Charities fear 'nuisance' penalties will discriminate

Mental health charities have expressed serious concerns about proposals to introduce new penalties for 'nuisance and disturbance behaviour' on NHS premises.

The proposals deal with behaviour that falls short of what might be considered criminal or anti-social, but which still causes 'annoyance' and disrupts care.

They would allow people other than the police to remove those deemed to be causing a nuisance from NHS premises if they refused to leave. And they would open the way for fines of up to£1,000 to be imposed subsequently.

The plans, which were unveiled this summer and linked by ministers to the government's 'Respect' agenda, were embraced by unions.

The Royal College of Nursing welcomed them as 'another way to tackle violence against NHS staff' while Unison said they would 'send out a strong message that threatening behaviour towards staff will simply not be tolerated'.

However, a consultation has revealed that other groups have serious concerns; not least that the consultation document presents no evidence of a link between 'nuisance and disturbance behaviour' and violence and assault.

Emily Wooster, policy officer for Mind, said there was not a definition of 'nuisance and disturbance behaviour' in the document, meaning 'subjective assessments' might be made that discriminated against vulnerable groups.

'There is no evidence that these new powers are needed,' she added. 'The document makes no attempt to deal with the underlying causes of poor behaviour, which might include long waits and poor communication. We would like to see a different approach [that tackles those] first.'

In its formal response, the Mental Health Foundation also described the plans as 'unnecessary, badly thought through' and 'likely to discriminate'.

The consultation document says new measures are needed because behaviour that does not warrant a police response can still disrupt NHS services - and security staff are unable to deal with it if they cannot remove those involved.

It gives examples of 'nuisance and disturbance behaviour' as an ex-mental health user who 'consistently returns to premises? without good reason' and a group of individuals who visit an acute trust and 'ignore no smoking signs and create a mess in the toilets'.

It says that nobody who has a mental health problem, who is under the influence of alcohol or drugs, who needs medical treatment, has received bad news or wants to complain 'in a fair and reasonable manner' should be subject to the new powers. However, Mind queries how a full assessment of people's conditions and circumstances will be made.

The consultation document, which was issued by the Department of Health on behalf of the NHS Counter Fraud and Security Management Service, says chief executives should designate a 'responsible person' to authorise removals.

The Institute of Security and Health says there is plenty of legislation to deal with violence and harassment and 'lowering the threshold' for a police response would be a better way forward than putting new responsibilities on to security staff.

It also argues that trying to apply the new measures to 'NHS premises' is out of date when the NHS is becoming a commissioning body with many types of providers.