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Lord Addington: Once again I rise briefly to support this amendment. To have a clinically well recognised illness which is not defined creates all the terms of confusion to which the Minister referred in relation to earlier amendments. There is no definition of a well recognised illness. It is well known that if five professional people are asked their opinion, there will be at least six different answers. I suggest that considerable problems may be caused. Moreover, when does a new development become well recognised? That is another problem.

The amendment goes back to an earlier definition brought forward by the Government in another piece of legislation. It refers back to what the Government know and have dealt with. Surely the amendment is an acceptable step forward.

Lord Campbell of Croy: Perhaps I may add a few words to the debate. I have had long experience of mental illnesses. I understand my noble friend's difficulties in trying to make sure that a lot of cases do not go to tribunals and courts. This is a very difficult area for someone who, after the Bill has been enacted, complains that he or she has been badly treated.

The words used in the Bill are "a clinically well recognised illness". In my experience, on many occasions, even now with all the advances that have been made in the past 30 or 40 years, it may be quite clear that somebody has a mental illness but it is difficult to diagnose. Is it schizophrenia? Is it some other form of illness which has similar effects and symptoms? That is my one query: somebody may clearly be suffering from a mental illness but the doctors may not for months be able to say exactly which illness it is.

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Lord Ashley of Stoke: One of the problems is that the definition of mental impairment leaves unprotected the very people whom we ought to be protecting: people with learning difficulties or personality disorders and those who are brain damaged.

The Minister argues in the Bill that only clinically well recognised problems should be included. He gives the impression that he has been advised by junior hospital doctors who are concerned with broken legs and other simple problems. Psychiatry is not like that. It is a very young science in a very complex area. It is a little like talking to economists: every economist has a different opinion. Practically every psychiatrist has a different opinion about a given disorder or whatever. I do not feel that one can insist, as the Minister insists, that one is only concerned with clinically well recognised problems.

The provisions are narrow and inadequate. They are very restrictive. I am surprised that the Minister lends his name to them. I know that he recognises the need to go as wide as possible. The provisions give a sense of injustice to people who are mentally ill and certainly a sense of injustice to those campaigning for them.

Members of this Chamber have been advised by some splendid organisations and have been sent wonderful briefs. I have in mind organisations such as RADAR and the Disability Alliance. The excellent briefing on this issue from MIND assures us that it makes no sense to abandon the perfectly good definition in the Mental Health Act. I see no argument against that. That definition, as I am sure the Minister is well aware, is comprehensive, is used by medical practitioners and is fair. So we could not ask for more. We ought to depend on that well established definition.

My noble friend referred to the comment made by the Minister in another place, which, I must say, took me aback. He said that it is no function of the Bill to cover "moods and mild eccentricities". We should challenge the noble Lord the Minister to say whether or not he agrees with that incredible comment. The Minister in another place is a caring person who has worked hard on the Bill. I hope that he will agree to some improvements. I do not want to criticise him personally. But I believe that the Minister in this Chamber ought to say whether or not he agrees with that irrelevant and misleading comment.

The final point I wish to make is this. Mentally ill people are in desperate need of protection, and protection from this Bill. They suffer more discrimination than people in wheelchairs and those who are blind, because the latter are understood and their problems recognised. But the problems of those who are mentally ill are not. However, where they are recognised, people feel embarrassed and uncomfortable. Therefore, they are given a low priority. People are frightened of mental illness. This fear, prejudice and embarrassment leads simply to inadequate resources. If Ministers today—and certainly at Report stage—refuse to give proper protection to mentally ill people, they themselves are guilty of discrimination. I hope that the Minister will be able to take on board these amendments.

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4.30 p.m.

Baroness Gardner of Parkes: I do not follow the line which has just been put, although I found it an interesting one. The fact that one is not being asked to give a named mental illness suggests that the terminology is sufficiently wide to enable everything under psychiatric treatment to be covered. I read the MIND definition on the orange paper which is splendidly clear and easy to follow. It says that the term is not defined. I would have thought that "clinically well-recognised illness" would have covered all these conditions. I should like the Minister to make clear to me that the "mental impairment" referred to covers congenital mental defects like cerebral palsy or Down's syndrome or anything of that kind, and that "mental illness" is the only clinical point we are discussing at the present time. I believe that the present wording is all right.

