Mental Health Bill [HL]

My Lords, first, I acknowledge the comments made by the noble Earl, Lord Howe. He has made a significant improvement on the original amendment, which I welcome. I do not know whether the Government plan to accept it or not. I still have some concerns. They are twofold. First, if you ask a person exercising authority under the Mental Health Act to take into account the Race Relations Act, the Sex Discrimination Act, the Equality Act and so on, you are putting in their mind when they take a decision to discharge or admit that they may face a legal consequence under one of the linked Acts if they get that decision wrong. That is a problem. I do not think that most professionals in most areas read the full Act other than once or twice in their lifetime, so guidance is more important. At times in both this House and the House of Commons, we set ourselves a double bind. We call for less legislation, but we put things in Acts that require people to jump through even more hoops in order to take a decision. We must be aware of that balance. To my mind, the key Act here is the Race Relations Act. In our previous debate, every one of us acknowledged that there is a major problem in the psychiatric area generally with the excessive treatment of people from ethnic minority communities. We must ask, first: do we deal with that by inserting a reference to the Race Relations Act in the Bill? Secondly, if doctors, nurses and others have that in the forefront of their mind, what effect will it have on their decision-making? It might result in them facing legal action. That is a problem for them. I have felt for many years—I do not think that this will be deeply disputed—that part of the reason why we have an excessive number of ethnic minorities in psychiatric institutions is a lack of doctors from ethnic minorities, something that the medical profession needs to put right and pay more attention to. The other factor, which is deeply unquantifiable, is the extent to which the pressure on ethnic minority individuals in the community as a result of their being from an ethnic minority and perhaps experiencing extremes of racial hostility, may trigger or accentuate a medical condition that would not otherwise be picked up, or even be a problem. We need to focus on that area, rather than just saying that the doctor, nurse or whoever must be aware of the Race Relations Act. There is still a problem with that. I would not lose too much sleep if the Government accepted the amendment in its current form, but I would be worried that in time we might find ourselves arguing that this should not have gone into the Act because it imposed a duty on professionals that was unreal and that perhaps tempted them not to take actions that they would otherwise take. It is a very real dilemma, and I have no criticism of the intentions of the other two speakers or of the other noble Lords who have added their names to the amendment. Indeed, I believe that we all share those intentions. It is, as always in legislation, a question of whether you deliver those intentions or whether you inadvertently put other barriers and hurdles in the way that cause a problem. I hope that the Government will give considerable thought to the amendment before deciding whether to accept it, although I welcome it as a significant improvement on the other amendments in the list. There were contradictions in that list, which again indicates the problem; I suspect that if you trawl through the various Acts referred to in the amendment, you might find contradictions in them, too. We are passing something that must stand up not only in our opinion or in a code or guidance, but in a court of law, and under which a professional will have to decide whether they are in danger of being in breach not only of what will become the Mental Health Act but of one or more of the other Acts referred to therein.