Oral Answers to Questions

Hywel Williams Excerpts

Tuesday 21st October 2014 Commons Chamber

[Mr Hunt]

I am afraid that that says it all. Opposition Front Benchers tell us continually that they are not prepared to condemn what is happening in Wales and that the health service in Wales is performing well, yet here is an opportunity to prove it—an independent study by the OECD of the four NHS systems in the UK—and Labour is trying to block it. This issue matters, because the policies in Wales are what Labour wants to do in England.

[Hywel Williams (Arfon) (PC)]

Will the Secretary of State concede that for many decades people from north Wales have had to travel to England for treatment? In that respect, both Government and Opposition Front Benchers are culpable.

[Mr Hunt]

The Government are happy for people to travel anywhere in the United Kingdom. My concern about health services in England is the pressure created, because for every patient that goes from England to Wales, five want to come from Wales to England.

Health

Hywel Williams Excerpts

Monday 9th June 2014 Commons Chamber

[Hywel Williams (Arfon) (PC)]

As a Plaid Cymru MP, it is something of a problem to respond to the Queen’s Speech on health matters, not only because it contained little about health in the first place but because health is largely devolved. Some time ago, when Alan Milburn was Health Secretary, I asked him about nurses’ pay, and he responded that he was eternally glad that he had no responsibility for things Welsh. He was wrong at the time, but now nurses’ pay is devolved. That is the measure of the problem that I face.

On the whole, the content of the Queen’s Speech was rather thin, with little attention given to the growing challenges we face of rising inequality, regional disparities, and an economic recovery that is built on fairly precarious foundations. The impacts and consequences for Wales are fairly obvious because of our higher rates of sickness and disability, higher proportion of older people, and greater needs in respect of poverty. Hon. Members may have seen today’s report on child poverty, which paints an alarming picture and casts doubt on the Government’s ability to reach the 2020 target of eradicating it. I think that that is now beyond reach, unfortunately.

Given the nature of the Queen’s Speech, I fear that the coming year will be a matter of treading water. For Wales, we have the continuation of the Wales Bill, but we also have missed opportunities. There are matters of particular concern to Wales, not least the funding of the Welsh Government. I also fear that we will see further dismantling of the principles of the welfare state, dismantling of public services, and a failure to address the deep structural economic weaknesses that we have, with a recovery that is driven by an increase in personal debt and spiralling house prices in the south-east and in London, and continues, I am afraid, the UK’s long-term imbalance that has devastated the economy in Wales, in parts of England, and indeed in Scotland.

Plaid Cymru put forward an alternative Queen’s Speech with Bills that we would have liked to be included. The Bills have principles central to Plaid Cymru’s vision for Wales, which is built on equality, prosperity for all, and social justice. We have 10 ambitious and workable Bills founded on strengthening Wales’ economic position and its position in terms of democracy, and on improving the lives of our people, not least in respect of health outcomes.

When the pension tax Bill is before the House, we will call for proper consumer protection for people who will have large pots of money at their disposal, as the sharks are already circling. We are extremely glad that the Government are introducing the modern slavery Bill. We also welcome the legislation to strengthen the law in relation to child neglect and organised crime.

We particularly welcome the Bill to strengthen the complaints procedures for the armed forces. We have campaigned for a very long time on veterans’ issues, particularly post-traumatic stress disorder. We support the proposed measure and hope it will prevent ex-service people from suffering mental distress and psychiatric conditions, which have resulted in so many of them ending up in the prison system.

Other Bills are appealing at first glance. A case in point is the heroism Bill, which seems likely to garner good headlines in certain sections of the press, but I share the TUC’s fear that it will have a bad effect on health and safety legislation and working conditions in particularly dangerous industries.

Turning briefly to our own propositions, we would have liked an economic fairness Bill aimed at levelling up the growing wealth inequalities that exist on both an individual and geographical basis in the UK, which is the most unequal state in the European Union. Such a Bill would mirror that part of the German constitution that commits to regional equalisation and prioritises poorer areas for infrastructure and foreign direct investment.

We would also have liked a Bill to ensure that Wales is fairly funded on the basis of need. It is a long-standing complaint that Wales is underfunded to the tune of £300 million to £400 million, as identified by the independent Holtham commission. Every year, Wales loses that amount of money. The cumulative total has had a clear, bad effect on our economy and it is an ongoing injustice. More than that, it actually constrains the Welsh Government and what they can achieve, forcing them to choose between essential spending on health, education, economic development and many other desirable targets of expenditure. The effects of underfunding are seen throughout Wales, not least in our health service, but on this issue the coalition Government in London are deeply compromised as they chastise the Welsh Government for their undoubted failings in health, while at the same time denying them the resources and means to address those failings.

