I am delighted to open this stage 1 debate on the Mental Health (Scotland) Bill, on a motion that the Parliament agrees to the general principles of the bill.
I am pleased that we are debating mental health for the fourth time in this calendar year. That reflects the importance of mental health and the interest that the Parliament has taken in it. I am heartened to hear the Presiding Officer say that we are short of time, as that indicates the number of members who wish to speak and emphasises the great interest that we have in the subject.
We have debated much of the work that we are doing to improve mental health and mental health services, and we have discussed the progress that we have made and the challenges that we face in improving further. Doubtless, we will debate those matters again.
I am pleased to be able to briefly update Parliament about the £15 million of innovation funding that we announced in November and which is part of that work. Demand for mental health services has increased in recent years, so we must ensure that services continue to be effective and of high quality. The additional investment in the next three years will help to drive further improvements in the quality and delivery of mental health services so that people get the help that they need, where and when they need it.
The funding of £5 million in each of the next three years will comprise four key elements. The first is an allocation to national health service boards to be used in partnership with the wider public and third sector to support improved access to child and adolescent mental health services, to support innovative approaches to delivering mental health services and to identify new ways of treating people. Secondly, there will be an allocation to NHS Education for Scotland to further develop the quality of child and adolescent mental health services through training for staff in evidence-based psychological interventions. Thirdly, there will be an invitation to NHS boards and their partners to work with the Scottish Government on developing innovative approaches to working with people in distress. Finally, there will be an invitation to NHS boards and their partners to submit proposals to develop novel approaches to meeting the needs of people with mental health problems in primary care settings. We will soon write to NHS boards and their partners to set out more details on the fund, and I am happy to update members who are interested, if they would like me to do so.
Today, we are focusing on the Mental Health (Scotland) Bill, which is a key part of our mental health strategy and which looks to strengthen the rights of and protections for service users. The chief aim of parts 1 and 2 is to amend existing legislation so that it works as effectively as possible for service users. The bill seeks to address issues that were raised in the McManus review of 2009 and elsewhere. Part 3 introduces a victim notification scheme for victims of mentally disordered offenders in a way that respects the rights of victims and of vulnerable offenders.
I was pleased to note from the Health and Sport Committee’s stage 1 report that the committee supports the general principles of the bill. I thank that committee, the Finance Committee and the Delegated Powers and Law Reform Committee for their work in considering the bill at stage 1.
I am grateful to the Health and Sport Committee for the manner in which it took evidence at stage 1. It invited a wide range of stakeholders to give evidence, in the spirit of drawing out the changes that will, in line with the aims of the bill, best improve the system for service users.
The evidence and the committee’s report have been invaluable in helping the Government to reflect on whether we have the provisions exactly right, particularly when there is a range of opinions. I look forward to reflecting on members’ comments before responding to the report in due course.
I will now speak about some of the key individual provisions in the bill. Section 1 seeks to benefit service users by giving them more time to prepare for their first tribunal hearing when a compulsory treatment order is applied for. The aim is to cut down on repeat hearings, which can be distressing for service users. I have noted the concerns expressed to the committee that the change could mean that service users are detained for longer before they automatically appear before a tribunal.
Members might have noted the evidence given to the Health and Sport Committee by Dr Joe Morrow, the President of the Mental Health Tribunal for Scotland. Dr Morrow was very clear that the purpose of the proposed changes is to support service users by allowing them more time to prepare for tribunal hearings and to cut down on repeat hearings. I want to bring in changes that will help service users overall. We must balance the benefits that we are confident will result against concerns about extending the period of detention before the tribunal hearing. We are thinking hard about how best to achieve that balance and I will be happy to hear further views on that area.
One area that is raised in the committee’s report is the capacity of the mental health officer workforce. I recognise the incredibly important work done by MHOs and their vital role in safeguarding service users’ rights. As I noted to the committee, the bill does not quite reflect our intention on MHO reports when certain orders are extended. That caused some understandable confusion around costings, which was raised by the Convention of Scottish Local Authorities, and we will propose an amendment at stage 2 on that point.
The bill will introduce a very small number of duties for MHOs, most of which are considered best practice already and relate to only a few cases across Scotland. Although MHO numbers are ultimately a matter for local authorities, I am pleased to have seen an increase in the number of mental health officers who are receiving training. The Government has recently undertaken a scoping exercise to gather evidence about the issue. When the report of that work is available, we will, alongside stakeholders, identify any appropriate actions.
The committee noted comments on changes to suspension of detention. The Government based the provisions closely on recommendations in the McManus report and agrees with that report’s aims that suspension of detention provisions should be flexible to meet patient needs and should also contain safeguards. Suspension of detention should not be used as an alternative to a less-restrictive community-based order, which is why the safeguard of a tribunal hearing is included.
The bill updates provisions in the Mental Health (Care and Treatment) (Scotland) Act 2003 on appeals against conditions of excessive security. As I noted at the committee, the framing of the provisions in the 2003 act no longer reflect the nature of the estate, meaning that we were unable to use existing powers, which talk about transfer from hospital to hospital, to bring in an appeals process. We intend to introduce regulations that set out the levels at which appeals can be made at an early stage.
Turning to the nurse’s holding power, we feel that it is useful to clarify that the power to detain is for a maximum of three hours, and that it can be used for the purpose of a medical examination. That is not radically different from the current position; it just means that the period can be extended to three hours. I am very clear that, as now, we expect the power to be used in line with the principle of least restriction, and guidance will reflect that.
I have listened to the concerns about proposed changes to the timescales for appeal on transfer to the state hospital, when unwell patients might need longer than four weeks to lodge an appeal. I want to ensure that we strike the right balance, given other concerns about the effect of the current timescales. We are considering that matter carefully ahead of stage 2.
On named persons, I have been reflecting on whether we have the right balance between ensuring that service users have a named person only if they want one and protecting the most vulnerable. For many service users, the named person role is very important, and it is an important protection at a difficult time. It is therefore vital that we get the balance right, and I will lodge amendments at stage 2 that seek to do that.
One of the major changes in the bill is the introduction of a victim notification scheme for certain mentally disordered offenders, which will sit alongside the existing scheme for other offenders. We are introducing the scheme in response to a European Union directive on the rights of victims, which does not distinguish between the status of offenders. Furthermore, the Scottish Government has consistently shown its support to victims of crime.
We recognise that such offenders are vulnerable themselves. I will seek to ensure that we get the balance right while ensuring that the rights of victims to information are fulfilled. That is fundamentally important.
The committee acknowledged that the bill is intended to be a limited bill and is designed to make the 2003 act work as effectively as possible. I am aware that there are some long-standing issues that some people would have liked the bill to include, such as the issues that the Scottish Law Commission raised on incapacity and calls to bring incapacity and mental health legislation together. Those are very complex issues, but I make it clear that I have heard what people have been saying. There have also been some limited calls for consideration of whether persons with a learning disability on the autistic spectrum should be included within the scope of the 2003 act. I am clear that the bill might not be the best vehicle for those matters, and I want to consider them further before coming back to Parliament, separately from the process around the bill, to update members on my thinking.
I conclude—somewhat ahead of time, I notice—by reiterating that the aim of this amending bill is to improve existing legislation to ensure that the system works as effectively as possible for service users, and to introduce a victim notification scheme for mentally disordered offenders.
I look forward to hearing members’ thoughts on the bill. I hope that the Parliament will support its general aims, and I look forward to working with members of all parties as we continue to take it through Parliament to ensure that we have the most effective system in place for treating mental health disorders across the country.
That the Parliament agrees to the general principles of the Mental Health (Scotland) Bill.