Mental Health Units (Use of Force) Bill — House of Commons, 2018-06-15
Topic: Health
Philip Andrew Davies (Conservative, Centre-right): I agree. The same applies to amendment 41 —also in the name of the right hon. Member for North Norfolk—which would include the "threat of isolation" alongside isolation itself, and to his amendment 42, with which he wants to include the "coercion of a patient". I am not entirely sure why such an amendment is needed, to be perfectly honest. He includes a definition of coercion in amendment 43, as "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." I am not really sure what that adds to the Bill, to be perfectly honest. I do not think that anything it does add to the Bill is something that I could support anyway. I think that he is taking these definitions a bit too far given the Bill’s purpose The right hon. Gentleman’s amendment 37 would insert into clause 3: "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." With regard to using force with "the sole intention of inflicting pain, suffering or humiliation", I look to people who are more legally qualified than me, but surely that must already be illegal. I cannot believe that that can already be lawful in this country. Therefore, this amendment is not necessary either Amendment 36 refers to a "description of each of the methods of restraint that may be used…what steps will taken to reduce and minimise the use of force" and "a description of the techniques to be used" Paragraph (d) is the worst bit. It refers to "a commitment to reducing the overall use of force in the mental health unit." Would that potentially mean that restraint and force is not being used when it should be used because somebody had a commitment to reduce its overall use? Surely, we should be seeking to make sure that restraint and force are used appropriately—at the right times, in the right situations, with the right patients. As long as that is being done, the number of cases is neither here nor there. It is the appropriateness that matters, not the numbers. This amendment would mean that restraint would not be used when it should be used. The lack of trust in staff in this is something that I cannot possibly support Amendment 38 says that "subsection (1) must include a patient’s right to advocacy and how to access an advocate." Again, this may deter staff from using restraint even when it is necessary, thinking that they are going to get into a compensation culture with vexatious legal claims being made against them. We should not be passing laws that encourage that Amendment 79 says: "The Secretary of State must publish quality standards for training" and "The Secretary of State may delegate the publication of quality standards for training" There is already a requirement to have standards for training; the right hon. Gentleman seems just to want to add the word "quality". I am not sure that there is any indication that the standards for training would not be of quality anyway. It goes without saying that we want quality standards of training; we do not need to put that into the Bill Amendment 80 refers to "trauma-informed care". I do not have a particular problem with that. Again, it is an issue of how prescriptive we should be in relation to the training. I have already spoken at length about that. The right hon. Gentleman makes some fair points The right hon. Gentleman’s other amendments include amendments 83, 84 and 85. Amendment 83 says: "The Secretary of State must make a statement to Parliament, as soon as practicable following the publication of report under subsection (2)." It is difficult to disagree with that, to be honest. I do not see why that should not happen. I would be perfectly happy about it My hon. Friend the Member for Christchurch has also tabled some amendments. His amendment 88 would "leave out ‘mechanical or chemical’ and insert ‘or mechanical’." I think that he wants to get rid of the chemical type of restraint from the Bill. A chemical restraint can be described as a medical restraint to restrict the freedom of movement of a patient. Such chemical restraints can sometimes also be used to sedate a patient if necessary. I think that his amendment is understandable. My only concern is whether it might lead to perverse outcomes whereby chemical means of force are used more often than they should be to get round the Bill. I am a bit nervous that that may happen. I would therefore deter him from pressing ahead with it, although I certainly understand where he is coming from. Amendment 90 to clause 1 seems to be a consequential amendment, so we do not need to deal with that. Amendment 89 would leave out paragraph (b) from clause 1(6), to remove the isolation of a patient from the list of things referred to by "use of force". I am much more sympathetic to this amendment, because my hon. Friend makes a good point. I am sure he will express his own opinion when the time comes on why he feels so strongly about that, but my view on first reading is that it is perfectly sensible. Amendment 91 is consequential to that Amendment 98 is one to which my hon. Friend referred in an earlier intervention. It would insert the words "and their families" after "patients", to allow patients and their families to plan, develop and deliver their care and treatment in a mental health unit. This is an excellent amendment. It is essential that families are involved in the treatment of their family members. In many cases, if the family could have been more involved from the start and been able to help and warn what the situation was, such problems and terrible situations would not have happened. It is a very sensible amendment, and I hope that he will pursue it with vigour, because it is really important that we involve family members in treatment Amendment 100, which would ensure that guidance is published no later than six months after the Act is passed, is particularly pertinent to the discussions we have been having. My only quibble is that six months may be too long, but I certainly agree with the thrust of it, which is that there should be a time limit.