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Health and Social Care Bill

moved Amendment No. 94: 94: Clause 48, page 24, line 31, at end insert— ““( ) The Commission shall in its annual report demonstrate that visits to relevant patients under section 120 of the MHA are sufficiently regular to fulfil the Commission’s duty to ensure that the rights and welfare of those patients are safeguarded and promoted.”” The noble Baroness said: We return to concerns that have been expressed by the Mental Health Act Commission and I am joined in these amendments by the noble Lord, Lord Patel of Bradford, who is unable to be here. These exploratory amendments seek reassurance about how the CQC will discharge its special functions in relation to detained provisions. Amendments Nos. 94 and 96 would insert a requirement for visiting and interviewing patients in private, as required in Schedule 3, to be carried out sufficiently regularly to ensure that patients’ rights and welfare ““are safeguarded and promoted””. Amendment No. 97 imposes a requirement that those who do specific visiting in relation to the implementation of the Mental Health Act, and undertake a review of those powers in relation to individuals, should have special training and expertise in doing so. I want to stress that particular point—that the Mental Health Act Commission is, as noble Lords know from previous debates, very supportive of service users and carers for service users being involved in general visiting and inspecting of individuals’ welfare. However, when it comes to visiting in private, expertise is required. It is not always easy to recruit that expertise; when the Mental Health Act Commission was first established, it was actually quite difficult to persuade doctors and lawyers that they should be involved in this work. It was difficult to get the quality of person involved in this day-to-day commissioner type of work. Amendment No. 95 introduces a new category of patients to those who must receive regular visits from the commission. These patients are detained under the Mental Capacity Act, so dear to the hearts of those who sat through the ““Bournewood Gap”” debates in the Mental Health (Amendment) Act 1994. This would give rights under the new commission to visit this group of patients. Infringements of the liberty of these patients under the current proposals for their detention mean that they must fall within the optional protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, to which the Government have signed up. The 2006 protocol establishes the international inspection system for places of detention. The protocol’s objective is to establish a system of regular visits undertaken by independent international and national bodies to places where people are deprived of their liberty. Article 1 describes the importance of preventive visiting. Those detained under the Mental Capacity Act who lose their liberty fall clearly within its remit. It is not sufficient to leave vague in the schedules what degree of visiting is to be undertaken or what regularity must be achieved. This is frankly an area which light-touch regulation will do nothing to assist. It is possible to collect a mammoth amount of information and lots of data. We know well, for example, that self-reported standards reported to the Healthcare Commission about dignity and hospitals and so on are often fictitious and do not relate clearly to what is really happening on the ground. It is simply not possible to risk that with patients detained under the Mental Capacity Act or the Mental Health Act. You need to have trained specialists and not to leave this to the whim of the future CQC. Whatever degree of importance they give this task at the beginning, we need it established in the Bill that mental health wards are not like other wards and that people in them are at greater risk. We know that these wards are often very tough, violent places, with excessive noise, fear and sexual abuse. Poor ventilation, cramped conditions and a dirty environment often add to the problems. A lot of the wards are run at 100 per cent occupancy—the least risk, of course, being that someone will leave. I do not want to leave to chance the regularity and style of the visiting activity. We need to be clear about how we discharge functions of protection under the Mental Capacity Act for new Bournewood patients. I beg to move.