Private Notice Question asked by
To ask Her Majesty’s Government, in the light of reports that
people are being wrongly detained in secure hospitals units,
whether they will review the Mental Health Act 1983 to amend the
definition of mental disorder to exclude Autism and learning
disabilities.
(Lab)
My Lords, I beg leave to ask a Question of which I have given
private notice and declare an interest as president of the
National Autistic Society.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
My Lords, we recognise the significance of this issue and its
importance to stakeholders. The recent independent review of the
Mental Health Act considered the definition of autism in the Act
and recommended that the Government should keep it under review.
We will respond to the review’s recommendations via the
forthcoming White Paper.
My Lords, since 2015, there has been a 24% increase in the number
of autistic people sectioned, even if they have no mental
illness, because the Mental Health Act defines autism as a mental
disorder. Autism is not a mental disorder. Last weekend, the
Health Secretary promised to detach autism and learning
difficulties from mental health legislation. That is most
welcome, as is the appointment of the noble Baroness, Lady
Hollins, to chair an independent panel to oversee case reviews.
However, those reviews will be conducted over a 12-month period.
I press the Minister for one more step. Will the Government set
up an advice hotline for families who are in despair because they
have no idea where to go for help or advice as their children—and
they are children—face Christmas locked up and detained by a
medieval practice that deprives them of the human rights?
I thank the noble Lord for raising this very important Question
today. I should like to be clear that the Government are
committed to ensuring that people with learning disabilities and
autistic people have the best quality of life and live a full
life in the community. A lot of the work that has been done
recently, including reviewing and replacing the autism strategy
and doing case reviews of every individual who has a learning
disability or autism and is in in-patient care, is designed to
ensure that we deliver that. I shall take back to the department
the noble Lord’s specific point about a hotline for families and
ask what can be done.
(Lab)
My Lords, as my noble friend has rightly highlighted, neither
autism nor learning difficulties are mental health conditions.
These children should not be in wards which are likely to be
noisy, bright and unpredictable. Noble Lords may have seen the
report on Sky News about Jeremy, whose autistic daughter Bethany
is being held in a mental health unit. He has been campaigning
about her inhuman treatment for a long time—too long. He says of
the proposed review: “There are 600 people whose care plan says
that they should not be in hospital, and for half of them, their
local authorities do not even know that”. Those are the
Government’s own figures. We have had one review after another
since Winterbourne View, nine years ago. I agree with Jeremy— we
need action not reviews.
Worse, , the Secretary of State, is
apparently sitting on a report about Jeremy’s daughter and said
that it will be released before Parliament rises. Can the noble
Baroness ensure that Bethany’s report is released to her parents
this afternoon and tell the House when we will see action, rather
than reviews, for this vulnerable group of young people?
We absolutely agree with the noble Baroness’s point. We need to
ensure that everybody who can be cared for in the community is
able to be cared for. That is why we have reduced the number of
people in in-patient care by 22%; we have set a target to reduce
that number by 50%. We are driving that forward as quickly as
possible.
On the matter of the serious incident review of Bethany’s case,
we have received the report and are working to release it as soon
as possible. NHS England is taking action to improve Bethany’s
situation and secure an alternative, more suitable, provider in
the community as quickly as possible.
Regarding the case reviews of every individual, the Government
have committed to providing each patient with a date for
discharge or, where that is not appropriate, with a clear
explanation of why and a plan to move them closer to being ready
for discharge in the community. This significant commitment from
the Government should be welcomed.
(CB)
My Lords, I declare two interests. First, I had an editorial
published in the British Journal of Psychiatry last week,
proposing that learning disability and autism should be removed
from the Mental Health Act. Secondly, I have just agreed to chair
a panel to review the cases of people with learning disability
and/or autism who are in segregated care. Does the Minister agree
with the treatability criterion in the Act, particularly with
respect to the question of removing learning disability and
autism from it? In other words, does she agree that, in detaining
somebody in hospital under the Act, the excuse of doing so to
improve—or with the intention to improve—their behaviour, even
though their behaviour may be a reaction to inadequate social
care, is an inadequate reason for detention under legislation?
