Mental Health Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage
Wednesday 22nd January 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I will be brief, but in following the noble Baroness, Lady Fox of Buckley, I have to note that I do not believe that a complaints culture is a problem in the contexts covered by this Bill. There is, perhaps, a lack of listening to patients and those affected, and a lack of action rather than a problem with listening to complaints. In that context, I commend the noble Earl, Lord Howe, who cited extensive testimony from Blooming Change. One thing that struck me when looking back over the previous days of Committee was that it would have been good to hear, perhaps even more than we did, direct testimony and the voices of those who are experts by experience. The phrase “nothing about us without us” really stuck in my mind and it is important that we keep that in mind throughout Committee. Again in response to the noble Baroness, Lady Fox, I think it is important not to seek to downplay the mental health crisis that we are seeing across our society. There is a huge shortage of services meeting people’s very clear and acute needs, and acute needs are what we are largely covering in this Bill.

I attached my name to Amendments 50 and 51 tabled by the noble Baroness, Lady Tyler of Enfield, which address non-drug-based interventions. In essence, I agree with everything the noble Baroness said; I just want to stress her points. When we talk about non-drug-based therapies, we are tempted to think we mean talking therapies and psychological therapies. Those are tremendously important, but this is where we also need to take the broader public health context. I mentioned on an earlier group digital treatments such as Avatar for those who hear voices. They are the kind of new, different ways of looking at things that people may not have been trained in, and it is important that they are considered. I also talked a fair bit about the gut-brain axis and dietary interventions such as green prescribing, in which we have seen great advances across the medical fields in recent years—exposure to green spaces and the chance to get exercise in green spaces. That makes me think that we need to think about facilities and how we make sure there is provision within them, which, in some ways, this amendment would help to cover.

As a noble Lord said earlier, we are talking about making sure we are treating the whole person and not a condition with a drug. I thought the contribution from the noble Lord, Lord Crisp, was very important, as is his amendment. I am not sure whether it needs to be in the Bill, but it would be interesting to have the Minister’s comments on making sure that consideration of withdrawal symptoms is part of prescribing practice. That is absolutely key and central. I note a report from the universities of Berlin and Cologne out last year which showed that the second-most prescribed antidepressant in the UK, venlafaxine, also has the second-highest rate of problem withdrawal symptoms. We need to make sure that is carefully considered pre-stage—before we get to the withdrawal stage, are we going to create that problem? I do not know whether it could be incorporated in the amendment, but it is something to think about anyway.

The other amendment—slightly oddly—in this group in my name is Amendment 154, which again, as on a previous group, I put down at the request of the Law Society. It is about mental health tribunal pilots for challenges against treatment decisions. To some degree, we have already discussed this in the earlier group, but I would be interested in whether the Minister has any comment on the amendment. I think that it is fairly self-explanatory, so I will not go through it further.

[Lord Scriven (LD)]

My Lords, I shall speak to Amendments 54A and 54B in my name, which are on a very narrow part of the treatment plan for individuals. Before I do that, let me say that I support the amendments in this group, particularly the general thrust of what been said; that is, that the automatic medical model must no longer be the default position and a much more social model must be added on to the medical model so that they complement each other.

Having said that, I listened very carefully to the noble Baroness, Lady Fox, but found it very difficult to understand what was required. She argued against the use of medication but then argued against quite a lot of the non-medicated issues. Her intervention was a bit confusing in terms of understanding what the importance was.

My amendments are predominantly about Clause 18, which is about the use of ECT. The clause allows for the emergency use of ECT based on a second medical opinion. The element I wish to speak to is the very wide Henry VIII power that the Government wish to give themselves in regulations to do away with the second medical opinion in an emergency. The Bill says:

“The appropriate national authority may by regulations amend this Act to provide for circumstances in which functions of a second opinion appointed doctor in relation to treatment falling within section 62ZA(1) may or must be carried out instead by the approved clinician in charge of the treatment in question”.


New Section 62ZB(3) then says:

“Regulations under this section may make … (a) provision subject to specified exceptions; (b) different provision for different cases; (c) transitional, consequential, incidental or supplemental provision”.


