Hewitt Defends Mental Health Proposals

Controversial revisions to mental health legislation will strike the right balance between improving patient safeguards and protecting the public, the health secretary, Patricia Hewitt, said yesterday.

The introduction of supervised community treatment is “essential” to help ensure that discharged patients continue to take medication and treatment to keep them well and help to protect the wider public, she said. Ms Hewitt was opening a Commons second reading debate on the mental health bill.

The bill, which has suffered a series of defeats in the Lords, would amend existing legislation to ensure patients continue to take medication following discharge and to prevent relapses.

Its provisions will see some psychiatric patients discharged from hospital subject to supervised community treatment. Those undergoing the treatment will be obliged to comply with a specified regime, which campaigners say will place unnecessary restrictions on their civil liberties and may deter people with mental health problems from coming forward for treatment.

Every year around 55 to 60 murders are committed by mental health patients, and the provisions in the bill are aimed at reducing such tragedies.

Ms Hewitt told MPs: “Modern medicine and clinical practice has shifted the whole focus of care into the community and the law needs to follow. The bill would enable a patient who is detained in hospital to be released under supervised community treatment, enabling some patients to be discharged into the community earlier than would otherwise have been the case. A real benefit to themselves and often their carers as well.”

Ms Hewitt told MPs that the government had “on a number of issues” sought to reach agreement with the House of Lords. But she added: “We are not prepared to accept the amendments that have been made there restricting the use of community treatment orders to patients who have been detained as compulsory patients at least twice. I believe that would be a wholly unacceptable restriction on clinicians.”

Ms Hewitt said other changes in the bill would require “appropriate treatment” to be available before a person could be detained. This would be known as the “appropriate treatment” test and would replace the current “treatability test”. This was another issue where the government would seek to reverse amendments made in the Lords.

Ms Hewitt said: “I believe this bill strikes the right balance … between modernising the legislation in line with the development of clinical practice, improving patient safeguards and protecting more people from harm.”

The shadow health secretary, Andrew Lansley, said the Tories would support second reading but would be arguing about some of the controversial provisions in the bill. He said there were “significant problems” within mental health care, including the reduction in the number of beds and the pressure on trusts’ finances.

The government’s attempts to introduce mental health legislation had been “one of the less impressive tales of policymaking” in the last 10 years, he said. “And there is some competition on that score,” he added.

Mr Lansley said the government had not listened to the “expert consensus” which had emerged on how the legislation should be framed. The government’s argument that it was trying to balance the “rights of patients and the protection of the public” was a “false dichotomy”.

The Tories will back the bill as it has been amended in the Lords, Mr Lansley said. He said compulsion was necessary in some cases, but its scope should not be widened to such an extent that it “drives patients away”.

Liberal Democrat spokesman Norman Lamb said the bill, as amended by peers, was good and had his party’s support. He said changes made in the Lords provided safeguards for vulnerable individuals, and warned that if the government insisted on reversing them it would be making “a very serious and dangerous mistake”.

But health minister Rosie Winterton said that to water down the proposals would lead to “extremely vulnerable patients being denied treatment and will lead to an increase in public safety risk”.

The bill gained its second reading without a vote.