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When is a principle not a principle? In this Bill.

An interview in the Human Resources Department. The HR manager is speaking – gently, warmly, openly, collegially, in partnership with the service user…

‘I want you to know that we sincerely have your interests at heart, Annabelle. We have even written down our basic principles, just so all colleagues appreciate how much we value them.’

‘Sounds good. What are these principles?’

‘Annabelle, here they are.’

The HR manager hands Annabelle a Code of Staff Procedures. Annabelle reads an extract:

Our general principles are that:

1) Staff will be involved in decision making

2) Decisions are to be made fairly and openly

3) Interference to staff in providing their employment and the restrictions imposed in respect of them during their employment will be kept to a minimum necessary to protect their health and safety or that of other persons.

‘Sounds ideal. I’ll just go off and get on with my job then. Nice to have your support.’

‘Hold on a minute. You’re sacked.’

‘What?’

‘We don’t think this job is right for you.’

‘Hey! What about my input to this decision? It isn’t fair. What about the general principles in the Code?’

‘Annabelle, rest assured that I am hearing you. Let me assure you that we have a clause that covers the principles. Read this.’

Annabelle reads:

The Code provides that one or more of the general principles is not to apply:

a) in circumstances in which its application would be impractical or inappropriate

b) in relation to the decisions or persons specified in the code.

So, you see, we have invented a Code that means we can do absolutely whatever we like to you, whatever you say. Good isn’t it? Oh, could you clear your desk in, say, the next ten minutes Annabelle? Many thanks.’

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Uncivilised? Unacceptable? Victorian? Obviously it is…unless you happen to be a civil servant in the Department of Health.

The draft Mental Health Bill 2002 permits exactly this barbarity. George Orwell would have been proud to have dreamt up Section 1 paragraphs 3) and 4). Take a look for yourself: http://www.doh.gov.uk/mentalhealth/draftbill2002/draftbilljune02.pdf

Regardless of what you think about mental health legislation it is surely cause for national concern that a government department considers it acceptable to adopt general principles that are plainly not general principles. Either there are no principles, and everything is left to ‘clinical judgement’ (i.e. an arbitrary mix of re-invented psychiatric categories and biased social values) or there are secret general principles. Or – worse – it is a mess of both.

The government invites responses to its draft bill. Mine is that the very last thing people experiencing mental difficulties need is prevarication and subterfuge from those giving themselves yet further powers to control them.

If there is a general principle within the draft bill it is ‘people who are a problem must do what they are told and if they don’t we will make them, whatever they say’. And if that is the way things are then at the very least everyone should be able to acknowledge the truth.

We need honesty in mental health work – honesty about the limitations of the psychiatric system, honesty about the abuse of human dignity that is part and parcel of involuntary detention and medication, and above all we need honesty about the real point of removing people’s liberty.

So I ask the Department of Health, what principles really underpin your draft Mental Health Bill? According to my own Code of Ethics I’m entitled to an honest answer.