We were greatly disappointed, though perhaps not surprised, that the Government botched the chance to end zero-hours contracts, particularly in the care sector. We would have liked an employment rights Bill to adopt measures to protect and empower workers.

I will catalogue the other measures we would have liked to see, including a natural resources Bill transferring responsibility for all of Wales’s natural resources from the Crown Estate and Westminster to Wales. We would also have liked more direct support for the tourism and hospitality industry and, lastly, a Welsh-language provision Bill to strengthen the requirements to provide services in Welsh, particularly by private organisations working without Wales into Wales. In respect of this debate, I point specifically to private organisations providing health care in England.

Oral Answers to Questions

Hywel Williams Excerpts

Tuesday 14th January 2014 Commons Chamber

[Jane Ellison]

The right hon. Gentleman is right to say that it is a very serious situation, and we of course keep a very close eye on it. Higher-risk work with asbestos must be licensed by the HSE, which has recently published an updated approved code of practice, “Managing and Working with Asbestos”. The code provides guidance and practical advice to companies, because we do not want more people being exposed in the way that so many have been in the past.

[Hywel Williams (Arfon) (PC)]

There is particular interest in this dreadful disease in my constituency because of the location of a factory that used asbestos. Can the Minister assure me that further research into treatment for this condition will be carried out in conjunction with research institutions in Wales and in conjunction with the Welsh Government?

[Jane Ellison]

Obviously, health is a devolved matter, but research goes across the United Kingdom. In 2012-13, we spent £2.3 million on research into this disease through the National Institute for Health Research. The hon. Gentleman may be aware that during the passage of the Mesothelioma Bill, which has recently passed through this House, ministerial colleagues agreed to write to the Association of British Insurers. The Department of Health is seeking to set up meetings with the ABI and the British Lung Foundation to explore how insurers can individually sponsor specific mesothelioma research.

Care Bill [Lords]

Hywel Williams Excerpts

Monday 16th December 2013 Commons Chamber

[Hywel Williams (Arfon) (PC)]

it is a pleasure to follow the hon. Member for Pudsey (Stuart Andrew). I know about the fine work that he did at Hope House, or Ty Gobaith as we call it in Wales. It serves both sides of the border, and that is relevant to some of my later remarks—which I hope will be brief, given that they are slightly tangential to the main thrust of the debate.

I speak as the co-author of a bilingual training package on social care, published in Wales some 20 years ago, entitled “Gofal”, which is Welsh for “care”. It marked the beginning of the divergence of social care in Wales from the care that was previously available in England and Wales. I want to say something about that difference and how it will be addressed.

I always supported real independence, choice and dignity for older and disabled people in my former life as a social worker and a social work teacher. The hon. Member for Sheffield, Heeley (Meg Munn), who is not in the Chamber now, referred to carers’ rights. I was one of the sponsors of the Carers (Equal Opportunities) Act 2004, which was promoted by the hon. Member for Aberavon (Dr Francis).

Let me now draw attention to some details that relate to the working of the Bill. Certain aspects of it are complex, given that social care has been devolved to the Welsh Assembly. In the other place, my noble Friend Lord Wigley asked some questions which, as far as I can see, have not yet been answered satisfactorily. I hope the Minister will tell us—or write to me about it later—what discussions have taken place between his Department and the Welsh Government.

The Social Services and Well-being (Wales) Bill is currently before the Assembly, and has now reached its Report stage. It is an important piece of legislation for Wales, and is similar to this Bill in many respects. It will increase the number of services for which people can claim a direct payment from the local authority, will introduce national eligibility criteria, and will provide for portable assessments to avoid the cost and trouble of reassessments.

Let me make a general point about funding. I understand that the Bill will require additional spending of about £1 billion in England. If I am correct—these are the figures I have been given—it would probably generate about £60 million of Barnett consequential spending in Wales. Will the Minister confirm whether a figure has been agreed, and if so, will he tell the House—or me later on—what it might be?

