Policing and Crime Bill (Second sitting)

Lord Beamish Excerpts

Tuesday 15th March 2016 Public Bill Committees

[James Berry]

Q Finally, are there any particular categories of offending in respect of which you are especially concerned about having a restriction on the time you can bail someone for pre-charge?

Sara Thornton: There are certain offence types and sorts of investigations. Any investigations that require the examination of digital forensic material will be problematic. Often, child sexual abuse investigations, where you have masses of third-party material within social services, can be problematic. Indeed, so can financial offences where you have got frauds and you are trying to get information from banks. It would be a mixture of different sorts of offence types, but also investigations that involve certain sorts of evidence.

[Mr Kevan Jones (North Durham) (Lab)]

Q Will you say what powers you actually need and how the system would work if it were an offence to break a bail condition?

Assistant Commissioner Rowley: In the same way that at the moment it is an offence to breach a bail condition post-charge, one could bring the same sort of approach pre-charge. You would not make it life imprisonment; it might be a year for the maximum sentence or something like that. It would not be the most serious offence but it would give some degree of traction.

If you were considering legislation, you could think about whether you put that in place for breaches of bail for all matters or just for serious crime and terrorism. There are ways you could consider it. You could consider how a subject may appeal to a judge against the conditions put on them. There are things you can put around it, but fundamentally it is the ability to say, “If you breach that condition, there is some follow-through from the legal system.”

[Mr Kevan Jones]

Q Sara raised the issue of domestic violence. It is terrifying for a woman.

Assistant Commissioner Rowley: Exactly.

[Mr Kevan Jones]

Q Would you cover that?

Sara Thornton: Absolutely. If it was an offence to breach police bail, for which somebody could be charged, not only would there be a sanction; it would also mean that when you look at their criminal record in future cases, you know that they have a history, on the record, of breaching bail. I am not completely confident whether a police bail has been breached now, but it almost certainly would not get to be a criminal record and I am not sure it would be that transparently available to all other police officers.

--- Later in debate ---

[Jake Berry]

Q I have one final point. Recent police research revealed that the PCC governance of police forces, as opposed to the old police panel governance, has saved the taxpayer around £2 million every year. If there were similar savings to be made by the extension of PCC governance to the fire service, do you think that both the fire service and the police service could usefully use those savings to prioritise front-line services?

[Mr Kevan Jones]

That is a difficult question.

Sara Thornton: Collaborations of all kinds deliver all sorts of benefits. They can concentrate expertise, save money, help you to deal with crises and share best practice. In the same way that we already have collaborations with the fire service, which are about shared control rooms and shared estate to save money, if there is more of that, there is more potential to save money.

[The Chair]

I thank the witnesses for their evidence. Not only the brevity, but the accuracy of their responses means that we managed to finish earlier than anticipated. The Committee will be suspended for 15 minutes.

--- Later in debate ---

[The Chair]

Q We will now hear oral evidence from the Royal College of Psychiatrists and the “Get Maisie Home” campaign. We have until 4.30 pm for this session. I ask the two witnesses to introduce themselves for the record.

Dr Chalmers: My name is Dr Julie Chalmers. I am a specialist adviser in mental health law to the Royal College of Psychiatrists. I am also a community psychiatrist, and I chair the multi-agency section 136 group at the college.

Sally Burke: I am Sally Burke. I am mum to Maisie, a 14-year-old girl who is struggling with mental health issues. She is also on the autistic spectrum.

[Mr Kevan Jones]

Q To start with, what are your general views on the provisions in the Bill about amending the Mental Health Act 1983?

Dr Chalmers: First, we welcome the focus on mental health crisis, following on from the excellent work that has been done by the concordat. The college is very much behind the principles that are driving the changes to legislation. Having said that, there are some very sensible changes. For example, there is the issue regarding clarification of a public place. My colleagues in the British Transport police and the healthcare workers who work alongside them have struggled with that issue. That is a very important change, because we know that the railway line is an important issue with suicide.

However, we have to step back and see section 136 in a much wider context of crisis care. I would be concerned that the legislation cart is coming before the horse. There have been significant changes in the past two years. Certainly, the number of people who are going to a health-based place of safety has increased. As you may know, the figures are variable, but it looks like about 80% of people, if not more, now go to these places. So there have been considerable improvements within the health services in their response to crisis.

