Mental Health Bill [HL]

moved, as an amendment to the Motion that this House do agree with the Commons in their Amendment No. 1, at end insert ““and do propose the following consequential amendment to the Bill: 1A: Page 5, line 8, at end insert- ““(aa) respect for diversity generally including, in particular, diversity of religion, culture and sexual orientation (within the meaning of section 35 of the Equality Act 2006),”” The noble Baroness said: My Lords, the Minister began by talking about how the debates in this House had had a great influence on the debates that subsequently followed in another place. That is true. However, this amendment and several of those that will follow this afternoon reflect the fact that there remains between the two Houses and between the Government and the whole of the Opposition some fundamental disagreement about the legislation’s purpose and application. To go back to arguments held in this House and another place recently about principles in mental health legislation and about exclusions, we still believe that overall the Bill significantly changes the balance of the Mental Health Act 1983 away from the rights and protection of patients, which we believe are in the interests of public safety, towards giving greater power towards clinicians. The amendment moved at an earlier stage by the noble Earl, Lord Howe, was an attempt to clarify again the purpose of mental health legislation. With that amendment and with this one we were following statements made by Professor Genevra Richardson’s expert committee and by the Mental Health Act Commission 2004, which said that, "““for the law to be of value—to patients, State administrators, mental health professionals, the police, the courts or the Tribunal—its meaning cannot rest upon the discretion of those working within its framework. We do not find it difficult to envisage the inappropriate use, however well meant, of mental health legislation for non-medical purposes of social control””." That has been the concern at the heart of the debates. The debates in this House were more to the point than those in another place. I must confess that I found the debates on these matters in another place at times almost distressing. The flippancy with which some Members of another place addressed the underlying issues was not edifying. The Minister was right to pay tribute to those of us in this House who, albeit sometimes in inelegant ways, have attempted to find a way to give expression to the principles to which we subscribe not only in this House and in legislation, but which are commonly held throughout society. It remains a concern to me that there has been so much resistance from a very small section of the mental health profession who feel unable to subscribe to a set of standards that are now common in practically every area of life. Commercial companies now have long lists of equality statements. Every public authority has a list of duties. I do not understand why this should cause such turmoil to some members of the psychiatric profession. We have had some rather spurious arguments during our debates. Why it should prove to be impossible—the word that has been used—for parliamentary counsel to draft a list of exclusions for this Parliament is difficult to understand. We have quoted exemplary legislation from around the world—from Scotland, New South Wales, Victoria and New Zealand—in which there are list of exclusions that go with definitions of mental health. They are clearly understood and have not posed the major problems that might enable a legal challenge by people who wish to evade compulsory detention, as the Government suggested might happen. Inevitably, at this stage of a Bill, we arrive at a point where principle goes against the tough daylight of pragmatism. I say that in order to explain to the many people outside, who have followed our debates with great intensity and great care, why those of us who believe this to be a matter of such importance will now sign up to something which we acknowledge is less than satisfactory, which it is. We believe that we will be making a statement, which, as the Minister said, may be declaratory, about what mental health legislation should be in our society now and that society should treat with decency and dignity people whose behaviour is different and, sometimes, difficult and challenging. The amendment standing in my name, which I understand has support from around the House, is important, but it is not perfect. For example, it does not deal with the matters raised by the Government at the beginning of the passage of the Bill about paraphilia; nor does it deal with the important issue of belief. In this day and age, how people choose to express their beliefs is becoming increasingly important for society and for mental health professionals. We already have people detained under mental health legislation, at least in part because of their beliefs. I believe that it is important for us to state that there will be exclusions for people on the basis of their religious beliefs and sexual orientation. Why? This country remains part of the tradition of modernisation of mental health legislation. We led the way and we continue to have a part to play in setting standards for ourselves. These are recognised around the world and, for the past 100 years or so, have changed how people with mental health problems have been viewed and how their rights have been extended. Some of the debates in another place were disappointing in that they were conducted by people who had clearly forgotten some of the many abuses in the mental health services in this country, where there are still people who were subjected in the past to wrongful application of compulsory mental health treatment. I meet some of them in the course of my work and, although they are now very old, one does not have to be a professional to see the long and lingering damage that a misapplication of mental health treatment can do to people just because they happen to be different. Imperfect though this amendment is, I believe that it is important not only as a declaratory statement but in practice, if only to serve to say to mental health professionals that their judgment will continue to be subject to scrutiny. I say to the noble Lord, Lord Rix, as he disappears, that it was in part his early speeches in our debate about the lack of exclusion for people with learning disabilities that fired up those of us who kept going in the face of opposition from the Government. This is an imperfect amendment to a Bill that is certainly better than it was when it came to this House initially. The Bill is not the step forward for people with mental health problems that we all wanted, it is not the Bill that we needed and it will not be the legislation that we need, but I hope that by the end of today, with the addition of amendments like this, we will have clarified the situation for practitioners who in the future under this legislation are going to be far more accountable for their actions and decision-making than ever before. I hope that this House will yet again have proved that it serves a very important purpose in sticking up for those people who do not have a voice—in this case mental health patients. I beg to move. Moved, as an amendment to the Motion that the House do agree with the Commons in their Amendment No. 1, Amendment No. 1A.—(Baroness Barker.)