Particular circumstances apply in Wales. For historical and industrial reasons—the prevalence of heavy industry—Wales has higher levels of disability. Thousands of people retire from England to Wales—they are very welcome, but there is a cost implication. Wales has the highest proportion of older people of any country or region in the UK. Nearly one in four of our people are over 60, and that figure is expected to increase by a further 5% over the next 10 years. Any funding system based merely on total population will therefore inevitably generate inequalities. In passing, I refer to my concerns about the Government’s census proposals. I fear we might not have proper data in the future—but that is a debate for another time.

I am concerned that provisions in this Bill that have an England and Wales remit will impact on the changes taking place in Wales under the Welsh legislation I just mentioned and, equally, that changes in Wales will have implications for cross-border placements and the possibility of care packages. What discussions has the Minister had with officials in Cardiff? Have all outstanding issues been resolved? In particular, have we resolved the issues relating to social services assessments possibly being undertaken in Wales for persons who then move to England, and likewise of care packages for persons moving from England to Wales? It is a particular issue where I live and along the north-west Wales coast. If they speak later, other Welsh Members may refer to that as well.

The difficulties to which cross-border issues might give rise are covered in clause 37 and schedule 1, which relates to cross-border placements. Paragraph (1) deals with cross-border placements from England to Wales, but the schedule does not specify—or so it seems to me at least, but perhaps my reading has not been close enough—who is responsible for paying. Are the provisions in paragraph 1(5) meant to cover this? It is far from clear to me. Might this be a matter for regulations? Again, I would be glad to hear from the Minister, either later this evening or by other means. We need some reassurances on these matters. It is also less than clear that paragraph 6(2) and (3) are adequate to provide full recompense, where relevant, in all cases.

I turn to the proposed health research authority in clauses 107 to 114. Clause 109(3) and (4) state that the HRA’s remit is to promote the co-ordination of standardisation of practice in the UK in the regulation of social care. Particular aspects of social care in Wales require a specific approach. The socio-economic make-up of Wales is different. Gross value added levels in some areas of Wales are as much as 40% below average levels in the UK. The financial profile against which any new policy is set will inevitably differ in Wales and England and will have to allow for Wales’ significantly higher disability levels. Wales has already set a cap of £50 a week on charges for home care.

Finally—and perhaps inevitably for me—I turn to language and culture issues and draw the House’s attention to schedule 1(13). For reasons that will become obvious, I quote directly from the Bill:

“Am ddarpariaeth ynghylch lleoliadau trawsffiniol i Loegr, yr Alban neu Ogledd Iwerddon neu o Loegr, yr Alban neu Ogledd Iwerddon, gweler Atodlen 1 i Ddeddf Gofal 2014.”

That merely means:

“For provision about cross-border placements to and from England, Scotland or Northern Ireland, see Schedule 1 to the Care Act 2014.”

I quote that merely to emphasise that Wales is another country and that we do things differently there. When cross-border assessments are made, language and culture issues are particularly important, and I hope that that will be taken into consideration. Clause 109(4) places a duty on the HRA and the devolved Administrations to co-operate with one another. I am curious to know how such a duty is to be enforced. What happens if disagreement arises, as inevitably it will, between conflicting expectations in Wales, Scotland and England? Does the Secretary of State in England have to act as a referee in such a dispute? I am not against such co-operation—very much the reverse—but the ground rules need to be clear.

Oral Answers to Questions

Hywel Williams Excerpts

Tuesday 26th November 2013 Commons Chamber

[Jane Ellison]

My hon. Friend is absolutely right to highlight the fact that cross-border health care is an area of great concern. There is a requirement to take note, as he says. The work is ongoing and I am happy to have those discussions with him.

[Hywel Williams (Arfon) (PC)]

It is not only patients local to the border who access treatment in England. Patients from as much as 90 or 100 miles away in the west of Wales—for example, young babies—access treatment on the Wirral. However, does the Minister agree that it is in the interests of hospital trusts in England to take patients from Wales, as it has been demonstrated that they often make the difference between a viable and non-viable service?

[Jane Ellison]

Of course, it is possible, depending on clinical need, for clinicians to recommend treatment in England. The hon. Gentleman knows that there are ongoing discussions, some of which are quite difficult, but the intention is obviously to ensure that we get the best health care for everyone. I would urge the Welsh Government, in particular, to consider ways in which they can review how arrangements are made in Wales. There have been calls for a review of hospitals in Wales, not least the one today from the Royal College of Surgeons.

