Draft Mental Health Bill

Debate between Baroness Armstrong of Hill Top and Lord Kamall

Tuesday 28th June 2022 Lords Chamber

[Lord Kamall (Con)]

I start by paying tribute to all the work the noble Baroness has done in this area, and for educating me more on this issue when I was a relatively new Minister. All I can say at this stage is that patients who have a co-occurring mental illness as well as a learning disability or autism may well be detained under the Act, but we want to make sure that there is support in the community. This is one of the big debates we have seen on a number of issues—for example, on social care. How much of social care will be in homes and how much will be in the community? Does technology improve that? Does constant online communications technology, sensors and the ability to speak to somebody online almost immediately change that equation? A lot of that will be discussed as we debate the Bill and by the experts who, we hope, will be on the pre-legislative scrutiny committee.

[Baroness Armstrong of Hill Top (Lab)]

My Lords, I chair the Public Services Committee and we are currently concluding a report on workforce in the public sector. I hope the Minister will be able to read it and think about it over the recess to make sure that he takes account of it. In my work with women with complex needs, particularly those who have been groomed, it is absolutely clear that their sexual exploitation has led to significant trauma. The NHS will never be able to be the first body they interact with, or able to train enough people in the next 10 years to look after the wide range of people who we know now need mental health care. That means the Bill must link to the work of the voluntary sector and how we address trauma in people first approaching a public service, or any service. I am concerned that the Government think they can do it just by training more people, which will take a long time. They need to be working in a pathway that starts at a very different level.

[Lord Kamall (Con)]

I could not agree more with the noble Baroness. One thing we must be well aware of is that, although there are pressures and we are asked for more funding, the Government alone cannot do all this. Sometimes officials, be they from local or national government or from another state organisation, are mistrusted by vulnerable people. Local civil society groups, voluntary organisations and, often, those who have suffered the same problems themselves and then been inspired to set up their own organisation to support others—who can empathise with the situation many of these poor women are in—are sometimes the best first point of contact. As the Government spend more on this, we must make sure that we are not squeezing out the voluntary sector or local civil society, but working in partnership with them.

NHS: Gambling Treatment Services

Debate between Baroness Armstrong of Hill Top and Lord Kamall

Monday 28th March 2022 Lords Chamber

[Lord Kamall (Con)]

I am very happy to take two questions at once; I will even take three, if noble Lords want, and try to answer them.

The important point that a number of noble Lords are making is that many want to see a polluter pays principle. In economics, this goes back to negative externalities, where you attack things that are considered bad. Some people call them bad; others call them negative externalities. However, when you say that the polluter should pay, who is that? People sometimes say that it should be users but, if you do that, users will end up paying more. Others say that it should be the industry, but will the industry then pass on those costs to users and put those people into even more distress? This is why we want to look at this issue in a joined-up way. Yes, it is about the gambling industry, and this may well be the option we land on, but we want to make sure that we tackle the issue in a completely holistic way.

[Baroness Armstrong of Hill Top (Lab)]

My Lords, I welcome the Government saying that there needs to be a range of treatment and not just the hard-end clinics. I declare my interest, as in the register, having recently become a trustee of GambleAware; I did that because I want those people who are scared of going for treatment and frightened of the stigma to be able to access early intervention, which means much more work for the voluntary sector. Can the Minister commit to the Department of Health ensuring that the pathway is very clear and will involve early intervention, particularly for women, so that they do not have to end up in heavy-end treatment?

[Lord Kamall (Con)]

The noble Baroness makes a very important point: people must be treated as individuals—they will have come to addiction from different pathways. We have been engaging with the Department for Digital, Culture, Media and Sport on a number of issues. Additionally, the Office for Health Improvement and Disparities regularly engages with NHS England working-level counterparts, including recently on the establishment of a joint task and finish group on integrating the gambling treatment pathway. Referring directly to the question asked by the noble Baroness, there is no one simple pathway into gambling, and there is a stigma. By putting it at the forefront of some NHS services, we are showing that we are taking it seriously, and that it is not just an affliction but an addiction. We recognise that we must do more to tackle that.