That is quite a wide Henry VIII power.

To prove that I really am Billy No-Mates and do not get out often on a cold night, I read the wonderful 10th report of this Session from the Delegated Powers and Regulatory Reform Committee, which makes exactly the same points but in more eloquent language. This is a very wide Henry VIII power, and the committee does not really understand why the Government are seeking—even though it is through the affirmative procedure—such wide powers in such broad language.

The committee said that it would expect the power to be drafted with significant limitations and a framework for when it could be used. My amendment seeks to do exactly that. It would not prevent the clinician in change from using ECT in an emergency case without referring to a second practitioner in certain circumstances, but the regulations would be within a framework laid out in Amendment 54B, that

“the treatment is immediately necessary to save the patient’s life … obtaining a second opinion would cause a delay that places the patient at a significant and imminent risk of death or serious physical harm, and … the treatment is reversible”.

The regulations would have to be written so that

“Any amendment made under subsection (1) must specify the exceptional nature of the circumstances in which the second opinion may be dispensed with”.


A report to Parliament on subsection (1) dispensations would also have to be made.

I believe, from reading the wise words of the Delegated Powers and Regulatory Reform Committee in its report, that it is important that the regulations have a framework, so that the Minister still has flexibility but is constrained by what is in the Bill. That is why I have spoken to this amendment.

Mental Health Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage
Monday 20th January 2025 Lords Chamber

[Lord Scriven (LD)]

My Lords, I will speak to my Amendment 44 in this group. Having listened at Second Reading, I was minded to table this amendment based on my noble friend Lady Parminter’s speech giving her real-life experience of the need for community treatment orders. Both the amendments and the Second Reading debate show the wide range of views on community treatment orders, ranging from some who feel they are not needed to those who feel that they are needed and those who feel a review is needed. However, something in the present system is not quite right, so, again, this is a probing amendment to try to understand where the Government’s thinking is.

Given that, even if a review were to take place, CTOs would still exist, my amendment would in principle provide an initial 12-month period for a community treatment order with some very clear provisions. If we are going to have these provisions, they need to be on the face of the Bill rather than in the code of practice—even if they are not the provisions in my amendment. I suggest that the initial order is for 12 months and that, before the order is made, the patient has to be consulted, as well as

“the patient’s nominated persons, and any relevant mental health care professional involved in the patient’s treatment or care planning”.

Importantly, the CTO has to be in line with the necessity for therapeutic benefit, and it has to involve consulting a second medical professional. I understand that the wording of the amendment may not be correct, because a particular type of medical professional, a psychiatrist, would need to be consulted with regards to the community treatment order and whether it will have therapeutic benefit.

I suggest that, at the end of the 12 months, if the clinician feels that an extension is needed, a review takes place, which goes through the process that I have just outlined—to ensure that there is therapeutic benefit, and a second medical practitioner is consulted—and that it is then reviewed after a maximum of six months. That is absolutely right in terms of trying to ensure that the therapeutic benefit is central and a second medical opinion is provided, particularly at the review stage, to ensure that there is a need for the CTO. The reason for this is the wide range of views on CTOs but also the statistics regarding the racial discrimination that there appears to be around their use, which is well documented and well evidenced.

I look forward to the Minister trying to explain the Government’s thinking on community treatment orders and how they need to change. Clearly, something is not quite right in the implementation, the length of time that people are on CTOs and whether CTOs have therapeutic benefit for many of those who are on them.

[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.

Anaesthesia Associates and Physician Associates Order 2024

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Monday 26th February 2024 Lords Chamber

[Lord Scriven (LD)]

My Lords, I have listened to the debate very carefully. My professional experience as a former health service manager over many years is that we have had this debate about people taking on different roles in health and always the same arguments come. Whether it be physiotherapists taking on roles, nurses becoming nurse practitioners or pharmacists coming into this, the same argument always happens: that somehow this dilutes patient care and safety. The answer is that it does not if it is properly regulated, there is proper training and there is proper monitoring of what happens to patients.

