Chamber
Plenary, 14 Nov 2001
14 Nov 2001 · S1 · Plenary
Item of business
Mental Health Law
I wish the Minister for Health and Community Care continuing good health.
We can welcome the Executive's policy statement with commitment and enthusiasm, because mental health problems should always be given top priority. I know from experience of visiting patients who have mental health problems that those problems can give rise to great anguish for the patient and family members.
It is not always easy to strike the best balance between the interests of the patient and the protection of the wider community, which may include members of the patient's family. Finding the right balance involves enormous patience, hard work, understanding and good will. Just as the interests of the community have to be taken into account, so do the interests of the patient. It is all too easy for a doctor exercising authority and powers over a compulsorily detained patient to overdose that patient, which may have long-term ill effects.
I remember one patient saying to me that there is no stigma attached to having a sprained ankle but that there is to having a sprained mind. I applaud the minister's admirable aim to remove any such stigma. I believe that the Administration is right to set out a statement of basic principles for the proposed bill.
Compulsory care and treatment should be used only as a last resort and should be linked to a plan of care for the patient. We would like to know a good deal more about how patients can be compulsorily treated in the community, rather than in hospital. That is a worthy aim in cases where a patient needs such treatment, but we need to know in detail how the situation would be dealt with in the event of non-co-operation.
I welcome the proposal for a new independent tribunal to consider compulsory measures. The great advantage of a tribunal is that it can consider each case impartially and on its merits, having weighed up the evidence from the doctor, the patient, family members and others who are directly affected. We have a serious reservation, however, in that the tribunal is entitled to release a patient even if that is contrary to the medical evidence and the advice of the doctor. The tribunal's jurisdiction has no check on that. In other words, the minister has no say if a potentially dangerous patient is about to be released into the community. I believe that such a safeguard operated in the past as a protection to the public and I would be glad if the minister could reassure us in that respect.
Janis Hughes was right to welcome the strengthening and clarification of the rights of carers. I note that reforms are proposed for dealing with mentally disordered offenders. Those proposals will provide for a more thorough assessment before the court makes a disposal. It is important to remember that some offenders with serious mental disorders and a history of violence can be dangerous. There is a risk that the proposed bill could focus too much on the interests of an offender who is a patient rather than on those of the community. That is a question of getting the balance right. It is important, for example, that a person who takes another's life should not be released without some provision for supervision. We will be pressing that point with the minister.
It goes without saying that the proposed bill must be supported by a sufficiency of resources. Some years ago, I had to deal with the aftermath of a tragic case in which a mental patient stabbed a police officer to death. I put in place a package of reforms, which was welcomed by George Foulkes. The reforms included provision for contact with the doctor of a known patient who is acting in a wholly unacceptable or dangerous way.
I recognise the proposed bill for what it is: a sincere and genuine attempt by the Administration to deal appropriately with the subject of mental health. However, I fear that it may not give sufficient weight to the protection of the public. We will seek to address that matter in committee.
We can welcome the Executive's policy statement with commitment and enthusiasm, because mental health problems should always be given top priority. I know from experience of visiting patients who have mental health problems that those problems can give rise to great anguish for the patient and family members.
It is not always easy to strike the best balance between the interests of the patient and the protection of the wider community, which may include members of the patient's family. Finding the right balance involves enormous patience, hard work, understanding and good will. Just as the interests of the community have to be taken into account, so do the interests of the patient. It is all too easy for a doctor exercising authority and powers over a compulsorily detained patient to overdose that patient, which may have long-term ill effects.
I remember one patient saying to me that there is no stigma attached to having a sprained ankle but that there is to having a sprained mind. I applaud the minister's admirable aim to remove any such stigma. I believe that the Administration is right to set out a statement of basic principles for the proposed bill.
Compulsory care and treatment should be used only as a last resort and should be linked to a plan of care for the patient. We would like to know a good deal more about how patients can be compulsorily treated in the community, rather than in hospital. That is a worthy aim in cases where a patient needs such treatment, but we need to know in detail how the situation would be dealt with in the event of non-co-operation.
I welcome the proposal for a new independent tribunal to consider compulsory measures. The great advantage of a tribunal is that it can consider each case impartially and on its merits, having weighed up the evidence from the doctor, the patient, family members and others who are directly affected. We have a serious reservation, however, in that the tribunal is entitled to release a patient even if that is contrary to the medical evidence and the advice of the doctor. The tribunal's jurisdiction has no check on that. In other words, the minister has no say if a potentially dangerous patient is about to be released into the community. I believe that such a safeguard operated in the past as a protection to the public and I would be glad if the minister could reassure us in that respect.
Janis Hughes was right to welcome the strengthening and clarification of the rights of carers. I note that reforms are proposed for dealing with mentally disordered offenders. Those proposals will provide for a more thorough assessment before the court makes a disposal. It is important to remember that some offenders with serious mental disorders and a history of violence can be dangerous. There is a risk that the proposed bill could focus too much on the interests of an offender who is a patient rather than on those of the community. That is a question of getting the balance right. It is important, for example, that a person who takes another's life should not be released without some provision for supervision. We will be pressing that point with the minister.
