Mental Health Units (Use of Force) Bill

John Bercow Excerpts

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

[Mr Steve Reed (Croydon North) (Lab/Co-op)]

I beg to move, That the clause be read a Second time.

[Mr Speaker]

With this it will be convenient to discuss the following:

New clause 2—Independent investigation of deaths: legal aid—

‘(1) Schedule 1 to the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (civil legal services) is amended as follows.

(2) After paragraph 41 (inquests) insert—

“41A  Investigation of deaths resulting from use of force in mental health units

(1) Civil legal services provided to an individual in relation to an investigation under section (independent investigations of deaths) of the Mental Health Units (Use of Force) Act 2018 (independent investigation of deaths) into the death of a member of the individual’s family.

(2) For the purposes of this paragraph an individual is a member of another individual’s family if—

(a) they are relatives (whether of the full blood or half blood or by marriage or civil partnership),

(b) they are cohabitants (as defined in Part 4 of the Family Law Act 1996), or

(c) one has parental responsibility for the other.”

Amendment 86, in clause 1, page 1, line 13, leave out sub-paragraph (ii).

Amendment 87, page 1, line 15, leave out subsection (4).

Amendment 44, page 2, line 3, leave out “force” and insert “restraint”.

Amendment 40, page 2, line 4, after “use” insert “or threat ”.

This amendment, together with Amendments 41 to 43, would extend the definition of the use of force for the provisions in the Bill to cover threats of the use of force and coercion.

Amendment 88, page 2, line 4, leave out “mechanical or chemical” and insert “or mechanical”.

Amendment 89, page 2, line 5, leave out paragraph (b).

Amendment 41, page 2, line 5, after “isolation” insert “or threat of isolation”.

See explanatory statement for Amendment 40.

Amendment 42, page 2, line 5, at end insert “or

(c) the coercion of a patient.”

See explanatory statement for Amendment 40.

Amendment 90, page 2, leave out lines 14 and 15.

Amendment 91, page 2, leave out lines 16 and 17.

Amendment 43, page 2, line 17, at end insert—

““Coercion” means the use or threat of force, with the intention of causing fear, alarm or distress to control a patient’s behaviour or elicit compliance with the application of a use of force.”

See explanatory statement for Amendment 40.

Amendment 92, in clause 2, page 2, line 20, leave out “a relevant” and insert “any”.

Amendment 93, page 2, line 23, leave out “relevant”.

Amendment 94, page 2, line 25, leave out “relevant”.

Amendment 45, page 2, line 30, clause 3, leave out “force” and insert “restraint”.

Amendment 95, page 2, line 32, leave out “relevant”.

Amendment 37, page 3, line 2, at end insert—

‘(6A) A policy published under this section must set out that the use of force will only be used without the sole intention of inflicting pain, suffering or humiliation, or subjecting patients to tortuous, inhumane or degrading treatment, or without inflicting punishment or intimidation.”

This amendment would prevent the use of force with the sole intention of causing suffering or harm to a patient, in line with the Mental Health Act code of practice and the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.

Amendment 36, page 3, line 3, leave out from “out” to end of line 4 and insert—

“(a) a description of each of the methods of restraint that may be used in the mental health unit;

(b) what steps will be taken to reduce and minimise the use of force in the mental health unit by staff who work in the unit;

(c) a description of the techniques to be used for avoiding or reducing the use of force in the mental health unit by staff who work in the unit; and

(d) a commitment to reducing the overall use of force in the mental health unit.”

This amendment would require mental health units to commit to reducing the overall use of force, and increase transparency about how they intend to achieve this and what types of force they permit.

Amendment 46, page 3, line 4, leave out “force” and insert “restraint”.

Amendment 47, in clause 4, page 3, line 7, leave out “force” and insert “restraint”.

Amendment 38, page 3, line 8, at end insert—

‘(1A) Information under subsection (1) must include a patient’s right to advocacy and how to access an advocate.”

This amendment would ensure that people’s legal rights to advocacy, under existing provisions, are communicated to them in relation to the use of force.

Government amendment 1, page 3, line 16, at end insert—

“unless the patient (where paragraph (a) applies) or the other person (where paragraph (b) applies) refuses the information.”

This allows for cases where a person refuses the information provided, and supersedes subsections (9)(a) and (10)(a).

Government amendment 2, page 3, line 22, leave out subsection (5) and insert—

‘(5) The responsible person must take whatever steps are reasonably practicable to ensure that the patient is aware of the information and understands it.”

This expands the duty to provide information accessibly so that it requires the responsible person to take whatever steps are reasonably practicable to ensure the patient understands.

Government amendment 3, page 3, line 33, leave out subsections (9) and (10).

