Funeral Directors: Regulatory Regime

Baroness Browning Excerpts

Wednesday 9th September 2026 Lords Chamber

[Baroness Merron (Lab)]

We look forward to working with other jurisdictions to see how their best practice works, and that will, of course, include Scotland. I am very keen that we continue to work closely, for example, with the funeral provider cohort, most of whom, let us acknowledge this, do a first-rate job with immense dignity and professionalism and have been let down also. Safeguards have to be effective without imposing disproportionate burdens and, while it is a bit premature for me to prescribe how the regulatory framework will work, I can assure the noble Baroness that we are looking very closely at what she raises.

[Baroness Browning (Con)]

My Lords, I support the Government in regulation, because what has happened in Hull has been tragic for the people concerned. We have noticed increasing television advertising for funerals without any form of ceremony or service. Of course, that is personal preference, but it looks as though the public are increasingly putting their faith in funeral directors to have sole charge of the deceased from the time they die to the time they are cremated, without necessarily having any input from people around them—of course, some people have no surviving relatives or friends—and I think that trust needs to be regulated.

[Baroness Merron (Lab)]

That, my Lords, is exactly why we are taking the action that we are.

New Autism Strategy (Autism Act 2009 Committee Report)

Baroness Browning Excerpts

Wednesday 10th June 2026 Lords Chamber

[Baroness Browning (Con)]

My Lords, I declare my interest as a vice-president, along with my noble friend Lord Touhig, of the National Autistic Society, and I hold lasting power of attorney for autistic adults. I thank the excellent chair of our committee—I genuinely think we would not have got here without her.

When the right honourable Dame Cheryl Gillan MP chose to introduce what is now the Autism Act 2009 in the House of Commons, she did so because she believed that autism is different and that the transition from childhood to adulthood was a cliff face, and that failure to understand and support autistic adults deserved its own Act of Parliament. I can confirm this with certainty, as Cheryl was a friend, and I was privileged to serve on the autism Public Bill Committee with her.

The report before us today is titled Time to Deliver: the Autism Act 2009 and the New Autism Strategy. The Government’s response to the report is described by the autism charity sector as unacceptable—that is putting it mildly. The new strategy, due next month, has been kicked into the long grass, with no attempt to set out a timetable to plan the new one and no discussion with the autism charities to agree priorities. A request I made to the Minister to discuss this was passed many weeks ago to the Commons Minister, and I have heard nothing since.

I turn to the reason for this small but important Act of Parliament, and to the report, which identifies why autism is different. Autism is a spectrum of degrees. Some will travel through life with minimal need for support and, at the other end, the need will be for 24-hour specialist support. In the middle will be so many for whom this Act of Parliament and its strategy are the blueprint for a place in society that is safe, meaningful and fulfils each individual’s potential. Many will be of average or even higher intelligence, but all people born autistic will die autistic. There is no medication, although there may be additional conditions as well as autism.

Nearly 20 years on from the Act, we still see autistic people with shorter life spans and the highest suicide rate of all neurodiverse conditions. Autistic people are detained in mental institutions and there is a 60% unemployment rate, often for life. I say to the Government that it is really time to deliver. Do not delay the new strategy because other things are going on. If the new proposed SEND policy is not going to be delivered until 2030, that is no reason to halt work on an Act that is already on the statute book. If services to support changes to the Mental Health Act, which has already been passed, will not be in place for some time, that is no reason to delay the strategy.

The 2009 Act states that the Secretary of State for Health must

“prepare and publish a document setting out a strategy for meeting the needs of adults in England with autistic spectrum conditions by improving the provision of relevant services to such adults by local authorities”

and “NHS bodies”.

The committee’s report is a year’s work by this House, which, together with discussion with autism charities and those with lived experience, would provide the Government with a new strategy that would make such a difference. It is, after all, the law of the land already. I expect the Government to abide by the law of the land and, when the Minister winds up, to explain how and when they will deliver it.

GP Contract

Baroness Browning Excerpts

Tuesday 17th March 2026 Lords Chamber

[Baroness Browning (Con)]

Is there any monitoring of when GPs insist on a telephone call rather than a face-to-face meeting, or when things are sent by email to the surgery and they are then triaged by others rather than their normal GP? Is there any identifying of just how many cases they miss of those very serious conditions that subsequently end in serious illness or even death? I am particularly thinking of such things as sepsis, where the symptoms are not always so overt to begin with as they are as the disease progresses. Is there any monitoring of how successful these new systems are in picking up those types of diseases?