It goes without saying that the proposed bill must be supported by a sufficiency of resources. Some years ago, I had to deal with the aftermath of a tragic case in which a mental patient stabbed a police officer to death. I put in place a package of reforms, which was welcomed by George Foulkes. The reforms included provision for contact with the doctor of a known patient who is acting in a wholly unacceptable or dangerous way.
I recognise the proposed bill for what it is: a sincere and genuine attempt by the Administration to deal appropriately with the subject of mental health. However, I fear that it may not give sufficient weight to the protection of the public. We will seek to address that matter in committee.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
The next item of business is a debate on motion S1M-2438, in the name of Susan Deacon, on renewing mental health law, together with an amendment to that moti...
The Minister for Health and Community Care (Susan Deacon):
Lab
I am pleased to speak to the motion and proud to lead a debate on such an important issue.This afternoon we are debating the Executive's proposals for renewi...
The Presiding Officer:
NPA
Before I call Nicola Sturgeon to move her amendment, once again I ask those who wish to take part to press their request-to-speak buttons, because I have to ...
Nicola Sturgeon (Glasgow) (SNP):
SNP
I welcome today's debate. I have no doubt that there will be considerable consensus across the chamber about the Scottish Executive's proposals. I agree with...
The Presiding Officer:
NPA
Before I call the representatives of the other two parties, I advise members that the time limit on back-bench speeches will be five minutes.
Mary Scanlon (Highlands and Islands) (Con):
Con
As our business today started with a mention of the patron saint of mothers, on behalf of the Scottish Conservatives, I congratulate the Minister for Health ...
The Presiding Officer:
NPA
I do not think that it is an arrival as yet. Is it an arrival?
Mary Scanlon:
Con
Did you not know, Presiding Officer? I am not implying anything saintly about the minister, but I am delighted about the news of her new arrival.We are delig...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I congratulate the minister on her impending happy event and pay tribute to the lengths to which she is prepared to go to scrutinise Scotland's maternity ser...
Margaret Jamieson (Kilmarnock and Loudoun) (Lab):
Lab
Many members will be aware that, over many years in my previous employment, I gained much experience of mental health services in Scotland, particularly in t...
Mr Kenneth Gibson (Glasgow) (SNP):
SNP
I am pleased that the minister has now decided to join my campaign to reverse Scotland's declining birth rate. I wish her all the very best over the coming m...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
I want first to echo the sentiments that the minister expressed in her speech and to add my support to the motion that is before us.One in four people in Sco...
Lord James Douglas-Hamilton (Lothians) (Con):
Con
I wish the Minister for Health and Community Care continuing good health.We can welcome the Executive's policy statement with commitment and enthusiasm, beca...
Mrs Margaret Ewing (Moray) (SNP):
SNP
I feel as though I am participating in a discussion rather than in a debate; I am pleased about the consensual approach that the Parliament is adopting on th...
Des McNulty (Clydebank and Milngavie) (Lab):
Lab
Like others, particularly Margaret Ewing, I very much welcome today's debate on what is an important subject. The Parliament's second bill on mental health w...
Robin Harper (Lothians) (Green):
Green
I add my congratulations to the minister on her impending good news. My business manager gave birth to a fine bouncing baby last month; I am sure that she wo...
Dr Richard Simpson (Ochil) (Lab):
Lab
I declare that I am still a fellow of the Royal College of Psychiatry and I am a member of SAMH.The Millan report is a patient, thorough and comprehensive re...
The Deputy Presiding Officer (Mr George Reid):
SNP
From now, speeches are down to four minutes.
Stewart Stevenson (Banff and Buchan) (SNP):
SNP
Presiding Officer, thank you for chopping off the last page of my speech.I join the prevailing consensus in the chamber and welcome the Millan report and the...
Mr David Davidson (North-East Scotland) (Con):
Con
Members will be well aware of this week's coverage of my daughter Suzy's current problems with an eating disorder. I therefore intend to talk principally abo...
Brian Adam (North-East Scotland) (SNP):
SNP
I will address two matters, one of which is advocacy, to which others have referred. Individual advocacy has been discussed, and I do not doubt that the mini...
Mr John McAllion (Dundee East) (Lab):
Lab
In the spirit of consensus that is prevailing today, I will begin by welcoming all the speeches that have been made during the debate. In particular, I want ...
George Lyon (Argyll and Bute) (LD):
LD
I, too, congratulate the minister on the announcement of her pregnancy—there has certainly been consensus on that today. There has been consensus throughout ...
Ben Wallace (North-East Scotland) (Con):
Con
The Scottish Conservatives welcome the opportunity to debate the proposals for new legislation on mental health. Mary Scanlon underlined our commitment to th...
Shona Robison (North-East Scotland) (SNP):
SNP
The debate has been productive and worth while. There has been much agreement and we are extremely pleased that the SNP's amendment has been accepted. Long m...
The Deputy Minister for Health and Community Care (Malcolm Chisholm):
Lab
The debate has been excellent and, as Margaret Ewing put it, a shining example of what the Parliament is about.There have been continual references to the wi...