James backs Private Member’s Bill on use of force in mental health facilities

Speaking in the House of Commons, 3rd November 2017

James Cleverly backs a Bill to improve the management of the appropriate use of force used in relation to patients in mental health facilities. In particular, he supports a clause that would require standardised record keeping on use of force across all facilitis which will provide an accurate understanding of how many times the use of force unfortunately leads to injury or fatality and may also, in itself, prompt a pause for reflection before force is used.

James Cleverly (Braintree) (Con)

I am conscious that it can sometimes be a blight on a Member’s political career to have someone from the other side of the Chamber lavish praise upon them, so I apologise in advance to the hon. Member for Croydon North (Mr Reed) because the opening comments of my speech could hang like a political albatross around his neck for some time. I hope he recognises, however, that even if that is the case—I suspect it will not be—the work he has done in bringing forward this private Member’s Bill will more than offset any detriment.

I suspect that when the Bill makes its way through the House and is enacted, people will look back at this as a tipping point. That is exemplified by the first few names on the list of sponsors. It is of great credit to the hon. Gentleman, both as an individual and a parliamentarian, that he is able to get support from all the parties in England and from both sides of the House. The Bill is drafted in a way that makes gaining cross-party support as easy as possible and gives it the best chance of being enacted. At a time of ultra-partisan politics around the globe and when things are proposed specifically to create division and to play games, it is refreshing to see a Bill that is clearly designed to improve and, in many instances, save lives, so I thank him for that.

The Linden Centre in Chelmsford serves my constituency, and I regularly have meetings with its management and with the Essex Partnership University NHS Foundation Trust. It is clear that the management of that mental health centre are passionate about protecting service users and improving the mental health of the people under their responsibility. I also have a close working relationship with Essex Police, whose officers are also passionate about protecting people. Before I go on, I want to echo the words of my right hon. Friend the Member for Wells (James Heappey)—[Interruption.] He is not yet a right hon. Member.

Philip Davies

It is only a matter of time.

James Cleverly

It is inevitable. I echo the thanks that my hon. Friend the Member for Wells put on the record to the medical professionals, police and others who work so hard to try to protect people who have either acute or chronic mental health episodes. I would not want any of the conversation about deaths and restraint in mental health units and by police officers and others to be in any way seen as an implicit criticism of them. They do incredibly important work, often in the most difficult and challenging of circumstances.

Bob Stewart

My hon. Friend has close links with the police and with medical professionals. Do they use the same approach to restraining people? I would have thought that the police might be harder than nurses; do they use the same techniques and just apply different sections of the techniques?

James Cleverly

I only really have detailed experience of medical and policing practices from my time on the Metropolitan Policy Authority in London and now, as the representative of Braintree, from the Essex Police and my local mental health trust, so I cannot talk about the universality of the situation. However, without a shadow of a doubt, the message that I am picking up is that there is huge variation across and within constabularies and trusts.

The group of clauses relating to accountability is one of the most significant parts of the Bill, and my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) touched on this. I am one of those gruff and grumpy old Tories—[Interruption.] At this point, Members are supposed to join in a chorus of “You’re not that old.”—[Hon. Members: “You’re not that old!”] I thank hon. Members, although no one cried, “You’re not that grumpy.” Clause 7 is incredibly important. I am a gruff and grumpy old Tory, and my instinct is to take away as much red tape and administrative burden as possible but, as my hon. Friend the Member for Faversham and Mid Kent highlighted, this modest additional administrative burden is welcomed by the profession.

There is an old saying in management consultancy, “If you want to change something, measure it”—[Interruption.] I can see my hon. Friend the Member for Faversham and Mid Kent nodding. It is important to register the use of force whenever it is applied, because that will do two things. It will prompt a small pause for reflection if someone knows that they will have to justify the use of force, and it is inevitably a good thing if they recognise in that moment of pause that the use of force is not appropriate. Perhaps more importantly, if the decision is made that force is the appropriate action, clause 7 will mean that there is a record of all the times that force has been used, including the times when that force does not lead to injury or, in the most tragic cases, death. That will enable us to get an accurate understanding of how many times the use of force unfortunately leads to injury or fatality, which is important because it will remind us of the difficulty faced by many professionals.

Mr Reed

I am grateful for the hon. Gentleman’s generous comments earlier. I should make it clear that it is not my intention that the Bill should impose any additional administrative burden. Institutions already collect data on the use of force, but they do not collect it in the same way, so it cannot be compared. The Bill will simply standardise what currently happens to allow greater scrutiny, rather than imposing a new burden.

James Cleverly

That is a fair and balanced intervention. In my next sentence—honestly, this is true—I was going to list some things that, if they are not already collected, really should be collected. It is not a bad thing if the Bill creates a standardisation so that we can see the differentials between forces and trusts.​

One of the most difficult and contentious points—this goes to the heart of my opening remarks about the impact the Bill could have on British society—is that, without a shadow of a doubt, we know that examples of huge community friction, of civil disorder and of further injury and loss of life have been caused when families, friends of families and wider communities feel that the use of force has led to an unnecessary death. I will be as cautious as I can with my words because of the sensitivities, but it is particularly acute in Britain’s black communities.

There is huge disproportionality between the black community in Britain and the rest of the communities in Britain—and it cannot possibly just be chance—in the rate of death and injury in custody of people suffering mental health episodes. That has to be addressed. No single Bill can solve the situation, as it has been long in the making and will take a very long time to resolve, but this Bill could be a big step in the right direction.

If, as I suspect it will, the Bill reduces the incidence of serious injury or fatality among people suffering mental health episodes, that will in itself have a knock-on effect in reducing some of the community friction and disorder that we have seen in the past. Unfortunately, I suspect there will be further cases where a black man is detained and dies after contact with the police, but if it can be evidenced that in all instances force is applied modestly, minimally and only when absolutely necessary, that might help to defuse some of the tensions that have in the past led to further difficulties.

In conclusion, I thank the hon. Member for Croydon North, and the other hon. Members who have supported this Bill, for introducing to this place a Bill that makes it easy for those of us who want to see genuine improvement both in mental health and community cohesion to support it. I commend it to the House.

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James’ other interventions in the same debate

James Cleverly
I do not know the ethnicity of the constituent who died in custody, but does my hon. Friend agree that it can be intimidating for police and medical professionals when the person they are dealing with is physically big and robust? As well as the measures in the Bill, they need our support to ensure safety for them and for the people for whom they are caring.
James Heappey
My hon. Friend, as ever, makes an excellent point. These are highly challenging, confrontational situations. 

James Cleverly

A number of years ago, when I served on the London Assembly, I visited Feltham young offenders institution. I cannot help but think that there are a number of young men in Feltham who had mental health problems but whose interactions with the police and authority during mental health episodes reached a stage at which they became violent and ultimately found themselves incarcerated, perhaps at least in part because of that lack of understanding and training on the part of the police. It is not a moral criticism but an observation that training could help the police officers and some of those young men, who were ultimately incarcerated in what was not necessarily the most appropriate institution.

James Heappey

I very much agree. It is interesting to reflect on conversations I have had with police and community support officers in my constituency. The nature of their job means that they understand or know more intimately the community they serve. Very often they have an insight into the mental health of people they routinely see around town who are on the edges of antisocial behaviour or even breaking the law. They can often deal with them very differently because they understand who they are dealing with. The PCSO job description is such that PCSOs naturally seek to de-escalate ​and deter, rather than enforce the law. My hon. Friend makes an interesting observation, and I certainly agree that it is possible to avoid these circumstances arising as often as they do.

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