(1 year, 3 months ago)
Grand CommitteeMy Lords, as with many policy areas, there are complex issues to consider when devising public policy on alcohol licensing. In devising licensing regulations, the Government must take into account the balance between the well-being of people who wish to drink alcohol in moderation in a public place and those who live nearby licensed premises, against the danger that high levels of alcohol consumption can lead to criminal activity, road accidents and domestic violence, and, indeed, costs to the health service and the police. Add to this the needs of businesses that serve alcohol as part of their legitimate business model and you have a complex picture.
It is the complexity of the decisions that need to be made at a local level that led the Select Committee to urge the Government to take action to ensure greater co-ordination between the planning and licensing functions of local authorities. This evening, this Committee has heard a passionate explanation from my noble friend Lord Foster of the reasons the committee came to that conclusion. They also recommended better training for councillors engaged in making these complex decisions so that they can adequately take all these factors into account and make decisions that are right for their local area, along with a mechanism to ensure the required co-ordination.
It is disappointing that, in the Government’s response, they appear to believe that nothing further needs to be done in this respect. Instead, we got a litany of the actions the Government are taking to provide treatment for those who abuse alcohol, with serious consequences for themselves and those around them. This is shutting the door after the horse has bolted. However, I am hearing from colleagues serving on local councils that the availability of such services has been much reduced in the last few years. The funding comes from the public health grant, which has been halved. You cannot make a loaf without flour, and the Government are expecting local authorities to do too much with too little.
Is the Minister aware that 70% of local authority funding has to be dedicated to mandatory services such as children in care, elderly people who are reliant on public funding for their care, and residential care for people with physical and learning difficulties? This means that non-mandatory services, such as drug and alcohol services and others, have had to be cut. In light of all this, what progress have the Government made on the sincere recommendation of the committee for better training of councillors and co-ordination between planning and licensing?
Although licensed premises play an important role in what is called the night-time economy and keeping town centres alive, and indeed provide a lot of jobs, particularly for young people, it is the public services that bear the costs when things go wrong. One area where things have gone wrong recently is in the behaviour of people who have been drinking to excess before boarding an aircraft. There have been a number of cases where airline staff have had to delay a flight or detain or remove a passenger to avoid not just annoyance but actual danger to other passengers. It might avoid the need for this if the sale of alcohol airside was brought within the ambit of the licensing regulations. Will the Government please reconsider their intention not to act on this?
Most licensees are responsible people and carry out their business in the interests of customers and their community, but there are some who do not. The committee recommended that any future national database of licence holders should include records of refused, suspended or revoked licences to avoid such people getting licences elsewhere unless they change their ways. Will the Government ensure this happens?
About a third of the victims of domestic violence claim that the perpetrator was under the influence of alcohol when the attack occurred. This suggests that licensees have a great responsibility to stop serving someone who has clearly had enough. I understand how difficult that is, not only to make the judgment itself but to take action and ban the person, who will undoubtedly object loudly. Is the ability of the licensee to take such difficult decisions taken into account when considering renewal of his or her licence? Is there any co-ordination between the local police, who may have to deal with offenders, and the local licensing authority? The police will know which premises are the culprits, since they will often have to deal with the consequences. Are they sufficiently well trained for this duty? On the matter of alcohol-related offending, the government response promised “a National Working Group” to reduce such offending, share good practice, trail innovative solutions and ensure that “existing licensing powers” are applied in full. Can the Minister say who sits on the working group, to whom it answers and when it will report?
As we know, there has been a large increase in the amount of alcohol bought from supermarkets—we just heard that from the noble Lord, Lord Smith—especially during the pandemic. This brings us to recommendations about the use of taxation to control excess consumption. Following years of resistance, the Government have taken welcome action on high-alcohol white cider, because of its use by alcohol abusers. However, there is more to do. I welcome the Government’s commitment to review the new alcohol duties after three years but ask the Minister what further action they plan to take—for example, by reviewing the effect of minimum unit pricing in Scotland and Wales. In doing so, will they always bear in mind the needs of those licensed businesses which serve alcohol to moderate drinkers with or without a meal? They are legitimate businesses and their profits are already under a great deal of pressure.
The temporary pavement licensing scheme is to be made permanent through the levelling-up Bill. That is all very well—we all like a drink in the open air when the weather is fine—but what do local authorities get out of this extension of the premises of commercial businesses into the pavement area which they own and have a duty to clean? Will the bars pay a fee or increased business rates for the privilege of extending premises from which they make money? Local authorities are desperate for cash; might it not be a good idea to help them out a bit here?
I support what the noble Lord, Lord Holmes of Richmond, said about the danger of obstructions on the pavement to people with disabilities, particularly visually impaired people. I recently had to speak to the manager of my local Co-op, in the interests of local visually impaired people, about no less than four large free-standing advertisements on the pavement outside the shop.
