Peers Vote Down Ministers On Compulsion For Mentally Ill

The government was defeated in the House of Lords last night over legislation to strengthen powers of compulsion in the treatment of mentally ill patients in England and Wales. A rebel alliance of peers won by a majority of 106 on the first of a series of amendments to the mental health bill.

The cross-party group is concerned that ministers’ proposals would take away patients’ civil rights. Its show of strength in the voting lobby suggests that further government defeats are inevitable.

The bill would allow psychiatrists to detain people who have committed no crime if they are diagnosed with a serious personality disorder. Such patients could be held in NHS premises even if the disorder were untreatable.

Ministers think potentially dangerous people should not be left in the community if there is a risk they might murder.

The bill would also create a power of compulsory treatment in the community to make sure patients discharged from psychiatric hospital continue to take the prescribed medication.

The government’s defeat came on an amendment that would allow psychiatric patients to refuse treatment if their decision-making faculties were intact. Lady Barker, a Liberal Democrat spokeswoman, said other NHS patients had a right to refuse treatment, and it was wrong that mentally ill patients did not: “Our provision, we believe, would make services less threatening to patients, and therefore patients would be more likely to come forward to seek treatment …”

The Department of Health said later: “The needs of patients and the risk posed must determine whether compulsion should be used – not their decision-making ability. The amendment places patients’ decision-making ability above the imperative to protect them and others. It risks excluding them from legislation that should protect them.”