Mental Health (Approval Functions) Bill

Hywel Williams Excerpts

Tuesday 30th October 2012 Commons Chamber

[Norman Lamb]

I can assure the hon. Lady on that point. All SHAs have undertaken an assessment of the position, and the position has been regularised for future cases in those four SHAs. Of course, individual patients may be moved to different parts of the country, but the problem relates to those four SHA areas.

[Hywel Williams (Arfon) (PC)]

Rampton and Ashworth are involved, and patients from Wales travel to those hospitals. Have there been any discussions between the Minister’s Department and the Wales Office or the Welsh Government on the implications of this for patients from Wales?

--- Later in debate ---

[Norman Lamb]

I am grateful to the hon. Gentleman for that intervention, but I am afraid that I struggled slightly to hear all the points that he was making. Perhaps the best way of dealing with all this is to ensure that I respond in writing to all his questions. I can also assure him that the Secretary of State spoke to the Northern Irish Minister yesterday and briefed them fully on the situation. There is good liaison there.

Our current assessment is that about 2,000 doctors were not approved properly in line with the provisions of the 1983 Act, and that those doctors have participated in the detention of between 4,000 and 5,000 of the patients currently detained in NHS or independent sector hospitals. There are two important points that I would like to make clear now. First, the decision to detain a patient under the Mental Health Act is primarily a clinical one. There is no suggestion, and no reason to believe, that the irregularity of the approval process for these doctors has resulted in any clinically inappropriate decision being made, whether the decision was to detain or not to detain. Nor is there any suggestion that the doctors approved by mental health trusts are anything other than entirely properly qualified to make these recommendations.

All the proper clinical processes were gone through when these patients were detained. There is no reason why the irregular approval process should have led to anyone being in hospital who should not be—or vice versa—and no patients have suffered because of this. The doctors had no reason to think that they had not been properly approved; they acted in total good faith and in the interests of the patients throughout this period. As of Friday last week, the SHAs concerned had corrected their procedures and all the doctors involved had been properly approved. I hope that that addresses the question raised by the hon. Member for Wolverhampton North East (Emma Reynolds).

[Hywel Williams]

This may be a naïve question, but will the Minister tell us whether doctors approved in one SHA area are then approved automatically for other parts of England or possibly parts of Wales, or is the approval confined to the particular SHA area?

[Norman Lamb]

My understanding is that people are approved for the SHA in which they work, but it is an important question and I will happily confirm the position to the hon. Gentleman in writing.

In the light of our legal advice, we do not believe that any decisions made about patients’ care and detention require review because of this irregularity. Doctors should continue to treat patients who are currently detained under the Mental Health Act in the usual way.

My second point is that we have been advised by First Treasury Counsel that there are good arguments to show that the detentions involving these particular approval processes were, and are, lawful. Given the seriousness of the issues, counsel also argues the need for absolute legal clarity and advises that this is most safely resolved through emergency retrospective legislation. We are taking that advice. As soon as the irregularity was identified, the Department moved swiftly to identify the best course of action and to put the necessary preparatory work in place. Officials immediately sought initial legal and clinical advice, and then swiftly analysed the options, including the reassessment of all the potentially affected patients, working with the health leads in the regions involved and clinical experts from the Royal College of Psychiatrists.

When I was briefed on the situation, I asked for detailed information on the time it would take—the Secretary of State has also sought and obtained this advice—and the clinical risks involved in reassessing all potentially affected patients. Last Friday, the Secretary of State asked for an emergency Bill to be drafted over the weekend as a matter of contingency, and he briefed the Prime Minister personally the following day. Following further discussions and analysis over the weekend, the decision to introduce emergency legislation was taken on Sunday.

At all times, the Secretary of State’s priority—and, indeed, mine too—has been to resolve this in a way that follows clinical advice. That is the most important thing. In the interests of a group of highly vulnerable individuals, it is important to do this in the most sensitive way. It would not have been feasible quickly to reassess all the patients and it may well have caused great distress to them and their families.

We have worked to remedy the problem as it relates to current and future detentions. The accountable officers for the four SHAs in question have written to Sir David Nicholson, chief executive of the NHS, to confirm that they have made the necessary changes to their governance arrangements. Furthermore, the accountable officers in the other six SHA areas have written to Sir David to confirm, in the light of this issue, that they have reviewed their own arrangements and are in full compliance with the Mental Health Act. That directly addresses the question asked by the hon. Member for Wolverhampton North East. I can confirm, incidentally, that approval in one SHA applies elsewhere in England. The Bill will put right those doctors’ approvals wherever they are now practising. That again gives complete clarity to that particular point.

