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Mental Health Bill [HL]

It is entirely understandable that noble Lords have raised the question of how services are, essentially, to be regulated, because a statutory scheme would amount to regulation—that is what this is about—where ECT is given to patients who are under compulsion. Clearly, given the concerns about the administration of ECT, it is important that there is a safeguard and that the public and patients can be given assurances that ECT will only be administered in the most appropriate way. I fully understand the comments that have been made. However, we have in the current arrangements an appropriate way of ensuring that services are provided effectively. I agree, however, that, if there is a problem in that some facilities are not applying for the voluntary accreditation scheme, there is an issue about how those organisations can be encouraged to do so. Mental health providers, including those providing ECT treatment, are regulated by the Healthcare Commission, which is responsible for regulating the facilities in line with the standards for health service providers set by the Department of Health. That regulation, which has been part of the reforms that the Government have brought to the House over the past seven, eight or nine years, is about ensuring patient confidence as well as ensuring the quality of services. I pay tribute to the Royal College of Psychiatrists, which, in 2003, established the voluntary accreditation scheme to which the noble Earl, Lord Howe, referred, the ECT Accreditation Service. It is open to all clinics and hospitals in the UK and Ireland where ECT is administered. Participating clinics undergo a process of self-review and an external peer review over a period of six to nine months. The results are considered by the ECTAS accreditation advisory committee, which recommends a rating to the college’s court of electors. The scheme provides an assessment of the clinic against standards and, through feedback and advice, seeks to help clinics continuously improve while disseminating best practice throughout the sector. The Healthcare Commission values the information that comes out of the process, and it often forms part of its screening process for providers that have taken part in the scheme. Much information comes out of the college’s other accreditation scheme for acute in-patient mental health services or the reviews undertaken through the quality network for in-patient child and adolescent mental health services that also helps the commission in the process of assessing mental health service providers. Noble Lords will also know that the Government recently published a consultation, The future regulation of health and adult social care in England. It seeks to ensure that we have a proportionate system of regulation. In that context, I believe that we have the best of both worlds. We have statutory regulation through the Healthcare Commission and the voluntary accreditation scheme run by the Royal College of Psychiatrists. I would not want to change that balance, because it is the best type of balance. Providers are encouraged as much as possible to do the right thing by bodies that are concerned with the area under consideration, with the Healthcare Commission being responsible in law for the overall regulation of healthcare providers. We have a situation in which not all providers of services are voluntarily accredited through the royal college scheme. By its very nature, it is a voluntary scheme; therefore it would not be appropriate for the Government to dictate to individual providers that they should voluntarily subscribe to the scheme. However, I accept that it would be in everyone’s interest if all providers took advantage of the accreditation scheme, and I am willing to institute discussions between my officials and the royal college to see what could be done to encourage providers that do not take part in the accreditation scheme to do so.