I turn to access. Recently, a former colleague put a photograph on her Facebook page of her disabled husband in his wheelchair outside a new local restaurant. Unfortunately, there was no way he could get inside. She went in to ask the manager what arrangements they had made for disabled customers, and they had not made any. I got the impression that he was not too polite either. I am sure that this is not typical of managers of licensed premises and I realise that some premises might be difficult to make accessible, but they will lose customers if they do not adapt. It is quite wrong that they do not make every effort. I would like to see an access and facilities statement as a requirement in licence applications and renewals. Can the Minister say what progress has been made on the review of Part M of the building regulations regarding access if, as they say, the Licensing Act is “not the appropriate vehicle”?
Finally, the committee recommended that the late-night levy should be reviewed in consultation with the trade and the local community. It says that it is a blanket measure that may not be appropriate everywhere. When will the Government respond to this recommendation? As I understand it, they have not done so yet.
Licensed premises contribute a good deal to local economies, provide jobs and allow us all to go out, relax and enjoy ourselves—all of us, not just those with working legs. I am a great believer in a bit of joy, so I hope the Minister in responding to this debate will have inclusive joy for everyone in mind.
(1 year, 5 months ago)
Lords ChamberI know this issue has been raised in the House of Commons recently in a 10-minute rule Bill. It is certainly a matter that the Home Office has under review, and it may be something that we hear more about later.
My Lords, what are the Government doing to encourage more intelligent and public-spirited young women to join the police force? Would that not go a long way towards making women feel that when they reported sexual abuse they would have a more understanding ear at the end of the phone? It would make women feel much safer on the streets if they knew that a female police officer might be there to help them.
I entirely agree, and there is much in what the noble Baroness says. I do not, I am afraid, have the statistics to hand as to the level of women among recent recruits to the police in meeting the 20,000 target that was in the last manifesto, but I can certainly find that out and write to her.
(3 years, 4 months ago)
Grand CommitteeMy Lords, I was not a member of Science and Technology Committee when this report was written, although I am now. I am really sorry I missed it, because it was clearly a fascinating and important investigation. However, I have read the report, which was up to the committee’s usual high standard of rigour and integrity, and the main impression I gained was that the forensic service in this country has become a shambles and, regrettably, has fallen a long way from its former high standard. The noble Lord, Lord Patel, called it, more politely, inadequate and dysfunctional. This is bad in itself, but it is a particular disaster given the fact that the science is moving so rapidly in new directions and the demand for the service is growing exponentially, particularly in relation to digital evidence.
High-quality forensic science is crucial for the operation of justice. It is important to the accused, both guilty and innocent; it is important to victims, both existing and potentially in future; it is important to the police, judges and advocates to enable them to do their job properly; it is important to juries who need confidence in the quality of the forensic evidence to allow them to be as sure as possible about their decisions; and it is important to the public on whose behalf the criminal justice system works. But it is clear that, for whatever reason, not usually the fault of those who work in the service, the service has let us all down over recent years and lost its former high reputation. The committee has done an excellent job in its report of getting to the bottom of what has gone wrong and proposing a comprehensive plan of what needs to be done to put it right.
Four aspects jumped out at me as I read the report. First, on leadership and resources, the committee led with this issue in its very first recommendation. I absolutely agree that the service needs strong leadership at arm’s length from government. The committee recommended a forensic science board to take the lead in strategy, organisation and regulation. The Government instead proposed a less independent alternative—a steering group of the Criminal Justice Board jointly chaired by the Home Office and Ministry of Justice. That is hardly arm’s length. Where is it? Does it exist? What has it done since the report in spring 2019? Do we have to wait another two years for action? Yes, we now have a statutory regulator, thanks to a Private Member’s Bill, but this is no use without adequate powers and resources.
The committee listed five powers in its recommendation 12, all of them needed to enable the regulator to ensure the quality of provider organisations and individuals, and the ability to force them to improve or remove them from the service as necessary. It is outrageous that some providers are currently unregulated and some so-called expert witnesses not adequately qualified. The Government did not agree with these recommendations, but I believe that a regulator needs teeth, otherwise how can he or she do the job? It is nearly 10 years since the Government promised that the regulator would have such statutory powers, a time lapse which the committee described as embarrassing. Can the Minister assure us that the Government will take appropriate action so that it is no longer embarrassed?
On resources, following the disastrous cuts to legal aid, the committee heard that the defence sometimes lacks the ability to commission its own forensic testing where the evidence is disputed and, on the prosecution side, the police need adequate resources to build their case. Some police forces use their own labs, some put the work out to private providers and some a mixture of the two. But if you are going to put a public service out to the market, you have to show private providers that there is a stable business there in which they should invest. As the committee’s evidence shows, the market is fragile and some providers may close down. The Government’s response is to reform procurement policy. This sounds to me like saying, “If we don’t like the price of butter, we can go to a different supermarket.” Can the Minister tell us what it actually means apart from an attempt to get more for less?
