Mental Health Bill [HL]

moved Amendment No. 25: 25: After Clause 21 , insert the following new Clause— ““Children and young people After section 142 of the 1983 Act insert— ““142A Admission to age appropriate setting In the case of an application for admission for assessment and treatment for a mental disorder, whether voluntary or not, in the case of any child or young person under the age of 18 years, a clinician with specialist training in child or adolescent mental health shall assess the needs of the child or young person and a PCT or equivalent health board shall provide for such services and accommodation as are sufficient for the particular needs of that child or young person. 142B Medical assessment by a CAMHS specialist prior to imposition of compulsion for a child or young person In the case of a minor under the age of 18, who is admitted for assessment under section 2 or admitted for treatment under section 3, one recommendation as specified in these sections shall, except in an emergency where no child or adolescent mental health specialist is available, be made by a qualified child and adolescent registered medical practitioner. 142C Clinical supervisor Wherever under any provision of this Act a responsible clinician is to be appointed if the patient is a minor under 18 that clinician shall, except in an emergency where no child and adolescent mental health specialist is available, be a child and adolescent mental health specialist.”””” The noble Lord said: My Lords, as this is the first amendment I have moved at this stage of the Bill, I should like to say that I appreciate the efforts the Minister has made to respond to the many points which rained down during Committee. I think we can say that there are at least some rays of sunshine—I hope we will see them on this amendment and on others. The Minister knows, however, that I and other noble Lords who have put their name to the amendment attach much importance to it, which concerns children and young people exclusively. The first part of the amendment deals with the requirement to treat children and young persons under the age of 18 in a way appropriate to their needs. The public might think that this is so self-evident that we should not have to debate it on the Floor of the House. However, we know that despite the very great improvements in mental health care and services in recent years, in practice children and young persons with mental health problems and disorders are not always treated in an age-appropriate setting. My noble friend Lord Patel of Bradford gave some shocking examples when he spoke in Committee, and the very recent report by the Children’s Commissioner, entitled Pushed into the Shadows, has some more. In presenting this Bill, the Government have given Parliament the right opportunity to improve the present situation for children and young people. We know that many mental health problems come about in the teenage years and that the best assessment and care at this time and the confidence of the patient in his or her treatment can give longer-term benefits, and perhaps help to reduce the revolving-door phenomenon under which mental health patients go in and out of hospital, which it is one of the Bill’s objectives to reduce. More specifically, the amendment requires first that for children and young persons under the age of 18, when there is an application for admission and treatment for a mental disorder, there should be an assessment by a medical practitioner with specialist training in child or adolescent mental health; and secondly that the health authority or equivalent health body, "““shall provide for such services and accommodation as are sufficient for the particular needs of that child or young person””. " We find this quite appropriate to the Bill, as did our Scottish colleagues when they included the same words in Section 23 of the Mental Health (Care and Treatment) (Scotland) Act 2003, thereby setting an excellent precedent. We recognise that in proposing including the appropriate treatment test in the criteria for detention, the Government have recognised that there is a problem and sought to provide a partial remedy. To that extent, there is common ground between us. But the effect could be that if the primary care trust did not provide care in a CAMHS unit and an adult unit was deemed not safe, the child or young person could not be detained and would not get the place of safety which might be necessary. Nor does the Government’s approach deal with children or young people to be admitted on a voluntary basis. Our approach is more direct and, in our view, more reliably effective. At an early stage, the Minister indicated that it is not appropriate to put services on the face of the Bill. We are frankly baffled by that argument. As a former civil servant, I feel tempted to say that it must have been invented by a civil servant. The Mental Health Act, as amended by this Bill, is littered with service provisions, which is a good thing. As Rosie Winterton, the Minister of State, made clear on 30 January in the all-party parliamentary group: ““This Bill is about making sure that people get the care they need””. Good for Rosie. In any event, in this amendment we are not talking about a newly differentiated group of people, such as market gardeners, asylum seekers or circus artists, but proposing an amendment for children and young people. In almost every sphere of our society we differentiate services for children and young people—for example, children’s hospitals, school buses, young offender institutions, the Children Act and so on. The two remaining parts of this amendment are complementary to the first. They deal with medical assessment by a children and adult mental health specialist, and clinical supervision by a similarly qualified specialist for children and young persons under the age of 18. The Minister will note that for practical reasons these requirements can be over-ridden in case of urgency or emergency. Finally, despite the Government’s good intentions, which we recognise, neither the code nor the Government’s policy guidance has protected the children who have been admitted to adult wards in past years and we are not convinced that a reiteration in the code will make much difference, which is why we invite the Government to put this provision in the Bill. I beg to move.