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Mental Health Bill [HL]

I support the proposal of the noble Lord, Lord Warner, that the Government take this away, look at it, understand the strength of feeling about the principles, but do not go down the road suggested by some on all sides of the House. My first priority in a debate of this type is to ask myself, ““Will this be effective?””. At the moment my concern about the proposed list of principles, or anything like it, is that it would be ineffective and in certain circumstances it could be counterproductive. First, as people were half-recognising, some of the things in the list are practices not principles and it would be a job to make them stand up as principles in a court of law. Secondly—this is very important and needs to be taken into account by many on all sides of the legislature—a good code of practice can be much more effective in law at protecting people’s rights than principles in a Bill. There are one or two areas where we could get into severe difficulties, even if this list of principles were taken away to be rewritten. I would like to give an example, which is my last point but an important one. For many years I have taken the widely supported view that one of the main failings of the British mental health system has been the overrepresentation of certain ethnic-minority groups—most particularly, Afro-Caribbeans and Africans—among those receiving psychiatric treatment. That is mirrored by the singular lack of doctors and other people in key positions who are drawn from those communities. Yet we see in this list an attempt to put that into a principle, which it might need to be, but in a portmanteau way, linking it to a host of other things, including language. When I last checked, there were at least 170 or 180 languages spoken in London alone; I think there are well over 200 now. Many of those are spoken only by a small number of people. It is not just that if you had such principles in the Bill you would have to produce psychiatrists who spoke the language; you would also be expecting nurses or others in a hospital situation to deal with an individual, knowing that the principles of the Bill stated that they must take account of their language and treat them equally, even when they were unable to communicate effectively with them. Certainly, in many, many cases, they would not be able to get an interpreter or another person to speak that person’s language. If you list the principles, you have to be 100 per cent sure, and I mean 100 per cent sure—I say that particularly to the noble Lord, Lord Carlile, with his legal experience—that you can realistically deliver on them. If you cannot do so, it is not a matter of opening the floodgates to legal cases; it is that you have failed to be effective. In legislation such as this, we are trying to be effective. Either the list of principles must be very tightly drawn up and very well defined or you go down the road of a code of practice. If the Minister is minded to take up my noble friend Lord Warner’s suggestion, I ask him to come back to the House with some indication of how we, much more effectively than in the past, can address the racial imbalance in the British mental health system. It is profoundly serious and very significant, but it will not, in my judgment, be dealt with by putting a principle on the face of the Bill. This is about training, practice and a requirement for how health authorities and the various professionals and groups involved address the problem. Although one or two people have dismissed it, the suggestion made by my noble friend Lord Warner that the Government look at this again and come back to it is a good one. I do not see why the Government should have difficulty with the general principle, if you like, about what should be in the list of principles. There is every question about how effectively you will deliver on them. If you are going to go down that road, you have to be very clear about the principles; they must be very clearly spelled out, very brief and very easily interpreted by a court of law; otherwise, you will end up being totally ineffective on something that people feel quite strongly about.