Mental Health Units (Use of Force) Bill

Debate between Norman Lamb and Steve Reed

Report stage: House of Commons
Friday 15th June 2018 Commons Chamber

[Mr Reed]

The hon. Gentleman raises an important point, and I look forward to the comments of the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price). It is important that there is consistency across all forms of state detention so that those who suffer traumatic circumstances, or even death, are treated in the same way.

If lessons are not learned from such incidents, the chance to prevent further deaths is missed, and we end up with a series of what look like isolated tragic incidents, such as Seni’s death, that are actually part of a wider institutional problem that has not been recognised and therefore not dealt with. It is unacceptable that institutions responsible for the care of patients suffering from mental ill health are subject to less scrutiny than institutions that detain criminal suspects and prisoners. It is no wonder that the casework of the campaigning charity Inquest, which works with bereaved families, shows that so many people who rely on such services no longer have confidence in them.

Another barrier to justice for families is funding for legal representation. Dame Elish Angiolini’s excellent report concluded last year that

“families face an intrusive and complex mechanism for securing funding”,

because there

“is no legal aid for inquests other than in exceptional circumstances”.

The Angiolini report recommended that legal aid should be awarded to families in the case of deaths in police custody. The Government have accepted that there is a need to look at that in the Lord Chancellor’s review and, in the spirit of consensus that has characterised the development of the Bill, I would welcome an update from the Minister on what work is being done on that. It makes little sense not to extend legal aid to situations in a mental health unit, because we need consistency across all forms of state custody. The families of patients should certainly not be disadvantaged compared with other bereaved families, and new clause 2 would ensure that legal aid is available to family members in relation to an investigation of an unnatural death in a mental health unit.

I will briefly address some of the amendments tabled by the Government, the hon. Members for Shipley and for Christchurch (Sir Christopher Chope), and the right hon. Member for North Norfolk (Norman Lamb). I welcome their efforts to strengthen the Bill, which has progressed through the Commons with a real sense of consensus, both from the Minister, and from every professional body and patient advocacy active in the sector. It is important that such work continues during the Bill’s remaining stages and beyond.

On the scope of the Bill and which mental health units it applies to, the hon. Member for Christchurch tabled amendments 86, 87 and 92 to 95, which would extend the Bill’s scope to cover all independent providers of mental health care. The principle behind the amendments seems sound, because every patient, whether NHS or private, should be protected by the same rights. However, I know that the Minister has some concerns about the practicalities of extending the Bill’s scope in that way, not least about how wholly private providers would report data through NHS Digital and the limits of statutory guidance in that respect, so I look forward to her comments.

[Norman Lamb (North Norfolk) (LD)]

Does the hon. Gentleman share my view that whether the measure gets into the Bill or not, we need to reach a point at which data is provided from private providers and from the NHS in exactly the same way so that we can compare how people are treated on both sides of the divide?

[Mr Reed]

I absolutely agree. The Bill sets up a process and attempts to change the culture of the services, and I hope that the Bill’s successful passage will not be the end of that process. The right hon. Gentleman’s point needs to be taken into account.

Mental Health

Debate between Norman Lamb and Steve Reed

Thursday 16th May 2013 Commons Chamber

[Mr Steve Reed (Croydon North) (Lab)]

It is a pleasure to follow many moving and thought-provoking contributions. I want to raise the case of Olaseni Lewis, known to his family as Seni, who died after his family left him in the care of the mental health service. Seni was a 23-year-old young black man living in Croydon North, the constituency that I now represent. He had a degree in IT and plans for further postgraduate study.

Seni had no history of mental or physical illness when, on 31 August 2010, he started to behave in an uncharacteristically odd and agitated manner. His parents did what they thought was the right thing by taking him to hospital. He was admitted as a voluntary patient for a few days’ assessment and care. His family left him, when visiting hours ended at 8 pm, with reassurances that they would be contacted if anything happened.

Seni became agitated in his family’s absence, and even more so after he was told that he could not leave the hospital even though he understood he was there voluntarily. It appears he was sectioned in order to detain him against his will, and was then restrained and held face down on the floor by several members of staff and by police officers who had been called after he kicked a door, although there is no evidence that he was violent towards anyone.

