Following the publication of the Government’s response to the Joint Parliamentary Committee Report on the Draft Mental Health Bill, Members of Hafal – Wales’ principal charity for people with severe mental illness – have expressed their disappointment and dismay at the Government’s plans.
“The Government states that it has accepted in full or part well over half the Committee’s recommendations. However, the Government has failed to respond to the key issues, and where it has agreed with recommendations, it largely only makes reference to non-existent Codes of Practice,” said Bill Walden-Jones, Chief Executive of Hafal.
“We recognise the small improvements made to the Bill by the Government; but there is still a very, very long way to go. We will continue to campaign for a fair and balanced approach.”
Richard Mayes, a Hafal client, added: “This Bill should really have put the patient at the centre and tried to serve their needs as best it could, with compulsion as a last but necessary resort. This would have made a fair and humane Bill for the new century. Yet according to the Government’s plans the Bill will still pander to the public’s fears. This could be a wasted opportunity.”
The main areas of concern expressed by the charity were as follows:
• Scope: Hafal notes the exclusion of substance misusers from the scope of the Bill; yet other groups, such as those with learning disabilities or sexual deviants, still inappropriately come under the scope of the legislation. Whilst unfairly targeting certain people, this also could vastly increase the already overwhelming workload of mental health services.
Richard Timm, a client of Hafal, stated: “This law could be a disaster for Wales. We don’t have the resources to support it here. Our services are way behind those in England. In fact it could mean that services get worse in Wales because so many doctors will be tied up with delivering the new law.”
• Reciprocal Rights: The Committee recommended that a person with a mental illness should have the right to treatment under the Bill. But whilst the Government agrees about “the importance of assessment and treatment at an early stage for people with mental health problems,” it ultimately rejects the principle for the Bill.
Helen Oseman, a client of Swansea Hafal with experience of severe mental illness, said: “One of the main things we have campaigned for is the right to early treatment. If severe mental illnesses like schizophrenia are treated early, patients are far less likely to become very ill and end up needing to be sectioned. This saves the person from a frankly terrible experience, and it means that their illness is better managed from the start.
“A right to early treatment would balance out the compulsion, but the rights of patients have been ignored by this draft Bill.”
• Insufficiency of the Welsh Infrastructure: Hafal was especially concerned that Wales simply does not have the infrastructure to support this legislation, and the Committee acknowledged this, pointing out that Wales’ services are less developed than those in England.
However, no stipulation that services in Wales must be brought up to the standard of services in England before the Bill is implemented has been introduced.
The responsibility for ensuring appropriate treatment is also given to National Service Frameworks of England and Wales. But, explains Walden-Jones: “This means nothing to service users in Wales who have first-hand experiences of the poor services currently available in many areas. In Wales the NSF, whilst in policy terms is widely supported, has simply not been implemented on time, and to suggest that the rights to appropriate treatment are sufficiently catered for by these guidelines is frankly ridiculous.”
• Carers’ Rights: Whilst the Government was positive about improving the process for appointing a patient’s Nominated Person, it was not agreed that they should gain the rights that the nearest relative currently has under the 1983 Act.
Rob Davies, a carer, said: “Carers will lose rights which they had under the 1983 Act. They will be excluded from key rights such as the power to seek discharge. Carers should be given more rights by a new Act, not fewer. It seems like we’re going backwards, not forwards.”
Furthermore, whilst Hafal cautiously acknowledges the Government’s endorsement of the Committee’s recommendation that patients have the right to make advance statements (for example, specifying the treatment they don’t want), they were disappointed that these advance statements were not to be binding on clinicians.
Peter Davey from Flintshire, Chair of Trustees at Hafal and a carer, stated: “On these points the Government has disregarded not only the advice of service users, voluntary organisations and health professionals, but also the Scrutiny Committee, comprising members of the House of Commons and the House of Lords.
“The Government must surely listen to the people who know best, and the people who will have to live with a new Act: people with severe mental illnesses and their carers. As the voice of users of mental health services, Hafal now calls on Welsh MPs and Lords to press for constructive amendments to the Bill when it is introduced, and deliver the message of our Members.”
Bill Walden-Jones, Chief Executive of Hafal, added: “Despite the Government’s plans, the fight to amend the Bill will continue. Our Members are more determined than ever to put their points across, particularly with regard to services in Wales which are insufficient to cope with the demands of the current draft of the Bill.
“We made reasonable suggestions to the Government. We didn’t say ‘No to any compulsion’, we asked that it be carefully balanced with reciprocal rights for patients. Yet our suggestions though largely accepted by the Scrutiny Committee as sensible and just, have been largely ignored by the Government.
“Essentially the Government has turned down the offer of a partnership with patients and families such as those we represent. The result is a lost opportunity, and potentially a law that is worse than 1983 Act it replaces. Where’s the progress in that?”