Lord Mackay of Ardbrecknish: Perhaps I may begin by agreeing with the noble Lord, Lord Carter, when he reminded us that there is a good deal more to this Bill than just discrimination in employment. We should remember that. Indeed, I suspect that we shall be coming to that in more detail later on. The noble Lord, Lord Ashley, indicated that this was a very difficult field as indeed it is. Perhaps I may say a few words about our approach to the coverage of mental illness. I should also like to underline that "mental impairments", including learning disabilities, and so on, which are not mental illnesses, are covered as set out in Clause 1. We see no need for particular reference to such mental impairment in this schedule. We are now dealing only with the mental illness part of the issue.

We are clear that a recognised mental illness which has substantial and long-term effects on day-to-day activities should be within the scope of the Bill. People who have such illnesses are disabled in any commonsense use of the term. That would include, for example, schizophrenia, manic depression and severe and extended depressive psychosis. It would also include a range of other conditions well recognised by clinicians, both psychiatrists and psychologists, who practise in this field.

But as my right honourable friend William Hague said in another place—and this has already been quoted—we are clear that it is no function of the Bill to cover mild eccentricities, moods, etc. as constituting disability. I mentioned earlier on in previous debates that shyness, stubbornness, etc., also lie outside the scope.

The point being made by my right honourable friend in the other place was this. These symptoms, if I may call them that, could be claimed to come from a mental illness in the case of someone who either does not get a job and wants to find a reason for not getting it; or decides not to turn up at work when he already has a job, or does not agree to do a particular part of it. Service providers and employers could well be taken to court in those circumstances. That is why we have tried to make it clear. We do not want to open up and widen discussion to the possibility of claims based on obscure conditions which, as we say, are unrecognised by reputable clinicians.

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I know that there are many Members of this Committee who are interested in the world of science and medicine. They will be aware that there always seems to be someone in the world, with fairly impeccable credentials on the face of it, who comes up with some of the most amazing theories in the world of science. Is it not amazing how often we find that somebody attaches themselves to it and begins bombarding Ministers, Members of Parliament and Members of your Lordships' House, with closely argued letters, all based on the views of perhaps one clinician—dare I say it?—in some obscure American university? That seems to be the favourite stomping ground of some of them.

For these reasons, we want to make sure that in this Bill we are dealing with mental illnesses which are clinically well recognised. I take the point that perhaps we do not have the tightest definition we should like, or certainly that I should like. It is not an easy field, but a difficult one. I believe that the words we have chosen will encompass all the types of people and conditions that we want to help.

In dealing with physical impairment, I am confident that we can rely on the reference in Clause 1 to the,

    "ability to carry out normal day-to-day activities"

to ensure that minor impairments, which do not amount to disabilities, are not covered by the Bill. The relationship of mental illnesses with the ability to carry out day-to-day activities, is a more difficult relationship to set down. We shall be debating it in connection with a later amendment.

I believe that we need a further provision to make it clear that the Bill does not cover unrecognised conditions of the kind which I have mentioned. That is the purpose of Schedule 1, paragraph 1(1) of the Bill as regards which the noble Lord's amendment seeks to take out words including, "clinically well-recognised".

The other part of the noble Lord's proposal is to link the definition of mental illness or mental disorder in this Bill to the definition in the Mental Health Act 1983. I do not believe that that is helpful. The definition in that Act is as follows:

    "Mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind".

That definition appears to fall within the wide coverage of our term "mental impairment". The area of difference lies in alleged mental illnesses which have not achieved adequate clinical recognition. I believe that I have already explained the reasons why we feel that they should be excluded.

A further difficulty as regards this amendment is the specific reference to the term "psychopathic disorder" in the Mental Health Act definition. We made it clear in the other place that we intend to use the regulation-making powers to exclude psychopathic and other personality disorders from coverage in the Bill. I do not believe that it is in the public interest to protect people with psychopathic disorders from discrimination. It would bring the Bill into disrepute and cause employers and service providers great concern.

Perhaps I may reiterate our overall purpose. As I said, we do not intend to include in the Bill obscure conditions which are unrecognised by reputable

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clinicians. It seems likely that the only additional illnesses brought in by the Mental Health Act definition would be those which are not so recognised. That apart, our intention is that "mental impairment" shall be widely construed. We believe that we have achieved that.

I hope that that assures the noble Lord. I do not believe that there is too much between us although it may look as though there is quite a lot when one looks at the paper. I hope that the noble Lord will accept my reassurances as to why we believe these words are necessary and that it would not be wise to take on board the definition in the Mental Health Act.

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