I thank the noble Baroness for taking on the chairing of the
independent panel. I cannot think of anybody better placed to do
so. When it comes to her question about the detention of an
individual to improve their behaviour, again, I do not think that
anybody in this place or elsewhere could disagree with her. On
changing the Mental Health Act, we commissioned the independent
review led by Sir Simon Wessely, who is also a leader in the
field. He reported in December. In its findings, the review made
it clear that we need to modernise the Mental Health Act, ensure
that views are respected and ensure that patients are not
detained for any longer than is absolutely necessary. Sir Simon
stated that there is “no clear consensus” on removing autism from
the Act, and that,
“we have heard also about the many negative consequences that
could arise from being outside this framework … this should be
kept under review”.
Obviously, we will not respond to that immediately. There will be
a White Paper by the end of the year. We will consider this
carefully and we recognise the strength of feeling on this
matter.
(Con)
In support of what the noble Lord, , and the noble Baroness
said—we greatly welcome her chairmanship of the review—there is a
very good reason for removing autism as a mental disorder: it is
not a mental disorder. It is as simple as that, although it is
true that people with autism, including children, will have
comorbidities and will develop a mental health condition on top
of their autism. I do not know whether the Minister understands
my frustration, but I have been raising this issue in Parliament
for nearly 28 years. The real problem is that we do not have
sufficient psychiatrists who understand and can differentiate
between autistic behaviour and what they believe to be psychotic
behaviour. Once patients start the spiral of medication for
psychosis, the autism disappears and the person disappears
altogether.
My noble friend puts this very clearly. The Government accept
completely that autism and learning disability are not mental
disorders. The question is whether being excluded from the
legislation would cause challenges or difficulties for those who
may have autism and mental disorders. We will have to consider
that carefully as we go into the process of considering a review
of the Mental Health Act. As my noble friend just said, we
recognise that we will have to go through a careful process. We
also recognise the strong feelings—and the correct view—that
autism and learning disability are not mental disorders. There is
no disagreement on that point.
(LD)
My Lords, does the noble Lord—I am sorry, does the Minister agree
that we are confusing disability with illness, something which
has gone on for far too long? Are we going to have a programme to
train people in recognising the different facets of the two and
how they interact? The treatment of many people with autism has
undergone is probably the best way to induce poor mental health
in many of them. Can we please do something to stop that?
I thank the noble Lord and I recognise the challenge to my gender
today. He and my noble friend are absolutely right that we must
ensure that all health and social care staff have appropriate
training on autism and learning disability. A number of Members
of this House have campaigned long and hard to ensure that this
happens. Some £1.4 million of government funding has been put in
place to develop and test some new training packages and today we
published the government response to the consultation on
mandatory learning disability and autism training which confirms
the intention to introduce mandatory training for all health and
social care staff. I think that that is an excellent step forward
and I am absolutely sure that this House will scrutinise it for
its effectiveness. That is right, but it marks a steps forward
and should be welcomed.
Tributes to Mr Keith Phipps
3.31 pm
The Lord Privy Seal ()
(Con)
My Lords, before we move on to the rest of our business, I would
like to take this opportunity to pay tribute to a loyal servant
of the House, our Principal Doorkeeper, Mr Phipps. I know that
the whole House will join me in thanking him for his 25 years of
outstanding service.
A dedicated public servant, Mr Phipps left school at 18 and
joined the Coldstream Guards. He served in the Army for 22 years
and in December 2000 enlisted as a Yeoman of the Queen’s
Bodyguard. In 1994, Mr Phipps joined the House as a Doorkeeper
and was promoted to Principal Doorkeeper in 2005. As he rose in
seniority, he consistently served Members of the House with his
characteristic charm, good nature and unfailing politeness. He
handles colleagues with the utmost courtesy, while at the same
time making it clear that there is an underlying message of
authority, along the lines of, “Don’t mess with me”—some might
say, the original strong and stable. Over the years he has
provided Members, long-standing and new, with his wise counsel,
as my noble friend attested in his maiden
speech. During their time in the Army in Hong Kong and Northern
Ireland, my noble friend found that Company Sergeant-Major Phipps
was right about most matters and could be relied upon to steer
his company commander in the right direction. Many noble Lords
will recognise that description of Mr Phipps, who has been a
source of wisdom on procedure and custom, helping to steer us all
in the right direction; and of course, his commanding presence
made him the ideal candidate to act as the master of ceremonies
during the Queen’s Diamond Jubilee lunch, which hosted Her
Majesty the Queen and 700 guests in Westminster Hall.