I understand that there is some anxiety, but I have to say to the BMA, in particular, that its language in the briefings it has given has driven the bullying and ostracisation of colleagues in hospitals who are valued members of a clinical team. That is the word: “team”. It needs to be led by a senior doctor, normally the consultant, without ostracising people within that team. I gently say to the noble Baroness, Lady—I have forgotten.

[Baroness Bennett of Manor Castle (GP)]

Bennett.

[Lord Scriven (LD)]

The noble Baroness, Lady Bennett of Manor Castle—I remembered the Manor Castle because of Sheffield, but I could not remember the Bennett bit—that, twice during her contribution, she used the term “a second-rate service”. These people do not provide a second-rate service; they provide and augment the team service, to ensure that patient outcomes are as good as they can be.

On the whole, I support the fact that these orders are being laid, although there is one issue that I think needs to be thought through carefully: if the GMC is going to regulate, there is an issue about the way that the distinguishing of the registers is dealt with. I see that as a potential trip-up point if not thought through very carefully; I hope the Minister can give the House some assurance on that.

On the whole, I support the regulations. This is just a continuation of many years of different people in the team taking roles. With the correct regulation and the correct training and supervision, this will improve patient outcomes and service.

Illegal Migration Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage
Wednesday 7th June 2023 Lords Chamber

[Lord Scriven (LD)]

My Lords, I will speak to Amendments 60 and 65 in my name. I thank my noble friend Lord German and the noble Baronesses, Lady Lister of Burtersett and Lady Bennett of Manor Castle, for adding their names to these amendments.

Because of the lateness of the hour, I will not add to the very powerful speech by the noble Baroness, Lady Mobarik, and give all the reasons why increasing child detention time limits is a bad thing to do. However, I want to go back to what so many noble Lords have asked during this Committee stage: where is the evidence that this is required? The Government have not given any evidence or any reason why 24 hours-plus is required. Since the time limits for unaccompanied children were introduced back in 2014, there has been no empirical evidence and no indication of problems that have arisen which have caused either a pull factor or a push factor for child migration to this country. What is the problem? For a change of policy of this significance, which affects some of the most vulnerable children in the world, the scale of the problem and what problem this will solve have to be put before this House.

We could make the comment that so many noble Lords have, and which I am sure the Minister might: in due course, it will be in the impact assessment. However, the real issue is this. When the Minister stands up at the Dispatch Box, the reason and evidence for this, and the problem it is going to solve, need to be placed before your Lordships, otherwise we cannot in any conscience extend the detention limits.

It was a great part of our history when the Deputy Prime Minister in the coalition Government, Nick Clegg, insisted that children, for immigration purposes, should not be detained, and the Conservative partners in that coalition Government agreed. Noble Lords can see that nothing has changed, so the Minister has to explain what the problem is, what has changed and what problem this will solve.

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to follow the noble Lord, Lord Scriven, and to speak specifically to the amendments in this group to which I have attached my name and to the general tenor of this. I did consider not rising to speak at all, because the incredibly powerful speech of the noble Baroness, Lady Mobarik, and her proposition that the words “detention” and “children” do not belong in the same sentence, can be said to sum up all of this debate.

However, I did want to give voice to someone else in this debate—the voice of a nine year-old who was held in immigration detention previously in the UK before the laws were changed. When asked how detention made her feel, this nine year-old said very simply, “Sad and angry. Feel like screaming or breaking something”. That is a nine year-old, talking about the kind of experience that we could again be subjecting children to in this country if the Bill goes through.

To put that in terms of a 2009 briefing paper from the Royal College of GPs, the Royal College of Psychiatrists, the Royal College of Paediatrics and Child Health, and the Faculty of Public Health:

“Reported child mental health difficulties include emotion and psychological regression, post-traumatic stress disorder … clinical depression and suicidal behaviour.”


A more recent paper, published in 2023 by Tosif et al, entitled Health of Children Who Experienced Australian Immigration Detention, said it showed devastating impacts on children’s physical and mental health and well-being and on their parents’ parenting capabilities. I wanted to allow that voice to be heard and to share that medical reference.