Secondly, it is currently unclear where accountability lies in government. I echo the question from the noble Lord, Lord Patel: can the Minister say clearly where accountability lies now? Is it with the steering group or whichever department happens to be in the chair at the time? There is also a lack of co-ordination. The committee proposed that the new FSB should work with the regulator and the proposed national institute for forensic science to ensure standards, strategy and co-ordination. Can the Minister say how the Government’s alternative structure will do that?
Thirdly, on research and forward planning, it is vital that there is a mechanism to look ahead and plan for investment in research into new forensic methods and, where appropriate, the use of artificial intelligence and automation and the practicality of how these can be integrated into the service. In the past, the development of and confidence in DNA evidence has allowed former miscarriages of justice to be corrected and unsolved crimes to be laid at the doors of the perpetrators at last. If resources are not put into the development of new forensic science, there will be more miscarriages of justice and unnecessarily unsolved crimes. Victims are always the ones to suffer for this but so does the whole of society. This is where the committee’s recommendation 21 of a national institute for forensic science within UKRI comes into the picture. Without such an expert group to do the horizon-scanning and ensure the funding for the correct areas of research, the rogues will always be way ahead of the forces for good.
That brings me to staffing. The service does not just rely on new methods but on high-quality staff. Where are the planning and resources for staff training? Recommendation 13 and others cover this. The proposed forensic science board would have the responsibility, together with the College of Policing and the Chartered Society of Forensic Sciences, to develop a strategy for the ongoing training of all forensic science practitioners, including those who provide expert evidence in court, as well as providing CPD on forensic science for practising lawyers. Given the rise in digital crime, it is essential that more staff qualified in this area are recruited. What system do the Government propose for the staff planning and training function, and why is it better than the committee’s recommendations?
Finally, on confidence, the noble Lord, Lord Patel, has outlined the delay and inadequacy of the government response. It makes me wonder whether this indicates a lack of interest on behalf of the Government or perhaps a lack of understanding of the role forensic science plays in building the confidence of the public in our criminal justice system. Does the Minister agree that a high reputation for forensic science can have a beneficial effect on the willingness of the public to co-operate with the police? It can also affect the prevalence of crime, deterring potential criminals as well as catching them. Police chiefs, in their evidence to the Committee, did not show that they have confidence in the Government’s response to the report. If they do not have confidence in the system, who can?
(3 years, 8 months ago)
Lords ChamberI have to say to my noble and learned friend that in local authorities, particularly when local authority systems are being used, there are firewalls to prevent some types of abuse, but if a child has a smart phone with such things as Messenger or Snapchat on it, it is incredibly difficult for local authorities to keep tabs on children who are at the end of such coercive behaviour. The noble Baroness, Lady Kennedy of Cradley, talked about the online harms Bill next year: that is going to be crucial, because it will place a duty of care on service providers and social media platforms to actually protect vulnerable people from this sort of thing.
My Lords, following up on the Minister’s reply to the noble Lord, Lord Harris of Haringey, she may be aware that industry compliance in taking down child abuse images fell by 89% in the first month of lockdown. What tools are the Government using, or threatening to use, to ensure that social media companies such as Facebook design and deliver platforms and services that put child protection front and centre?
I can guess at several of the factors, but one might be the ever-increasing use of encryption, so that not only can parents not see what their children are doing, but nor can the local authority or, actually, the internet providers themselves. This is at the heart of what the Home Secretary and Five Eyes partners are trying to discourage going forward.
(4 years, 2 months ago)
Lords ChamberMy Lords, the Home Secretary speaks every day to operational partners—the NCA, the police and the NPCC. It is not just that we are aware of the dangers of children being at home with their computers and not at school; significant effort has been undertaken to mitigate some of the potential for harm to children over this period. As for production of the report, that will come in due course.
My Lords, on 10 September 2018, the noble Lord, Lord Agnew, promised, in response to my question about an extra seminar on mandatory reporting, that
“the Government are committed to ensuring that legislation can adequately deal with this”—[Official Report, 10/9/18; col. 2093.]
issue, and would scope it fully “during the current Parliament”. Has that scoping taken place and, if so, what was the result?
I cannot answer on behalf of my noble friend Lord Agnew but I will certainly get him to respond to the noble Baroness.
(4 years, 2 months ago)
Lords ChamberMy Lords, will the Government provide the 10% of funding for the UK Safer Internet Centre currently provided by the European Union after the end of the transition phase of leaving the EU? Childnet gets 50% of its funding from the EU, so is even more vulnerable.
My Lords, efforts to combat CSA come from a number of funding sources, from the Home Office and elsewhere, and various NGOs. We will base our funding decisions on the best needs of children in this country and how to keep them safe.
