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Mental Health Bill [HL]

I fully understand that. What I am trying to say is that such an amendment to the Bill would, by its very nature, have the effect of forcing the health service and local government to give absolute priority to those services. There would be no similar duty in other areas of the health service. That is my point. I shall mention the legislation that we believe covers the responsibilities. Under the National Health Service and Community Care Act 1990, it is already the case that a person who appears to a local authority to be in need of care services is to receive an assessment of that need. The Secretary of State already has a duty, in the National Health Service Act 1977, to promote a comprehensive health service designed to secure improvement in the physical and mental health of people and in the prevention and diagnosis of illness. There are similar provisions in relation to Wales. Those are significant and important duties. Moreover, a process of inspection and regulation has also been established. We have the Commission for Social Care Inspection and the Healthcare Commission. Wherever the needs of a person being assessed for community care services are such that an assessment is also required from a health professional, the local authority is required to request a contribution to their assessment from the appropriate NHS body and to take into account the health services that are to be provided as a result. There is a statutory responsibility for NHS and local authority bodies to co-operate. Under the existing arrangements, community care assessments already provide the elements that make up the definition of ““treatment and support”” in subsection (10) of the amendment in the name of the noble Baroness, Lady Wilkins. That is current good practice. Therefore, the legislation itself meets many of the objectives which noble Lords wish to see in generic provisions that apply to health and community care generally. Surely one should also acknowledge the huge improvement that has taken place in mental health services over the past few years. Of course it is not perfect and much more needs to be done, but surely we should acknowledge the enhancements such as the whole purpose of the National Service Framework for Mental Health and the guidance given to the health service. There has been extra investment. The noble Baroness, Lady Neuberger, has referred to early intervention teams, crisis resolution teams and assertive outreach teams. We face many more challenges, and we want to do everything we can to improve the performance of the mental health service. We want to ensure that patients know their rights and that the gaps in provision which noble Lords have mentioned will be met. However, given the existing statutory framework and the problem of singling out mental health provision as Amendment No. 55 suggests—for we see a real problem there—surely the emphasis has be on the work of the care commissions and on monitoring performance management. That government role goes hand-in-hand with the legislative changes we are proposing. We will do everything we can to ensure that the current improvements continue.