Subsections (9)(a) and (10)(a) are superseded by Amendment 1. Subsections (9)(b) and (10)(b) are unnecessary as the information will not be of a nature that would cause distress.

Amendment 96, page 3, line 36, leave out “the responsible person considers that”.

Amendment 97, page 3, line 42, leave out “the responsible person considers that”.

Amendment 48, in clause 5, page 4, line 3, leave out “force” and insert “restraint”.

Amendment 79, page 4, line 3, at end insert—

‘(1A) The Secretary of State must publish quality standards for training provided under subsection (1).

(1B) The Secretary of State may delegate the publication of quality standards for training under subsection (2).”

This amendment would require training on the use of force to comply with quality standards.

Amendment 98, page 4, line 6, after “patients” insert “and their families”.

Amendment 9, page 4, line 9, leave out paragraph (c).

Amendment 49, page 4, line 11, leave out “force” and insert “restraint”.

Amendment 50, page 4, line 12, leave out “force” and insert “restraint”.

Amendment 80, page 4, line 13, at beginning insert “trauma-informed care, including”

This amendment, together with Amendment 81, would ensure that training requirements for staff include training on trauma-informed care.

Amendment 81, page 4, line 14, at end insert

“and the impact of the use of force on a patient who may have experienced violence and abuse.”

See explanatory statement for Amendment 80.

Amendment 51, page 4, line 15, leave out “force” and insert “restraint”.

Amendment 52, page 4, line 16, leave out “force” and insert “restraint”.

Amendment 99, page 4, line 18, leave out “the principal”.

Amendment 10, page 4, line 18, leave out “or ethical”.

Amendment 53, page 4, line 18, leave out “force” and insert “restraint”.

Amendment 11, page 4, line 18, at end insert—

“(l) the roles, responsibilities and procedure in the event of police involvement,”

Amendment 12, page 4, line 18, at end insert—

“(m) awareness of acute behavioural disturbance.”

Government amendment 4, page 4, line 30, leave out “meets the standards of” and insert

“is of an equivalent standard to”

This is a small drafting change that clarifies that training does not need to be provided under Clause 5 if training that was recently provided was of an equivalent standard to the training provided under that Clause.

Amendment 13, page 4, line 31, leave out subsections (5) and (6).

Amendment 100, page 5, line 8, clause 6, at end insert—

‘(7) Guidance under this Act shall be published no later than six months after this Act is passed.”

Government motion to transfer clause 6.

Amendment 101, in clause 7, page 5, line 11, after “any” insert “significant”.

Amendment 54, page 5, line 12, leave out “force” and insert “restraint”.

Amendment 39, page 5, line 13, leave out subsections (2) and (3).

This amendment would improve transparency and accountability about the use of force by ensuring consistency in the recording of all uses of force, not just those that are above a threshold to be set in statutory guidance.

Amendment 102, page 5, line 13, leave out subsection (2).

Amendment 55, page 5, line 13, leave out “force” and insert “restraint”.

Amendment 14, page 5, line 13, at end insert

“or does not involve physical contact”.

Amendment 103, page 5, line 14, leave out subsection (3).

Amendment 56, page 5, line 14, leave out “force” and insert “restraint”.

Amendment 104, page 5, line 17, leave out subsection (4).

Amendment 57, page 5, line 20, leave out “force” and insert “restraint”.

Amendment 58, page 5, line 21, leave out “force” and insert “restraint”.

Amendment 59, page 5, line 22, leave out “force” and insert “restraint”.

Amendment 60, page 5, line 23, leave out “force” and insert “restraint”.

Amendment 61, page 5, line 25, leave out “force” and insert “restraint”.

Amendment 62, page 5, line 26, leave out “force” and insert “restraint”.

Amendment 63, page 5, line 28, leave out “force” and insert “restraint”.

Amendment 64, page 5, line 31, leave out “force” and insert “restraint”.

Amendment 15, page 5, line 33, leave out paragraph (k).

Amendment 65, page 5, line 36, leave out “force” and insert “restraint”.

Amendment 66, page 5, line 38, leave out “force” and insert “restraint”.

Amendment 67, page 5, line 39, leave out “force” and insert “restraint”.

Amendment 68, page 5, line 40, leave out “force” and insert “restraint”.

Amendment 21, page 5, line 41, at end insert—

“(q) the relevant characteristics of the staff involved (if known)”

Amendment 16, page 5, line 43, at end insert—

‘(6A) Records must also be kept in the patient’s medical notes.”

Government amendment 5, page 6, line 5, leave out

“made by or under the Data Protection Act 1998”

and insert

“of the data protection legislation”

Amendments 5 and 6 are consequential on the Data Protection Act 2018.

