Mental Health Bill [HL]

Debate between Baroness Bennett of Manor Castle and Baroness Fox of Buckley

Committee stage
Monday 20th January 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I will speak to my Amendments 67 and 86. I think that this is the right place—I apologise for my earlier confusion; I had a problem with the list.

I will start with Amendment 86 because it follows on from the very important contribution from the noble Lord, Lord Scriven. I should preface this by saying that I cannot claim that what I will say originates from me; it is based on the Law Society briefing, which many noble Lords will have received. I saw that nobody else had picked up this amendment, but I thought that it was so important that it should be picked up. As the explanatory statement says:

“The amendment would keep the safeguard of an automatic referral to the tribunal when a patient’s Community Treatment Order is revoked which results in them being detained in a mental health hospital”.


As the noble Lord, Lord Scriven, said, a range of views on CTOs has been expressed in these debates, but the general direction of travel is certainly not to remove safeguards and we should be keeping the safeguards that already apply. I will not claim great expertise on this, but it seemed to me that this is an important issue that we need to discuss in Committee.

Amendment 67 is somewhat different but really important. Later on, we will discuss very important issues, which I have signed amendments about, concerning minoritised communities being potentially overtargeted or subjected more to mental health provisions. This amendment picks up something that no one else has picked up, which is economic and social disparities relating to community treatment orders. I went looking for some statistics on CTOs in disadvantaged communities, but I was not able to split them out; perhaps the Minister has them. However, the charity Rethink Mental Illness talks about the burning injustice of how Mental Health Act detention rates are three and a half times higher in the most deprived areas of England compared with the least deprived. Looking at those figures, I can only see that CTOs must be something very similar to that.

We need to ask a question here, and we need the stats and that is why we should have the reporting. It is probably unclear whether we have a psychiatrisation of poverty, so that when people are living in conditions of poverty, that is seen as some form of mental illness in itself, or a discriminatory application of the law against people living in conditions of poverty. The third possibility is that poverty is making people ill. Either way, we should know about these facts. They should be regularly reported, and we should be able to examine them and check on them.

I was just looking at an issue that will be raised later about debt and mental health, on which I will point noble Lords who have not seen it to a really interesting POSTnote that the Parliamentary Office of Science and Technology produced on that subject last year. It suggests a two-way relationship between financial and mental well-being. People with mental health issues are three or more times more likely to have problem debt.

Some interesting recent research in a study published in Public Health indicates how social conditions are related to mental health. “Sandwich carers” in the UK —the 1.3 million people who have responsibility for caring for children and older parents—have experienced a significant decline in mental health.

These issues around social and economic disparities and the use of community treatment orders are embedded in the community, and it is crucial to see what is happening. Amendment 67 aims to ensure that we get regular reports relating to community treatment orders.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I wanted to speak to this group because I made some harsh criticisms, on principle, of community treatment orders at Second Reading concerning their coercive and intrusive nature. Since then, perhaps similarly to the noble Lord, Lord Scriven, I have had cause to think again, not least after speaking to a number of working psychiatrists and taking on board the comments of the noble Baroness, Lady Parminter, at Second Reading, which really had an impact on me. It is quite unusual to change one’s mind in this place—maybe it is just me—so I wanted to note that.

I was reminded of this issue by practitioners—I was once one of those—when they said, “We worry about how many idealistic discussions about mental illness just do not take into account the reality of chronic mental illness”; I thought that was a fair reprimand. There are a group of people who are chronically symptomatic, perhaps some of them may never be well, and CTOs are a way to allow people to leave hospital who otherwise clinicians might worry would be too risky to release.

I have been thinking about this issue and in that sense was happy to see and support Amendment 44 in the name of the noble Lord, Lord Scriven, which sets out time limits. It is useful to think about probing time limits, renewal safeguards and so on, because one does not want automatic continuation and therefore indefinite CTOs on the books, which is what people are concerned about.

I would have been more enthusiastic about Amendment 66, put forward by the noble Lord, Lord Kamall, and the noble Earl, Lord Howe, which calls for a statutory review of CTO use, but the wording implies that CTOs are problematic per se. Perhaps we need a more open-ended review, because one of the reasons why CTOs are so contentious for so many people is their spiralling and increasing use, and we need to understand why that is.

One worry I have about the Bill in general, and not just this group of amendments, is that, because the drivers of the legislation are concerns about inappropriate hospital admissions and wanting to ensure that we have proportionate detention powers which are used only as a last resort, we need to be wary of demonising hospital care and recognise how much good can be done for mentally distressed patients in hospitals, particularly if they are given time and resources and the right kind of medical intervention. But, as with all hospital matters, that is not necessarily what is happening. Many psychiatric wards are under pressure to get people out into the community as soon as possible—in the sense not of them being well, but of freeing up hospital beds. One might wonder whether the CTOs are a mechanism for effectively turfing patients out before they are ready or well enough.

