Mental Health Bill [HL]

My Lords, I support the amendment moved by the noble Baroness, Lady Barker. Many in this House and the other place have spoken passionately and at great length about the inequalities that exist for certain minority ethnic groups in our mental health system; the Minister and the noble Earl, Lord Howe, have said the same. Regrettably, I cannot see what we have done in all our discussions and amendments to the Bill that will even begin to rectify or alleviate the situation. Despite our best efforts, there are no principles set out in the Bill, something that I and many others would have liked to see. That would have been one small step towards reassuring those in the black and minority ethnic communities, along with all those delivering mental health services, that we are serious about addressing these failings. Although the amendment before us falls far short of that, it is essential, as it will go some way towards ensuring that the Act is applied with due concern for non-discriminatory principles regarding religion, culture and sexual orientation, although the issue about belief is missing. I want to raise one specific issue to follow on from the noble Earl, Lord Howe. We are all aware that, under the Race Relations (Amendment) Act 2000, all proposed legislation on equality has to undergo a race equality impact assessment—a REIA—to pre-empt the possibility that the proposed policy could affect some racial groups unfavourably. While it is true that the Government have published an REIA on the Bill, we know from the published letter from the Commission for Racial Equality to the Department of Health that the CRE has consistently raised grave reservations about the adequacy of this assessment. The letter says: "““At each stage of the process of discussion between the Commission and the Department, the Commission has made the Department of Health aware of its concerns regarding the REIA and its potential impact upon the provisions of the Bill””." The commission identifies a number of these concerns, not least the wholesale absence of specific service data, the distinct lack of monitoring and the failure to address potential adverse impacts arising from changes to the Mental Health Act. The commission’s letter also says: "““The Commission’s considered view is that the Department has not adequately considered the impact of the proposals in line with the duty to have due regard to eliminate unlawful discrimination, promote equality of opportunity and good race relations””." It is true that Department of Health officials began a process of consultation on the REIA. However, due to a lack of time and, I believe, poor planning, this resulted in a number of major disagreements, not least about the process of consultation and engagement with black and minority ethnic communities and key agencies. In an attempt to resolve the situation and to move matters forward, the Department of Health established an advisory group, consisting of a number of eminent professionals, to advise on the final REIA. I was asked to chair that group, and I must declare that interest. Despite the lack of time, the group produced a series of important recommendations that, if taken into proper account in the final published REIA, would have gone a long way towards reassuring communities and services that the department was serious about addressing these issues. Suffice it to say that many of our views and recommendations—one of which was to establish a royal commission—were not taken into account when the final REIA was published. These matters are well known to many noble Lords, but it has only recently come to light that the Commission for Racial Equality had also expressed serious concerns. I have to wonder whether, had we known of the CRE letter earlier, this would have affected our deliberations or, indeed, those in the other place. However, we are where we are. It would be helpful if the Minister reaffirmed for the record that, notwithstanding the criticisms of the CRE, it is the intention of the Government that this Act should not have discriminatory effects on racial—or, for that matter, any other—grounds. It is for these reasons that I support this amendment, although the matter is unlikely to end here. There is a great deal of concern about these matters among communities and professionals. I am well aware that the National BME Mental Health Network, which consists of carers, service users, communities and eminent mental health professionals, will be actively campaigning for a judicial review on these very issues. I believe that we need a national committee of inquiry, if not a royal commission, in order to determine once and for all what lies behind the significant and worrying disproportion and differing treatment of black and minority ethnic patients, and to put to an end the mischief making of some academics in the field, who are attempting to discredit the whole concept of institutional racism. I am conscious of the time, but I am also aware that this may be our last opportunity to raise these important issues in relation to the Bill. In supporting the amendment, I hope that I make my view clear that much more action is needed. We need to know that something will finally be done to address the scandalous situation of black and minority ethnic patients, their carers and families.