(6 years, 11 months ago)
Grand CommitteeMy Lords, I strongly support the campaign of the noble Baroness, Lady Meacher, to make medicinal cannabis available legally for patients who can be helped by it and I congratulate her once again on her persistence. While the noble Baroness, Lady Williams, is very welcome in her place today, I agree with the noble Lord, Lord Crickhowell, that we should be seeing a health Minister responding to a debate of this nature—so does she, I think. The lack of availability of this medicine for thousands of people in pain is just one of the terrible consequences of a failure over the years by the Government to see that their policies are not working. Their stubborn persistence with a set of policies that are manifestly failing is extraordinary. If any other policy were as much of a failure as the Government’s drugs policy, they would drop it like a hot potato.
The current classification of drugs is meant to avoid their misuse but fails completely to do so. On top of that, it penalises people for whom cannabis can be a lifesaver. They and their clinicians are forced to resort to powerful drugs such as morphine to alleviate pain because cannabis has become caught up in the debate on recreational drugs.
Let us take the case of five year-old Alfie Dingley, mentioned by the noble Lord, Lord Dubs. Alfie has life-threatening seizures. The drugs being used to treat him at the moment are frequent, intravenous steroids which could shorten his life, cause him to develop cancer, damage major organs or even induce psychosis. All other treatments have failed and his parents and grandparents live in constant fear of his next, possibly fatal seizure. Yet in Holland, where the law on cannabis is more rational and compassionate, doctors are able to treat children such as Alfie successfully.
In the Republic of Ireland, a named practitioner can be licensed to prescribe cannabis for medicinal purposes to a named patient. A number of other countries do something similar, so why can we not do that here? Can we not have a trial in this country to look at how children such as Alfie can be helped under proper medical supervision? Given that Alfie, along with many of the other patients we have heard about, has been given many other powerful drugs, some of which are not licensed for children as young as him, surely the risks of allowing him legal access to cannabis are considerably less? Yet to obtain cannabis legally, as we have heard is the case with other patients, Alfie’s parents would have to travel abroad at their own expense. Ironically, Alfie’s UK consultant would be willing to prescribe cannabis but is not allowed to do so. Rescheduling cannabis, as the noble Baroness, Lady Meacher, has suggested, would allow that to happen.
I and my colleagues heard from many patients in the noble Baroness’s commission when considering the matter. The evidence was very compelling. Today, your Lordships have called on the Government to base their policy on evidence, not misguided prejudice. The Government should hear the voices of the thousands of generally law-abiding patients who are forced to break the law or go to enormous trouble and expense to travel abroad to get the medicine that they know works for them. Those people do not want to have to do that, and there are thousands more who could benefit but are not prepared to take the risk. Why are we putting good people in this invidious situation? It is cruel, it is illogical and it is time that the Government did something about it.
(7 years, 6 months ago)
Lords ChamberMy Lords, I am certainly very happy to send congratulations to Cressida Dick. I do not think I am the first Minister to do so, but perhaps I am the first Minister in your Lordships’ House to do so. It is a very good appointment, and, of course, she is the first female Metropolitan Police Commissioner.
Does the Minister agree that confidence that they know what they are doing enables people to step forward in these situations, rather like the rugby player who recently stepped forward to give first aid to a member of the opposing team? Does she therefore agree that it is in response not just to terrorism but to the ordinary traumas of everyday life that we should all have a look at the citizensAID training?
The noble Baroness makes an important point. It is about the simple things, and the benefit of the citizenAID app is that there are very simple things that people can do, once they are in a safe place themselves, to help people and potentially save lives.
(7 years, 8 months ago)
Lords ChamberI concur with much of what the noble Lord has said. It is frustrating to have to do so but it is important to wait for the outcome of the Scotch Whisky Association case in Scotland. I totally agree that alcohol-related admissions to hospital are worrying, as is the fact that alcohol is now the leading health risk factor for people between 15 and 49, which is a very wide age group. That is not to mention the cost to the public purse.
My Lords, the Chief Medical Officer has shown evidence that heavy drinking under the age of 20 can cause abnormalities in the brain in those areas that deal with motivation, reasoning and interpersonal skills. In the interests of the future health, happiness and productivity of our young adults will the Government choose the policy option which is most likely to reduce drinking by teenagers who do not have a lot of money: minimum pricing?
My Lords, the PHE alcohol evidence review certainly talked about reducing the affordability of alcohol being one of the most effective, and cost-effective, ways of reducing alcohol harm. Back in 2013, the coalition Government pledged to look at minimum unit pricing. We will keep it under review in the light of the outcome of the Scottish case. I also concur with what the noble Baroness said about the developing brain. The overuse of both alcohol and cannabis has been shown to have very serious consequences for mental health.
(7 years, 8 months ago)
Lords ChamberMy Lords, we now move to issues relating to the interaction between the police and people with mental health problems. This amendment would ban the use of police cells for adults detained under Sections 135 and 136 of the Mental Health Act 1983 in the same way as this Bill now bans it for children under 18.
