Mental Health Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Bradley
Lord Bradley Portrait Lord Bradley (Lab)
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My Lords, I strongly support Amendment 131, to which, as my noble friend Lady Tyler has stated, I have added my name. I can be brief because of the eloquence and comprehensive nature with which she introduced the amendment.

First, to note my registered interests, as this is probably the last day of Committee, the establishment of a mental health commissioner was recommended by the Joint scrutiny Committee of which I was a member. So it was a great disappointment that the Government did not include it in the Bill.

As I said at Second Reading, the mental health commissioner should be a voice at national level, promoting the interests of those who are detained and who are likely to be detained under the Mental Health Act, together with the interests of their families and carers, raising awareness of their needs and challenging stigma and stereotypes. Crucially, the commissioner should be at the forefront of tracking and scrutinising the implementation of these reforms.

There is widespread support for the establishment of the commissioner, both inside and outside Parliament and from statutory, non-statutory and charitable organisations. For example, the Centre for Mental Health, for which I am an ambassador, has stated:

“A Mental Health Commissioner … would offer sustained leadership for mental health—complementary to existing roles and structures in government. They would operate both within the machinery of state and in the media and wider public sphere. They would have influence within government and the NHS, but with the freedom to speak out when necessary: to lead public debate, challenge stigma, and break boundaries and taboos”.


I totally agree with this view. However, in reply to this proposal at Second Reading, supported by many noble Lords, the Minister pushed back on it stating that there are concerns that

“the proposed mental health commissioner’s function would be potentially largely duplicative of existing bodies and functions, and nobody wants to risk diluting accountability or causing confusion”.

The Minister went on to say:

“As noble Lords will know, Dr Penny Dash has been asked by the Secretary of State to assess if the current range and combination of organisations within the healthcare regulation landscape is effective and to make recommendations of what might be needed, and I think it is important that we await her recommendations”.—[Official Report, 25/11/24; col. 584.]


The key word here, I think, is “regulation”, and I do not agree with this view.

Since Second Reading, I have looked at the terms of reference of commissioners and regulators in various areas of public policy, and I believe that these roles are quite distinct. I agree with the noble Baroness, Lady Tyler: the role of the Children’s Commissioner and the separate role of the education regulator Ofsted are a good comparison. I do not think these two roles dilute accountability or cause confusion. Further, I cannot remember if it has ever been suggested that these roles should be amalgamated or that the Children’s Commissioner should be abolished. In fact, I believe that there is widespread support, particularly from the public, for the invaluable independent work undertaken by a Children’s Commissioner.

I also think the Minister herself has made a very persuasive case for a mental health commissioner in her many constructive responses to the amendments already debated, especially today. My noble friend has noted, among other things: the complexity of the legislation and its interrelationship with the Mental Capacity Act 2005, the need for significant investment in community services, the development of a skilled and complex workforce, and the number of years it will take to implement all the provisions of the Bill. This will need rigorous, robust and consistent oversight of implementation and wider health policy and service developments over the next decade and beyond.

The establishment of a mental health commissioner will ensure transparency and accountability and introduce a real force for good for the development and delivery of high-quality mental health services across the country. I hope the Minister will now agree and support this amendment.

Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP)
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My Lords, in following two such eloquent contributions, I can be extremely brief. I thank the noble Baroness, Lady Tyler, for what is clearly a major piece of work in producing this amendment. I attached my name to it because the creation of a mental health commissioner is such an important issue that it was crucial that there was a demonstration of support that was as wide as possible—a full slate of support here, even in Committee, as I am sure there will be should this come back on Report, unless the Minister says it is a great idea and she is going to go ahead with it right now.

I will add one other point of comparison, on something with which I have been a little involved myself: the comparison with the Patient Safety Commissioner. Noble Lords will remember that a case for the Patient Safety Commissioner was made from the then Government Back Benches, by Lady Cumberlege. She spent a couple of years fighting to finally get a Patient Safety Commissioner. We have seen the work that the Patient Safety Commissioner has done since the creation of the post: we have seen some very specific, detailed work on the issues of vaginal mesh and sodium valproate. Digging into the details and supporting a fight to get something done are really something that only these independent commissioner positions can do. Otherwise, very often, it falls to severely underfunded NGOs and perhaps to Members of Parliament who are enlisted in a cause but have many other calls on their time and resources as well.

We have discussed again and again how difficult it will be to bring this Bill into effect and, as the noble Baroness, Lady Tyler, said, to address the issues of discrimination and inequality that we know are already there. This is surely an absolutely obvious thing to do to help ensure—as so many noble Lords have been saying today and previously in Committee—that we get this done.