Although we believe that there are good arguments that past detentions under the Mental Health Act were and are lawful, it is vital that doctors, other mental health professionals and, most importantly, patients and their families have absolute confidence in the decisions made. That is why, in relation to past detentions, we have decided that the irregularity should be corrected by the Bill.

--- Later in debate ---

[Andy Burnham]

I thank the Secretary of State for his intervention. We understand that these are urgent matters, and I am sure that he is receiving briefings from the Department, but I think that there is a sense among Opposition Members that that is not good enough, and that he should have been here to answer the questions that were asked. We appreciate that he will be winding up the debate, but I hope he will take careful note of all the questions that are asked, and will give every Member present the fullest possible answer.

First things first: let us begin with the detail. I think it would help the House to know more about the extent of the checks that have been carried out on the 4,000 to 5,000 cases involved. The very fact that the number remains vague suggests that there has not yet been a thorough case-by-case review. Does the Minister—or, indeed, the Secretary of State—agree that it is essential to conduct such a review, and to put a precise number on the extent of the problem? I asked yesterday whether the Department could tell us how many of the people concerned were in high-security hospitals. I think that that is an important aspect of the issue, and I should be grateful if the information could be given to us at some point this afternoon. Without detailed case-by-case checks, how can we be sure that this procedural defect was the only technical irregularity in the process that was operating in the four SHAs concerned? We need to be reassured that there are no further problems that will need to be corrected at a later date.

That brings me to another question that was not answered yesterday. Families of the people involved will have heard yesterday’s news, and will no doubt have been unsettled by it. Does the Secretary of State agree that it is important for the Government to make arrangements, urgently, for direct communication to take place with the families who have been directly affected so that the issue can be explained to them more fully, and in isolation from some media coverage that may not give them the reassurance and support that they seek? Have such arrangements been made, and has any facility been provided enabling questions to be answered so that people can be given that reassurance and support?

That, in turn, brings me to another important point. If the Government were to leave a vacuum in terms of advice and communication, it could of course be filled by less scrupulous elements of the legal profession seeking to initiate compensation claims. We have already read warnings today that efforts may be made to encourage patients to sue for £500 or £600 a day, the amount that a prisoner would receive in compensation for unlawful detention. I am sure the Secretary of State agrees that any such activities would be highly unsettling, and would amount to the potential exploitation of vulnerable people. I hope he will join me in sending the clearest of messages to the legal profession that that would not be at all welcome. On the other hand, we would not want to see any curtailment of individuals’ legitimate right to challenge the decisions made affecting their liberty as a result of the Bill.

[Hywel Williams]

I am glad that the right hon. Gentleman has made that second point. The fact that some people are litigious, possibly as a result of their condition—of which that is a notorious aspect—should not detract from their right to pursue a case if they wish to do so.

[Andy Burnham]

That is a good point. So many cases are involved that challenges may have already been in progress before this technical problem arose. There may have been complaints about the nature of the decision-making process, the number of professionals involved, or any matter relating to the process by which the decision was made.

I hope that it will reassure the hon. Gentleman to learn that I have been given access to Government lawyers—the Secretary of State promised that yesterday, and I am grateful to him for arranging it—and I have been assured that the Bill will not wipe away an individual’s right to issue a legal challenge on a different point of process. That is a fundamentally important point, and I am glad that the hon. Gentleman has given me an opportunity to put it on the record. We would certainly not support the Bill if it were intended to wipe away an individual’s rights retrospectively, and I am sure that the hon. Gentleman would not either. We are grateful for that reassurance from the Government.

Along with the urgent steps that are being taken to correct the legal position, we need a review of how this came about in the first place. If it had happened in a single SHA, the explanation might have been easier to ascertain and understand, but the fact that it happened in four SHAs points to a more widespread issue of concern. It raises the question whether the problem arose from historical practice among clinicians and NHS bodies in the four regions concerned, or whether a piece of Department of Health guidance that was circulated in the past may have been responsible. I hope that the Minister or the Secretary of State will be able to enlighten the House further.

We want the Harris review—which I support—to cover all the technical issues surrounding mental health, so that the House and the public can be absolutely certain that no other technical failures or breaches of regulation have been identified. Let me make two appeals to the Secretary of State. First, I ask him to consider widening the remit of the review, and ensuring that in future it can take the broadest possible view of arrangements for sections under the Mental Health Act 1983. Secondly, I ask for the review to be conducted as swiftly as possible, so that it can inform the current reorganisation of the NHS.

