I agree, and as has been mentioned, there is good practice in co-locating police officers and other emergency services with mental health professionals.
My other problem is with who takes such a decision. Clearly, if someone is in crisis and faced with a choice of being taken to a police cell or being allowed to stay at home, most people will stay at home even if that is not the safest place for them. Likewise, their relatives or carers may feel that they have no choice but to take the default position of keeping somebody at home. Perhaps when the Bill goes to Committee we should examine exactly how the measure would work in practice, because it could also lead to the problem being masked. Like the hon. Member for Broxbourne (Mr Walker), I think that we need a place of safety. That does not necessarily have to be a bed—I will come to that issue in a minute—but we need places where people can be taken and properly assessed. These statistics may suddenly disappear, and people might not be placed in that position—the local health commissioners might suddenly say that we do not need a place of safety, but that is not currently the case. We need clarification on what is deemed a place of safety.
Clause 59(5) states that the police must consult a health professional before using section 136 of the 1983 Act. It requires a police officer, where practicable, to consult a doctor, nurse, approved medical professional or another person as specified in the regulations—we have not seen those yet—before using their section powers. Again, I have some problem with that provision. I can see it working in practice in a situation such as those outlined where there is good triaging work, but it is a big call on a police officer in a difficult situation when somebody is in crisis—especially if they are threatening to take their own life—if practical steps have to been taken to consult a mental health professional. The thrust of the provision is right, but I am not sure
how it would work in practice without a clear indication that local police forces have ready access to mental health professionals. I accept, however, that in some places great work is being done on that with joint working.
Clause 60 refers to the place of safety and police cells. Should a police cell be a place of safety for somebody with a mental health issue? It certainly should not. Subsection (6) prohibits the use of cells for those under 18, and I completely agree with that. The only problem is that if there are alternatives to the police cell, what will the default position be? People say that more beds are needed, and in some areas that is a problem. In other areas, however, we need places of safety to take people to. We cannot separate the crisis that faces housing in London, for example, and mental health issues. If we have proper supported housing and other projects for people to go to, that is the alternative. A bed is not always the answer to these problems. The Crisp report demonstrated that 500 people had to travel 50 km to access a mental health bed. However, because such statistics are not kept nationally, how will we know whether the targets are being met? At the moment, statistics are kept sporadically, and perhaps in Committee we should insert some provision for them to be kept nationally.
The thrust of the Bill is right, and clause 60 provides regulatory powers to the Secretary of State on the use of police cells as a place of safety for those aged 18 or over. The regulations will set out the circumstances in which a police cell may be appropriate for someone waiting for an assessment. I do not question for one minute the Government’s direction of travel in not wanting to place people with mental health issues in police cells, but some examination of what those regulations would mean is important. Clearly, if beds or places of safety are not available locally, people will wait a long time. I have spoken to police officers in my area and a police cell is the last place they want such people to be in.
Measures to reduce the maximum detention time from 72 hours to 24 hours are welcome. However, I would even question the 24-hour limit, which I think is linked to Police and Criminal Evidence Act 1984 regulations. These people are not criminals, so why do we have to use the same time limit? Guidance for commissioners from the Royal College of Psychiatrists on section 136 says an assessment should be made within three hours. In Committee, we should try to reduce the time limit down to a maximum of three hours. I am not criticising civil servants for drafting the provisions thinking they would fit in with the PACE regulations, but the inference of criminality stigmatises people who are clearly not criminals.
The chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston) raised the issue of when the 24-hour period starts. Does it start from when the person is detained in a police van or police car, or does it start when they arrive at the place of safety? This could make a big difference if people are being transported long distances to a place of safety. These issues need to be considered.
The issue of health service advocacy is completely missing in the Bill and needs to be addressed. Under the Mental Health Act 1983, there is provision for independent advocates for people with mental health issues. There are some exceptions, however, one of which happens to be the place of safety under sections 135 and 136 of the
1983 Act. People need advocacy and I would like some provision in the Bill to allow access to it. People in crisis will not be in a position to argue for their rights or to ensure they make the right decisions. The idea that advocacy is an exception rather than mandatory under the Act again puts pressure on statutory services to take it seriously.
I do not want to be churlish. I recognise that the Government are trying to move forward and I welcome what is being proposed, but the practical implications perhaps need to be considered in Committee. Alongside that consideration, we need a debate about what is a place of safety. In some cases it will be a bed, but the hon. Member for Broxbourne has other examples of places of safety run by charities and others. Unless the provisions in the Bill are implemented alongside changes to the health service and the voluntary sector, the issue, which is perceived to be a problem, will be placed unfairly back on to the police. We need to ensure the two are linked up. I hear what the Government say about £15 million being made available, but that is a drop in the ocean compared with the problems we face. We need to ensure that local commissioners work with the emergency services and others when commissioning local services. This is not just about beds. I am coming around to what the hon. Member for Broxbourne said as perhaps more appropriate.