We cannot do our job if we do not have the resources. Changes to the law could put pressure on the crisis services at a number of points, and I can expand on this if the Committee wishes. For example, there is the suggestion of changing the length of time to 24 hours. In principle that is an excellent idea. We want to reduce the time that people are subject to detention, particularly when that has been prompted by someone who is not a mental health professional. I think that 24 hours is a realistic timeframe in which to do that if the resources are in place. Generally, the areas that keep figures will tend to be the good areas. However, it is possible to meet people’s needs within a relatively short period of time, and do the assessment within several hours of presentation. That is perhaps not within the three hours that the college would set as the gold standard, but it is certainly within that longer period. It does become a problem if someone is intoxicated, or if they come in overnight when resources are less available and that gets passed on to the daytime services. There may be a knock-on effect.

The main problem that I see with the laudable aim of reducing the time for which people are subject to detention is when we come to the very small group of people who are subject to section 136 who need to be detained in hospital. As you have probably heard, approximately 20% of people need to come into hospital, and some of them will need to be detained under the Mental Health Act. If we cannot identify a bed for a person to go to, we might very quickly run up against this 24-hour time period. Then we—the AMHP, the approved mental health professional—are left in the most appalling situation. It is the job of the AMHP to make the recommendation for admission to hospital based on two medical recommendations. We have to say which hospital and which bed that person is going to. If we cannot identify that, then after 24 hours we will be in a position of acting unlawfully, because we have no way of detaining the person. I note that the Bill as it is currently written suggests that someone could be detained on clinical grounds. There is a lack of clarity around on what grounds we could extend.

I want to flag up to you the very important point that we may be in a situation where we cannot find a bed. That is not just me shroud-waving. The Committee will be aware that the Lord Crisp commission has highlighted the appalling situation where we are struggling to find beds. On occasions, we have to send people away, usually to independent hospitals. I will say a word about the difficulties there. Something like 500 people in a month have to travel more than 50 km to find a bed.

It sounds easy, “Let’s just find a bed in an independent hospital. Why wouldn’t they want to take somebody?” My team is in this position several times a month, where we will phone around several hospitals looking for a bed. Perhaps this sounds ungenerous, but sometimes it feels that if you have a choice you can cherry-pick the kind of patients you want to take. Often we think we are offered a bed, then we send the details and it is turned down. I am really concerned. Although I welcome it in principle, I just want to flag up the important resource issues that we might come up against with the 24-hour period.

[Mr Kevan Jones]

Q Like you, I welcome the broad provision that has been put in place but I have this concern. What will happen is that people will not be taken to a police cell—which is what we are trying to avoid—but will likely be kept at home because that is now deemed as a place of safety.

Without statistics being published, we will see the number of people being referred to police stations going down, but we will not know what has happened to them. Do you think there should be in the Bill an onus on a local force to keep statistics of what happens to people under sections 135 and 136? Otherwise, we could get a situation whereby the problem just gets masked rather than solved.

Dr Chalmers: Your point is very well made. As early as 2011, the inter-agency group made a plea for good statistics. If you do not know what is happening we cannot track it.

If I could just take you back. I think we need to distinguish section 135 from section 136. Section 136 will never occur in a person’s home. What I think the Bill seeks to address is the lack of clarity about whether you could undertake the assessment in the patient’s home when you had entered with a warrant. It is the police who will administer, if you like, the warrant. They will act on the warrant accompanied by the AMHP and a doctor.

Up to now it has been unclear whether you could stay in that person’s home to undertake the assessment, or whether the Mental Health Act as written required you to remove a person to a place of safety. I have done many assessments in a person’s home, and I think that is probably better than removing them, particularly if it is not clear that you will actually detain somebody in hospital. It is important to clarify that.

Your point about data is particularly pertinent to section 135, where those are not collected nationally. Of course, there are two 135 warrants. There is the one to enter a person’s home to remove to a place of safety, and one to return them to hospital. We do need those data.

[Mr Kevan Jones]

Q Can I clarify the position? The Bill would require a police officer to consult a mental health professional or nurse before removing someone from a place of safety, where it is “practicable to do so”. What is your view on that wording?

Dr Chalmers: My personal view is that that has slipped in. As far as I am aware, that was not consulted on. I do not necessarily know what the college position would be, other than to say it is always a good thing to talk. I would say that as a psychiatrist.

