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Mental Health Bill [HL]

I support the proposed new clause but do not want to reiterate too many of the arguments that have been advanced by the four previous speakers, almost all of which I agree with. I should add the disclaimer that I no longer pretend to have any serious neurological or psychiatric knowledge. The previous speaker was, of course, a very distinguished neurologist. I approach this subject more from a decision that I took in October 1975 to review the then mental health legislation. It was a long time until we eventually got the Mental Health Act 1983. I confess that I am not particularly proud of that Act. It has some quite serious deficiencies, and the Government can claim considerable credit for correcting many of those deficiencies in the Mental Capacity Act. In our debate on 8 January, the noble Lord, Lord Carlile, mentioned that the Mental Capacity Act was, "““a close cousin of that legislation””.—[Official Report, 8/1/07; col. 37.]" That is right. It is also a close cousin of this legislation as well as of the Children Act. We cannot pass the Bill without constantly reviewing the Mental Capacity Act. In some ways, it is a pity that it is not all included. Nevertheless, we now have to face the reality. We have to deal with this Bill as it is and try to make it as good as we can. The noble Baroness was slightly too gentle on the question of the Scottish law. Historically, social legislation in England and Wales has been greatly benefited by the fact that, on a number of occasions, the Scottish legislation has been in advance of us and we have learnt from it. I never forget taking the Children’s Act through Parliament in 1975 and finding how much we were influenced by the fact that Scottish legislation had already been there. I know that the argument may be used that we do not yet have enough experience there, but we do have experience. Scotland would not have legislated for this without very careful consultation with all aspects of the mental health services in Scotland, which are, on balance, better than those in England and Wales. We have to recognise that. That Scotland already has this provision is an almost overwhelming argument for accepting it. It would be absurd to pass this Bill, with the Mental Capacity Act in existence, and not grapple with this problem. The noble Earl, Lord Howe, succinctly drew the distinction between why it would probably not be right in this circumstance to invoke the exact terms of the Mental Capacity Act and why we should set a slightly lesser test. One has therefore to look at that in impaired decision-making. I am very much influenced by the noble Baroness, Lady Murphy, with her practical experience. She was right that it will not make a dramatic difference—it will obviously influence a few cases—but it will make a dramatic difference to how this legislation is seen. I listened to most of the debate on Monday. I had some sympathy with the Minister on principles. It is not an easy issue, because one is grafting principles on to an amendment and on to the 1983 Act, although I hope that he comes forward with some modification and some principles that are perhaps not so detailed. I understood his later arguments—in particular those which I missed but which I have read—as to why the Government were reluctant to do this, but I hope that we will not go through this legislation being told that we have to resist all amendments. This is not wonderful legislation. The Minister has a deserved reputation in this House for being an expert in mental health and as somebody who listens. I shall not belabour the point, because it usually means that one is trying to use this as an argument for one’s own. I would contemplate voting against the whole Bill if no changes are made to it. I was 26 years an MP. I know that what has driven this legislation is a great deal of dissatisfaction among individual MPs and a feeling of despair that the system simply cannot cope with some of these cases. Unfortunately, we are giving MPs the impression that this legislation will deal with this problem. It may or may not do so; it will be very much on the margin whether it does so. It will not distress me tremendously to see this Bill lost again. The Government should recognise that they have already lost Bills in this area and they could well lose this Bill. They will have to show a good deal of feeling and understanding for expert opinion. The Royal College of Psychiatrists deserves a serious hearing on this Bill. Where it has doubts and where it wants amendments, it should be listened to with great care. This is a crucial new clause to be added to the Mental Health Bill. If the Government were to reject it, I certainly would look much harder at the balance of the Bill as a whole. This Government of all Governments should have no reason to reject the clause. They are the sponsors and creators of the Mental Capacity Act. It is a perfectly logical extension of that Act that this clause should be in the Bill. I therefore urge the Minister to accept it and hope that he will do so. He may of course want to make drafting amendments, and I am sure that whoever has proposed the Bill would not mind that in any way. However, I look on this as a crucial issue. I say in response to all those headline stories which preceded this Bill and the public relations coup of having inquiries announced in the Sunday newspapers that we are in grave danger of kidding ourselves that the passage of this Bill will deal with this terrible problem in a community of a minority of people who cannot be coped with. There is out there—in the medical profession, particularly psychiatry—a real feeling that this is a Home Office driven Bill, which is intended to give the impression that it will solve a problem, when we all know in our heart of hearts that the problem is resources, the problem is the amount of time we can spend on these things and the problem is the problem. There may not always be solutions to this. We have to accept that in a community there will always be people who do not fit, who are very difficult to handle, and who, particularly as they grow up, become a tremendous burden on their parents. Members of Parliament get immensely frustrated—I have been one—but sometimes, however, you have to tell people that there is not always a solution to things. The danger of this legislation is that it is pretending to do things. There is too much pretence around in politics at the moment. I hope that this new clause is accepted.