(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, 9 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, 9 months ago)
Lords ChamberMy 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.
(7 years, 9 months ago)
Lords ChamberThe noble Lord is right to raise this issue. The Government recognise the need to invest in places of safety and £15 million has been allocated to 88 projects in England to improve provision for those in mental health crises, including increasing places of safety.
Will the Minister define what she means by the last possible option? What are the Government doing to develop a humane alternative to the use of Tasers in psychiatric wards?
I am happy to tell the noble Baroness what I mean by “last possible option”. Something like Taser would be used only when all other methods of restraint are deemed not appropriate or to have failed, and where distance is required between the police and the person who is being extremely violent. That is what I mean by the last option. As to never using it, we can never say that it will not be used because the alternatives—I talked about this with the noble Baroness the other day—are to use more extreme methods of restraint, and we would not want that.
(7 years, 10 months ago)
Lords ChamberI start by thanking all noble Lords who have taken part in this debate. Although there have been opposing views on the amendment, it has provided a very balanced set of points. This group of amendments includes two proposed new clauses about police use of Tasers. As the noble Baroness, Lady Walmsley, explained, her amendment seeks to bar the use by police officers of a Taser or other electroshock device in psychiatric wards.
Any use of force by police officers in psychiatric wards, or in any other setting, must be appropriate and proportionate—the noble Lords, Lord Harris and Lord Dear, the noble Viscount, Lord Hailsham, and my noble friend Lord Attlee made that point and gave some very good examples this evening. The use of force must be necessary and conducted as safely as possible. Therefore, it is right that if police officers need to attend and use force, they should be expected to account for their actions, as the noble Lord, Lord Harris, said.
It remains the Government’s position that the deployment of police officers to mental health settings, and the tactics used, should remain an operational matter for the police force in question. Tasers are an important tactical option for police officers. Unfortunately, some of the most extreme behaviour can occur in mental health settings and can escalate to the point where it can be met only with force—as dictated by the high degree of urgency and grave threat to staff and other patients. I am talking about cases where other de-escalation tactics have probably been tried and have failed. Again, the noble Lords, Lord Harris and Lord Dear, and the noble Viscount, Lord Hailsham, made those points.
A blanket ban on the use of Tasers on psychiatric wards, as proposed by this amendment, would remove this valuable police tactic and therefore potentially reduce the safety of officers, hospital staff and indeed patients. In some extreme cases, it could leave officers with no choice but to use another, potentially more dangerous option as the only means to resolve a violent situation and keep others safe. The same noble Lords made these points. Police officers themselves have made it clear that they would not want their options constrained by a blanket ban on Tasers. Officers have a range of tactics and equipment available, and a Taser is but one of them. In deciding which tactic to use, an officer will assess which is likely to be most effective and proportionate.
The Government accept that more can and should be done to ensure that all uses of force, including of Tasers, are necessary and proportionate. For this reason, the former Home Secretary asked former chief constable David Shaw to lead an in-depth review of the publication of use-of-force data, including data on where force is being used, such as in a hospital setting, to ensure that the use of these sensitive powers is transparent. With the agreement of fellow chief officers, Chief Constable Shaw recommended that every time the police use a significant level of force on an individual, such as the use of Tasers, a range of core data must be recorded. This includes ethnicity, age and location, so that we will be able to identify every time force is used in a hospital or mental health setting. The data will enable thorough scrutiny of proportionality and effectiveness.
That brings in the point that I think the noble Lord, Lord Rosser, made about force seeming to be used more in some places than in others. All forces have worked to implement this new recording system, and I anticipate that the collected data will form part of the 2017-18 Home Office annual data return. I can tell noble Lords that in 2015 there were 10,329 uses of Tasers by police. Actual firings of the device—this is an important point—accounted for 17%. Non-discharges —where the Taser is drawn, aimed, arced or red-dotted—accounted for 81% of Taser use. Red-dotting accounted for 51%—the most common use.
All forces have worked to implement this new recording system and, as I said, it should be in force in 2017-18. The Government have also taken further steps to ensure greater scrutiny of the use of Tasers in mental health settings at local level, where operational decisions are made. Charles Walker MP raised some valuable points on this matter during consideration of the Bill in the House of Commons.
Both Home Office and Department of Health Ministers have in the past few days written to police and crime commissioners, chief constables and the chairs of local mental health crisis care concordat partnerships to ask them to work together to ensure that sufficient local joint scrutiny arrangements are in place. As local leaders with overall responsibility for policing and mental health crisis care, they have been tasked with ensuring that mechanisms are in place in their areas for the joint identification and scrutiny of any use of Tasers in a mental health setting.
