Mental Health Act 1983: Detention of People with Autism and other Lifelong Conditions

Tim Loughton Excerpts

Thursday 20th January 2022 Commons Chamber

[Sir Robert Buckland]

My hon. Friend is absolutely right about the waste of resources that I am afraid underlies much of this. I shall come to some of the figures, which are pretty shocking. He is right to highlight the levy that is being introduced in April. It is imperative that the £12 billion that we are told is being earmarked as part of the £36 billion to be raised from the levy is actually used on social care.

The worry we all have is that the money will be eaten up by spending on the health backlog, and that there will be no audit trail at all to make it possible to ensure that it is, in effect, ring-fenced and used in social care. I put that big challenge to Ministers. The Health Secretary knows my strong view; I was writing about it in the national media on Sunday. We have to really laser in on these issues.

The horror of Winterbourne View is still seared into my mind 11 years on, together with other instances of abuse. But in general, we are not in this position because of malice or hostility towards people with autism or a learning disability; we are here because of indifference, frankly. It is all too easy to make the assumption that because the person has been detained for their own safety, the letter of the law has been followed and the clinicians have given their opinion, that will just have to do. That really is not good enough in this day and age.

Recent news coverage of the cases of Tony Hickmott and Patient A has brought these issues into stark relief. I will briefly mention Mr Hickmott’s case, which was highlighted by the media just before Christmas. Ongoing legal proceedings mean that I must limit my remarks, but I read reports that this gentleman has been detained for more than 20 years under this system—nearly half his entire life. That is deeply distressing for his family and should be of grave concern to the rest of us.

Patient A’s case was reported in The Sunday Times just after new year, the result of some excellent investigative journalism. He has been confined for over four years so far in a secure apartment at the Priory Hospital Cheadle Royal. That apartment—I use the word advisedly—is the size of a large living room. He is monitored by CCTV. His food and medication are passed through a hatch. He is now 24 years of age. The story of his life leading up to this incarceration is heartbreaking in itself but also emblematic of failure. The interventions made exacerbated his existing anxiety, creating a descending spiral of deterioration in his health that has resulted in over-medication, more restrictions and even poorer mental and physical health. We are spending money on harming people rather than saving them.

[Tim Loughton (East Worthing and Shoreham) (Con)]

It is so good to have my right hon. and learned Friend on the Back Benches in some respects; he is such a champion of this cause and is making a very important contribution. Does he agree that it is a completely false economy not to be thinking smarter, and lazy not to be able to let people out of NHS facilities where there may be better community facilities and better working with the families? It would, of course, mean a much better life for the person involved as well. The chemical cosh that he just referred to and the use of restraint, which in some places is disproportionate, is a sign of failure, and that the person is not being looked after appropriately. That is what needs to change.

I should have declared my entry in the Register of Members’ Financial Interests at the beginning of this intervention.

[Sir Robert Buckland]

My hon. Friend, who has long experience of this matter, having served with distinction as Children’s Minister and as a long-standing campaigner on these issues, makes a hugely important point about the chemical cosh that is medication. I think he and I agree that we are not here to single out or criticise many dedicated care staff and NHS workers who do their very best to care for and support in-patients. They deserve our thanks; they are doing the day-to-day work. I am talking about the system that allows this to happen—that allows, in effect, a standing reproach to us all. This is 2022, not 1922.

There are two strands to the approach that we need. First, as the hon. Member for Strangford (Jim Shannon) said, earlier and better interventions are needed to prevent cases spiralling into crisis in the first place. Secondly, better community-based alternatives to the continued detention of in-patients are needed. It is my firm belief that with the better commissioning of community support, the need for recourse to detention would inevitably fall. That would create a virtuous—rather than vicious—circle, which would benefit all.

There is not only a social, health or moral price being paid for this failure, but a financial one. In 2015 the National Audit Office estimated that, in the year 2012-13, the NHS spent £557 million on in-patient services for people with learning disabilities whose behaviour could be challenging. More than half a billion pounds was spent on services that harm people, and that figure is from nearly 10 years ago. The cost now will be considerably more. That speaks volumes about the failure of the present system.

Although the Mental Health Act was reformed in 1983, it is, in essence, a replication of a regime that was created under the Mental Health Act 1959. That is a 60-year-old framework; to say that it is out of date understates the argument.