[Baroness Merron (Lab)]

All the systems are under constant review. It might be helpful if I point out to the noble Baroness that one of the key things in the GP contract for 2026-27 is the requirement for all clinically urgent patients to be dealt with on the same day. That is not required currently; I think that will make a huge difference. Again, I emphasise that we will not be defining “clinically urgent”: it will be down to practices to use their clinical judgment, and that is the right place.

NHS: Heart Valve Disease

Baroness Browning Excerpts

Thursday 12th March 2026 Lords Chamber

[Baroness Merron (Lab)]

I am sorry to hear the experience that the noble Baroness describes. We are indeed seeking to have a whole-team approach to the whole patient. I absolutely agree with her that it should indeed consider where somebody is in their life stage.

[Baroness Browning (Con)]

The noble Lord, Lord McCabe, referenced older people in particular in his Question—he did not say where he drew the line at old, but perhaps I will declare an interest. What happens, for example, when really older people need heart surgery but are considered to be an anaesthetic risk? With new developments in heart surgery, I wonder whether the Minister can tell us what progress there has been in carrying out procedures without necessarily needing to have invasive surgery.

[Baroness Merron (Lab)]

I can privately share with the noble Baroness that I suspect that “older people” covers both of us: it is over 65. The point that she makes is important. The option of what is called a TAVI intervention is far less invasive than a surgical intervention, as she referred to. That activity has grown significantly year on year, with something like a 16% increase on 2024-25. That is a very welcome step forward as we move towards minimally invasive procedures.

Rare Cancers Bill

Baroness Browning Excerpts

2nd reading
Friday 16th January 2026 Lords Chamber

[Baroness Browning (Con)]

My Lords, it is a great pleasure to follow the noble Baroness in her contribution this morning. This short but very important Bill was brought from the Commons in July last year. Many of us feel we have waited a very long time for it to appear on the Floor of this House, so I very much welcome it today.

I was first contacted about it by one of the many charities which are very involved in this, Pancreatic Cancer UK. Sometimes, when we hear of cancers, whether we are personally involved or not, we are quite surprised that this cancer is regarded as a rare cancer and to find that there are so many of them—well into three figures. As we have already heard from the noble Baroness, Lady Elliott, 47% of cancers diagnosed each year are for rare or less common cancers. They account for 55% of cancer deaths and include some of the lowest survival rates. In the past, I have been very interested and had communication with head and neck cancer charities and blood cancer charities. Even within one charity, there will be many cancers that are regarded as a rare cancer.

Of course, the Bill seeks to redress these poor survival rates with greater focus, particularly on research. The Less Survivable Cancers Taskforce supports the Bill. It says that the Bill would ensure that there is a named lead in government, as we have already heard, with a responsibility to support research and innovation for rare cancers. As it stands, these cancers often struggle to attract research funding and attention compared to other diseases. A named lead would ensure that there was a strategic focus on rare cancers in government for the first time. This would help to co-ordinate efforts, look at gaps comprehensively and ensure that these cancers become the main priority. I hope that when the Minister responds she might flesh out a little bit how she sees that role developing.

The Bill would also ensure that patients can get better access to and find relevant research and clinical trials. I think many of us have encountered people who, in diagnosis of a rare cancer, or very often just any cancer, are desperate to find trials that are going on. Where do you start to look? Who holds this information? This is a very important part of the Bill. Currently, many patients with rare cancers miss out on potentially life-extending clinical trials simply because they do not know about them. The current system makes it difficult to match eligible patients with appropriate trials, meaning that trials can struggle to recruit enough participants and, potentially, promising treatments cannot move forward. Again, I would like it if the Minister could tell us how the medical profession, starting at primary care, accesses this sort of information when a patient is in front of them.

The Bill places a duty on the Government to review and potentially strengthen orphan drug regulations. The orphan drug regulations aim to incentivise research into rare diseases, because the current incentives for pharmaceutical companies to develop treatments for rare cancers are not strong enough.