I am very encouraged by the 53% reduction in the use of police cells as places of safety during 2015-16. The police, mental health services, local authorities and voluntary sector partners deserve our congratulations on that. However, that still left 2,100 people taken to police cells—a situation that will have led inevitably to exacerbation of their mental health crisis. I listened very carefully to what the Minister said in response to a similar amendment that we discussed in Committee. I thank the Minister for the meeting that we had at the Home Office to discuss it. I am encouraged by the clearly expressed intention of the Government eventually to reduce the use of police cells to zero, and I hope that the Minister will feel able to accept this modified amendment, which takes account of her concerns.
We got rid of discriminatory mental health legislation only a few years ago, and we are on a journey towards parity of esteem between physical and mental health. The Mental Health Act 1983 is now over 30 years old, and we need further to update how we treat people with mental health problems and enshrine that in statute. At least two police forces have now managed to reach the desirable target of zero use, which proves that use of police cells can be avoided even in exceptional circumstances, so we are not asking for something that has been shown to be impossible; we are asking for something that has been shown to be possible. But we appreciate that it requires the provision of more health-based places of safety, more training, better regulation, better partnership working and more diversionary strategies such as street triage.
That is why subsection (4) of the new clause, which my amendment would insert into the Bill, makes provision for delayed implementation until such time as the Secretary of State is convinced that everything is in place to ensure that there is no longer any need to take people in mental health crisis to a police cell for their assessment to be done. I appreciate that this was not strictly necessary, as implementation is dealt with elsewhere in the Bill, but I included it to make clear what I am asking for. I suggest that an implementation date of April 2019 is quite achievable.
When you are in a crisis, you need compassion and understanding and, with the best will in the world, the police are not the people to give that. That is why the police themselves are keen that the objective of my amendment is achieved as soon as possible. A mental health crisis is a mental health car crash. Nobody who broke their leg in a road accident would expect to be taken to a police station for triage; they would be taken to a health-based place of safety for their needs to be assessed and treated—in other words, an A&E department in hospital. We cannot say that we have achieved parity of esteem between physical and mental health if we continue to treat mental health emergencies in a different way from the way we treat physical emergencies. People detained in this way are not criminals and yet they are treated as such and feel distressed and confused, making it even more difficult to help them get well.
I was pointing that out as just one of the reasons why it might be—but we have to remember that, as we know, mental health is going through a huge change at the moment. As I said in a debate on Monday, I am afraid that we are going from a very low base. We have to be aware that it will take time for these places of safety to be there to ensure that we have an increased number of beds or places of safety for these people to be taken. That is part of the reason for the discrepancy.
To go back to further points raised on mental health, the noble Lord, Lord Rosser, raised an issue related to the respective changes to police powers under Sections 135 and 136 of the Mental Health Act. The noble Lord suggested that the maximum detention period should be reduced further to 12 hours. We are confident that the Bill reduces the maximum detention period by the appropriate amount—from 72 hours to 24 hours. The Government have seen evidence that the average assessment under Section 136 is conducted in under 11 hours. Furthermore, we fully support the target set by the Royal College of Psychiatrists for assessments to commence within three hours. However, there are some cases when it is not possible, due to the condition of the person detained, to conduct a meaningful assessment within 12 hours: for example, if they are intoxicated through alcohol or drugs.
The noble Lord also mentioned duties on police to consult with mental health professionals, with detainees having a right to an independent mental health advocate. The second issue concerned access to independent advice. Clause 78 requires police officers to seek advice from certain specific healthcare professionals, if practical, before making a decision to exercise their powers under Section 136. This is about supporting police officers to make the best possible decisions when they encounter a person who may be experiencing a mental crisis. This provision builds on existing good practice of police forces and local NHS services working together collaboratively, including through street triage schemes. The “if practical to do so” condition will avoid tying the hands of an officer if, in their judgment, they need to use the powers quickly to secure an individual’s safety.
On detainees’ access to advice, for example from a mental health advocate or an appropriate adult, the guidance supporting the implementation of these provisions will set out the expected support to be provided to any person detained at a place of safety under Section 135 or Section 136. Such support can, in our view, most appropriately be provided by health staff already present, rather than another person in a bespoke role, which would introduce delays and jeopardise professionals’ ability to conduct the assessment within 24 hours.
The noble Lord asked whether a person’s detention is disclosable if they subsequently apply for a disclosure and barring service check. In 2015 the Home Office published revised statutory guidance on enhanced DBS checks in relation to Section 135 and Section 136 detentions. The guidance now emphasises that the use of these powers in and of itself is unlikely to be sufficient to justify disclosure. The police are now directed to specifically factor in the behaviour of the detained person at the time, and how long they were detained. The Government’s position is that we cannot wholly rule out the possibility that there will continue to be circumstances in the future when a person’s behaviour is so extreme that it can safely be managed, at least initially, only in a police station. We are not legislating for some future point when that position will cease to be the case, which is what the amendment suggests.
