HL Deb 04 March 1992 vol 536 cc833-6

Lord mottistone asked her majesty's government:

whether they are satisfied that psychiatrists, general practitioners and social workers are receiving adequate training in the provisions of the Mental Health Act 1983.

Baroness Denton of Wakefield

My Lords, the Government are satisfied that the training needs of psychiatrists, general practitioners and social workers having responsibilities under the Mental Health Act 1983 are being adequately met. We shall continue to seek such further improvements as experience suggests are necessary.

Lord Mottistone

My Lords, is my noble friend fully satisfied that the psychiatrists and particularly the GPs receive adequate instruction on the 1983 Act, in particular on the recently amended code of practice?

Baroness Denton of Wakefield

My Lords, the training of those groups is carried out under their professional bodies. We have every reason to believe that they are fully briefed on the Act, on the code and on the circular amending it.

Lord Ennals

My Lords, what makes the Minister feel so confident? Has she seen the comment of the Mental Health Act Commission that it: remains extremely concerned about the apparent lack of knowledge amongst doctors and other health professionals about the consent to treatment provisions in the Mental Health Act"? What training do general practitioners and psychiatrists receive on that part of the Act?

Baroness Denton of Wakefield

My Lords, it is part of an extremely extensive programme in which doctors are expected to have had three years' post registration experience and at least six months' full-time psychiatric experience. Forty per cent. of trainees in general practice have had six months' experience as a senior house officer, which means that they must be well aware of the Act.

I remind the noble Lord that in support of my noble friend Lady Hooper he drew attention to further assistance and said that since the adoption of the code of practice: I am informed that officers of MIND have travelled up and down the country advising social workers, doctors and nurses on the terms of the code". We are grateful for that.

Lord Thurlow

My Lords, is the noble Baroness aware of the recent Audit Commission report published about a fortnight ago which is totally at variance with which she has just told the House? The commission judges that there is a widespread lack of understanding on the part of staff at all levels, including GPs and others in the district health authority, of what are the Government's excellent objectives. The commission predicts chaos in April 1993 unless urgent additional steps are taken to train staff and in particular to select and train effective care managers.

Baroness Denton of Wakefield

My Lords, I reply to the noble Lord by quoting from the Audit Commission report which states: The process is only now starting and it is not yet possible to describe the full implications. At present it is easier to outline the problems than the solutions". However, the Audit Commission's press release stated: considerable guidance has already been provided by the Government on the implementation of the Act".

Lord Winstanley

My Lords, am I right in believing that the National Schizophrenia Fellowship has sent to the department details of a whole number of cases in which patients have been let down and have suffered as a result of a lack of knowledge of the Mental Health Act 1983 either by general practitioners or by social workers?

Although it is not easy to reach GPs, particularly elderly ones, surely we can give adequate training to social workers, especially those who have to deal with the mentally ill, to make sure that they are fully aware of all the provisions of that very important Act. It is obvious that many are not now adequately trained.

Baroness Denton of Wakefield

My Lords, the department has reason to be very grateful for the constant help which it receives from the fellowship which has drawn points and cases to its attention. That has been of great assistance. The Government are aware of the need to train social workers. In 1992–93, £29 million will be spent on training local authority social workers. In the past three years the total amount of spending has risen by almost 100 per cent.

Baroness Faithfull

My Lords, I refer to the statement made by the noble Lord, Lord Winstanley, about the assessment of social workers who have pursued the 60-day course laid down for the training of social workers who are to be mental health officers and psychiatric social workers administering the Mental Health Act. Is it not true that in 1986 the 60-day course was started and that the Council for Education and Training in Social Work wished the social workers to be assessed as being satisfactory to carry out the work, but that NALGO—the trade union concérned—stood in the way of that arrangement? Is my noble friend aware that NALGO opposed it and that the Minister of the day supported NALGO? If the social workers are not assessed, can my noble friend say how we are to know that they are the best people to carry out that work?

Baroness Denton of Wakefield

My Lords, the Council for Education and Training in Social Work approves the programme and monitors the standards of the courses for approved social workers and, as they are called in Scotland, mental health officers. It is for the local authorities to satisfy themselves that social workers have reached a satisfactory standard before approval. I am sure that noble Lords will be pleased to know that the council is currently reviewing the regulations for the training of social workers who seek approval.

Lord Ennals

My Lords, I am most grateful to the Minister for quoting my very wise words. I ask her to read them again. She will discover that I was talking about the training of social workers. At that date the Mental Health Act Commission had not made its report which explicitly relates to psychiatrists and general practitioners. I hope that the noble Baroness will address her mind to that part of my original question.

Baroness Denton of Wakefield

My Lords, all training schemes in psychiatry are assessed with a view to accreditation by the Royal College of Psychiatrists subject to accreditation being withdrawn if the exacting criteria are not met. Higher professional training includes clinical experience in this area and knowledge of the Mental Health Act. I hope that explanation reassures the noble Lord.

Lord Elton

My Lords, is my noble friend aware that the Government's prompt reaction to the debate on the Motion tabled by my noble friend Lord Mottistone on 16th January, by issuing an amendment to the code of practice, is extremely welcome; as is the massive increase of expenditure on training to which my noble friend Lady Denton of Wakefield has referred?

Baroness Denton of Wakefield

My Lords, I am delighted to welcome my noble friend's comments which are again evidence of the close co-operation of everyone concerned in this area.

Lord Carter

My Lords, is the Minister aware that the Mental Health Foundation estimates that 6 million people—10 per cent. of the population—suffer from mental illness and that all but 60,000 of them are living in the community? Is the Minister also aware that it is estimated that 3.7 million people are deemed to be seriously at risk? Therefore, does the noble Baroness agree that it is vitally important that GPs, social workers and health professionals are fully conversant with the Mental Health Act and particularly with the procedures as regards hospital admission?

Baroness Denton of Wakefield

My Lords, the noble Lord, Lord Carter, draws attention to matters of serious concern which are also recognised by the Department of Health. It was announced in February that a national task force is to he established to further the development of locally-based mental health services. It will be concerned with questions of "how" and not "whether".

Lady Kinloss

My Lords, in view of the advances in the treatment of psychiatric patients, what arrangements are the Government making to ensure that general practitioners and social workers are aware of the latest developments, particularly as their work loads may already be very heavy?

Baroness Denton of Wakefield

My Lords, I am delighted to assure the noble Lady that full arrangements have been made not only by the Government but by the practitioners' own professional establishments.

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