I just want to make one final reflection. There is a hashtag I use on Twitter quite often, #CampaigningWorks. Sometimes people say, “Well, it should have worked indefinitely. Why do we have to fight this same battle again?” I think that what the Government have got this evening is a very clear message that this battle has been fought before. We have learned a huge amount and got all the evidence from last time, and it is going to be fought again, even harder, from all sides of your Lordships’ House, to stop this element of child detention and to stop this Bill going through.

Levelling-up and Regeneration Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage
Monday 20th March 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

Well, my Lords, follow that. After that devastating forensic analysis explaining exactly why Clause 77 should not stand part of the Bill, I rise briefly to add a couple of additional points to the arguments just presented. I very much agree with the noble Lord, Lord Stunell, that this clause should go altogether, but I also understand that the noble Baroness, Lady Taylor of Stevenage, is trying to ameliorate the mess to some degree. But I think it is clear that getting rid of the clause altogether is by far the best option, and I note that the Local Government Association has expressed its concerns about it.

I want to add one case study, one piece of analysis and one warning for the Minister and the Government in general. The case study concerns what has happened not with a street name but with a similar story in Stroud. There is what has been described as “an offensive racist relic” clock that glamorises the slave trade. When this became an issue, the council started an eight-week consultation. Some 1,600 people in a town with a population of 13,500 responded to that consultation; 77% said that the clock should be taken down. This is an interesting case study. One issue is that the clock is on a building owned by a trust. It is possible that the Secretary of State may have to be referred to on whether the trust is allowed to have this clock, which the people of Stroud have expressed their desire to see removed. This is my cautionary warning to the Government and the Minister. Do Ministers really want to get tangled up in these stories and issues?

Maybe they do, which brings us to the question asked by the noble Lord, Lord Stunell, about the purpose of this clause. It would appear that the purpose of the clause is that Ministers can be seen to take a position; that is surely a very bad reason to write law. The other case study warning, which has not been mentioned here but should be, concerns Bristol and the Edward Colston statue. That was a demonstration of what happens when public opinion is not listened to and when there is a strong clinging to tradition. As other noble Lords have said, times have moved on and things put up in the past are now offensive. People will take things into their own hands. It is clear that these are local issues that should be decided at a local level, and the Government really should not be sticking their oar in.

[Lord Scriven (LD)]

My Lords, I rise briefly to continue the absurdity that my noble friend Lord Stunell spoke about. Clause 77(6) says:

“An alteration has the necessary support for the purposes of this section only if … it has sufficient local support”—


so one needs to determine what is “sufficient local support”—

Procurement Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage
Monday 11th July 2022 Grand Committee

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise not solely to demonstrate that there is broad ideological support for small and medium-sized enterprises being given a larger share of the kind of procurement that we are talking about; I do so also because I have attached my name to Amendment 75B in the name of the noble Baronesses, Lady Thornton and Lady Hayman.

I am going to attempt not to repeat everything that has been said but I want to pick up something said by the noble Lord, Lord Wigley. No one else has drawn attention to the fact that the previous group and this one are related. They have aspects acknowledging that SMEs bring different qualities—particularly quality. The noble Lord suggested that, if we do not put in specific provisions about SMEs, it is inevitable that the big companies will dominate. I say that if we do not put in provisions about social value and quality of services—as the noble Baroness, Lady Thornton, said, that is delivered under the Public Services (Social Value) Act—and do not account for those things, it will possibly be even more telling against SMEs than the rules and the points addressed by the amendments.

I am not particularly picking on the noble Lord, Lord Aberdare, here as I was going to say this before he spoke, but I have seen from all sides of the Committee a huge focus on productivity improvement and innovation, but we need to be careful about that terminology. Again, this point comes back to the previous group: a lot of what we are talking about here is the provision of care and the caring services, the type of provision that really does not lend itself to the same kind of measurement as how productively you are producing widgets. If a nurse is caring for a dying person, maybe it would be more “productive” if they were caring for two dying people at the same time instead. We really have to ask ourselves about that. I can see some head-shaking happening but a lot of our measures of productivity have been that gross and raw, and have failed to acknowledge issues of quality and service.

We need to acknowledge that there are many elements of our service economy where those measurements would be inappropriate. If you are providing a rape crisis service to people in rape crisis, how do you make that more efficient? What does that actually mean? What does innovation mean in that context? I think we sometimes fall into a narrow, widget-based, economistic way of looking at these issues, and we need to look at them much more broadly.

