Edwina Hart: “Let’s be absolutely honest, we still have an awful lot more to do on mental health”

The general principles of the Proposed Mental Health (Wales) Measure, which will eventually grant new law-making powers on mental health to Wales, have been debated in the Senedd.

The debate, which took place yesterday, followed a report published earlier this month by the Assembly’s Legislation Committee No. 3 and saw a range of issues – including children and young people, timescales in relation to assessment and care plans, stigma and advocacy – raised by Assembly Members.

Notable contributions to the debate included:

• Dai Lloyd, Chair of Legislation Committee No. 3’s statement that: “On those patients who need the support provided by secondary mental health services, the task of developing a care and treatment plan and appointing a care coordinator will be a statutory requirement under the proposed Measure.”

• Chair of the Children and Yong People’s Committee Helen Mary Jones’ AM view that: “Delivery of children’s services over the last ten years has been very poor. It has been a matter of shame and distress to us all the way our Children’s Commissioner has had repeatedly to draw attention over the years to failures in services.”

• Alun Davies AM, speaking on behalf of the Chair of the Constitutional Affairs Committee, stating that the following phrase (in italics) in the proposed Measure could be problematic in relation to care plans: “Mental health service providers will then be (after agreeing a care and treatment plan) required to provide services for the patient in so far as is reasonably practical to do so.” Mr Davies said this phrase may mean that care plans could be drawn up in such a way that they “put too much emphasis on the availability of resources rather than the needs of the patient.”

• Jonathan Morgan AM, whose Legislative Competence Order led to the proposed Measure, wondering, in relation to timescales on the provision of assessments and care plans, that: “If we are happy to fix targets in the Annual Operating Framework to fix the body, I don’t see why we can’t have targets to fix the mind as well.”

• David Melding AM stating that: “We need a whole person approach to care planning. All too often people in mental distress are not at the heart of the care planning that’s going on and they feel more isolated as a result. This situation needs to be fully addressed in the Measure.”

• Health and Social Services Minister Edwina Hart’s final remark that: “The Measure has been a long process but let’s be absolutely honest, we still have an awful lot more to do in terms of legislation on mental health and development of services.”

Ms Hart concluded yesterday’s debate by responding to the recommendations made on the proposed Measure by Legislation Committee No. 3, the Finance Committee and the Constitutional Affairs Committee.

Amongst her lengthy and detailed response (which can be viewed in full via an e-mail link below) she:

• Welcomed and accepted the recommendations of the Legislation Committee and Constitutional Affairs Committee to look at ways of extending the remit of the Measure to cover parts 1 and 2 so they apply to under 18s as well as adults.

• Said she was “very happy to accept the recommendation that care plans under Part 2 of the Measure reflect the Recovery Model.” She added that: “This reflects our current approach to mental health policy, putting recovery at the heart of policy making. I will ensure that regulations and guidance reflect this approach.”

• Assured members that “there will be adequate consultation with all relevant parties in the course of drafting regulation concerning the content of care plans.”

• Recognised that given stakeholders and members have a keen interest in care plans the issue of needs and resources in relation to the patient, as raised by Alun Davies AM during the debate, will be examined in more detail.

Bill Walden-Jones, Chief Executive of the mental health charity, Hafal, commented: “The worry for our Members is that the Measure certainly looks like a good thing but the devil is in the detail.

“The core of the Measure – the bit which could make the biggest difference – is Part 2: this section accords a legal right to secondary mental health patients to have a care plan the format and content of which may be prescribed. The trouble is that any old care plan will not do much good: some current care plans do little more than state a medical prescription, who will administer it, and that it will be reviewed in a year. To make a difference it is essential that the format and content of a decent quality care plan is clearly prescribed.

“The Assembly Government has already identified from service users and families what should be in an holistic, recovery-focused care plan: the nine life areas which need to be covered are already prescribed in the Welsh Code of Practice for the Mental Health Act and these same nine areas have been flagged as quality practice for the current Care Programme Approach by the Minister. So the work on identifying what is needed has been done: now we need to see that what goes into the Measure is not vague guidance but legally-required practice.

“There are other useful elements in the Measure but we mustn’t be distracted from the centrality of Part 2 and the need to get its content and accompanying regulations right.”

The next step for the Measure will come on September 23rd when consideration of amendments will be made by Legislation Committee No. 3.

The debate can be viewed via Senedd TV: http://www.senedd.tv/  whilst a transcript of the debate is accessible via the National Assembly’s Record of Proceedings which can found here: http://www.assemblywales.org/bus-home/bus-chamber/bus-chamber-third-assembly-rop.htm?act=dis&id=191557&ds=7/2010..

To view the National Assembly for Wales’ Proposed Mental Health (Wales) Measure page, which includes the latest news and in-depth detail on the Measure please visit: http://www.assemblywales.org/bus-home/bus-legislation/bus-leg-measures/business-legislation-measures-mhs-2.htm

To read the Assembly’s Legislation Committee No. 3’s report on the Proposed Mental Health (Wales) Measure please visit: http://www.assemblywales.org/cr-ld8114-e.pdf

To read Hafal Chief Executive Bill Walden-Jones blog please visit: http://billwaldenjones.blogspot.com/

To view Welsh mental health charity Hafal’s briefing on the Legislation Committee’s Report on the Measure please visit: https://www.mentalhealthwales.net/mhw/documents/Briefing%20July%202010%20B_.pdf