guardianship order").

The noble Baroness said: This amendment is relatively minor and raises no issue of policy. It serves to correct an anomaly in the provisions relating to patients subject to guardianship who go absent without leave.

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Clause 2(3) provides for the return of patients who abscond to the Republic of Ireland after having gone absent without leave. As it stands, this applies both to patients subject to hospital orders and those subject to guardianship orders. Under Section 88 of the 1983 Act, however, patients subject to guardianship orders who go absent without leave may only be taken into custody within England and Wales. The effect of Clause 2(3), therefore, would be that patients subject to guardianship orders who went absent without leave could be taken into custody in the Republic of Ireland, but not if they abscond to Scotland, Northern Ireland, the Channel Islands or the Isle of Man.

The proposed amendment seeks to put matters on an even footing. It limits the effect of Clause 2(3) to those patients subject to hospital orders. Patients subject to guardianship orders who go absent without leave would remain liable to be taken into custody within England and Wales alone. I beg to move.

On Question, amendment agreed to.

Clause 2, as amended, agreed to.

Clause 3 [Leave of absence from hospital]:

Baroness Cumberlege moved Amendment No. 68:


Page 16, line 36, at end insert:
("(1A) In Schedule 1 to that Act (application of provisions to patients subject to hospital and guardianship orders), in Part II (patients subject to special restrictions), in paragraph 3(c) (modifications of section 17(5)), for the word "six" there shall be substituted "twelve".").

The noble Baroness said: In moving this amendment I wish to speak also to Amendment No. 69. These amendments introduce a new Section 1A which amends Schedule 1 to the 1983 Act. This will have the effect of enabling the responsible medical officer to recall a restricted patient—those who are subject to the Home Secretary's powers defined in Section 41 of the Act—from leave of absence at any time up to 12 months from the first day of his absence on leave. The Home Secretary will still be able to recall the patient at any time.

These are relatively minor amendments which raise no issues of policy. They serve to correct an oversight in the Bill whereby the provisions for leave of absence relating to restricted patients differ from those relating to unrestricted patients.

Clause 3 amends Section 17(5) of the 1983 Act to remove the limit of six months on the period for which leave of absence may be granted to detained patients in England and Wales. This will allow a longer period of rehabilitation—up to a maximum of 12 months—under the care of an RMO before a patient's liability to detention ends.

As it stands, the position of restricted patients is covered separately in paragraph 3(c) of Part II of Schedule 1 to the 1983 Act. In Schedule 1, however, the time limit of six months after which a patient cannot be recalled by the RMO remains. The proposed amendments bring the position of restricted and unrestricted patients into line by changing the maximum six-month period provided in the schedule to one of 12 months. I beg to move.

On Question, amendment agreed to.

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