I congratulate the sponsors of the Bill in both Houses, Dr Scott Arthur MP and the noble Baroness, Lady Elliott of Whitburn Bay, who brought it to the Chamber this morning in such a lucid way. I hope I am not being optimistic in saying to the Government that Private Members’ Bills never succeed unless government supports them; we all know that. I hope the Minister is going to support this one.

Resident Doctors: Industrial Action

Baroness Browning Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I am grateful to my noble friend, and I share his view. I am sure he will be very familiar with this, but it is worth reminding ourselves that in the Statement we are debating, the Secretary of State said last week:

“On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with”.


As the Secretary of State outlined and my noble friend referred to, we have inherited

“training bottlenecks that … leave huge numbers of resident doctors without a job … UK graduates”

used to compete

“among themselves for specialty roles; now, they are competing against”

the rest of the world.

“That is a direct result of the visa and immigration changes made by the previous … Government post-Brexit, and … compounded by the”


then Government’s

“decision to increase the number of medical students without also increasing the number of specialty training places”.—[Official Report, Commons, 10/12/25; col. 429.]

This has not just come about, and I am grateful to my noble friend for reminding us of the history of this.

[Baroness Browning (Con)]

My Lords, the Minister was asked what happens next. May I ask her to consider this? Notwithstanding what has already been discussed tonight in this Chamber, the general public out there are going to face a long period with a lot of bank holidays. If we think back to the Covid period, people, for different reasons, were reluctant to dial 999 or 111 to get medical advice or to seek assistance. I know from a personal point of view that I would really not want to be admitted into an emergency department unless I was literally dead. People have a fear of this: we see the trollies and hear now of the shortage of staff. I say that having worked in an operating theatre over a Christmas period.

Can the Minister say what plans the Government have already made to give accurate information to the general public about how they should proceed during this Christmas period if they have relatives who are showing cardiac symptoms or severe respiratory problems? There is a need for some practical guidance on what to do and to encourage people—if they are sitting at home and are genuinely that ill, they must seek help.

[Baroness Merron (Lab)]

I absolutely agree with a number of the points made by the noble Baroness, particularly her last one: people must seek the help they need. I assure your Lordships’ House that the entire focus of the department and the NHS will be on getting the health service through this double whammy of flu and strikes. Despite the huge extra numbers, there will still be people who are not vaccinated. Therefore, in addition to seeking help when needed, I also make a plea to those who have not yet been vaccinated please to do so; that will help immensely.

It is probably worth saying that the next round of strikes will bring the total number of days of strike action to 59, over 14 rounds of industrial action, since March 2023. So I remind your Lordships’ House that this did not start with this government but has preceded it for some time.

To the noble Baroness’s point about performance, I pay huge tribute—as I am sure we all do—to the dedication of NHS staff at this time. During the November round of strike action, the NHS set an ambitious goal to maintain 95% of planned care. It succeeded in doing that, which is totally down to the NHS workforce pulling round. We also proved last time that we could maintain a near full programme of elective care. Our immediate plan, which the noble Baroness asked about, is to replicate this over the upcoming five days of industrial action in December. There is no reason for these strikes, and I know the effect they have and the concern they create for the general public. The noble Baroness allows me to remind us that these strikes are not supported by the general public.

Terminally Ill Adults (End of Life) Bill

Baroness Browning Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Winston (Lab)]

My Lords, as a member of the Select Committee that the noble Baroness has just referred to, I think she ought to refrain from criticising something that the committee either said or thought. We merely took evidence. As we will see in the report, we did not make those observations personally.

[Baroness Browning (Con)]

My Lords, many years ago, in another place, I served on the pre-legislative scrutiny committee and was present taking what became the Mental Capacity Act through the House of Commons. When I came to your Lordships’ House in 2010, I was fortunate enough to secure a House of Lords inquiry to look post-legislatively at how the Mental Capacity Act was working. From the evidence we took at the time, we found that the ability of the medical profession—by which I mean not just doctors but all those across the piece, including social care workers—was not as ideal as it perhaps sounds in today’s Committee. Whatever is built into the Bill to assess either capacity or ability, there will need to be a heck of a lot of training for us all to feel comfortable that the professionals involved know how to go about their task.