Police, Crime, Sentencing and Courts Bill

Debate between Baroness Bennett of Manor Castle and Lord Bradley
Lord Bradley Portrait Lord Bradley (Lab)
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My Lords, I rise to speak—briefly at this hour—to this group of amendments and declare my interest in the register, particularly as a trustee and vice-chair of the Prison Reform Trust.

I strongly support these amendments, which have been so effectively moved by the right reverend Prelate the Bishop of Gloucester. I support everything she said. It is essential that the courts fully take into account primary caring responsibilities, especially for a child, in their sentencing decisions and recognise the consequences of not doing so on the impact on the child and the family.

I will not repeat all the arguments that I made in Committee, but, as we have heard, the key document before the courts at sentencing is the pre-sentence report. However, as the charity Women in Prison has pointed out in its supplementary evidence to the Justice Select Committee, the information from Her Majesty’s Prison and Probation Service shows a real decline in proper pre-sentence reports over the past decade. In 2010, for example, pre-sentence reports were available for 62% of all court disposals, reducing to only 53% in 2018. Almost half of the sentences that result in a custodial or community order have no new pre-sentence report prepared to inform the sentence. We have heard—and I support—the improvements that are being looked at in this area but that is the current situation and it must be urgently addressed.

Further, there is a lack of data to disaggregate those figures according to gender. In answer to a Parliamentary Question in 2019, the Government could not say how many women who are likely to be the primary carer had been imprisoned without a pre-sentence report. This remains totally unacceptable. Even where a pre-sentence report is available, it does not routinely provide information to the court about caring responsibilities. As I said in Committee, and it is worth repeating, in January 2021 I asked a Parliamentary Written Question about how many children in each of the past five years were taken into care because their mother was given a custodial sentence. Extraordinarily, the Answer was that the data requested was not something that Her Majesty’s Prison and Probation Service recorded. I am pleased to hear that it is now addressing that issue, but I again ask the Minister with what action and over what timescale will this matter be addressed.

Or course, prisons collect information on caring responsibility, but at the point of prison reception. That is simply too late. The damage to the child and the family has been done, especially for those sentenced to a short prison sentence. We can and must do better. The pre-sentence report must include information about primary care responsibility. Data from various sources must be brought together. They include: the local authority, which currently has responsibility for safeguarding children; the health service, because of the impact on the family and individual; and particularly liaison and diversion services. There must be agreed information-sharing protocols.

We must invest further in technology to ensure that information can flow seamlessly across the criminal justice pathway so that there are no barriers to the information being available to the judiciary in a timely way, ideally at first court appearance. Delaying getting that information can mean that the woman in the example I am giving is put on remand while that information is collected. Again, damage to the child and the family flows from that decision. We must try to reduce the number of people put on remand who have primary carer responsibilities. These amendments would underpin this ambition, and will be a significant step forward in limiting the damage, both social and economic, of imposing a custodial sentence—often a short one—which has the impact on the family, instead of administering a robust community sentence.

Ensuring a clear understanding of primary carer responsibilities will mitigate against the often-irreversible consequences for children of being taken into care, and the primary carer losing their home and employment. I am sure that the Government can see the overriding benefits of this, and will, like me, support these amendments tonight.

Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP)
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My Lords, I rise briefly to offer Green support to the right reverend Prelate, who so powerfully introduced these amendments. Indeed, the stress on the need for information is absolutely crucial.

I want to make a very specific point on how the damage of a prison sentence can be magnified where a prisoner who has primary carer responsibilities—most likely a woman—is then subject to recall to prison for a further time. I am drawing here on a report from the Centre for Women’s Justice, which notes:

“The Transforming Rehabilitation Act 2014 provided that all offenders who had served prison sentences of more than one day should be compelled to attend probation supervision for one year. They can be recalled to prison if probation staff find they have failed to comply satisfactorily. Women on licence recall now make up 8% of women in custody.”


That is a truly shocking and surprising figure. This reports notes that the main reason for recall is

“failure to keep in touch with the supervising officer”,

rather than some more serious offence.

A report by the Prison Reform Trust noted that, of 24 women recalled, three had been pregnant at the time of recall. One said that the reason why she failed to attend an appointment was due to a hospital visit for a pregnancy scan. She was then separated from her other children and put back into prison, with further massive disruption obviously resulting. Will the Minister look into this situation? This is part of the sentencing guidelines, but there is a particular issue here in respect of probation and the way in which women—or anyone with caring responsibilities—are treated in this situation.