I hope that, with all the things I have set out, and given our clear shared objective of doing what is in the best interests of all concerned, including their safety, I hope that the noble Baroness will be content to withdraw her amendment.
My Lords, I thank those who supported my amendment. I was fascinated by the treatise of the noble Lord, Lord Rosser, on other aspects of Sections 135 and Section 136. He is, of course, absolutely right that there is no correlation at all between the use of police cells and the rurality or urbanisation of the area concerned: absolutely none. I have always known that Merseyside is a very special place—because that is where I come from—but apparently in Merseyside there are no “exceptional circumstances”, whereas there are in other places. I cannot understand the Government’s determination to insist that there will be exceptional circumstances in other places if there are none in Hertfordshire and Merseyside.
It is quite clear that the Government are not going to move on this. However, I have to say that I welcome, of course, what the noble Baroness said about regulations. We will have to keep a very careful eye on how these work and whether they achieve our joint objective of bringing the numbers down as low as possible. I very much hope that that is exactly what will happen over the next few years. The hour being what it is, I beg leave to withdraw the amendment.
My Lords, Amendment 118 places a duty on police forces to refer children under 18 who are the victims of a sexual offence or other forms of child abuse for a mental health assessment by an appropriately trained professional. It mandates a currently poorly used referral pathway. I listened carefully to the Minister’s response in Committee and have changed the amendment that I bring forward today. I wish to stress that this amendment does not mean that all these children will need a CAMHS intervention or will have a diagnosable mental health condition. It is designed not only to support children who are the victims of these awful crimes but to inform commissioning decision-makers about the magnitude of the problem, so as to ensure that the right services are in place. We cannot rely on the numbers that reach the clinical threshold for intervention, because these thresholds are far too high, given the shortage of child and adolescent mental health services.
The amendment is deliberately not prescriptive as to who “an appropriately trained professional” would be, leaving this to regulations and local flexibility. This person could be a nurse, school councillor, trained social worker, councillor in a sexual assault referral centre or another appropriate local professional. The amendment strikes the right balance between local and national responsibilities. It introduces a national requirement for a referral pathway and assessment, but it does not set out the how and where, which will be up to local areas to determine. This is responsive to the level of need of these children and the evidence we have that they are not receiving the therapeutic support they need for their recovery.
As I said at the outset, the amendment would not mean that all victims of a sexual offence or other forms of child abuse would meet the clinical thresholds. Some may, but some may need other types of support—for example, school or community-based child sexual exploitation support groups, family support services, or support for parents and children to equip them to understand the emotional impact of abuse. The amendment would deliver the recommendation in Future in Mind, which the Government are committed to implementing in full, that,
“those who have been sexually abused and/or exploited receive a comprehensive assessment and referral to the services that they need, including specialist mental health services”.
The evidence for the amendment is compelling. In the past year the Children’s Society has calculated that more than 40,000 crimes of a sexual nature were reported against children. Each of these 40,000 is a child suffering the effects of horrific crimes, which come with a multitude of long-term effects that need to be addressed. We have only to read the recent media accounts of many footballers who were abused as children to understand the lifelong effects of these terrible experiences. They destroy lives and careers. Analysis by the Children’s Society of referral pathways for vulnerable groups found that less than half of mental health trusts identify children who have experienced sexual exploitation in referral and initial assessment forms. The NSPCC review of local transformation plans found that only one-third of these plans mentioned provision of services to meet the needs of these children. Yet while these figures are appalling, the experiences of the victims themselves show the need for the amendment even more.
Last week the noble Lord, Lord Kennedy, and I attended a meeting organised by the NSPCC and the Children’s Society and I want to share with noble Lords the account of Sarah—not her real name—who told her story. I record my thanks to her for sharing her experiences and her powerful message as to why this amendment is needed. Sarah was abused from a very young age by a member of her extended family and this had a long-term impact on her life. As her understanding of consensual relationships developed, Sarah realised that what she had experienced was abuse and as a teenager she suffered from clinical depression and was extremely suicidal. She was later referred to counselling and gradually came to terms with what had happened to her. The abuse had a long-term impact on her mental health, including eating disorders, drug abuse, PTSD and abusive relationships. At the meeting Sarah told us that the support she received was invaluable for her recovery. She thought that the amendment would support young people who had experienced sexual exploitation and help them recover more quickly by ensuring a direct referral from the police.
