Labour won a significant concession from the Government on the controversial Health and Social Care Bill last night in the Lords - on the right of patients with mental health problems to have integrated aftercare not subject to charging.
Clause 39 of the Bill would have changed the current duty on aftercare in section 117 of the Mental Health Act 1983. Ministers said that this was a tidying up exercise so that duties transferred to Clinical Commissioning Groups. I argued, however, that the effect of their plans was to remove a currently free standing duty on co-operation and replace it with a gateway duty. This would mean health and social service commissioners could have unilaterally decided to remove aftercare rather than agreeing as they do now. It would also mean that aftercare could be something for which patients could be charged.
I pointed out that the free standing duty had been the subject of much previous debate and confusion, and that the House of Lords had made a ruling on section 117 (in what is known as the Stennett case). That ruling preserves the nature of the current duty and I argued it should not be removed without full and proper debate by Parliament about the implications. Citing cases that had been before the Ombudsman, I made the case that even with the current protection many authorities had charged people for their aftercare. If they do that in the good times what will stop them charging when the duty is removed at a time when they are facing severe budget restrictions and cuts?
Crossbencher Victor Adebowale supported my amendment, to ensure that the voluntary sector have to be involved in decisions. As Chief Executive of Turning Point he did not want to see the people they care for adversely affected by changes to the current duty.
Lord Adebowale and I previously met the Lords’ Health Minister, Earl Howe, and departmental officials to discuss our concerns. Despite this, the Government had made no changes to clause 39 when it came up for debate last night. I expressed dismay that the government had not listened and that it had come to this. Lord Adebowale said the clause would threaten the aftercare of some of the most vulnerable people in society at a point in their lives when they most needed it.
As a former Chair of the Mental Health Act Commission, I know the importance of aftercare for people suffering with mental illness and I refused to retreat from defending their rights. Then, in a dramatic last minute turnaround the government said it would not oppose my amendment. Against the daily mounting opposition to this Bill this is one of the very few occasions when Ministers have actually listened and changed their plans in response.
Lord Kamlesh Patel of Bradford is a Labour Peer