I draw the Committee’s attention to the report last month of the National Audit Office, whose press release stated:

“The Department for Health and Social Care (DHSC) and NHS England (NHSE) do not clearly understand what proportion of palliative and end-of-life care is delivered by independent adult hospices, and therefore, how much they are reliant on the sector, or what the real impact of government funding is”.


We have heard that palliative care is patchy. I know from my own recent experience with a close relative that, had I not been somebody capable of organising it myself, it would not have taken place. We are not dealing with finite disciplines in the debate on this group, and I caution the Committee that it is not as perfect out there as it sounds today.

[Baroness Butler-Sloss (CB)]

My Lords, I declare that I was a vice-president of Hospiscare in Exeter. I am probably the only person in this Committee who has tried cases of capacity, again and again, both as a High Court judge and in the Court of Appeal. One case was so difficult that the Court of Appeal, where I was presiding, sat until 1 am. Noble Lords may not have thought that the Court of Appeal did that very often. It is important for your Lordships to realise that some cases that I tried were extremely easy to try—one in particular involved a Miss B, who was obviously competent—but other cases were extraordinarily difficult. One case—the one that we did until 1 am—concerned somebody with a needle phobia who was expected to need a caesarean, and she objected because she could not bear the idea of a needle. At one in the morning, we took the view that she did not have the mental capacity to decide on her caesarean. She was hugely relieved and had the operation without any trouble. But that was not a unique case—the time was, but not the problem.

Suicide Reduction

Baroness Browning Excerpts

Monday 8th September 2025 Lords Chamber

[Baroness Browning (Con)]

I know that the Minister has an interest in this. Would she please find time to read the report, published last week jointly by Cambridge and Bournemouth universities, on suicide and autism? Among all the neurodivergent conditions, autism has by far the highest suicide rate. It is not rocket science why; it is preventable and I know the Minister will do all she can to help get that figure down.

[Baroness Merron (Lab)]

The noble Baroness is quite right to speak as she has done. The suicide prevention strategy and the seven priority groups it identifies does include autistic people. As the noble Baroness will know, I think that is particularly key and I will certainly be pleased to look out for the report to which she refers.

Mental Health Bill [HL]

Baroness Browning Excerpts

Report stage
Wednesday 2nd April 2025 Lords Chamber

Some reassurance from the Minister at the Dispatch Box that this will be looked at, rather than overlooked, would make me feel that this major social phenomenon is not going to be swept under the carpet—because I think it will negatively impact on the implementation of the Bill.

[Baroness Browning (Con)]

Before the noble Baroness sits down, she mentioned autism several times, but the whole purpose of the Bill is to remove autism and learning disability from mental health, where it previously was. In fact, I served on the Bill Committee, as did others in the Chamber, in 2005-06, when I was really opposed to autism being added to the 1983 Act. But it was added, and now it is being taken out, I am very pleased to say.

I hope that the noble Baroness will accept that there is a piece of legislation about this on the statute book: the Autism Act 2009, which is being reviewed by the House at the moment. Autism is not some fad, something that people just make up, or something temporary; it is a lifelong neurological condition. I raise the failure to provide the right services for people with autism who are in that part of the spectrum where they need support. Not everybody does: it is a spectrum, and I quite agree that there are people on the spectrum who cope quite well with life, knowing that they have autism and not needing that sort of support. We have discussed that support a lot in the course of this particular Bill, and if you do not provide it where it is needed—this is the weakness that we are looking at in the current Autism Act—that leads to quite serious mental health conditions, including suicide. Of all the conditions that the noble Baroness mentioned, among the autistic community the suicide rate is the highest.

[Baroness Fox of Buckley (Non-Afl)]

I genuinely appreciate that intervention. That is what I think too. It is precisely the inappropriate use of terms such as autism in relation to this overdiagnosis that concerns me, because it is too glibly used. That is part of what I am talking about. I absolutely want those people who need the intervention to get it, but my concern is if it becomes widely used socially, in the way that I did not want to go into in great detail, on university campuses or in society in general. I note the TikTok phenomenon of people getting diagnoses and that being used, and so on. My concern is that the label, the labelling process and the demand for diagnosis and treatment squeeze out the very people that the noble Baroness is talking about.