The amendment will also contribute to parity of physical and mental health. Recently, nine ex-Health Secretaries wrote to the Health Secretary to encourage the Government to,
“make good the promise to achieve genuine equality”,
between physical and mental health. Parity of esteem was enshrined in law by the Health and Social Care Act 2012, yet examples of this being enacted in policy are still rare. We know that nine out of 10 children who have experienced abuse at an early age will develop a mental illness by the time they are 18. Without assessment, how can we know which 10% will not need help? Issues faced include post-traumatic stress disorder, anxiety, self-harm, depression and, as we have heard, suicide attempts.
This is not a novel idea. There are numerous examples of where preventive public health initiatives have been set up in response to data on the prevalence of certain conditions affecting the physical health of a population. For example, cervical screening is now offered to all women over the age of 25. My first job out of university in the late 1960s was scanning the cervical smears of women with symptoms, so I know how effective screening is at picking up early cancer and pre-cancerous cells so that the patient can be treated early. The current rate of cervical cancer is 12 cases per 100,000 women—0.012%. Since its introduction, the screening programme has led to a decrease in the number of cervical cancer cases by about 7% each year, and it is estimated that up to 5,000 cases of cervical cancer are prevented annually because of cervical screening. That is a terrific record but the prevalence of cervical cancer is a great deal less than nine out of 10.
My Lords, I hope we do not go down this road. It seems a thoroughly bad idea. Of course there is a good case for voluntary provision. There may be many cases where assessment is highly desirable but this is coercive. It imposes an obligation on the police officer to do what is set out in the amendment.
I would like to make it clear that it would be only with the consent of the child, so it would be consensual as far as they were concerned.
That is not what it says in the amendment. Had it been so, I would not object, but we are talking about a piece of legislation, and it is coercive. If the police officer has to do it, presumably the child has to co-operate. You are not dealing just with young children, either. You are dealing with people up to the age of 18 and I would have thought that there were a substantial number of cases where the child would not want to be assessed and would find it pretty traumatic if he or she was. While there may be a strong case for putting in place a voluntary system for doing it, there is absolutely no case for making it coercive. I really hope that the House will not think of pursuing such a policy.
My Lords, I thank the noble Baroness, Lady Howe, and the noble Lord, Lord Kennedy, for their support. I reassure the noble Viscount, Lord Hailsham, that there is nothing coercive about this. I think there is a misunderstanding because a health issue is being debated in a criminal justice Bill. The reason there is no need to mention anything to do with consent in the amendment is that it is quite unnecessary. Any professional who would be doing the assessment has a professional duty to engage with any patient only with that patient’s consent. Indeed, it would be self-defeating even to try to do an assessment because it would not be effective, so it is totally unnecessary to mention consent in that situation. It is perfectly normal that consent is an absolute given in health issues among all health professionals.
I say to the noble Earl, Lord Attlee, that it is not inflexible either because it should not be for a policeman to decide whether a young person has been affected mentally by the situation. It is coercive if you count coercing the police to do the right thing and share the information, but it is not coercive in relation to the children. The police have to share the information, and it is then for the qualified person doing the assessment to decide what level of help—or no help at all—is needed by that child. That is perfectly straightforward and I see no reason why it should not be done.
The fact is that the police sometimes refer children for mental health assessments, but very rarely. Sometimes children go through a lot of barriers before they get to the assessment, and they disengage. They say, “I can’t do with having to tell my story over and over again to a whole series of people”. What should happen is a referral from a police officer directly to the people who can assess—with the child’s consent, of course—as their professional duty, whether that child needs any help at whatever level.
Clearly, I am not going to convince the Minister, but I should like to keep talking to her about this. Indeed, we have a meeting in the diary for next Monday about this very thing, so I would like to do that. Because of that, I beg leave to withdraw the amendment.
My Lords, this is another thing on which I did not succeed in convincing the Government in Committee, but I listened very carefully to what the Government said and have made some changes.
I had been seeking to ban the use of Tasers by police in psychiatric wards, but since the Government feel that their use may sometimes be necessary, my amendment asks the Government to specify very clearly in regulations the exceptional circumstances under which Tasers should be used. Bearing in mind that the use of such a weapon is a very serious issue and has sometimes led to the death of the person who has been tasered, my amendment asks that any use of such a weapon in a psychiatric ward should automatically be referred to the Independent Police Complaints Commission as a matter of course in just the same way as a death in custody is reported and investigated. By that means we would find out in considerable detail what led to such a severe intervention, and that information can be helpful to the police and mental health providers in improving the way they deal with people in great distress who may well have turned to some kind of violence or aggression. The hour is late, and that is all I wish to say. I beg to move.
My Lords, I agree with the noble Baroness that the hour is late, and therefore I shall be brief. I was here for the debate in Committee on this subject and I was wholly persuaded by the Minister about the undesirability of this amendment. I know full well that Tasers can be very injurious and I know that they are dangerous, but I also know from considerable personal experience that people in psychiatric wards can be extremely dangerous, volatile and violent.
