My Lords, the Minister has rightly been recognised for his commitment to the Bill and his work with all of your Lordships to improve what came to your Lordships’ House. It was not, in that sense, his Bill; he inherited it. He has worked hard with us, as has his colleague, to make things better.
I still find myself a little heavy hearted about the Bill, however. A few days ago, a substantial document dropped through my letter-box with a covering letter from Professor Roy McClelland, who is now chairing the Bamford review of mental health and learning disability services in Northern Ireland. That document was a volume of legislative proposals for Northern Ireland. From the beginning, it set out that mental health legislation should be based on fundamental principles, particularly those of the protection of the human rights of the whole community, but particularly those who were to be held and treated under compulsion.
That review, in the Northern Ireland context, brought together a wider range of people, patients, carers, professionals and officials than had ever been done. It mirrored what we have heard when NGOs, carers, people involved in healthcare and patients and their families have expressed their views: they want the legislation to be based on fundamental principles. The Minister will undoubtedly say that it is. Well, perhaps, but reading through this I had the impression that if the officials who had put the material together had been advising the Almighty when he was looking down on Sinai, Moses might have come down with something saying, ““The high priest will address questions like murder, theft, respect for the Sabbath and for one’s parents, but only in the context of what is efficient and potentially effective””. I do not think that the right reverend Prelates would be espousing their faith and convictions with quite the passion they do if that had been before them.
I ask myself why the Government have been so adamant that the principles should not be in the Bill, clear and irrefutable. It is said that it is for legal reasons. Lawyers make good servants but bad masters. When I listen to what my noble friend Lord Carlile has said—and I am sorry that he is unable to be with us today—I am affirmed in my view that there is something rather more to it. In this, the noble Lord, Lord Soley, has, as ever, been deeply helpful to the House. He has pointed up the real reasons why the principles cannot be put in the Bill. One reason is that a fundamental principle is an attention to the concern of constituency MPs about the problem of the complaints they receive about difficult people. That is one of the fundamental principles that underlie the Bill. Secondly, one of the reasons for putting these matters in a code of practice in a slightly indefinite way is that it makes them non-justiciable if someone challenges them—here the Minister may be able to put my mind at rest and tell me that I am wrong. The noble Lord, Lord Soley, said that we do not want them challenged because it is very expensive for the NHS. It is, and it is just as expensive for any poor patient, family or carer to confront the courts, but they do not have the resources. One of the things this House is here to do is to protect those who do not have resources or power against those who do, and sometimes that is government. If that is why these matters are not in the Bill, it is not satisfactory and does not give me great comfort.
Singularly in the field of healthcare, this legislation is about compulsion. It is about compelling patients to be where they do not want to be and to take treatment they do not want to take in a context that they do not like. It is also about compelling healthcare workers to do things they must not want to do. Why do I say that? I say it because the Minister made it clear at an earlier stage in the Bill. When I observed that much of the care required by people with disturbed personalities was unavailable because of resources issue, the Minister was at pains to point out that it was a matter of compelling and pressing healthcare workers, particularly psychiatrists, to treat people who they were saying were not treatable. Many psychiatrists will find that difficult to take. It is a serious accusation that, effectively, they have another agenda rather than a commitment to the care of their patients. I do not believe that that is true in the majority of cases. Compulsion as regards carers, those giving treatment and the patients must be taken extremely seriously. I entirely accept and support any compulsion on psychiatrists and others to ensure that they observe the rights of black and minority-ethnic community patients and, indeed, the rights of patients as a whole, but that is not what is being proposed.
I said earlier that I still have a somewhat heavy heart. The Bill is better than before and better than nothing, and we can be grateful for the thoughtful, courteous and respectful way in which Ministers in this House have dealt with genuine concerns and with the material before us. I hope that they have more influence than us to persuade their colleagues in another place to adopt the same approach so that the advances that have been made in the Bill, which are genuine improvements, are maintained and built upon rather than taken to pieces.
Mental Health Bill [HL]
Proceeding contribution from
Lord Alderdice
(Liberal Democrat)
in the House of Lords on Tuesday, 6 March 2007.
It occurred during Debate on bills on Mental Health Bill [HL].
Type
Proceeding contribution
Reference
690 c127-9 
Session
2006-07
Chamber / Committee
House of Lords chamber
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2023-12-15 11:58:10 +0000
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