I expect this additional scrutiny to lead to all relevant policing and health partners working closely to look at the full circumstances surrounding police officers being called to attend, the specific circumstances of any use of Tasers, and the lessons they can learn for the future.
As I have said, the Government and police believe that a blanket ban on the use of Tasers in psychiatric settings risks the safety of the police, hospital staff and patients. That said, I agree that more should be done to ensure that any use of Tasers in such circumstances is open to effective scrutiny. That is an important point.
The amendment tabled by the noble Lord, Lord Rosser, goes rather wider in seeking a review of all police use of Tasers—not just in mental health settings. As I just explained, the Government are committed to ensuring that the police use their powers and tools proportionately and are keen that all use of force by the police—including Tasers—be recorded and published.
The benefits of the planned new data collection system will be to enable the police and others to review practice in certain locations, against certain groups, and so on. This will enable deeper examination of the reasons for the use of force and inform adjustments needed to guidance, policy and authorised professional practice, if any. We have asked the police and others to ensure that this happens and, on that basis, I hope the noble Baroness feels able to withdraw her amendment.
My Lords, I thank the Minister for her reply and the noble Lords, Lord Ouseley and Lord Rosser, and my noble friend Lord Paddick for their support. I am sorry that I have been unable to take the noble Viscount, Lord Hailsham, or the noble Lords, Lord Dear and Lord Harris, along with me. I must say that I felt that in his enthusiasm in making his case, the noble Lord used somewhat unparliamentary language. In 16 years in your Lordships’ House, I have never been called silly before. The amendment was certainly not regarded as silly by the mental health patients who have approached us about the issue.
The noble Baroness mentioned that use should be appropriate, but we have had to move the amendment to highlight the issue today because it seems that “appropriate” has become a lot more frequent. We have heard some figures about the number of times that the police have been called in. At least the noble Lord, Lord Harris, was able at the end of his remarks to agree with me that part of the problem is undoubtedly the lack of sufficient properly trained staff in mental health wards, which needs to be addressed.
We will think carefully about what has been said on all sides of the argument between now and Report, but, for the moment, I beg leave to withdraw the amendment.
My Lords, I am grateful to the noble Baroness, Lady Walmsley, the noble Lord, Lord Kennedy, and the noble Baroness, Lady Benjamin, for their explanation of the amendments. We appreciate that their intention is to ensure that the proper provision is made for vulnerable or traumatised children. We absolutely agree that we must ensure that such children never fall through the gaps between services, but I put it to the noble Baroness, Lady Walmsley, that the overriding determinant of referral for health services must be clinical need. Not all children and young people who have been abused or exploited will develop a mental health problem, and intervening unnecessarily or inappropriately can in itself be harmful.
All that said, it is essential that healthcare practitioners who work with abused children and young people should have the capacity and capability to provide evidence-based treatment where needed. This will be addressed through the emerging workforce strategy, which is being put in place to deliver the key proposals in the Department of Health report on children’s mental health. The Department of Health is also introducing routine procedures so that sensitive inquiries are made to establish whether a child undergoing a mental health assessment has experienced neglect, violence or abuse. This will be an important step towards establishing a child’s or young person’s need for support. The important thing is that children and young people get the right care at the right time, based on their needs, not on a non-clinician’s view of their potential needs based on their experiences.
On amendment 221, it is worth adding that individuals, including children where appropriate, need to consent to receive treatment. Where a person indicates that they would like to avail themselves of any referral, consent can be sought for relevant personal details to be passed to the health provider, which is the proper course of action. It would be likely to be inappropriate, and in breach of data protection, automatically to pass on personal details and potentially sensitive information, even to a health provider. It may be helpful for noble Lords to know that NHS England published a Commissioning Framework for Adult and Paediatric Sexual Assault Referral Centres (SARC) Services in August 2015, which outlines the core services in SARCs and referral pathways to other services. They are now being rolled out throughout England.
On the basis of my remarks, I hope that the noble Baroness feels content to withdraw her amendment.
My Lords, I thank the Minister, though I hardly know where to start. I know that I want to keep my remarks short, as those here for the dinner-hour debate are waiting.
