Policing and Crime Bill (Sixth sitting)

Debate between Lord Beamish and Karen Bradley

Committee Debate: 6th sitting: House of Commons
Tuesday 12th April 2016 Public Bill Committees

[Karen Bradley]

I know that it will seem odd to the shadow Minister for a Home Office Minister to refuse further powers, but I will at this stage. I will return to that point later.

I will deal first with whether a health-based place of safety is the most suitable place of safety in every case, which goes to the nub of amendment 157. As the hon. Member for North Durham knows, a private home can already be used as a place of safety for a person detained under section 136 of the 1983 Act if the occupier consents. Clause 60 will make it possible to use a private home as a place of safety after a section 135 warrant has been used to enter those premises.

Where consideration is given to using a private home, it should be because it is the most appropriate place of safety for meeting that person’s needs, and not due to a lack of better health-based alternatives. In determining which place of safety to take a person to, those involved will need to consider all the relevant circumstances in the round. However, if the person concerned is particularly frail or likely to be very distressed if away from familiar surroundings, removing them from a home setting may be judged to be, on balance, more harmful than helpful. Conducting the mental health assessment in the home may therefore prove both quicker and a more satisfactory experience for all concerned. Similarly, it may be preferable to take a young person to their family home, rather than detaining them in a strange place where they know no one.

There is no question of a person being taken to a private residence or forced to remain there against their will. The use of a private dwelling as a place of safety will require the active consent of both the person detained and the occupiers of the residence.

The shadow Minister talked of street triage. When I have met street triage teams across the country and seen mental health clinicians working with law enforcement, the best cases have been where the law enforcement officer has allowed the mental health professional to take responsibility for the necessary decisions. I have seen examples of the mental health professional, rather than the police officer, going into the place where the individual in crisis is, assessing them and determining whether they should be arrested or detained, whether at their own home, at somebody else’s home or in a health-based place of safety.

Anybody who has been in a police custody suite—I hasten to add that it was not as an inmate, in my case—will know that it is stark and brightly lit, with no shade and nowhere to hide. It is a horrible environment for somebody who is ill to find themselves in. Going to a health-based place of safety is a much better option, but it may be that some people can be treated better and get the appropriate care in their own home. I assure the hon. Gentleman that we are not saying that there is no need for health-based places of safety—absolutely not. We are determined that health-based places of safety will be available as they are needed, but for some people it is better to be treated in their own home. In the majority of cases I genuinely believe that the health-based place of safety is the best place, but for a small number that will not be the case.

The Bill is designed to increase the flexibility that police and medical professionals have to act in the best interests of the person concerned in a wide range of circumstances, while ensuring that appropriate safeguards remain in place to prevent abuses of such a system.

Amendment 159 seeks to provide that the period of detention would commence when a decision to detain was made, rather than on the person’s arrival at a place of safety. As the hon. Member for North Durham will know, sections 135 and 136 enable someone to be removed to a place of safety if that is required. Once they arrive at the place of safety, it is essential that the mental health professionals have sufficient time to conduct the assessment and arrange any further care and treatment that are required. Any individual in such a circumstance must have the opportunity to have a thorough assessment that is not driven by detention deadlines.

Amendment 159 would unfairly penalise both the people in need of care and the health professionals assessing them if the decision to remove them was taken in an isolated place and if getting them to a place of safety would take some time. I know from my constituency that in isolated rural constituencies, things just take more time. As it happens, one also cannot give birth in Staffordshire Moorlands because there is no maternity facility. If one goes into labour, it will take at least half an hour to reach a maternity hospital. That is the reality of isolated rural communities.

Similarly, what about situations in which removal is difficult and risky for all concerned—for example, when someone is threatening to jump off a bridge? An attending police officer would probably make the decision to detain very soon after arriving on the scene, but it might take time to get the individual off the bridge. Would it be reasonable to require the police officer, in that highly pressured situation, to think about the clock ticking towards a time when they would have to release the person, whether or not they had managed to get them to a suitable place for a mental health assessment?

I do not think that that is what the hon. Gentleman intends with his amendment. I think he intends to ensure that the person is transported to a place of safety as quickly as is reasonable. That can be addressed through guidance and the performance management of ambulance response times, rather than through legislation. Front-line professionals need to make the right decisions, taking account of the circumstances and the individual’s best interests.

