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Prisons: Healthcare

My Lords, I, too, congratulate the noble Lord, Lord Chan, for encouraging such a useful, informative debate. I am never sure whether being the last speaker is a gift or just plain bad luck. Today it seems like a blessing because I have almost lost my voice, and most of the points that I had intended to make have already been made by experts in the House. I will confine my words to an area of concern to the black community. It is no secret that the African Caribbean population is over-represented in the prison population. Many of those people are there because they have committed crimes of one sort or another, but others are there because they are ill. They are victims of mental illness. They suffer mostly from a form of mental illness commonly labelled as schizophrenia, which can, I am told, be treated. There is now documented evidence that some people function very well if treated and medication is taken in the right doses. It works best when the patient is supervised. We are all aware of the requirement for a case plan to be prepared for a person’s compulsory detention, which means that treatment is properly considered, recorded and available for scrutiny. No treatment under compulsion can be given—except in a real emergency—until a care plan has been prepared and is in the patient’s records for consultation. The care plan is expected to provide the legal authority for treatment and provides a visible record of such treatment for the patient and his or her representative. The clinical supervisor has a duty to consult with the patient and others in preparing the plan. What percentage of black patients on compulsory orders have a full care plan during internment and after discharge? I visited a volunteer-run home in Greenwich for mentally ill persons released from prison. The supervisor raised the following concern: none of the patients who came to him had a care plan; neither did they recall having one in place during the whole of their internment. That is most worrying. It leads to not only the patients but the family feeling that they are being treated less favourably than other patients.