I too have spent many years trying to distinguish between autism and mental illness. It drives me mad that people do not know the difference. My problem is that, in the debate about this issue, they are very often all lumped together in a way that is medically not clarifying, but the demand for a medical label can mean that people are not even that choosy about which one they get. That is where I have tried to raise an issue.

[Baroness Browning (Con)]

I am very grateful for that response. The noble Baroness said that autism is different; it certainly is different, which is why it has its own Act of Parliament.

[Lord Kamall (Con)]

My Lords, as I said on the previous group, I will start by speaking to the amendment in my name and that of my noble friend Lord Howe. It would require the Secretary of State to conduct a review into the ability of the CQC to effectively fulfil its role

“in carrying out its duties under the Mental Health Act 1983, and … in regulating the provision of mental health services”.

We have also included proposed new subsection (3), which would ensure that the review of the CQC’s functions will also include an assessment of whether it will be able to “effectively carry out” its new duties under the Bill.

As the Minister will know, in May 2024, Dr Penny Dash was commissioned to conduct the independent review of the operational effectiveness of the CQC. The full report, published in October, found

“significant failings in the internal workings of CQC which have led to a substantial loss of credibility within the health and social care sectors, a deterioration in the ability of CQC to identify poor performance and support a drive to improved quality—and a direct impact on the capacity and capability of both the social care and the healthcare sectors to deliver much needed improvements in care”.

In addition, my noble friend Lord Howe raised the issues arising from his meetings with the charity Blooming Change on a number of occasions. It has raised serious concerns about the CQC’s monitoring activity. We also know that the Secretary of State himself has claimed that the CQC is not fit for purpose, and that there are some fundamental issues with how the CQC oversees the mental health care system.

As we have heard from other noble Lords, one solution would be to have an independent mental health commissioner. Our solution is to call for a review of the CQC that specifically focuses on its mental health functions, to make sure that it does its job properly. The review conducted by Dr Dash comprehensively assessed the CQC’s ability to regulate primary, secondary and community care, but it did not focus on the sufficiency of mental health care regulation. I thank the Minister for the brief meeting with my noble friend and me earlier this week, in which she indicated that she would be able to give greater assurances on this particular issue. I look forward to what the Minister has to say on it, because this is part of our justification for not supporting the mental health commissioner: we want to see a strengthened CQC. We do not want duplication, but, in avoiding duplication, we want to make sure that the CQC does the job it is supposed to do. I hope I can get that assurance from the Minister when she speaks.

I have some sympathy with Amendment 61, in the name of the noble Baroness, Lady Fox, in line with the comments of the former Prime Minister, Tony Blair, but I also have some sympathy with what the Secretary of State said. We thought about whether we could find an appropriate amendment to table on this. We have to be very careful and sensitive about this issue: we in Parliament or officials in Whitehall cannot hope to pronounce on the issues individuals face in their homes or communities. It is about getting the balance right.

The noble Lord, Lord Alderdice, also spoke about the concerns about overdiagnosis, but we cannot just make a generalisation. We have to make sure that the mental health professionals are doing their job, with the right guidance, to ensure that we understand the needs of each individual. For that reason, I thought it was far too difficult—and it would have been insensitive —for me to lay an amendment on this topic. I did not want to go there for that reason. This is an issue that has to be discussed, but we have to do it in the most appropriate way—in a sensitive way that understands those who suffer seriously from mental health conditions.

Let me turn to the amendments tabled by the noble Baroness, Lady Tyler. She and I have both raised the issue of racial disparities. In Committee, I went in very strongly on it—this is the issue that matters to me personally very much, and I shared some of my own experience of racial discrimination. I am as frustrated as everyone else that we still have not resolved the problem to this day; we still do not understand why, disproportionately, black men in particular are subject to detentions and community treatment orders. I asked questions at the time. What do we know? What do we not know? What are we doing to fill that knowledge gap? Once we have filled that knowledge gap, what are we going to do about it? Once again, I thank the Minister and her officials for the detailed meetings that they had with us when they laid out some of the things that they are doing. Could I tempt her to share with noble Lords some of that discussion and her letter, to assure us all that the Government really are on top of that issue, know what they are doing and are going to address these problems?