When I joined this House in 2014, Mr Phipps and his team made me
feel very welcome. He has always been willing to help out and on
several occasions has taken pity on my poor guests, who
invariably get the most uninformative tour of this place, taking
over as tour guide with panache and more anecdotes than I could
ever remember. His generosity and good humour are, I am sure,
valued by all noble Lords.
Our remarks today come earlier than expected. Mr Phipps
officially leaves on 13 December, but today is our last day with
him as our Principal Doorkeeper. As the season’s festivities get
under way in the coming month, I am sure that the Cirencester
Salvation Army will want to seize the opportunity to sign him up
for a starring role as Joseph in the nativity play, a role that I
understand he played successfully some years ago.
Mr Phipps, on behalf of the whole House, thank you for your
incredible service to us. We wish you and Sue all the very best
for the future; enjoy your well-deserved retirement.
(Lab)
My Lords, this feels a bit like the end of an era, because Mr
Phipps has become a bit of a legend in your Lordships’ House. As
we have heard, his journey from the Coldstream Guards to the
longest-serving Principal Doorkeeper is one in which he can take
immense pride. Much of his work will exist in fond memories—his
own, ours and those of the many colleagues with whom he has
served. It was also captured when he played a starring role in
the 2017 “Meet the Lords” mini-series, an appearance—or should
that be performance—that has earned him his own personal entry
and credit on the IMDb website, which prides itself on being,
“the world’s most popular and authoritative source for
information on movies, TV shows, and celebrities”.
Today we say farewell to a celebrity in our midst.
I first met Mr Phipps when I was a fairly new MP in the other
place and had a group of constituents visiting from the men’s
group at one of our local churches in Basildon. He will not
remember this, but I remember it very clearly. I walked through
the Peers’ Lobby with some trepidation and approached the
imposing-looking gentleman in a white tie. Very politely, I
asked, “Would it possible for my guests to sit below the Bar to
get a better view of the Lords’ proceedings?” In rather imposing
tones, he asked, “Are they all wearing ties?” Then, spying one
member at the back of the group, he pointed and said, “He’s not
wearing a tie; he won’t be able to get in”. Embarrassed and a
little puzzled, I looked around at my guests and spotted the
offender. I said, “But, Mr Phipps, he’s the vicar and he’s
wearing a clerical collar”. He let him in. For a few years now,
just to be on the safe side, one of our staff in the Labour Lords
office, Rob Newbery, has kept a drawer full of ties to provide
for any Peer or Peer’s guest who requires one.
Noble Lords
Oh!
We are here to serve.
In all the years he has been in your Lordships’ House, we have
appreciated Mr Phipps’s company, efficiency and natural
authority. We have always known who is really in charge. I hope
he has enjoyed his time with us as much as we have. I had to
smile at the comments of his late father, Ken, when he reflected
in 2012:
“He enjoys his job I think—he has a little moan every now and
then, but who doesn’t?”.
On a more serious note, it is both an honour and a pleasure to
thank him on behalf of these Benches for his dedicated and
unparalleled service to your Lordships’ House. There is no doubt
that he has made his mark in the most positive way, for which we
are extremely grateful.
Keith, we are going to miss you. We wish you and Sue, your wife,
a very long and happy retirement. There is only one thing left to
say: thank you and goodbye, Mr Phipps.