It seems to me that the crux of the issue is the interrelationship between the 1983 Act and the potential for reorganisations of the NHS to disturb important existing arrangements and procedures for the carrying out of these essential public functions. That is the crux of the matter. I accept that a problem may have arisen as a result of the introduction of SHAs and PCTs in 2003, and we will have to wait and see whether that was the case. Regardless of the answer to that, however, the Government still have to face a relevant and current issue: they have to be absolutely sure that the changes they are proposing—and which the Opposition continue to believe are unnecessary and highly disruptive to an NHS that is functioning well for the vast majority of people—will not run the risk of causing further confusion.

We have not had anywhere near enough clarity from the Secretary of State—or his predecessor, the right hon. Member for South Cambridgeshire (Mr Lansley), who has just left the Chamber—on how some of the essential functions of NHS bodies to do with safeguarding and public protection are to be handled in the new NHS structure. Many months have passed since the publication of the Government’s first White Paper, yet there are still doubts in the minds of clinicians and others practitioners on the ground. That is an indictment, and shows the confusion the reorganisation has created. We are seeing the emergence of myriad new bodies in the NHS whose functions are not yet fully understood or specified by the Government. This crowded landscape has the potential to cause for further uncertainty. I therefore today ask for more clarity on this matter.

As things currently stand, what will the NHS arrangements be for sectioning people under the mental health provisions to be introduced from April 2013? I do not yet know with confidence what those arrangements are, and if I do not know there is a good chance that the wider public and many people working in the NHS have no idea. The Government need to answer these questions.

There is a further specific question the Department needs to answer, and it goes to the heart of the issues under discussion. I am sure I heard the Secretary of State say yesterday that the secondary approval function that SHAs are meant to carry out will come back to the Department of Health following the Government’s current reorganisation of the NHS.

--- Later in debate ---

[Andy Burnham]

My hon. Friend makes a very important point, and we have the seen the beginning of the kind of campaign he advocates with the work of the Time to Change group. There has also been incredible bravery from individuals such as the cricketer Marcus Trescothick, who spoke out very publicly about the difficulties he had faced, and just a few weeks ago in this House we witnessed some incredibly powerful contributions from Members on both sides of the Chamber: for the first time Members spoke personally and publicly about the difficulties they faced.

I think a change is under way, therefore. People who have been suffering alone will take great heart and encouragement from these developments. We are beginning to challenge the last taboo—the last form of acceptable discrimination in our society—but that does not come a moment too soon. My feeling is that Parliament is finally waking up to the full scale of the mental health challenge we face. A Bill before us at the moment will outlaw the discrimination that exists whereby somebody who has suffered a serious mental breakdown is unable to be a Member of Parliament, a company director, a juror or a school governor. It is so important to remove that discrimination from the statute book because it sends a message that recovery is not possible, and that if someone has a serious mental breakdown there is no possibility of their coming back and playing a full part in our society. The further problem with that legislation is that it prevents those people from being in leadership positions in those organisations—in schools, in Parliament and in companies—where they could develop a better understanding of mental health and what policies need to be put in place to support people who may experience those problems.

[Hywel Williams]

Does the right hon. Gentleman share my concern, and that of organisations such as Mind, that the rate of compulsory detention seems to be growing, as does the rate of detention in police cells?

[Andy Burnham]

We need to look carefully at those trends. I remember the moment when my thinking about mental health changed. It came when I was Secretary of State for Health and I received the Bradley report on mental ill health in the criminal justice system. I recall the moment when I read the statistic that seven out of 10 young people in the system have some form of undiagnosed or untreated mental health problem. My jaw dropped and at that moment I realised that we were seriously failing many thousands of people by failing to give them the support they needed when they needed it, and so they went into detention and down a path of failing to fulfil their potential. That is a terrible indictment of our life today. In addition, the level of prescribing of anti-depressants has almost doubled over the past decade. We are issuing almost 40 million prescriptions for anti-depressants, which suggests to me that insufficient alternatives to medication are available in our communities and people are being given very old-fashioned, outdated interventions by the authorities which are not meeting their needs. That is why we cannot allow this complacency any more and why we need a modern approach to good mental health care.