I was unsure about how effective the provision in Amendment 49 would be. I know that it is not very fashionable for politicians to say, “I don’t know”; we are supposed to make a firm decision one way or the other and agree or strongly disagree. But I wanted to reflect on whether that amendment would represent an additional burden on the healthcare professional, additional cost or additional bureaucracy. Given that we cannot, at this stage, say for sure how this will turn out, I support the suggestion of the noble Baroness, Lady Tyler, to pilot a scheme of a senior responsible person to address racial disparities. If we could pilot it in some places, it would give us the data to understand whether a responsible person would be effective in addressing those disparities. We all know that more needs to be done. We have had successive Governments of all political colours, and we still have not solved this problem. Let us be determined, as a House, whichever party we are, to tackle this problem of racial disparities, and let us make sure that we do it in the most effective way.

I am grateful for what the Minister said on Monday, but I hope that she will give some consideration to what the noble Baroness, Lady Tyler, said about piloting a responsible person to see whether that works. Maybe it will not work, but at least we would have the data and evidence. I would appreciate the Minister giving a more detailed explanation of some of the research that is being conducted to fill that gap, so we can understand why there are still racial disparities and what Governments of any political colour would have to do to address them.

Mental Health Bill [HL]

Baroness Browning Excerpts

Report stage
Monday 31st March 2025 Lords Chamber

1: After Clause 3, insert the following new Clause—
“Application of the Mental Capacity Act 2005: autism and learning disability
(1) In Schedule 1A to the Mental Capacity Act 2005, paragraph 2, after the last line of the table, insert—

“Case F

P has autism or a learning disability and is not subject to any of the mental health regimes

See paragraph 5A”

(2) In Schedule 1A to the Mental Capacity Act 2005, paragraph 5, at end insert—
“5A (1) This paragraph applies in Case F in the table in paragraph 2.
(2) P is ineligible if the following conditions are met.
(3) The first condition is that P objects to being—
(a) admitted for treatment as a mental health patient, or
(b) given some or all of the mental health treatment.
(4) The second condition is that a donee or deputy has not made a valid
decision to consent to each matter to which P objects.
(5) In determining whether or not P objects to something, regard must be had to all the circumstances (so far as they are reasonably ascertainable), including the following—
(a) P’s behaviour,
(b) P’s wishes and feelings, and
(c) P’s views, beliefs and values.
(6) But regard is to be had to circumstances from the past only so far as it is still appropriate to have regard to them.
(7) For the avoidance of doubt, Case F and this paragraph do not apply to determine P’s ineligibility in respect of admission for assessment of mental disorder.””
Member’s explanatory statement
This amendment to the Mental Capacity Act 2005 would prevent the Deprivation of Liberty Safeguards scheme being used to replace detention under section 3 of the Mental Health Act for people with learning difficulties or autism who do not have a mental health condition.

[Baroness Browning (Con)]

My Lords, I will speak to Amendment 1, which is in my name, and then to Amendment 4, in the same group, to which I have added my name.

Amendment 1 is exactly the same amendment that I tabled in Committee. I have brought it forward yet again because I felt it was so important and I did not feel that we went into as much detail as we should have to recognise the real challenge that the Mental Capacity Act could have to the Mental Health Act, as amended by the Bill we are debating. I am enormously grateful to the Minister; she has not only had a one-to-one meeting with me specifically about this clause but has sent me a letter. I hope it will be appropriate for me to quote some of it.

I am concerned, as are others, including many charities—I refer to the charities I am registered to in the record—such as the National Autistic Society, Mencap and of course the Law Society, which I am grateful to for drafting this particular amendment. There is a difficulty with the Mental Capacity Act. Under the Bill, we wish to prevent people with autism and learning disabilities who have no additional identified mental health condition being deprived of their liberty—they should not be. The worry is that the existing Mental Capacity Act will be used instead to take away their liberty and admit them to a mental health hospital. We know the history in this area, which we have debated many times in this House.

In my discussion with the Minister, I raised with her the fact that the NHSE service model for commissioners sets this out very clearly. At 4.3, it says:

“Alternative short term accommodation (available for a few weeks)”—


we are talking about just a few weeks—

“should be available to people, as and when it is needed, to be used in times of crisis or potential crisis as a place where they can go for a short period, preventing an avoidable admission into a hospital setting. It might also provide a setting for assessment from teams providing intensive multi-disciplinary health and care support (see principle 7) where that assessment cannot be carried out in the individual’s home”.