It also seems that CTOs are necessary when community care is under huge strain, because the idea of voluntarily accessing a wide variety of support in the community is a myth in today’s circumstances. All the briefings we have been sent draw attention to this. A range of groups and people have argued—and a number of noble Lords have said this today—that we need more resources, money and staff for appropriate care in the community to really work. That sounds reasonable, but I am concerned that this will miss the target. I want to reiterate the elephant in the room that I mentioned at Second Reading, which I have not changed my mind about: culturally, we are seeing the medicalisation of more and more problems of the human condition. This encourages ever greater numbers of people to view social, economic, educational and personal difficulties through the prism of mental health.

Football Governance Bill [HL]

Debate between Baroness Bennett of Manor Castle and Baroness Fox of Buckley

Committee stage
Monday 16th December 2024 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Foster. I commend him on his leadership of Peers for Gambling Reform, of which I am a member. I apologise that I have not taken part at Second Reading and earlier parts of Committee. The Bill was being covered for the Green group by my noble friend Lady Jones. I am pleased to share with your Lordships’ House that her hip operation on Friday went very well and she should be back soon after Christmas. In the meantime, noble Lords get me instead.

The noble Lord, Lord Foster, has outlined the arguments, which I think are unassailable, for both amendments. I am particularly taken with Amendment 255, to prevent gambling advertising and sponsorship in football, because that will take us to where we need to go.

I declare a recent meeting with the group Gambling with Lives, particularly Liz and Charles Ritchie, who were bereaved following the gambling suicide of their son Jack in 2017. As the noble Lord, Lord Foster, said, we are seeing increasingly awful levels of harm, particularly among young people. There has been a doubling of the number of young people aged 11 to 17 with problem gambling, and 44 % of people who exhibit problem gambling are at high risk of thinking about suicide.

It struck me, listening to the Committee earlier today, that a phrase was used a great deal: fans are the lifeblood of the sport. Surely that is an illustration of the fact that the health of fans should be a matter of great concern to football clubs. The Lancet commission on gambling declared very explicitly only a month or so back that gambling has to be treated as a public health problem, and public health solutions are needed. That means protecting people from the gambling messages bombarding them.

I will quote a couple of statistics from 2021-22. There may have been a slight improvement since then, but not very much. During a single televised match, 3,500 gambling logos can appear. On “Match of the Day”, a gambling brand was visible up to 89% of the time. This can be described only as a bombardment and, as the noble Lord said, the consultation very clearly showed the views of fans.

We have also seen real progress from the Big Step campaign, which has been commended and is another illustration that campaigning works. But people are having to devote their lives to this cause, because the Government and the clubs are not doing the right thing. This, surely, is a place where the Government should step in to act.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the noble Lord, Lord Foster, and the noble Baroness, Lady Bennett of Manor Castle, will be unsurprised to know that I oppose these two amendments, which I will do briefly.

If the gambling industry is pouring money into football, I would say that that is a good thing. Anti-gambling commentators talk as if this were drug money coming from the Mafia. The whole tone is moralistic. We have already heard mention of match-fixing and cheating, as though it is all incredibly sordid and terrible. But let me just remind the Committee that betting firms are legitimate businesses. What, so they use their sponsorship to increase their market share—what is wrong with that? Is all football sponsorship beyond gambling to be forced to pass an ethics test—some kind of purity test? This is football, not some puritan revival movement.

Let us be honest: lots of football clubs need and appreciate this sponsorship money. It is all well and good that the Premier League has collectively agreed to withdraw gambling sponsorship from the front of clubs’ match-day shirts. That is a voluntary measure—it is up to it—but the truth is that, as we have ascertained in these debates, the Premier League can afford such lucrative virtue signalling, as I consider it. For the lower-tier and lower-league clubs and for the EFL, however, such sponsorship money is often invaluable. The Bill aims to help clubs become more financially sustainable, so the last thing it needs is external parties or legislators turning off one financial tap. This would mean that some cash-strapped clubs would face ruin if deprived of such revenue.

The Bill has been put forward in the name of fans and, whatever my reservations, I do not doubt that people have the fans at the heart of their discussions, whichever side they are on. But I remind noble Lords that millions of fans are less bothered about what logo appears on a player’s shirt or on advertising boards than they are about the quality on the pitch. There is more than a whiff of nanny state when they are patronisingly told by anti-gambling advocates that the ban would be for their own protection. It seems that anti-gambling campaigners do not trust fans to make their own decisions and make the right judgments about how they spend their own money.

Writing on this issue, Jon Bryan—who is an excellent commentator on the whole issue of gambling, which he posits and reminds us is a pleasurable leisure activity—says that it also undermines any notion of fans’ agency. The notion is put forward that, as soon as fans see a logo on a football shirt, they will rush off and place a bet, as though they are being groomed and just one punt away from addiction. This treats adult fans as children, and it is infantilising. It is often posed—