Motion to Approve the General Principles of the Proposed Mental Health (Wales) Measure

Speech by Peter Black delivered to Plenary on Tue 13th Jul 2010

Peter Black: I will start by reinforcing the message from Helen Mary Jones about the need for this proposed Measure to be age-blind. The committee was unanimous on this issue, and the evidence that we received was overwhelming: you cannot maintain an artificial barrier between children's mental health services and adult mental health services when you have so many problems with transition between the ages of 16 and 18, as have been highlighted time and again in the reports of the children's commissioner. The aspects of this proposed Measure that relate to care plans and advocacy need to apply to those under the age of 18 as much as to those over the age of 18. I am grateful that the Minister has said that she will look on this favourably. I hope that by the time that this proposed Measure comes back to the committee for Stage 2, it will have been substantially changed to reflect that committee recommendation and the various undertakings that have been given.

Another important aspect of this proposed Measure, and one that I set great store by, is how it will work in the community. The strengthening of primary health care in particular and the provision that Brian Gibbons referred to is crucial if this is to work. I believe that the way forward for mental health provision-and in tackling the stigma that has been referred to-is in embracing this recovery model whereby people with mental health issues are able to work through them in the community, leading a normal working life in the same as anyone else, and being able to live in the community in the same way as you or I or any other member of that community. That is why it is crucial that, when someone comes to a doctor's surgery, they are not automatically referred to a hospital, but that the doctor has the capacity, within that primary care centre, to handle the issue and to help that person.

It is crucial that we get housing right so that people can live in houses where they can access and receive appropriate support and manage their own affairs as part of that process. It is also crucial that the person who is diagnosed as having a mental health issue is able to live in the community without fear, and without having the services that they require being taken away from them. That is why the care plan contained in this is vital, and why the need for advocacy to help them to get those services is crucial as part of that.

A number of concerns were raised by the committee, and having listened to the Chair of the Finance Committee earlier, I know there was much praise for the Minister for having a far more robust financial appraisal of what this proposed Measure will cost than had accompanied other proposed Measures that have come before the Finance Committee. Having said that, there was evidence to the committee that did raise questions about whether the money allocated to this proposed Measure is sufficient to meet the demands that it will create, particularly if the proposed Measure is extended to become age-blind. There will clearly be a need to revisit the amount of money available for local government and health authorities to deliver on that issue.

Building capacity is key to delivering on this. There is no point agreeing a proposed Measure that creates a whole new range of rights for people who have been diagnosed with a particular mental health illness if you do not build the capacity to deliver on those expectations. That is why it is not just about finance, but also about working with local health boards at a community level to ensure that they put the relevant services in place.

My final point is on the issue of GP registration, because I do not think that it has been mentioned. The current situation, as the proposed Measure sets out, is that those who are entitled to a care plan need to be registered with a GP. The point was made on a number of occasions in the committee that that is in danger of excluding some of the most excluded individuals in our society, particularly those who are homeless, destitute, living on the streets, and so on. It is therefore important that we correct that anomaly so that access to these services and care plans is not just through being registered with a GP, but for there to be other routes to access that. The Minister has recognised that and will take it on board; I hope that she addresses that as part of her response to this debate.