Mental Health Bill [HL]

I spoke during the proceedings on the Mental Capacity Bill when it was before your Lordships’ House. I have attended each of the Committee days, waiting for the opportunity to give my strong support to my noble friend Lady Knight. I do so as someone who is in no sense an expert although my record on feeling strongly about these issues is as long as your Lordships’ arms combined. I will not repeat what my noble friend has said, except that she is absolutely right. There must be a profound respect for life, especially at a time when human life is at its most vulnerable—perhaps involving mental and physical health problems at the same time, which we must take into account. It must surely follow that any patient should receive adequate food and drink, subject to the provisos of my noble friend’s amendments. She may, of course, be considering amending her own amendments in due course, in the matter of anorexia and other issues, to make the amendments that she is moving acceptable to the Committee. Perhaps the Minister will help us on that. I say all that by way of introduction—I have only two points that I wish to make. First, I wish to stress the importance of the very new United Nations Convention on the Rights of Persons with Disabilities. This was accepted by the United Nations General Assembly only on 13 December 2006. Article 25 of the convention specifically concerns health. Paragraph (f) of that adopted convention forbids: "““Discriminatory denial of health care, or health services, or food and fluids, on the basis of disability””." By its own definition, this of course includes mental disability or cognitive disabilities of any sort. I hope that I am right in presuming that the United Kingdom will be, if it is not already, a state party to this very important convention. Before we return to this issue later in the Bill, perhaps the Minister would very kindly do three things, either in his wind-up, or in a letter—it might be more convenient for him place a copy of the letter to me in the Library of the House. First, will he confirm that we either are, or intend to become, a state party to this extremely important convention? Secondly, will he give us a timetable—or at least an outline timetable—for the adoption of this convention? Thirdly, will he explain to me and noble Lords how he, his ministry and NHS professionals will abide by this very recent convention, which has not perhaps received the attention it deserved in the media because of the Christmas period between then and now? My second point is to raise, in the context of this amendment, the growing fears among some, to which my noble friend Lady Knight has already alluded in graphic terms in her admirable and very disturbing speech—I hope and suspect that they are generally unfounded—that there might be a risk of those with mental and physical problems, unwillingly or unwittingly being starved and/or dehydrated to death in NHS hospitals. I will not repeat what my noble friend and other noble Lords said about this very important issue. Some professional observers working in the service have, since Christmas, represented to me that to them the principle of saving life in the NHS is sometimes—not often—being subordinated to subjective judgments on the questions of so-called quality of life. That quality of life is all too often measured by what seems to me and to those professionals to be the wrong standards; that is, that of the mentally and physically fit and able, rather than people in their own terms. I hope that that is generally wrong, but there is a bit of evidence for it. There is even more evidence that people are fearful, and that therefore it does become a reality, which I suspect the Minister and his colleagues will have to deal with. I see a growing paradox in the fact that for many years now, people were very glad to carry organ donor cards in order to give; yet now I am told that there is a growing grassroots movement, in which some people are being given, and wish to carry, what I can only term in shorthand ““self-protection cards””. Should they go into hospital, they will attest through that card that they do not wish to be dehydrated and/or not fed. I have not seen these cards, but I am told that there is a growing movement to promote them around the United Kingdom. My noble friend Lady Knight, with her acuity and speed, has handed me one. It is orange, and therefore it is an all-party card. I will read to the House from it. I never used to get this service in another place from my noble friend. I thought that I was her Parliamentary Private Secretary this afternoon, not the other way around. The human rights care card states: "““I direct any person who has care of me at any time to uphold and protect my right to life as guaranteed by Article 2 of the European Convention. Under no circumstances do I want food or fluid (howsoever delivered) to be withdrawn for the purpose—or a purpose—of hastening my death””." I have no present intention of dying, but I hope my noble friend will get me one of these cards, which is now hastening its way back to her. Perhaps the Minister has had the time to reflect on whether those cards have any force in law. Are they legally binding statements? If my present intention not to enter hospital turned out no longer to be true, and I had one of these cards and I was in hospital, is it a legally binding document? I wonder whether the Minister might be kind enough, having reflected on this issue, to draft a letter to me that can be placed in the House of Lords Library, giving a clear indication of whether the Government approve or disapprove of such cards. Perhaps the Government intend to introduce in parallel with the organ donor card a card such as the one that my noble friend Lady Knight has just drawn to the attention of the Chamber. I look forward very much to his reply in whichever form it comes, either orally this afternoon or by letter, or letters, later on. It is the first time that the noble Lord and I have debated in any place since he and I were rookie councillors in the old City of Oxford council chamber. The noble Lord, who I greatly admire, was a representative of what was then thought of as old Labour, just as I was a representative of what was then thought of as new Labour—