I think we all recognise that there will be some circumstances under which people will not be able to remain wherever they are, in either their domestic home or their normal place of residence. But, none the less, there should be alternatives to them being admitted to a mental health hospital.

To detain them under the Mental Capacity Act and the DoLS—deprivation of liberty safeguards—has other consequences. Those rights in the Mental Capacity Act include the rights of the nearest relative or nominated person to object to discharge, accessible and automatic referrals to tribunals, independent reviews of medical treatment, statutory care and treatment plans, and of course Section 117 aftercare. So it is not a question just of the Mental Capacity Act being used to deprive people of their liberties; there are associated issues that almost take away even more rights from the individual.

As I mentioned, the Minister and I have discussed this in some detail and I am very grateful to her for agreeing in her letter to me, first, that she has concern—I believe she has genuine concern—about this area. In order to mitigate what might happen under the Mental Capacity Act, she has shared something with me in her letter. I hope this does not seem impertinent, but it is such a good letter and I hope she will put it in the Library, because I am sure it would be of interest to many people in the House. She gave me a lot of data about how the Government are already making sure, and will continue to make sure, that there is proper monitoring of people who are detained under the Mental Capacity Act who may have autism or a learning disability but who do not have an associated mental health condition.

In bold letters, the letter says:

“Ahead of the changes to Part 2, Section 3, we commit to monitoring the data on the number of people with a learning disability and autistic people detained under the MCA”—


Mental Capacity Act—

“and will include a line on this in our standard publications”.

The existing data shows that the number is very few—it is in single figures. But, although it is in single figures, the Act that we hope to put on the statute book does not want anybody: we do not want even one person detained, as they have been previously. We hope that the Mental Capacity Act will not be used.

In addition to this commitment in bold from the Minister in this letter, I am half-comforted, because the other half of the equation is what happens if people are to stay in the community but in specialised environments and with specialised staff to deal with what might be a crisis. We have mentioned that, with autistic people, there could be a meltdown, which can be quite traumatic for the individual and for the people around them dealing with them, but is not a psychotic incident—an autistic meltdown is not a psychotic incident and it does not warrant automatic admission to a mental health hospital. How are we to identify suitable places when these facilities are needed? Again, the Minister has made commitments to the services that should be available in the community for people with autism and learning disabilities to make sure that those services and facilities are available.

--- Later in debate ---

[Baroness Merron (Lab)]

I have heard from noble Lords that they are concerned with having transparency, holding the Government to account and being updated on the situation. I absolutely agree with all those points, which is why I am pleased to make that commitment. Parliament has a number of routes available to it to hold the Government to account. I have just outlined the manner in which we will be transparent and the way the Government will be held to account by having to do that. As always, parliamentarians have the ability to scrutinise in many ways.

[Baroness Browning (Con)]

My Lords, we have heard a lot of very salient and not just helpful but wise words in the debate on this group of amendments. I thank the Minister for standing at the Dispatch Box and making commitments that are now on the record with this Bill. When people ask what Parliament’s intention was, she has left us in no doubt on some important points, particularly on my amendment concerning the need to monitor the use of the Mental Capacity Act in respect of autistic people and people with learning disabilities. I am grateful that she has done that and for a similar commitment I think I heard her make around some of the concerns that the noble Baroness, Lady Hollins, had.

Finally, the Minister has not given us exact dates as to when implementation will take place. We imagine it may be staged—not all in one go—but before the end of this year, the committee upstairs will report on the post-legislative scrutiny of the Autism Act. That will cover a wide range of issues, particularly services to people with autism. I hope that, perhaps in her deliberations on this Bill, when she sees that report—I cannot predict what the outcome of that will be—she will take those into account as well. For certain, services provided under the Autism Act, if they are provided in a timely way, will reduce the number of services that will be needed under the Mental Health Act. It is not rocket science; it is pretty basic that if you provide those services, that downward spiral in mental health is reduced. With that, I beg leave to withdraw my amendment.

Amendment 1 withdrawn.