Thursday 16 December 2010

Once more unto the breach...

I'm taking a lot of holidays as you may have noticed from the lack of serious posts and indeed today is my last day in work this year - we've had such an exciting year that I forgot to take my holidays earlier.

However, here's one to ponder. On Tuesday I attended a meeting of the Mental Health Alliance in London. The Alliance had a very high profile when the doomed draft Mental Health Bill and then the (enacted) Bill amending the '83 Act were under discussion. Arguably the Alliance won the argument but not the war, though mental health legislation would have been more repressive if the Alliance had not been there. Hafal played an honourable and distinguished part in the campaign both as part of the Alliance and in our own right: our leading campaigner Jo Roberts' evidence to the Parliamentary Scrutiny Committee looking at the first Bill was widely ackowledged as pivotal in the Committee's adverse report and so in getting the Bill scrapped.

To a significant extent the Mental Health Measure, though substantially a result of consumer pressure brought by Hafal members such as Jo, Lee McCabe, and other campaigners, put in place in Wales the reciprocal rights which the Alliance campaigned unsuccessfully to be included in the England and Wales legislation. But that still leaves unsatisfactory legislation relating to the use of compulsion in the form of the Mental Health Act itself.

Meanwhile it is interesting to note that the Northern Irish government is planning to enact a new mental health law integrating mental capacity considerations - sounds good. Wales of course cannot do this as the piecemeal powers transferred were effectively confined to the according of rights to patients (or, strictly speaking, imposing duties on services) not to amendment of the Mental Health Act except in a very limited, technical way.

The Mental Health Alliance has in recent times confined its activities to monitoring the operation of the amended Mental Health Act - and done a useful job - but there must be a question as to whether it is time to raise the banner again for reform of the England and Wales legislation.

Why? Isn't it too soon? Well, that is a fair point but against that you could argue as follows...

• The amended Act isn't working well. In particular the Alliance's fears about the use of Community Treatment Orders seem to be coming to pass, specifically lazy, long-term use of Orders to exact compliance from patients in place of persuasive therapeutic engagement.

• Many people in the new coalition UK government were, when in opposition, sympathetic to the Alliance's position from both a human rights and a pragmatic perspective.

• The coalition government arguably combines the libertarian instincts of some on the right (people like David Davis - I mean of course the MP for Haltemprice and Howden, not David Davies MP for Monmouth) with those of progressive liberals among the Lib Dems.

• The coalition government is keen to cut bureaucracy and to save money. Reform of mental health legislation could do both as well as serve patients better.

There is an added complication - or opportunity - for Wales inasmuch as the referendum next year could transfer more powers over mental health legislation - but still not powers equivalent to those in Scotland and Northern Ireland because they also have justice matters devolved.

I think we will have to act. The fact is that the Mental Health Act looks more and more out-of-date and anomalous as time goes by.

I wonder if the London-based charities will see it that way too?

Postscript: outing another closet Welsh person...
Why on earth would Henry V, classic English hero of Agincourt etc and enemy of Owain Glyndŵr, say he is Welsh in Shakespeare's play? By chance he was born in Monmouth Castle, hence the unlikely claim. Come to that we should also "out" the "English long-bow" - nothing of the kind, it was a classic Welsh weapon and indeed the famous archers at Agincourt were themselves Welsh mercenaries, veterans of Glyndŵr's failed rebellion. And ironically some of the "French" knights whom they shot down in the battle were also Welsh, their former leaders who had fled to the continent. You can't get away from 'em, especially where there's a fight to be had.