Amendment 158 seeks to reduce further the permitted period of detention. As far as I can see, there is no disagreement among members of the Committee that the current period of up to 72 hours is much too long. It was put in place to take into account bank holidays, weekends and so on, but that is not good enough. We cannot have a situation in which, because someone has a mental health crisis on the Friday night of a bank holiday weekend, they find themselves in a police cell for 72 hours. That is simply unacceptable. It cannot be right to hold someone who is suffering a crisis and is in urgent need of a mental health assessment against their will for up to three days anywhere, not just in a police cell.

Clause 61 deals with that issue by introducing the concept of a permitted period of detention, and setting that period at 24 hours. We have also allowed for an extension by a further 12 hours if—and only if—the person’s clinical condition merits it. This is not a target time. Just as they are now, we expect that the vast majority of cases will be resolved much more quickly. The Royal College of Psychiatrists has recommended, as a matter of good practice, that the assessment should start within three hours of the person being detained, and that has been built into the Mental Health Act code of practice. I want to be clear that 24 hours is not a target. We do not expect that a mental health assessment will start at 23 hours. We want it to start as soon as is reasonably practical, to ensure that the person gets the assessment and treatment that they need as soon as it is required.

We have been told by stakeholders that there will be occasions when the clinical condition of the person is such that they simply cannot be assessed immediately—for example, because they are intoxicated through drugs or alcohol. We have listened to that advice, and the maximum permitted period of detention has been set at 24 hours so that time is built in for the effects of intoxication to wear off. Otherwise, we would risk creating a situation in which the assessment process was made difficult or impossible because the person was unable to participate fully.

Equally, a shorter maximum detention period would risk the person having to be released before they had been assessed because they were not yet clinically fit to participate. Clearly, that would be in no one’s best interests. For those reasons, we have set the permitted period of detention at 24 hours. In the Government’s view, that provides a good balance between keeping periods of detention as short as reasonably possible and making sure that the assessment can be carried out in the most effective way.

The provision for an extension of not more than 12 hours over and above the original 24 hours, is for the very rare cases where the clinician responsible for carrying out the assessment is satisfied that the person’s clinical condition is such that the assessment cannot be started or completed within the 24-hour period. I want to be clear here: the provision to extend beyond 24 hours will be based solely on the person’s clinical condition. There is no scope for it to be used in any other circumstance, such as staffing problems.

In practice, the average period of detention is now less than 11 hours. That time includes the person being detained, the assessment being made and any future care or treatment arrangements arising out of that assessment being put in place. In the majority of cases, the necessary processes are already completed well within 24 hours. Of course, we recognise that the reduction to 24 hours may represent more of a challenge in some areas than others, but the work that is going on across England to improve mental health crisis care services, backed by both the national crisis care concordat and the 94 local concordat groups, is helping to develop services that can respond to the changing needs of the areas they serve.

I hope that I have reassured the hon. Member for North Durham that the 24-hour time limit is not some arbitrary figure that has been chosen for convenience, but a deliberate decision that seeks to establish the balance between compulsion and care that I mentioned earlier.

New clause 11 seeks to introduce an annual reporting requirement in respect of detention in places of safety. The Government agree that the police should be transparent about the use of their powers under the Mental Health Act, so that we can see how often these sensitive powers are used, who they are used for and what further actions are taken. That will enable the changes being made through the Bill to be monitored effectively. It is only through looking at the data that we are in the position we are in. When my right hon. Friend the Policing Minister had responsibility for this area, he was determined to get to the bottom of what was and was not working well, and to make the decisions and changes that were needed to get to things working well across the country.

The Health and Social Care Information Centre and the National Police Chiefs Council publish annual data on detentions under sections 135 and 136 of the 1983 Act. For section 135, data are provided by health services covering the volume of detentions in which people are taken to a health-based place of safety. For section 136, the data include the numbers of people taken to police custody and health-based places of safety and are provided by the police and health services respectively.

However, we know that police data in this area have varied in quality. As a result, the Home Office is working with forces across England and Wales on a new data collection system for section 135 and 136 detentions to raise the level of consistency across the country. The new data set is voluntary in 2015-16, but will become a mandatory part of the Home Office’s annual data requirement for all forces in England and Wales from April this year—this month.

