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TX: 24.04.08 - Mental Health Act Commission

PRESENTERS: JOHN WAITE AND PETER WHITE

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WAITE
Each year around 15,000 people are detained in locked units under the Mental Health Act. To ensure that they're being held legally and in appropriate conditions there's the Mental Health Act Commission or MHAC - a monitoring body set up in the early 1980s. In just under a year though it'll be gone, replaced with a new Care Quality Commission. This is one of the measures contained in the Health and Social Care Bill currently going through Parliament. Advocates of the change say the new regulator will streamline inspection and reduce bureaucracy but others fear the new arrangements will offer vulnerable mental health patients less protection than they have at present. Peter White has been investigating.

WHITE
Monica was detained for her own safety under the Mental Health Act in a psychiatric intensive care unit. She also has a physical disability. The detention took place in 2005 but some of her memories of it make it seem like yesterday.

MONICA
The ward itself was absolutely appalling, I was verbally abused, physically abused, sadly sexually abused, grossly intimidated and this was 24 hours a day for the whole seven months that I was actually on the ward. There were no facilities whatsoever for me, for bathing, washing, sitting. I had a sink with no plug and I had to sit on a little chair at the sink and basically throw water on myself for an awfully long time and a cleaner actually informed me that there was a disabled shower on the private ward.

WHITE
So that had been there all alone.

MONICA
Yes but the staff had told me there were no facilities in the building for me because I was locked - I was detained in a locked unit.

WHITE
In the end it was to the Mental Health Act Commission that Monica resorted for help. And it was the commission which intervened to get her transferred to a more appropriate setting. Chris Hegginbottom, the commission's chief executive until the end of last month, is concerned that under the new arrangements this kind of intervention is less likely to happen.

HEGGINBOTTOM
There's nothing in the bill, the Health and Social Care Bill, which requires the new Care Quality Commission to visit regularly and frequently. We know that that'll be the general intention of the government but there's nothing on the face of the bill which requires the new Care Quality Commission to do that visiting in that way.

WHITE
And what's the significance do you think of those visits, those monitoring visits that you do?

HEGGINBOTTOM
They're absolutely critical to ensuring that patients' rights are protected and that the quality of care for detained patients is of a reasonable standard.

WHITE
And for Jane Harris, head of campaigns at the mental health charity Rethink, this kind of independent intervention is crucial for this particular category of patient.

HARRIS
For detained patients you have to have more safeguards, you know for physical health conditions you can't have treatment imposed on you, you can't have treatment given to you against your will. In mental health those powers do exist for the state and we do need extra safeguards there.

WHITE
At Bethlem Royal Hospital just outside Beckenham in Kent there are around 90 detained patients on locked wards. The other day I joined Mental Health Act commissioner Harry Field, just as he was about to visit a number of patients there and I asked him about the kind of situations he'd be looking out for.

FIELD
Well the first thing I'll be talking to patients and I'll get direct evidence of the patients' experience and that's very important. At the same time I'll be listening, I'll be looking round, I'll be looking at the interaction between patients and staff on the ward. I will later look round the ward itself, just to make sure that the ward is satisfactory. So it's a combination of those things.

WHITE
If you see something this afternoon, for example, that's wrong what are your powers, what can you do?

FIELD
Most things I would try to resolve during the course of the visit if it was something simple. If it was more serious I would write a report to the trust and the trust have got a statutory duty to respond to our reports.

WHITE
Well shall we go inside and let you get about your business?

FIELD
Okay we'll go this way.

I told you earlier than this but thank you for waiting, I do appreciate it. Now I'm a Mental Health Act commissioner, have you met a Mental Health Act commissioner before?

PATIENT
Yes I have.

FIELD
So you know what we do, don't you?

PATIENT
Yeah.

FIELD
Now what I'd like to talk a little bit about - you know