I am going to finish with something on which I think the noble Baronesses opposite will agree, picking up on the point by the noble Baroness, Lady Neville-Rolfe, about 30-day payment terms. Speaking as someone who many years ago used to work for a small independent business that supplied supermarkets on 120 days, which usually meant 150-day payment terms, I think that is crucial. I say to the Minister, if he is responding to this group, that perhaps this is an issue that we could look at in future in the form of a letter. It is crucial for SMEs that it is acknowledged when 30 days or less being part of the procurement process needs to be written into the contract to enable them to bid. That could be an important factor.

[Lord Scriven (LD)]

My Lords, this has been a fascinating as well as nearly unanimous debate about the importance of small to medium-sized enterprises and the role they can play in innovating, stimulating, changing and helping local economies grow. Part of that will be—I have to say to the noble Baroness, Lady Bennett—through productivity. Productivity and quality in themselves are not too separate things; they can go hand in hand in caring services. I speak as a former health service manager. Productivity is not just about how you apply people; it is how you apply all the resources to get better outcomes for those you serve. Therefore, sometimes there are contradictions and it is hard, but they are not always separate.

I would like to speak to a number of amendments in this suite. I thank the noble Baroness, Lady Neville-Rolfe, for doing this in a previous life because—I am sure she will understand what I am about to say—every little does help, particularly with small to medium-sized enterprises. A number of the noble Baroness’s amendments are probing for one reason, I think. I am sure that the Minister will come up with specifics in the Bill which will help small to medium-sized enterprises, but I think the general view is that it does not do it. It does not go in depth and give the clarity which I and other noble Lords have said will help to give a level playing field for small to medium-sized enterprises, which is what is required.

In particular, an important amendment spoken to by the noble Baroness, Lady Noakes, on behalf of the noble Lord, Lord Lansley, was on capacity building. In my life of working in local economies, I have seen that the big thing that helps is capacity building for small to medium-sized enterprises. If anything should be on the face of the Bill, capacity building for small to medium-sized enterprises and not-for-profits should be, because they can—with help from the public sector in terms of capacity building—achieve quite a lot.

I have seen that in a number of areas including my own area of Sheffield when I was leader. We had something called “Buy for Sheffield”. It was not an issue of giving special treatment to small to medium-sized enterprises; it actually got ahead and gave a lot of capacity building. Through that capacity building and then through their own innovation, they could go to larger organisations and get part of the supply chain on their own volition rather than what normally happens, which is that the large organisations look for small to medium-sized enterprises down the supply chain because it gets them ticks. It actually meant that innovation came. There is something particularly in Amendment 86.

I am not quite sure why the noble Baroness, Lady Neville-Rolfe, chose £5 million because the average turnover of a small to medium-sized enterprise at present is about £756,000. I think because it is a probing amendment there has to be a cut-off point which says that for companies below a certain turnover there should be a special emphasis within this Bill. I hope that the Minister goes away and reflects on what has been said because it does not seem deep enough, and I am sure we will be coming back to this on Report as an important part of the Bill.

I agree with the noble Baroness, Lady Noakes. We have been diametrically opposed on many Bills, but on Amendments 290 and 295 there are elements I would want to see apply to small and medium-sized enterprises. I understand why the noble Baroness, Lady Neville-Rolfe, has done that, but there are some really important issues about the probity and capacity of small to medium-sized enterprises as to whether they get the procurement.

Finally, I want to re-emphasise what my noble friend Lady Brinton said. There is a huge contradiction between having a Bill for public procurement and then saying that, by statutory instrument, the Minister can take away that right for the health and social care provision. I was explaining this over dinner on Saturday to a number of friends who were asking me what I was working on in Parliament at the moment. When you explain the Procurement Bill, people glaze over, but when you explain that there is a provision for £70 billion-worth of their taxes to be excluded at the signing of the Minister’s pen, suddenly they become very excited—the glaze stops.