The annual data requirement will capture not only the number of detentions, but the age, ethnicity and gender of the people detained; the place of safety used, including, where applicable, the reason for using police custody; and the method of transportation and, where a police vehicle is used, the reason why. We intend to publish the data annually to ensure that there is full transparency, so I hope the hon. Member for North Durham will not need to ask written questions at that point.

[Mr Kevan Jones]

I welcome what the Minister has said, as it goes to the core of what new clause 11 aims to achieve. In what format will those data be published? Will there be a consistent approach, as she suggests, so that areas can be compared? That is the other important point to consider as this legislation progresses: we must ensure that it is working, that people do not end up in police cells and that we have comparable data from different areas.

[Karen Bradley]

The hon. Gentleman is absolutely right. If we do not have comparable data, we cannot compare. My right hon. Friend the Policing Minister, who set this work in train, was adamant that we needed comparable, appropriate data, which would be available online, so that we could make a fair comparison.

It is a fair suggestion that the length of time for which people are detained should be recorded, but there are practical difficulties. It would be incredibly difficult for the police to keep such information, because, quite frankly, we do not want police officers to be part of the process once somebody has been detained under section 135 or 136 of the Mental Health Act, apart from in the very rare cases where a police station is used.

Policing and Crime Bill (Seventh sitting)

Debate between Lord Beamish and Karen Bradley

Committee Debate: 7th sitting: House of Commons
Tuesday 12th April 2016 Public Bill Committees

[Karen Bradley]

My hon. Friend gets this absolutely right. As a central repository of intelligence and information, Action Fraud can work out which force is best placed to investigate. It may well be that that is the National Crime Agency or an international force. I will give an example. One of my constituents could go to the marketplace in Leek in Staffordshire Moorlands and have a fraud committed on them there. It would be very clear that that had happened in Staffordshire Moorlands and that Staffordshire police should investigate. But if that happens online, the criminal could be based in eastern Europe, or the far east, or anywhere in the UK. Action Fraud can put that information into a central repository and get the links; that means that we have an excellent facility for finding the right force to investigate and for finding the criminal.

[Mr Kevan Jones (North Durham)]

I do not disagree with what the hon. Member for Kingston and Surbiton was saying. These things are best looked at nationally—some of the conspiracies are clearly international as well—but does the Minister also agree that one of the problems with Action Fraud is that many people who have contacted it feel let down because of a lack of feedback about what happens in their individual case, or how their individual case may well be helping a bigger fraud?

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[Lyn Brown]

New clauses 46 and 47 act on a recommendation made in a joint report by NHS England and the Department of Health in 2013 called “Future in mind”, which argued that we need to ensure 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.

In 2014, the NSPCC produced a summary of the academic literature on the relationship between childhood sexual abuse and victims’ later mental health. In each instance, the NSPCC offered a conservative estimate of the known impact of one on the other. Despite that effort not to sensationalise, the numbers are truly shocking. Children who are victims of sexual abuse are twice as likely to suffer from depression as those who are not victims. They are three times as likely to attempt suicide, to self-harm or to suffer from post-traumatic stress disorder at some point in their lifetime and twice as likely to become dependent on alcohol, meaning that their physical health as well as their mental health is endangered.

All the evidence shows that the trauma and emotional confusion that follows childhood sexual abuse leaves victims more likely to suffer from poor mental health. We should, as a matter of course, do all we can to prevent that from happening, or at least to ensure that those mental health issues are made easier for victims to manage. That involves high-quality and appropriate mental health treatment and professional emotional counselling. There is evidence, for example, that abuse-specific therapeutic interventions relieve depressive symptoms among victims.

New clause 46 would require police or local authorities to make a referral whenever they receive a disclosure that a child has been the victim of sexual or other abuse. They would have to make a referral even if they do not believe there is enough evidence or grounds to take further legal action. That is important, because the burden of proof necessary for law enforcement to use its full array of powers is obviously higher than the level of suspicion needed for our full safeguarding and health measures to be utilised.