Government amendment 6, page 6, line 6, at end insert—

‘( ) In subsection (8) “the data protection legislation” has the same meaning as in the Data Protection Act 2018 (see section 3 of that Act).”

Amendments 5 and 6 are consequential on the Data Protection Act 2018.

Amendment 17, page 6, line 7, leave out subsections (9) and (10).

Amendment 22, page 6, line 7, leave out from “(5)(k)” to “mean” and insert

“(5)(k) and (q) the ‘relevant characteristics’ in relation to a patient and member of staff”

Amendment 23, page 6, line 8, leave out “the patient’s” and insert “their”.

Amendment 24, page 6, line 9, leave out “the patient has” and insert “they have”.

Amendment 32, page 6, line 11, leave out paragraph (c).

Amendment 25, page 6, line 11, leave out “the patient’s” and insert “their”.

Amendment 26, page 6, line 12, leave out “the patient is” and insert “they are”.

Amendment 33, page 6, line 13, leave out paragraph (e).

Amendment 27, page 6, line 13, leave out “the patient’s” and insert “their”.

Amendment 34, page 6, line 14, leave out paragraph (f).

Amendment 28, page 6, line 14, leave out “the patient’s” and insert “their”.

Amendment 29, page 6, line 15, leave out “the patient’s” and insert “their”.

Amendment 35, page 6, line 16, leave out paragraph (h).

Amendment 30, page 6, line 16, leave out “the patient’s” and insert “their”.

Amendment 69, in clause 8, page 6, line 21, leave out “force” and insert “restraint”.

Amendment 70, page 6, line 22, leave out “force” and insert “restraint”.

Amendment 31, page 6, line 26, leave out “and (n)” and insert “(n) and (q)”.

Amendment 71, in clause 9, page 6, line 33, leave out “force” and insert “restraint”.

Amendment 72, page 6, line 35, leave out “force” and insert “restraint”.

Amendment 82, page 6, line 39, at end insert—

‘(2A) The report published under subsection (2) must make reference to the annual statistics published under section 8.”

This amendment, together with Amendments 83 to 85, would improve accountability and transparency in the progress towards reducing the overall use of force.

Amendment 83, page 6, line 39, at end insert—

‘(2B) The Secretary of State must make a statement to Parliament, as soon as practicable following the publication of report under subsection (2).”

See explanatory statement for Amendment 82.

Amendment 84, page 6, line 41, leave out “and”.

See explanatory statement for Amendment 82.

Amendment 85, page 6, line 41, at end insert

“and the statement under subsection (2B).”

See explanatory statement for Amendment 82.

Amendment 73, page 7, line 2, leave out “force” and insert “restraint”.

Amendment 18, in clause 12, page 7, line 38, leave out “must take” and insert “should consider taking”.

Amendment 19, page 8, line 2, leave out “must wear it and” and insert

“should wear it and try to”

Amendment 20, page 8, line 6, leave out subsections (4) and (5).

Government amendment 7, in clause 13, page 8, line 32, leave out

“has the meaning given by section 2”

and insert

“means a person appointed under section 2(1)”

This improves the drafting of the definition of “responsible person”.

Amendment 74, page 8, line 42, leave out “force” and insert “restraint”.

Amendment 75, page 8, line 43, leave out “force” and insert “restraint”.

Amendment 76, page 8, line 46, leave out “force” and insert “restraint”.

Government motion to transfer clause 15.

Amendment 77, in clause 17, page 9, line 24, leave out “Force” and insert “Restraint”.

Amendment 78, in title, line 2, leave out “force” and insert “restraint”.

Government amendment 8, line 2, leave out “and similar institutions”.

This removes from the long title a reference to “similar institutions” as these are not covered by the Bill.

[Mr Reed]

rose—

[Philip Davies (Shipley) (Con)]

On a point of order, Mr Speaker. I am sorry to interrupt the hon. Member for Croydon North (Mr Reed), but I want to raise a matter of some importance. Also, I am sorry that I have not given you advance notice of this.

Mr Speaker, you are well regarded for your reputation of championing the rights of Back Benchers, but it has become apparent over the past few days that the rights of Back Benchers in this House are being massively curtailed. The deadline for tabling amendments for Fridays is Tuesday evening, which gives people the opportunity to consider the amendments that have been tabled. The timescale is the same for every Bill’s Report stage.