I speak as somebody who was for some years Minister for the special hospitals. There were three mental hospitals in my constituency. I was the Minister for Police for a time and, relatively recently, I was on the monitoring board of a local prison. I know they are different, but in prisons you see many people who ought to be in psychiatric hospitals. The truth is that sometimes there is no choice: people get possession of a weapon and threaten their nurses or pose a very real threat to the other residents on the ward. What is a police officer to do if summoned and faced with a person with a knife? The truth is that in exceptional cases—which I will come to in a moment—a Taser may be necessary. I am certainly not going to go down the road of prohibiting that by statute.
What does “exceptional circumstances” actually mean? I can tell the noble Baroness: when there is a reasonably founded belief that it is necessary in self-defence or in defence of a third party. If I was the Secretary of State and put that into a statutory instrument, so what? Ultimately, it has to be decided by the court. If you look at this amendment and reflect on its consequences for one moment, the police officer is guilty of assault unless he can bring forward the defence. But who is responsible for bringing forward the defence? Does he have to prove that his acts fall within the exceptional circumstances or does the prosecution have to negate their existence? I suspect the latter, but it is extremely difficult for a police officer in those circumstances. It is a legal minefield and good news for lawyers—which is not something I am advocating in this case. It is a thoroughly bad amendment and I hope we hear no more of it.
My Lords, this amendment brings us back to the use of Tasers. I am grateful to the noble Baroness, Lady Walmsley, for taking on board the points raised when we debated this issue in Committee and coming back with a revised amendment. My noble friends Lord Hailsham and Lord Attlee have given us a flavour of what we discussed then.
Any use of force by police officers in psychiatric wards on patients—or on any member of the public in any setting for that matter—must be appropriate, proportionate, necessary and conducted as safely as possible. When police officers need to attend and use force, they must be able to account for their actions. As the noble Lords, Lord Dear and Lord Rosser, and my noble friend Lord Hailsham indicated in Committee, a blanket ban on the use of Tasers in psychiatric wards would remove this valuable police tactic when they are dealing with potentially very violent situations.
I do not usually take interventions on Report, although I will acquiesce to the noble Baroness because she did not speak for very long.
I welcome the fact that the noble Baroness now accepts that there will be exceptional circumstances. My noble friend Lord Hailsham has very clearly outlined what exceptional circumstances would be, and I explained in Committee that it was when all other options for restraint had failed, particularly when the person has perhaps had to be kept at length from the police officer—in other words when going near the person would create a danger for other people.
The Taser was introduced to be used at that intermediate stage. It is to be used where de-escalation at the lower end has already been tried but has failed, and where the officer deems that other options—ranging from the use of lethal force, as my noble friend said, at the higher end—will not resolve the immediate threat in the safest and most proportionate way.
With regard to recording incidents, as the noble Baroness pointed out, each officer who deploys a Taser is required to complete a Taser evaluation form on every occasion where the device is used. The form should be completed prior to the end of each tour of duty, but in any case within 24 hours of the use. The police forces’ lead Taser officer is responsible for reviewing, collating and recording all Taser evaluation forms.
In Committee I explained that new police data were being collected on the use of force by officers, including force used in a hospital setting, to further improve the existing system of recording and reporting. Police forces are working to implement this new recording system and we expect data to be published as part of the Home Office’s annual data return in summer 2018 to ensure that the use of Tasers is absolutely transparent.
I put it to the noble Baroness that effective scrutiny of the use of Tasers is a better way forward than seeking to legislate. No officer will use a Taser lightly and will seek to argue that there were indeed exceptional circumstances. I have already pointed to the anomaly that this amendment would create in respect of the use of lethal force—no one wants to see that happen—if a safer tactic was unavailable. I hope the noble Baroness will feel happy to withdraw her amendment.
My Lords, I thank the Minister for her reply. Anyone hearing what has been said in the House tonight would think that I was asking for a ban on the use of Tasers. If noble Lords read my amendment carefully, they will realise that that is not what it would do. It accepts what the Government said in Committee, and during meetings that we had at the Home Office, that there may be exceptional circumstances. That is why I am no longer asking for a ban; I make that absolutely clear to noble Lords who have spoken.
However, it is a very serious matter for a police officer to use a Taser, as the Minister herself has said, in which case I think it would be helpful to the police if the Secretary of State were to specify clearly what is meant by “exceptional circumstances”. The noble Viscount, Lord Hailsham, has tried this evening to give a very simple account of what that means, and indeed the Minister has done the same. If it is that simple, why can it not be done? I think it would help the police.
I am aware that, following discussion in another place of an amendment similar to this one, a lot more information is now to be collected about the use of Tasers. I think that is a very good thing, and I look forward to seeing what we can learn from it. However, in this amendment I seek to be helpful to the police and to protect them by making very clear what they can and cannot do, and under what circumstances. But clearly the Government are not going to accept that, so I beg leave to withdraw the amendment.