The NSPCC has found that delays between children suffering from traumatic events and receiving treatment lead to exacerbated mental health issues and we know that victims of sexual abuse have often had difficulty in being believed by the professionals charged with their care and protection. Duties to refer are not new to our legal system when dealing with safeguarding measures. For example, some employers must refer an individual to disclosure and barring services whenever an allegation of a sexual or abusive nature is made. The provisions in the new clause would not charge local authorities or the police to carry out the task of diagnosis, which they are not trained to do. It would be a precautionary measure that applied to all those about whom they receive a disclosure, not just those they believe to be suffering from a mental or emotional health issue. It is a sensible proposal, in keeping with established safeguarding practice and the assignment of appropriate professional duties.

The proposals are also well thought out. New clause 47 would put a duty on the police to share information with the relevant mental health service commissioner in their area. I believe that that new clause would work with new clause 46 to create a culture of collaboration between law enforcement, health agencies and local government, which is needed if the victims of child sexual exploitation are to be given the care and support that they need.

[Karen Bradley]

I thank the hon. Member for North Durham for again raising a very important issue. He is absolutely right. We must make sure that vulnerable or traumatised children must never fall through the gaps between services. I would appreciate it if, when we meet, we could discuss the way that that might best be addressed, because I am not convinced that the best way is a mandatory way. For example, some young people who are abused or exploited do not develop mental health problems and I have a nervousness about intervening unnecessarily, which could create unintended harms. We need to make sure that we intervene where we need to and that each child is treated as an individual and has the care that they need; I do not think that it should be mandated.

[Mr Kevan Jones]

I take the Minister’s point. We cannot force anyone to have treatment, but the offer of some support for individuals would make a real difference.

[Karen Bradley]

I would really appreciate talking this matter through outside the Committee, and I would like the shadow Minister to attend that meeting as well. There is work being done. The shadow Minister mentioned the “Future in mind” report, which the Department of Health is working on to ensure that an emerging workforce strategy is put in place. Perhaps we can discuss that privately.

The hon. Member for North Durham referred to civil servants getting slightly scared about the idea that personal data should automatically be disclosed to third parties. I appreciate the good intentions, but I do think that that is a dangerous road to be travelling down. We need to have a conversation about how best to manage that.

It is right that we need to make sure that children get support. I have talked about the children I have met who have experienced abuse. They need the right support. At what point do they go into recovery? At what point can they lead a functioning life? It is clear from the work we are doing through the troubled families programme that in the families who have gone through the programme, there are multiple problems—mental health, abuse, domestic abuse and other problems. We need to tackle all of those. I know these are probing amendments and I hope that the hon. Gentleman will allow us to discuss them at length outside this room.

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[Mr Kevan Jones]

It is my understanding that if a local authority draws up a local policy, it can use cumulative impact to refuse further licences in an area.

[Karen Bradley]

The hon. Gentleman is absolutely right. There are already more than 200 cumulative impact policies in England and Wales and they allow local authorities to control the number or type of licence applications granted in an area where it can be shown that high numbers or densities of licensed premises are having an adverse impact on the licensing objectives. They can also put a levy on such premises. However, the cumulative impact policies currently have no statutory basis and it is unclear whether all local authorities are making best use of the power. That is why we intend to place them on a statutory footing both to maximise their effectiveness and to improve local authorities’ ability to ensure that the right premises for their area are granted licences to sell alcohol and late-night refreshment.

[Mr Kevan Jones]

I am a bit of an anorak on the Licensing Act 2003 from when we were in power. The Minister makes an important point about putting cumulative impact on a statutory footing. One thing that confuses the public is that while the ability to reduce licences or take action is there—the onus is on the local authority—in many cases they do not use the powers they have got.

[Karen Bradley]

The hon. Gentleman is absolutely right that local authorities do not necessarily use the powers available to them and this measure will ensure that they understand those powers and use them. I hope that he and the hon. Member for West Ham understand that the change requires proper consultation with those affected. We need to consult the licence trade, the alcohol industry and local authorities. Therefore—I hope that the hon. Lady will forgive me—we need a little time to undertake such consultations. We will do them as quickly as possible. I cannot promise that they will have been completed in time for Report, but suffice it to say that we support the objectives behind new clause 52 and will seek to bring forward proposals of our own as quickly as possible.