I just wonder whether that needs to be in legislation rather than in regulations or in the code of practice, because it is straying into an area of telling people what to do using the law, which I am not sure is particularly helpful. What we do know, based on evidence from the street triage projects, is that where people work together and there are conversations between police and healthcare professionals in some areas, it has led to significant reductions. If you include this provision, we are behind. The services are very patchy and variable. In some places it would work very well because police would have immediate access to somebody with authority to give advice. In other places, they would be foundering. Without bringing the resources alongside the law, there is the risk of setting people up to fail. Allowing things to develop in localities can find the best way of working, because there might be different pathways.

I have sidetracked your question, because I wonder whether we need to scrutinise whether that is a wise thing to have in statute rather than in regulation or within the code of practice.

[Mr Kevan Jones]

Q May I ask one last question on advocacy? Clearly, some individuals have family members or others to explain the law or situation to them. In many of these cases, individuals have no one. What is your view about making it a requirement for people to have access to advocates?

Dr Chalmers: It would be a pragmatic response. There are pragmatic responses and principled responses. It is essential that people have good information explaining in easy, accessible language what is happening to them and their rights at that point. Nursing staff in section 136 suites are well placed to do that. Again, I would imagine that that is patchy, but it is something that should be built into the specifications and reviewed.

The pragmatic answer is that for people on longer-term sections, for whom there is a statutory right to advocacy, the responses are patchy, so we have not got it right for the people who already have a statutory right to advocacy. I think stretching it to 3 o’clock in the morning is going to be very difficult.

[Jake Berry]

Q If I may address Sally: thank you for coming here today and for providing very detailed information about the journey you have been on with Maisie in advance of our meeting, for which we are all extremely grateful. As someone who has experienced the problems faced by yourself and Maisie at first hand, can you tell us a little about those experiences and what further you think we can do in the Bill to try to help parents who find themselves in the same situation?

Sally Burke: I have to state that of all the agencies we have worked with in crises, the police have gone the furthest in improving how they are with Maisie and understanding her. I welcome the Bill for not putting children in a cell as a place of safety. Maisie has not been in that position—just the thought of it—I did not realise at the time the damaging effect it would have had on her.

As Maisie’s parent my main concern was to keep her safe, but I was in too much of a state seeing my child doing the things that she was doing to make a long-term decision. With hindsight, I was able to reflect on what the police need to do in that crisis. I am now more hardened to it, so if Maisie wraps something around her neck, I can say, “Take that off”. Before, I would be going to pieces asking, “Oh, what do I need to do? I need to find a pair of scissors, but everything is locked away in a safe, so find the keys”. It is an awful predicament to be in, but you do get hardened to it, as you know, and a lot of police officers are hardened to those scenarios.

You need to have officers who can talk about mental health to parents. The approach of a lot of the front-line officers who turn up depends on their view on mental health. An older generation chap would think, “It’s attention-seeking, this. What do we do with this girl?” But younger people who we have had out seem to be more sympathetic and have more of an empathy on mental health and can deal with Maisie on a much friendlier, teenage level, which brings her down. If you have somebody who has quite a negative view on mental health thinking that she is having a behaviour fit and wants some attention, trying to bring her down in that scenario is not as effective.

It is also important to help a parent make a decision about the best way forward and the best place to go for safety that will have the best impact on that child in the long run. That is really important. My confidence has grown massively over the past two years since we first went into crisis. The first time I went into crisis with Maisie, if somebody had told me they were taking her to the moon right now to keep her safe, I would have said yes, because it was so horrible. You just cannot comprehend how you feel, as a parent. So I think it is about educating the officers who go out to these calls.

I have helped our local police force. I have been to conferences there and have heard the mental health cop talk to the officers and say, “60% to 70% of our time is spent on mental health conditions, yet we get hardly any training; 6% to 7% of our time is on criminal offences, or crimes, and how much training do you get for those activities?” When you see it in the balance, I think that would really help families and youngsters in mental health crisis.

Also, if you could sew into that, with your magic wand, some training on autism and learning difficulties, because that comes across as a bit of a grey area. Some officers just do not know what autism is and how to treat a child with autism. When Maisie is in crisis, she does not like to be touched, but an officer will come up to her and say, “Come on, Maisie, it’s okay” and she will freak out because she does not want to be touched. So there needs to be some education around how best to approach a child in that crisis scenario.