It has become apparent over the past day or so that the Government have a policy of saying that they will not agree to any amendments tabled unless they have at least eight days in which to consider them and to do a write-round of all Departments. That means that no Back Bencher has an opportunity to have any amendments that they table on Report accepted—the Government will automatically not accept those amendments because they have not had time to consider them. This means that the rights of Back Benchers are being massively curtailed, and also that laws will be passed that are not fit for purpose, because amendments that would otherwise have been accepted by the Government will not have been accepted. Will you look into this matter, Mr Speaker?

It seems to me that if Back Benchers are to have the opportunity to get their amendments accepted, we will need a new regime under which they will have to be tabled at least eight days before a Bill is considered; otherwise, we will have no chance. That would mean that the business of the House would have to be brought forward. Can you also confirm that, for anyone who has taken the time to table amendments to improve this Bill, the only way to have their amendments properly considered would be to ensure that we did not get to the end of our debate on these amendments today, meaning that proceedings would have to be rescheduled for a subsequent day, as that would give the Government time to consider whether to accept the amendments? Is that the only course of action open to a Back Bencher who has spent lots of time trying to improve the legislation?

[Mr Speaker]

I am grateful to the hon. Gentleman for his point of order, which is a source of some concern to me. Off the top of my head, it seems important to distinguish between two not altogether unrelated but, in important senses, separate matters. One is the question of the selection of amendments; the other is the question of the House’s treatment of them and the opportunity for treatment of them.

So far as selection is concerned, that is, as the hon. Gentleman knows, a matter for the Chair, and I will go about my duty in this matter the way that I have always done. I hope that I do this dispassionately but with a regard for Back Benchers. He and other colleagues will have discovered over the years that the views of the Government are not a matter of any particular interest or concern to me. If I think something should be selected, it will be selected.

Secondly, the hon. Gentleman will probably not be entirely surprised to know that I was not aware of any new intended arrangements being drawn up for the administrative convenience—I use that term non-pejoratively—of the Executive branch. That is not something of which a Whip has notified me. The Government might well think it most convenient to have rather longer, for the reasons that the hon. Gentleman has adduced, but it is not something of which I have been made aware. I think it would be useful to have knowledge of such a matter, but I do not think that anything can be done today. However, it would be a pity if Back Benchers were hampered in any way.

I would just add that in my limited experience—like the hon. Gentleman, I have never served in government, which I say as matter of some considerable pride—Governments are perfectly capable of operating quickly when it is convenient for them to do so, and of operating at a more leisurely pace when it is convenient for them to do so. If the hon. Gentleman is asking whether I have managed to discern the mindset of the Treasury Bench, I can say only two things. First, I have been here only 21 years, which is quite a short time in which to try to discern the mindset of those on the Treasury Bench. Secondly, if the hon. Gentleman were to think that I did understand fully the mindset of those on the Treasury Bench, he would be attributing to me an intellectual weight that I do not claim for myself.

If there are no further points of order for now, perhaps we can proceed with the oration of Mr Steve Reed.

[Mr Reed]

Thank you, Mr Speaker. I have sympathy for what the hon. Member for Shipley (Philip Davies) said, but I hope that during today’s debate we will find ways of achieving the objectives of his constructive amendments.

The Bill is known as Seni’s law after Seni Lewis, a young man from Thornton Heath in my constituency who died in 2010 after a period of severe and prolonged face-down restraint. Seni is one of too many people who have suffered unnecessary and avoidable deaths in our mental health services, and that comes alongside any number of unnecessary and avoidable injuries. Following the inquest into Seni’s death, the coroner’s verdict was clear that, without change, what happened to Seni will happen again, and it has already happened to others. That change is this Bill, and I am grateful for support from Members on both sides of the House, the Minister and every single professional and patient advocacy group working in the sector.

New clause 1 is probing. It arises from the fact that Seni Lewis’s parents, having suffered the trauma of the loss of their child in completely avoidable circumstances in 2010, had to fight the state for seven years simply to obtain an inquest to find out how their previously healthy 21-year-old son ended up dead on the floor in hospital. The coroner pointed to severe failings by the mental health trust, the police and the Crown Prosecution Service that led to delays in that inquest opening. The root cause of the problem was the insufficiently independent investigation conducted by the mental health trust into its own failings. The answer is to ensure that any death in such circumstances automatically triggers a fully independent investigation into the circumstances and causes of that death, with legal aid provided to the families of the deceased persons so that there is a level playing field for all parties taking part in the inquest.

Currently there is a huge disparity between how investigations are conducted for deaths in mental health units and those in other forms of state detention. When somebody dies in police custody, an external investigation by an independent national body happens automatically, but the same does not happen in a mental health setting. If a patient dies, the trust or private provider investigates itself or appoints another trust or individual to do so. That lack of accountability means that reports can be delayed or kept quiet, and can lack the necessary independence and rigour.