Mental Health Bill [HL]

Earl Howe Excerpts

Committee stage
Monday 27th January 2025 Lords Chamber

[Baroness Browning (Con)]

My Lords, Amendment 128 is in my name. A person with autistic spectrum disorder or a learning disability may be stuck in hospital for years; we know that they often are. We sincerely hope that matters will improve dramatically when this Bill is enacted, but we should not be so optimistic as to think that will happen in the near future. However, when somebody is in hospital that long and no longer needs clinical supervision—some in the autistic and learning disability community, for example, never needed to be in there at all—parents become extremely stressed and frustrated. There may be long periods when a close relative, often their adult child or a younger child, is stuck in these hospitals and the parents cannot get them out.

We heard in debate earlier this evening of the differences between the county courts and the mental health tribunals; of course, there are also people who sometimes resort to the Court of Protection. Although I heard noble and learned Lords giving their different views on these, most seemed not to regard the county courts as the most appropriate course. It is a fact, though, that the Court of Protection has had some success in getting out people who have been unduly held in mental health hospitals.

Amendment 128 proposes that mental health tribunals are strengthened to give them the same opportunity as the Court of Protection to make progress in releasing people from long stays in hospitals. If they are to do that, the mental health tribunals need to have more powers, particularly to require local authorities and the NHS to provide a report to enable discharge for a person who no longer clinically needs to be in hospital. This would give tribunals the same powers that the Court of Protection has under Section 49 of the Mental Capacity Act, because there has been some success.

The Court of Protection has been able to secure discharges because it is able to call for reports from local authorities and health services to put the case that it feels confident that it would be safe to discharge somebody. Parents who do this very often have to fund it themselves. Strengthening the tribunal cases, in line with the sort of powers that the Court of Protection has in getting information collated, to make sure the discharge package is sound is very important. This approach would be stronger and more effective than the Government’s proposal that tribunals make recommendations on Section 117.

That is what the Government propose, but I hope that the Minister will look carefully at this amendment. It would enhance mental health tribunals, increasing the number of people who have proper discharge packages through these tribunals. I do not see this as a competition between the Court of Protection and tribunals. Both have a place, and this will be important if we are to achieve what this Bill wants to achieve: to make sure that people do not stay in health mental hospitals a moment longer than they absolutely have to. I beg to move.

[Earl Howe (Con)]

My Lords, I believe we would all accept—and, personally, I am in no doubt—that my noble friend Lady Browning possesses a breadth and depth of experience in matters relating to autism and learning disability. By that, I mean that she has not just a familiarity with the day-to-day challenges of life for individuals with one or more of these conditions but a knowledge of the practical frustrations and hurdles that often have to be overcome if the best interests of such individuals are to be properly defended.

It is amply clear from what my noble friend has said that, if this amendment were inserted into the Bill, it would have the potential to make a material and beneficial difference to the process of discharging certain patients from a secure mental health unit in particular types of situations. As my noble friend said, and as we all know, there have been many instances where autistic patients have been detained inappropriately and for long periods under the Mental Health Act and where families have struggled to secure their relatives’ release.

I cannot see a logical reason why a mental health tribunal should not be placed on an equal legal footing with the Court of Protection in this very limited respect. I hope the Minister will agree.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am most grateful to the noble Baroness, Lady Browning, for tabling Amendment 128 and for her contribution, along with that of the noble Earl, Lord Howe.

On the proposals in Amendment 128, I can tell your Lordships that, under the current tribunal procedure rules, the tribunal can direct responsible authorities, which could be a local authority or an NHS body, to provide evidence. The practice directions that apply in mental health cases place a requirement on the responsible authority to provide reports and records relating to the patient’s detention treatment and any after-care plans. The tribunal can use these reports to decide whether the detention criteria are being met. Therefore, it appears that the tribunal has extensive powers to require responsible authorities to provide the information to support its decision on whether to discharge a patient. I hope that the noble Baroness will be satisfied with this response and will withdraw her amendment.