The Minister tried to explain this to my noble friend Lady Brinton; I was more confused after the explanation than before it. She needs to try harder to explain where the contradictions are and how they will be dealt with as a unified Procurement Bill. On the whole, like most noble Lords, I agree with the thrust of these amendments, but Ministers need to go away between now and Report and think carefully. It is clearly not strong enough to give a level playing field to small to medium-sized enterprises.

Elections Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Lords Hansard - Part 1 & Committee stage
Thursday 10th March 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, the processes of your Lordships’ House are enclosed in layers of impenetrable language, punctuated by archaic ritual and layered in complex paperwork that can confuse even the veterans among us. For International Women’s Day I have been exhorting the young people of Britain, particularly young girls, to watch the House of Lords—with some trepidation because it is not easy to understand if you just switch on Lords TV.

Many noble Lords will have noticed, in the great increase in our piles of letters and emails in our inboxes, that the House of Lords is—this is responding particularly to the comment of the noble Baroness, Lady Fox—a place where democracy is being defended. Several noble Lords have said, “Oh well, we don’t have to worry about this Government having the power of control over the Electoral Commission; it’s some other putative Government we are concerned about.” However, when I look at the police Bill, the judicial review Bill, the Nationality and Borders Bill and many others, and I look at my postbag of people saying they are concerned, I know that the public are asking us to represent them, and we have to worry about this Government as well as any potential future Government.

As a further piece of evidence, noble Lords may have seen, a week or so back, the Democracy Defence Coalition’s giant van and billboard parked—deliberately—outside Millbank House, where many of us have offices. That organisation represents hundreds of thousands of people who are concerned about this Bill. The top line in their list was concern about the independence of the Electoral Commission, which is what these amendments seek to address—particularly Amendment 4A.

Coming to the detail of this, I entirely understand the impulse from the noble Baroness, Lady Meacher, to try to put some controls and limits in. But the only way forward is to get these clauses out of the Bill. More than that, I agree with the noble Lord, Lord Foulkes, and others, that this Bill is an absolute mess. As others have said, the number of government amendments makes that very clear. We must not be proceeding with this Bill as an absolute minimum at the moment.

[Lord Scriven (LD)]

My Lords, I thank the noble Baroness, Lady Meacher, for tabling these amendments and setting an example for all of us in Committee to present our amendments with such brevity in such a concise nature. I declare my interests in the register which are relevant to this Bill.

The noble Baroness’s amendments do their utmost—if these two clauses are to remain part of the Bill—to keep the Electoral Commission as independent as possible from government interference. It might be worth looking at a dictionary definition of independence. It is: the ability to go about one’s business without being helped, hindered or influenced by others. The Minister may say that this is trying to help the Electoral Commission. Independence means that you stay out of the function of that commission.

In response to the noble Baronesses, Lady Noakes and Lady Fox, we have to be very clear what the amendments are trying to omit. The role of the Electoral Commission is not to carry out the priorities of the Government. Yet we see in new Section 4A(2)(b):

“The statement is a statement prepared by the Secretary of State”—


a Cabinet Minister—

“that sets out … the role and responsibilities of the Commission in enabling Her Majesty’s government to meet those priorities.”

The role of the Electoral Commission is not to meet the priorities of Her Majesty’s Government, it is to ensure free and fair elections for all parties—not at the behest of one political party. That is why these amendments, if the clauses stand part of the Bill, are important.

At Second Reading I said to the Minister that when the noble Lord, Lord Cormack, and I are together, there must be fundamental flaws in the Bill. With what the noble Lord, Lord Cormack, has just said, I feel like calling him my noble friend on this particular issue. His powerful words—as upsetting as they are to some noble Lords—are absolutely correct. At this time, when people are fighting for the basics of freedom and democracy, it is wrong that we are having to debate a Bill which tries to put the Electoral Commission’s strategy and priorities in alignment with those of Her Majesty’s Government—a political party. Those are not the free and fair elections which are the basis of a strong, functioning democracy.

It is for those reasons that if at a later stage your Lordships decide to see Clauses 14 and 15 stand part of the Bill, these amendments at least try to bring back a semblance of independence and take away the role of government. That is why these Benches support the noble Baroness’s amendments as drafted.