--- Later in debate ---

[Hywel Williams (Arfon) (PC)]

I state an interest as a member of the all-party group on social work. Before I was elected, I was for a short time an approved social worker under the Mental Health Act 1983. I was also a member of the Joint Committee that looked at mental health legislation before the passage of the National Health Service Act 2006. As far as I remember, the issue was not addressed that winter when we looked at the legislation in considerable detail.

First, to state the obvious, compulsory detention is a serious matter, as hon. Members and right hon. Members have said. The deprivation of liberty without the legal processes of the courts has always been subject to great safeguards. I accept that this is an emergency, but it is undesirable in the extreme that the subject is dealt with in such a manner. Emergency legislation should always be used as sparingly as possible, in particular in mental health.

The House will be interested to learn that the expert group examining mental health legislation in the winter before the 2006 Act was looking at legislation from the previous century. As I said at the time, they had been looking at it for years and years, not just overnight.

As I have said, I acted as an approved social worker for some time, and I was briefly a mental welfare officer under the Mental Health Act 1959. That measure was extremely unsatisfactory and, to contextualise the subject we are discussing, there was particular concern about section 29 of the Act, under which people could be taken into hospital compulsorily as an emergency for up to 72 hours, on the basis of one medical recommendation. Recourse to that provision was particularly high in rural areas such as mine where one could not get hold of a second approved doctor. That was one of the reasons why the 1983 Act tightened things up as much as it did.

The 1983 Act brought in safeguards and followed a long campaign by Mind, among other organisations, led by Larry Gostin. The burden of the Act is that better human rights safeguards must be in place, and I welcomed it at the time. One of its provisions was that two properly approved doctors should look at any application. That is the context for the worrying statement made by the Secretary of State yesterday.

I was glad to hear the Secretary of State’s assurances that the measure is a technical matter and that no one was wrongly detained, that proper clinical processes were carried out and doctors were properly qualified for the roles they undertook—apart from this technicality. I agree that the position should be regularised as soon as possible.

However, I take the points made by the hon. Member for Southport (John Pugh) and the right hon. Member for Oxford East (Mr Smith): there are rightful worries about compulsory detention and there could be further cases. We must get to the bottom of how the situation arose and find out why it has taken so long—more than 10 years—to come before the House. Did it not come up in any of the Department’s visits in its inspectorial role? I worked briefly as a freelance for the inspectorial arm of the then Welsh Office, so I know how much detailed care went into that role at the time. Why has the issue not come to the fore until now?

I have some questions that I will ask now, even though it is a Second Reading debate. Perhaps the Secretary of State could answer them when he winds up. As background to the Bill, I read that there are between 4,000 and 5,000 current patients. Can the Secretary of State confirm that they really are current patients? If so, are there many thousands of former patients who might have been sectioned who also have an interest in the matter? Is the figure current or a cumulative total? Does it include only in-patients? What about patients in the community on compulsory treatment orders? There could be many thousands of them. We need clarity about the size of that population.

I asked in an intervention whether only particular strategic health authorities were involved. Rampton was certainly involved; it takes patients from Wales and elsewhere. I was not sure whether Ashworth was included. The hon. Member for Southport seemed to indicate that Ashworth—Park Lane, as it was—had not been drawn in. Could the Secretary of State provide some confirmation?

There are questions about informing patients and their families about the problem that has arisen. Those people may be very vulnerable, given their condition. Some patients are likely to be anxious as part of their illness, and this situation could exacerbate their condition. We need to make sure that these events do not exacerbate existing conditions, so I should like some assurance from the Secretary of State about how patients, former patients and their families will be contacted. Will independent advocacy services be involved? I am not talking about lawyers or ambulance chasers, but about the many services properly set up in the community to support people.

Communication must be appropriate. The code of practice for the 1983 Act specifies that communication with patients must be made appropriately on the basis of age, gender, race and language. One of the reasons I am speaking in the debate is that some Welsh-speaking patients might have been involved, so I want to be sure that they will be contacted and communicated with appropriately. Because of this incident, the process might be upsetting for people who have been sectioned in the past, so I should be grateful for reassurance that long-term support will be available if that is a disturbing factor in their condition.

The briefing notes, which I read with interest, refer to compensation, which should be the last thing on anyone’s mind at a time like this. I was reassured, however, to learn that people can bring cases. Some individuals can be litigious. Sometimes, as part of their condition, they are notoriously litigious, as I said earlier, but that does not detract from their right to bring cases unless the court rules otherwise.

