Parliamentary update

Health Select Committee

The House of Commons Health Select Committee report on the provision of NHS mental health services was published in July 2000. The Registrar, Dr Mike Shooter, gave evidence on behalf of the College on 11 May. Dr Shooter was questioned closely about the future role of psychiatrists, their recruitment and retention and resources for mental health services. The Committee's two specialist advisers were Professor Robert Bluglass and Professor Tom Burns. The Report's major recommendations included closing the three special hospitals, a rejection of the Government's proposals to deal with ‘dangerous severe personality disorder’ (DSPD), the inclusion of the principles of reciprocity and non-discrimination on the face of any new Mental Health Act and further work to investigate the validity of a capacity test. The full report is available on the Committee's website at www.parliament.uk/commons/selcom/hlthhome.htm. The Government immediately rejected the closure of the special hospitals but will issue a full response to the report in the autumn.

The College also supplied written evidence to the Health Select Committee for their inquiries on consultants' contracts and public health. These are available on the College website at www.rcpysch.ac.uk.

Home Affairs Select Committee

The Government's response to the Home Affairs Select Committee report on DSPD was published in May (Home Affairs Select Committee, 2000). The Government pledged that any proposals for new legislation will be compliant with the Human Rights Act 1998 and that there would be a review of continuing detention at regular intervals. The response also recognised that there would be a need for better specialist provision, more research, better assessment tools and therapeutic interventions. However, the Government rejected concerns from mental health professionals about the detention of those who were not before the courts for sentencing on a current offence. The Home Office did not believe that the proposals were fundamentally any different in principle from legislation that currently applies under the Mental Health Act. The Government also rejected a recommendation from the Committee that any legislation on DSPD should be subject to annual renewal by Parliament. Psychiatrists in England and Wales may find the very different proposals suggested for Scotland by the MacLean committee (mentioned below) of interest.

The College also supplied written evidence to the Home Affairs Select Committee inquiry into Drugs and Prisons. Evidence given by the Prisons Minister, Paul Boateng MP, is available on the Home Affairs Select Committee website at www.parliament.uk/commons/selcom/hmafhome.htm.

Psychotherapy Bill

The Psychotherapy Bill, prepared by Lord Alderdice, was given its first reading in the House of Lords and printed on 18 May. The Bill would establish a registration body and registration mechanism for psychotherapists. It meets the College's concerns regarding registration, as medical practitioners will be exempted from the need to register. Owing to the lack of parliamentary time, Lord Alderdice hopes to bring the Bill back in the next session of Parliament and take it through the House of Lords. An MP will be needed to take the Bill through its Commons stages.

All-party parliamentary groups

All-party parliamentary groups are established by MPs across party lines with MPs or peers from more than one party as their officers. They hold regular meetings on subjects chosen by the group and are attended by MPs, peers and representatives of interested organisations. It is usual for the groups to be supported by a major charitable organisation in their area. The College supports the All-Party Mental Health Group, which is chaired by Dr Lynne Jones MP. The group issues a regular bulletin with its programme and information about current major initiatives, which is sent to all parliamentarians known to be interested.

Recently, Dr Rob Jones spoke to the group on advance directives and a meeting was held on dealing with dangerousness addressed by Dr Bob Johnson (James Nayler Foundation) and Margaret Pedler (Mind).

Other all-party groups with substantial mental health interests are drugs misuse, alcohol misuse, disablement, public health, clinical depression and autism. Members of the College's Parliamentary Liaison Sub-Committee and the Parliamentary Officer attend their meetings whenever possible. College members in touch with their local MP may wish to bring an appropriate group to their attention. Further information is available from Christopher Walden, Parliamentary and Policy Officer at the College.

The All-Party Drugs Misuse Group (2000) has issued a booklet, Dual Diagnosis, to which Dr Alison Lowe contributed with a presentation to the group and editing assistance.

Scotland

The Scottish Parliament, with health accounting for 40% of its annual budget, has been quick to make its own mark on legislation, policy development and service delivery, particularly in the field of mental health. Psychiatrists working in Scotland have had to adjust to dealing with politicians as part of everyday life.

To influence the rapidly changing agenda in mental health services, the Scottish Division established a Scottish Parliamentary Sub-Group of the Executive Committee. Convened in May 2000, this is now finding its feet.

The Parliament has been active in mental health matters. The first act passed by the Scottish Parliament was in response to the case of Noel Ruddle, which highlighted issues of treatability. The Adults with Incapacity (Scotland) Act is now law and has been well received. The Millan Committee (www.scotland.gov.uk/millan ) is due to report on proposals for a new mental health act and the MacLean Committee (www.scotland.gov.uk/maclean ) has reported on proposals to deal with mentally disordered offenders. Psychiatrists have been well represented in all these areas.

Mental health services come within the remit of the Health and Community Care Committee of the Scottish Parliament, and the Parliamentary Sub-Group of the College has sought to make links with this Committee.

To raise the College's profile the Sub-Group hopes to host a reception, jointly with users and carers, for MSPs, MEPs and local MPs with a view to establishing an All-Party Scottish Mental Health Group that will champion the wish of mental health service users and providers for better services for the mentally ill in Scotland.

Throughout, the College's Scottish Executive has been grateful to the officers of the College and the main Parliamentary Liaison Sub-Committee in London for the support, expertise and encouragement they have provided in the establishment of our Parliamentary Group.

Reform of the Mental Health Act 1983

The Government received over 1000 responses to the Green Paper on the reform of the Mental Health Act 1983. The Mental Health Alliance held a national lobby of Parliament on 7 June to press for changes to be made to the Government's proposals. The Alliance is made up of a number of charities including Mind, the National Schizophrenia Fellowship and the Mental Health Foundation. Meanwhile, College representatives have held discussions with Department of Health officials regarding the Green Paper. As Parliament rose for the summer recess it was announced that a White Paper (i.e. government proposals) for Mental Health Act reform will be published by Christmas. There will also be White Paper proposals about people with personality disorder from the Home Office.

For further details on any of these issues contact Dr Roger Freeman, Chair of the College's Parliamentary Liaison Sub-Committee at armfreeman@doctors.org.uk or Christopher Walden, Parliamentary and Policy Officer at cwalden@rcpsych.ac.uk. For information on Scotland contact Dr Ian Pullen at ian.pullen@scotland.com or Dr Denise Coia at gillian.duncan@glasgow-hb.scot.nhs.uk.