Health and Care Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Scriven (LD)]

I support in particular Amendment 217. In so doing, I draw the attention of the Committee to my interests as set out in the register, particularly as a vice-president of the Local Government Association.

I want to make three very clear points about this. First, this amendment refers to assessment; it does not refer to the package of care. The assessment is the first stage, before the social workers and before adaptation or anything else can happen, so the person leaving hospital gets a sense of independence and support to lead as independent a life as possible and to help them in their recovery. Evidence shows that the best way to start the assessment is on the day that the person is admitted. It is not about waiting for an optimal time. The assessment may change as the person progresses, but all the evidence shows that assessment should start on admission. The concept that there is an optimum point does not stand up to the evidence.

Secondly, having this framework within the Bill, with timescales and so on, does not stop local innovation, it just gives a framework for local innovation and integration to take place.

My third point is a question. I know of no condition—unless the Minister can inform the Committee of one—where starting the assessment two weeks after a person leaves hospital is in the best interests of that person; they may have to wait six, seven or eight weeks for the package of care to be put in place. Can the Minister tell us for which conditions the suitable and optimum point at which to start the assessment is after a person has left hospital?

[Baroness Bennett of Manor Castle (GP)]

My Lords, after this rich and informative debate, I will briefly make two points and offer the Green group’s support for all these amendments.

I share the shock expressed by the noble Baroness, Lady Tyler, and others that we are in a situation where in the House of Lords we are trying to put the situation back to what it was before because the Bill is making it so much worse.

I particularly want to address Amendment 269 about young carers. I should perhaps declare that I have never been carer—I have not been in that situation. But I want to share a little bit of what I learned from Sophie Dishman, who I met in 2015, when she was a student at the University of Sunderland. She told me that she became a carer at about the age of 12, but that it was only when she was 18 that she realised that she was a carer—a point that many others have addressed. As well as continuing to care, she created a campaign at the University of Sunderland to inform others about the situation and perhaps help others identify themselves as a carer. She produced a very clever, witty, attractive tote bag, with the line, “Being a carer at uni can be a lot to carry around”, a check list of all the things that you might have to do being both a student and a carer, and a useful leaflet, designed for staff in particular, showing signs that a carer might need help.

I want to make the point, which I do not think anyone else has made, that young carers are by nature people who have developed an enormous amount of capability, knowledge and skills. They are amazing individuals. It is not only the right thing to do but in society’s interest to make sure they are able, as the noble Lord, Lord Howarth, said earlier, to flourish and develop those capabilities. It is in our interest to do that.

I want to point to an article that has been out for only a couple of weeks, in volume 27, issue 1 of Child & Family Social Work. The headline is

“It’s making his bad days into my bad days”,

and the article is about young carers in the Covid emergency. This is where we are now. It is about just how much more difficult the withdrawal of services has made it for carers, particularly young carers. We have a huge, as yet uncertain, but certainly large, burden from long Covid, and many people will be taking on huge caring responsibilities because of it.

Health and Care Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Lords Hansard - Part 1 & Committee stage
Tuesday 18th January 2022 Lords Chamber

[Lord Scriven (LD)]

My Lords, I support Amendment 20 in the name of the noble Baroness, Lady Meacher, and in so doing declare my interest, as laid out in the register, as a vice-president of the Local Government Association and a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust.

NHS England defines the better care fund as being there to support

“local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.”

So why is that not the case for 30% of the population, children and young people, who have the same complex needs and the same need for integration as adults do to help and support them on their journeys? The better care fund has been around since 2014. My guess is that this was an oversight rather than a deliberate means to keep children and young people out. Having looked at examples of what the better care fund can achieve in integration and outcomes for adults, I believe that this oversight needs to be addressed. Children and young people need to be on the face of the Bill.

I think that the Government accept that things need to happen, because we have the children’s social care innovation programme, which is particularly about looking at innovation in social care along with healthcare partners. The problem, however, is that it is a bidding system and it is not for all local authorities. If you win the bid, you can do it. Children and young people across the country deserve and should expect the right to have innovation in integration to improve their outcomes regardless of where they live. It should not be conditional on their local authority being successful in a bid.

