Health and Social Care Bill

Amendments Nos. 51 and 52 propose specific matters relating to monitoring the application of the Mental Health Act that the noble Baroness, Lady Murphy, believes should be covered by regulations under Clause 16. Amendment No. 53 refers more generally to discrimination and health inequalities, although I understand that the interest of the noble Baroness, Lady Meacher, is particularly informed by the experiences of people with mental health problems, hence its place in this group. I understand the strength of feeling that underlies the amendments, and I hope to provide some reassurance that they are already provided for in the Bill or in our proposed registration requirements. In particular, I emphasise that as one of the Care Quality Commission’s core functions, set out in Clause 2, the commission will be under a statutory duty to monitor the use of the powers under the Mental Health Act. In doing so, I appreciate that the commission might need information on admissions, discharges and deaths of detained patients, as Amendment No. 51 seeks to address, both to enable it to take appropriate follow-up action and to make informed decisions about when to undertake a review or investigation of a particular hospital or trust. Draft registration requirement 13 includes a requirement to ensure that adverse incidents are reported. That will of course include the deaths of detained patients. The Bill also allows other types of information to be gathered. New Section 120C of the Mental Health Act will enable both the commission and the Welsh Ministers, who will be responsible for monitoring the application of the Act in Wales, to make reasonable requests for information in connection with the exercise of their functions under the Act. It will, for example, allow them to obtain information from hospitals—and from local authorities where patients are in the community—about the number of persons detained under the Act in a given period, together with details of such matters as their age, gender and ethnic status. It will also enable them to collect patient-specific information for the purposes of undertaking an investigation or review, or for the purposes of investigating a complaint. I believe that that meets the intention behind Amendment No. 51 without imposing too great an administrative burden on providers. Amendment No. 52 would enable the regulations under Clause 16 to require providers to demonstrate their compliance with the Mental Health Act. Providers of care for people subject to compulsion under the Mental Health Act already have a duty to comply with the Act, and the Care Quality Commission will have a responsibility to check that they are doing so. However, the Bill will provide some additional safeguards. The current consultation proposes that services which detain patients or deprive them of their liberty should be registered with the commission. The commission would then be able to act directly where there is a breach of the relevant requirements. Draft requirement 2 about, "““safeguarding people when they are vulnerable””," will be particularly relevant here. Crucially, the commission will also be able to take action if registered people are failing to comply with requirements in any other legislation that it considers relevant. It will therefore be able to employ its enforcement powers if a registered provider is failing to comply with relevant aspects of the Mental Health Act, the Mental Capacity Act or other legislation. I am confident that the Bill will also enable the commission to play its part in reducing health inequalities and discrimination on the grounds of disability. As I have explained, the commission will be able to take enforcement action if registered people are not compliant with other relevant legislation. This would include elements of the Disability Discrimination Act 1995 or other equality legislation that the commission considers relevant to securing the health, safety and welfare of those using health and social care services. Requirement 12 in the consultation, entitled ““Respecting people and their families and carers””, would also be relevant. It aims to ensure that: "““People’s privacy, autonomy and dignity are safeguarded and their human rights and equality are respected. This involves treating people as individuals, respecting their human rights and having systems to ensure that they are not discriminated against””." However, it is important to recognise that regulation alone can only go so far in addressing the complex issues of inequality and discrimination. The Government are also taking action in other ways to address these important issues, such as through the SHiFT initiative to tackle the stigma and discrimination surrounding mental health in England, and the National Strategy for Mental Health and Work, which is being chaired by Dame Carol Black. I hope that the noble Baroness will feel reassured that the necessary statutory requirements are in place to ensure that the very important principles behind the amendments will be embraced and that she will feel able to withdraw her amendment.