The Minister suggested that not all young people who have been abused require therapeutic help. Bearing in mind the figures that I gave at the beginning of my speech, we will not really know which 10% will not develop mental health problems unless we get them properly assessed. I may have used the wrong word—“refer”—in my amendment, but the point I am trying to make is that the police must ensure that the appropriate mental health commissioners in the area are made aware that a child may need therapeutic help and that an assessment should be done by a qualified person to find out whether they do. That is absolutely essential.
The fact is, we know that it is not always happening and that is why, as the noble Lord, Lord Harris, accepted, I felt it necessary to raise this, and I am not the only one. As I say, ChildLine also very much feels that this would be helpful.
Given the effect on the rest of the lives of these children, as my noble friend Lady Benjamin mentioned, a little bit of over-referral would not necessarily be a bad thing, because it will soon come out in the wash. If they do not need any help, it will soon be found out and the help will stop if it is not needed. The National Health Service is not going to give a whole lot of help to people who do not need it—it does not have the money. But the fact is that most of them do need it and it is not happening. After 16 years, I cannot believe that we are still here.
I will of course consider what the Minister has said and make further inquiries between now and Report stage in case it is not necessary, although I think it is. For the moment, I beg leave to withdraw the amendment.
My Lords, I am not going back on what I said on Monday. I think that I made clear on Monday that the accountability and functions of the bodies do not change.
On a point of elucidation, the Minister said that the Secretary of State could impose those conditions. Is there any circumstance in which the Secretary of State should not impose such fundamental conditions as she has outlined?
Sorry, would the noble Baroness say that again? I apologise.
I was just saying that the noble Baroness said that the Secretary of State could impose conditions such as meeting the current statutory duties of the Secretary of State or NHS England. I wondered whether there would be any circumstances in which the Secretary of State should not impose such conditions, because I think that they are pretty fundamental to standards.
I do not know of any such situation where he should not, but obviously each deal will be different. I cannot speak to a theoretical situation, but no one is suggesting that the Secretary of State loses the powers, particularly in respect of his ultimate accountability to Parliament for the provision of NHS services.
Most of the limitations and conditions that the noble Lord, Lord Warner, outlines could be specified in an order using the provisions, if doing so were considered appropriate in the context of a bespoke devolution deal. For example, we could enable a conferral of health powers on a combined authority to be accompanied by a condition that the combined authority must also meet the current statutory duties held variously by the Secretary of State for Health, NHS England and clinical commissioning groups.
Further safeguards are already provided by other provisions in the Bill. Before making an order to transfer functions, the Secretary of State must consider that such a transfer will improve the exercise of statutory functions. The Secretary of State is also bound by various duties in relation to the health service when exercising his functions. These are set out in the NHS Act 2006, and concern duties such as the duty to act with a view to securing continuous improvement in the quality of services and to have regard to the need to reduce health inequalities. Such duties would be relevant here and, in making an order transferring health service functions, he would be obliged to discharge them.
The order implementing a particular devolution deal must be debated and approved by both Houses of Parliament, and Parliament’s consideration will be supported by the laying in Parliament of a report setting out the detail of the deal, a new requirement under the provisions in Amendment 33, which the House passed on Monday. Those reports will set out and explain the full deal—that is, the wider context in which any order is being made. Hence, the report will set out and describe any memorandum of understanding that councils in the area, the combined authority and the various NHS bodies involved have agreed. That memorandum of understanding will describe and make clear the nature of the devolution agreement, including the degree of permanence or how long it is expected to last. We can see this in the MoU which Greater Manchester has entered into.
Amendment 66 would also require a combined authority to publish an annual report on its deal in relation to health. As we have noted previously, there will be a process for evaluating the progress on each deal agreed with each area as part of the deal. For example, the Greater Manchester deal has an extensive programme of evaluation, with evaluations being public documents available to all with an interest in the area and the progress that it is making. In this context, it is not appropriate to make a requirement about the reporting or evaluation of some particular aspect of a deal—indeed, an aspect that may not be in all the deals which are agreed.
We do not feel there is a need to restrict the ability of the Secretary of State to intervene as set out in Amendment 66. The Secretary of State is already under a duty when exercising functions in relation to the health service to have regard to, always subject to the interests of the health service, the autonomy of the bodies exercising health functions.
My noble friend will appreciate that I do not remember it, but he demonstrates, as always, a very good point.
My Lords, following the question from the noble Baroness, Lady Howarth, will the Minister say why the Government have pushed the introduction of tax-free childcare on by another year? Surely the watchword of this Budget was not “a Budget for security” but “jam tomorrow for hard-working families with children”.
My Lords, I think noble Lords will agree that it is certainly going in the right direction.