I can see no reason why, as the noble Baroness, Lady Meacher, said, the Government would not want to do this. It is an oversight in the better care fund. Putting children and young people on the face of the Bill would ensure that they received the integration and better outcomes that adults achieve through the fund.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I offer the support of the Green group for all the amendments in this group. My name is attached to Amendments 51 and 87 and it would have been attached to others had there been space. I can only commend the noble Baronesses, Lady Meacher, Lady Tyler of Enfield and Lady Finlay of Llandaff, for identifying a serious lacuna in the Bill and for providing practical, careful and sensible solutions to that.

The noble Baroness, Lady Finlay, said that the Bill was “by adults for adults”. The other amendments in the group address only half that phrase. It addresses the “for adults” part but not the “by adults” part, which is what my Amendment 103A aims to address. Young people are experts in being young people. We may think about the life experiences of a 12 year-old or an 18 year-old, but none of us really knows what it is like to be 12 or 18 at this moment. A phrase often used particularly by marginalised groups is “Nothing about us without us”—given the hour, I will spare noble Lords the Latin version.

Young people are undoubtedly a marginalised group in our society in that their voice is far too rarely heard. As I have reflected previously, they are hugely underrepresented in this place and in the other place. The under-18s do not have the vote. The under-25s in the voting population, for structural reasons that could be fixed but have not been, do not have the same kind of voice.

I entirely accept that, among paediatricians and social workers, there are many older people who have much expert knowledge, but it is crucial that we actually hear. My amendment seeks to address ICBs and sets out that, in statute, there should be an advisory board consisting of young people on every ICB. I believe that this is an important addition to ensure that young people’s voices are heard. It might be said that many ICBs may set up such a structure, but that is not the same as it being statutory, ensured in the Bill with a message from Parliament saying, “You have to listen to these young people’s voices”.

I doubt that I need to address this in detail, particularly with the occupancy of the Chamber for this group, but I want to mention the Children’s Society’s Good Childhood Report 2021, which looked at 10 to 17 year-olds. Among them, one in 15 were unhappy with their lives—the highest level in a decade. We know that children who are unhappy at the age of 14 are significantly more likely to display symptoms of mental ill health, to self-harm or, sadly, to attempt to take their own life by the time they are 17.

As the report makes clear, the pandemic is only part of this story. There is a climate emergency and a pervasive fear about the future that young people have lived their entire lives through. We are talking about people whose whole life experience, virtually, has been since the financial crash. One thing that we know addresses a sense of powerlessness, with all its negative effects on mental and physical health, is giving people a sense of empowerment—that is, a sense that they can take control of their lives, make choices and make a difference. I often see this with young climate strikers.

I believe that the measure proposed by my Amendment 103A would ensure that this group of amendments collectively addresses the two sides of the problem that the noble Baroness, Lady Finlay, identified. I want to take this forward and I invite noble Lords who are interested to talk to me about it. This should be included in the Bill. Let us hear from children and young people and make sure that ICBs listen to the children and young people they serve.

Coronavirus Bill

Debate between Baroness Bennett of Manor Castle and Lord Scriven

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Wednesday 25th March 2020 Lords Chamber

[Lord Scriven]

My Lords, I am a signatory to this amendment. I shall say two things: first, it is pleasing that the powers within the Bill talk about applying them under human rights legislation; secondly, I am glad those rights are included, because giving two and a half hours of parliamentary scrutiny to a Bill with such wide powers, even though it is emergency legislation, is not the way to make good legislation.

[Baroness Bennett of Manor Castle]

My Lords, I am very pleased to speak after the noble Baroness, Lady Kennedy; I second what she said about the prisons and would add immigration detention centres to that. People who have been accused of no crime should not be being held in dangerous conditions that threaten their lives. Particularly with this amendment, we have been focusing a lot on the level of fear. We have heard a great deal of powerful testimony about how fearful many people are—people with disabilities, people who are already ill and sick, and people who are old and frail. Regarding the kinds of reassurances that have been asked for: people may not know the fine details of the rights legislation, but a simple reassurance from the Government that they will comply with something that guarantees people’s rights will be terribly important.