(LD)
My Lords, I have seen Mr Phipps in two guises: as a doorkeeper
here in your Lordships’ House and as a member of the Queen’s
Bodyguard when I was captain of that august body. His attitude in
both environments was that of an experienced NCO having to deal
with a blundering second lieutenant who did not even know how to
salute properly. He knew how it was done. I certainly did not,
and I am sure that new Members of your Lordships’ House have felt
similarly at sea when they first tried to work out how we do
things here. But he has done that with everybody with an
avuncular friendliness and firmness that has been extremely
impressive.
At a time when the atmosphere in Parliament has sometimes been
extremely fractious, he has helped to ensure that the ethos of
your Lordships’ House reflects the tolerance and civility that, I
am sure, we all believe should characterise the operations of a
Parliament. We will miss him and the qualities he has brought to
his roles, and I am sure we will all do our best to uphold the
values he has brought to his work and our proceedings. We wish
him and his wife a long and enjoyable retirement.
(CB)
My Lords, on behalf of the Cross-Benchers, I enthusiastically
support what has already been said. But the three words I want to
use have not been used: “Salubritas Et Industria”. For the
benefit of the Cross-Benchers, that is Latin. It is the motto of
Swindon Town Football Club. I say this with feeling, because the
most important game in Swindon Town’s football history was a 4-3
win in a playoff for promotion to the Premier League in 1993. It
was one of the greatest games ever played at Wembley. Swindon
scored three goals by half-time; they were home and dry. The
opposition scored three goals, so it was 3-3. Then the ref gave a
penalty to Swindon Town. The opposition team was Leicester
City—my team since I was a boy. I have always had my doubts about
that penalty, but for today I will say, as Mr Ranieri once said,
“If the ref says is a penalty, is a penalty”. The result was that
Swindon went up to the Premier League, and within a very few
months, on the wings of that great triumph, Mr Phipps came here.
Here he has stayed.
Industria et salubritas. Looking at my own translation,
“industria”, as we are all well aware, means work. We have had
nothing but work from him, whenever it has been needed.
“Salubritas” means health; as we wish him a diminution in his
work, we on the Cross Benches wish him all possible good health
and a serene, peaceful retirement.
The Lord
My Lords, on behalf on these Benches I join in the tributes that
others have paid. Each of us coming into the House has been
greeted and welcomed. We have been guided, led in right
directions and stopped from going in wrong ones, always with
firmness and kindness. It is that kindness for which I thank Mr
Phipps as I, like others, wish him a long, happy, healthy
retirement.
(Con)
My Lords, I am distressed today, and your Lordships should be as
well, for the following reason. For some two years Keith Phipps
looked after me as a company commander. He kept me out of trouble
and on the straight and narrow. He supported me when he
conceivably may not have agreed with everything I wanted to
do—quite a lot that I wanted to do, actually—and since I have
been here he has similarly kept me on the straight and narrow and
out of trouble. If he is leaving, who will do that task? Your
Lordships should all be worried.
He has shown as Principal Doorkeeper the values and behaviour we
would wish for in such an esteemed position, exactly the same as
he showed in the Army. He has supported this House as he
supported the Army and has shown authority and dignity. I salute
him. We have been friends, I hope, for some time. His wife Sue,
I, my wife and he have dinner together from time to time. I hope
as he goes, we can remain friends and shall continue to have
dinner.
The Lord Speaker ()
My Lords, I conclude very briefly by placing on record my
personal thanks to Mr Phipps for the assistance he has provided
to me and my two predecessors as Lord Speaker, which has been
fantastic. I know from what has been said, and from my short time
in the Army, that service in the Coldstream Guards means that he
is made of very tough stuff. He will have developed a resilience
to many things, including serving under the noble Lord, . There is an apocryphal
tale about the noble Lord marching his platoon to a cliff edge.
Nothing was said and they went further and further, when Mr
Phipps suddenly intervened to say, “Say something, sir, if it’s
only goodbye”.
Mr Phipps’s service to the House has been exemplary, very much in
the highest tradition of public service. I know I speak for the
whole House when I convey to him our deep gratitude and, above
all, our very best wishes for the future.