Seni was held face down in a seclusion unit by up to 11 police officers for a total of 40 minutes in a way that appears to contravene international conventions on human rights and torture. During the course of that restraint, Seni slipped into a coma and was eventually put on a life support machine, which is how his family found him when they were eventually called four hours after they had left him. He was pronounced dead four days later.

The Independent Police Complaints Commission is responsible for investigating the events leading to Seni’s death. Its investigation began in September 2010. Instead of conducting its investigation under criminal proceedings and interviewing the police officers under caution, it chose instead to accept written accounts which were never challenged. It now accepts that that was a serious mistake.

In August 2011 the IPCC referred the matter and its report to the Crown Prosecution Service to decide whether to prosecute, with a recommendation against. In the meantime, the IPCC had received new information that led it to believe that a criminal prosecution should in fact be pursued. That new information, received in July 2012, was the pathologist’s report, which raised fresh concerns about the extent of restraint used against Seni Lewis. Frustratingly, the CPS refused to accept that new evidence because it was not included in the IPCC’s original report—even though it was the IPCC that wished to amend its own submission. The IPCC claims it has repeatedly raised that point with the CPS, but to no avail. The CPS refused to prosecute.

The IPCC, eager to put right its own admitted mistakes, tried to persuade the Metropolitan police to reopen its investigation in order to trigger a fresh investigation by the IPCC. Following legal advice, the IPPC believed that that would allow it to interview the police officers under caution and include the pathologist’s findings in a new report to the CPS. The Met, unfortunately, had contradictory legal advice telling it that the IPCC could not overturn its own original report and refused to open a fresh investigation. The IPCC is now accusing the Metropolitan police of blocking the investigation that the IPPC wants to reopen.

So we reach a highly unsatisfactory impasse. The police will not reopen the investigation, the CPS will not accept the fresh and potentially compelling evidence, and the IPCC is not allowed to overturn its own decision not to investigate under criminal proceedings even though it believes that the original decision was wrong. In the meantime, a bereaved family have been waiting, with astonishing patience and great dignity, for over two years and eight months for an answer to how and why their beloved son now lies dead after they placed him in the care of a hospital when he showed early signs of mental ill health.

The questions that this case raises are profound and frightening. The organisation Black Mental Health UK is concerned that black people are 44% more likely to be subject to detention under the Mental Health Act than their white counterparts, even though there is no higher prevalence of mental illness among the black community. Once in the system, black people are more likely to be labelled psychotic than their white counterparts for exhibiting exactly the same behaviour. They are also more likely to be given a diagnosis of schizophrenia and to be considered an immediate threat than non-black people. This group is 29% more likely to be subject to restraint and 49% more likely to be placed in seclusion. Black Mental Health UK believes this may be the result of prejudicial assumptions made about young black men in general, and in particular those labelled as suffering from mental ill health.

If black people are being treated differently from other people in a way that threatens their well-being, the community needs reassurance that the mental health service is not institutionally racist. We need a public inquest to establish exactly what happened to Seni Lewis in the four hours after he was first taken by his parents to A and E in Croydon. To date the Lewis family have been failed by the mental health service and the entire criminal justice system. Instead of the open inquiry this case deserves, we are treated to the unseemly spectacle of the IPCC, the CPS and the Metropolitan police fighting with each other and unable or unwilling to work together in the public interest to allow an effective investigation to take place.

I have raised the case of the Lewis family with Ministers over recent months but I am dissatisfied with their responses. When I asked when an investigation would be progressed, I was told this was an operational matter, but this case points to a wider systemic failing that requires Ministers to act and address it. When I asked the Home Secretary what advice was given to the police over how to operate in a mental health setting, I was told none. When I asked what discussions had taken place between the Home Secretary and the Health Secretary about the use of the police in mental health settings, I was told none. When I asked the Health Minister how many patients were restrained in a mental health setting and what their ethnicity was, I was told that the Department of Health does not collect these data. I do not wish to impugn the intentions of Ministers, but I have concluded that they are failing to give this matter the priority it deserves.

[Norman Lamb]

I apologise that I came in halfway through the hon. Gentleman’s contribution, but he is making extremely serious points. I would be happy to talk further to him about the case after the debate.

[Mr Reed]

I thank the Minister for his intervention. I am grateful for his generous offer, which I will certainly take up.