Houses of Parliament, the Bill was presented to the Queen for signing. Once signed by the Queen (as Head of State), the Autism Bill became the Autism Act 2009.
Marcel: Thanks for that, sis! Hanif, how does a Bill differ from an Act?
Hanif: Well, a Parliamentary Act is a Parliamentary Bill that has successfully completed its parliamentary journey, been presented to and signed by the sovereign (the Queen or King), acting in her or his capacity as Head of State. Then, and only then, does it have any legal power and can be implemented. Some Parliamentary Acts serve to prohibit certain actions or behaviour of individual citizens or organisations whilst others permit certain actions or behaviour. An example of the former could include the Marine Broadcasting Offences Act 1967, which made illegal pirate radio stations such as Radio Caroline. An example of the latter could include the Abortion Act 1967, which permitted legal abortions under certain conditions.
Marcel: So, what are Green and White Papers?
Ziva: A Green Paper is a discussion or consultation document that is issued by political parties around specific issues such as mental health, transport or the environment, whereas a White Paper (such as Valuing People (DH, 2001)) is a policy document that is often published by the Government. One of the purposes of a White Paper is to present service delivery guidelines which, although not mandatory, would be very good practice if they were to be implemented.
Marcel: So, how do reports fit into all this?
Hanif: An Independent Report is a report into specific events or issues and is often written or commissioned by organisations, such as Mencap, that are outside of formal government structures. Examples of such reports could include The Francis Report 2013, Mencap’s Death by Indifference (2007/2012) and the report into the abuse of people with a learning disability who were residents at Winterbourne View hospital in 2011. These independent reports often serve as a catalyst both for changes in how services are organised and delivered, and for the amendment or generation of new legislation.
Marcel: Thanks for this, Hanif and Ziva. I have a slightly better understanding of these various documents. Now, we will look at a number of these documents that have an impact upon me, those like me and those who are reading this.
BETTER SERVICES FOR THE MENTALLY HANDICAPPED (1971)
This White Paper came about partly as a result of a number of critical reports into the standard, type and quality of care that those with a learning disability received at a number of mental handicap (learning disability) hospitals in England and Wales. This report recommended halving the number of hospital places for those with a learning disability and that long-stay hospital settings for people with learning disabilities should gradually be closed and replaced with residential and ‘day care’ support in the community. Personal assessment of service user needs and greater involvement of the families of those with a learning disability were highlighted (Concannon, 2005).
Marcel: It took many years before many if not most of these recommendations became a reality for me and my friends.
JAY REPORT (1979)
The Jay Report was set up under the chairmanship of Mrs Peggy Jay. The Report called for a review of nurse training and proposed a new model that was more in line with the philosophy of ordinary living. However, the Report was critical of large institutional forms of service provision located on the edges of towns and cities and argued that such residential provision did not allow for community engagement. The Report argued that those with a mental handicap/learning disability had the right to live in an ordinary house in an ordinary street and to use and benefit from ordinary community resources. The framework of services should be one that both respects the person using the service and also meets the person’s needs. Finally, the Report recommended that mentally handicapped adults should have residential provision in or near the social and geographical communities in which they spent their childhood or early adulthood (Concannon, 2005).
Marcel: Once again, the issue of where I was to live was prominent in this report, although the language used throughout was that of rights and choice. However, it is likely that most people like me would not have been asked to have contributed to this Report.
MENTAL HEALTH ACT 1983
The Mental Health Act was the first piece of mental health law since 1959.
Part 1/Section 1: sets out the legal definition of learning disability (mental and severe mental impairment) as being an ‘arrested or incomplete development of mind which includes a significant or severe impairment of intelligence and social functioning’.
Part 2/Sections 2–5: allows for compulsory or voluntary admission to hospital either for assessment or treatment of a serious mental health issue. Section 5 allows doctors and mental health/learning disability nurses to prevent those with serious mental health issues from leaving a hospital. This section is applied if the patient is at high risk of harming themself or others if discharged from hospital.
Parts 3–5 deal with patients concerned in criminal proceedings or who are under sentence, consent to treatment (more on this in Chapter 6) and mental health tribunals.
NHS AND COMMUNITY CARE ACT 1990
The NHS and Community Care Act introduced an ‘internal market’ into the supply of health and social care within England, Scotland and Wales, with the State (local authorities) being more an ‘enabler’/broker than a direct health and social care provider. Local authorities were tasked to take the lead in enabling social care assessment and provision. The Act restructured the NHS into NHS Trusts and included the establishment of ‘fund-holding’ GP practices.
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