I have some concerns about doctors. I asked earlier whether approval by a strategic health authority automatically enabled people to act elsewhere. The Minister initially said that it was just within the strategic health authority area, but then he said it was throughout England. I should like that matter to be cleared up and, as a Welsh Member, I should like it to be cleared up in relation to Wales and possibly Northern Ireland and Scotland. I am worried that doctors may slip through the net because they have acted outside the four areas that have been identified.

What discussions has the Secretary of State or the Minister of State had with doctors’ representatives? I appreciate that time has been short, but I hope that doctors have been fully involved. Are there any implications—I cannot think of any—for the second doctor involved in sectioning? I should be grateful for reassurance on that point. Equally, are there any implications for the social worker, as it is usually a social worker who is involved?

Finally, has the Wales Office been involved in any way? I am glad that Wales, Scotland and Northern Ireland have been informed. It is more of an issue for Wales, given that we share many clinical services and people from Wales are often treated in England: special hospitals are an obvious example. I hope that there has been the closest co-operation possible between the Wales Office and the Welsh Government in Cardiff. I am glad that an independent review under Dr Geoffrey Harris has been announced. I hope that the Wales Office and the Welsh Government will be involved to the degree that they should be.

Oral Answers to Questions

Hywel Williams Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Burns]

My hon. Friend is absolutely right, and of course he speaks from the authority of living in a country that has a Labour Administration, where we see spending cut, waiting times and lists rising, and utter chaos in the quality of care for patients.

[Hywel Williams (Arfon) (PC)]

The Minister will know that large numbers of people from Wales, particularly north Wales, access treatment in England. What assessment has he made of the risks to such treatment if the legislation goes through?

[Mr Burns]

If the hon. Gentleman is trying to tease out of me what is in the risk register, I am afraid he will be unsuccessful, but if it is of any reassurance I can tell him that for people living close to the border there have been arrangements between Wales and the English NHS and they will continue. Those people will benefit if treated in England, because waiting times are falling in this country, unlike Wales where they are increasing.

Life Sciences

Hywel Williams Excerpts

Monday 5th December 2011 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend for that point. The industry has done quite a lot in recent years in publishing more data, including data that do not necessarily support the positive case that it is looking for, because all of us, and especially those working in the field, learn a great deal and, sometimes, as much from clinical trials that produce a negative result as we do from those that produce a positive result. So, I will certainly take her point away, explore it with my colleagues and write to her if we can take further steps in that direction.

[Hywel Williams (Arfon) (PC)]

Are the patient data proposals to be England-only or UK-wide? If so, what is the relationship with projects such as the SAIL—Secure Anonymised Information Linkage—database in Swansea and Biobank? I foresee some ethical problems, as Biobank operates specifically on a voluntary basis with a written, sought-for consent. Does the Secretary of State see that there might be some problems there?

Oral Answers to Questions

Hywel Williams Excerpts

Tuesday 18th October 2011 Commons Chamber

[Grahame M. Morris]

Sorry. I am referring to the next question.

[Hywel Williams (Arfon) (PC)]

What discussion has the Minister had with Welsh Ministers who are bringing forward legislation for an opt-out system of organ donation? If she has had such discussions, what conclusions has she drawn?

[Anne Milton]

The Government will examine thoroughly the detail of any Assembly Bill when it is laid before the Assembly, but I urge Wales to look at the evidence. We can look back to what happened in Spain, where there was presumed consent for 10 years without any shift in organ donation rates. The issue is more complex than that. It is about organ donor transplant co-ordinators and increasing donations from emergency medicine. A number of measures need to be put in place to increase those rates.

Southern Cross Care Homes

Hywel Williams Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

Yes, and I gladly undertake to ensure that if further information needs to be shared during the summer recess, hon. Members in all parts of the House will receive it in a timely fashion, so that they can address their constituents’ concerns.

[Hywel Williams (Arfon) (PC)]

There are 1,772 people in 35 Southern Cross homes in Wales, but I did not hear the Minister refer to them at all in his answer. Where does the buck stop, as far as they are concerned? Is it with Welsh local authorities, with the Welsh Government, or with him, even though this matter is devolved?

[Paul Burstow]

I have had, and continue to have, contacts with the Ministers responsible for policy in this area in the devolved Administrations, but the legal responsibility for continuity of care from the point of view of the public purse rests with the local authorities. That is where the legal powers sit, and it is where the legal responsibility has to be placed. We are working with the Local Government Association and others to ensure that the local authorities are able to put contingency plans in place.