Mental Health Bill [HL]

Debate between Baroness Merron and Baroness Fox of Buckley

Committee stage
Monday 24th February 2025 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I was pleased to see these amendments as well. The noble Earl, Lord Howe, explained why they are important. He has conceded—I tried to imply the same in my own amendment—that it is not necessarily clear how best to raise these issues, but that we need to. If we are seen by the public discussing a mental health Bill, going through the whole thing and refusing to acknowledge one of the big controversies of recent times, which was a mental health issue, it will discredit the Bill when it becomes an Act.

In relation to the reluctance of the NHS trust to publish its investigation and the use of patient confidentiality, I note that the families of the victims saw this very much as an excuse and were very angry about that. It does not help us to have a discussion with the public about mental illness because it then seems as though murder was committed but, somehow, mental illness was used as an excuse. We have all heard that argument being used; that is why I referred to the fact that there was some dispute about whether Calocane should be sent to prison or to hospital. The more openness that we can give this, the less stigma and confusion there will be. We need to have this debate out in the open.

Finally, I have a question on the judge-led inquiry and what we now know from the investigation by the trust. How will that impact this Bill? How, practically, will we be able to incorporate what we have learned from that into our discussion on a whole new piece of legislation on mental health? It would seem that we need to be able to take on board some of the recommendations of the inquiry and what we now know from the investigation by the trust.

[Baroness Merron (Lab)]

My Lords, I thank the noble Earl, Lord Howe, for tabling Amendments 160BA and 160BB, supported by the noble Lord, Lord Kamall, and spoken to by the noble Baronesses, Lady Tyler and Lady Fox.

I say at the outset that I understand the deep concerns raised today by noble Lords. I would like to take this opportunity to express my sincere condolences, and I am sure those of the whole of your Lordships’ House, to the families of Grace O’Malley-Kumar, Barnaby Webber and Ian Coates. The Secretary of State and I have met the bereaved families following these horrific killings, and, rightly, important actions have been taken, which the noble Earl, Lord Howe, asked about. Indeed, we have to look at what improvements must be made, both at the trust and across the country.

To take this further, NHS England and the Nottinghamshire Healthcare NHS Foundation Trust have accepted all of the recommendations made following the Section 48 CQC review into this incident, and action has started on implementation. The recently published independent investigation into the care and treatment provided to Valdo Calocane makes a series of recommendations, which NHS England and the Nottinghamshire Healthcare NHS Foundation Trust have accepted. I reiterate that the Government expect to see swift action to ensure that the recommendations are implemented as soon as possible. As the Prime Minister has confirmed, and as the noble Earl, Lord Howe, acknowledged, there will be a judge-led, statutory public inquiry into this tragic incident.

I now turn specifically to the amendments, and first to Amendment 160BA. We recognise the importance of transparency when there are concerns around a patient’s care, to enable a full understanding of what went wrong and how learning can be applied as a result. The courts already have legal powers to request, and where appropriate compel, disclosure of relevant reports, ensuring judicial access to relevant information. In criminal and civil proceedings, courts can make orders that particular information be provided, or issue witness summonses, while coroners can obtain documents as part of an inquest. There is no clear evidence that courts face systemic barriers in accessing necessary information.

There are also existing mechanisms to provide robust oversight and transparency. NHS England’s patient safety incident response framework sets out clear guidelines for responding to serious incidents involving patients who are detained under the Mental Health Act. Additional scrutiny is provided through investigations by the Health Services Safety Investigations Body and oversight from the CQC.

If information is not disclosed, interested parties already have mechanisms to access information, including judicial review, freedom of information requests and the coronial process for deaths in detention. While courts have the powers set out in the amendment, we absolutely recognise the importance of openness in mental health services, which is why officials are working with NHS England to ensure that information from investigations is as transparent as possible—something that all noble Lords have rightly referred to.

Valdo Calocane: NHS England Report

Debate between Baroness Merron and Baroness Fox of Buckley

Thursday 6th February 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the seriousness of the points the noble Lord makes. As he is aware, the report to which we are referring is concerned with the care and treatment provided by health services to Valdo Calocane rather than questions of culpability. More broadly, I remind your Lordships’ House that the Prime Minister has committed to establishing a judge-led inquiry into these attacks. We absolutely understand the importance of an inquiry. Having met the families myself, it is crucial to provide families with answers and ensure that this cannot happen in the future.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the Calocane report is a devastating mix of horror at state failures. It echoes everything from the grooming gangs to Southport, and you just think, “How could this have happened?”. The Minister said that we are dealing with this in Committee on the Mental Health Bill. I query that because the report has only just come out, and it seems to me that the Mental Health Bill will need to change to reflect the lessons learned, as the noble Lord, Lord Balfe, said. Otherwise, we are ignoring it. Will the Minister reflect on how that is happening?

Secondly, did she notice the worrying detail that staff were nervous about forcing treatment because debates here in Westminster on racism in the mental health system meant that they stayed back—they were silent—because this patient was black? Can the Minister assure us that those kinds of politicised issues should now be swept away from all service provision and that we will tell staff that the ethnicity of the patient does not matter and that they have to act according to procedures?

[Baroness Merron (Lab)]

I thank the noble Baroness for the opportunity to clarify that my reference to the Mental Health Bill discussions was in relation to the three points raised by the noble Lord, Lord Balfe, rather than the detail of the report. As I said, the recommendations have been accepted in full, and there is a programme of work to take them forward and for full reporting back. In respect of the further comments the noble Baroness made, it is of course the care of the patient that matters and protection for both the patient—whoever they are—and the public.

NHS: Single-sex Provision for Staff and Patients

Debate between Baroness Merron and Baroness Fox of Buckley

Wednesday 8th January 2025 Lords Chamber

[Baroness Fox of Buckley]

To ask His Majesty’s Government whether they plan to issue guidance relating to single-sex provision for NHS staff as well as patients.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, all employers, including the NHS, are required to comply with existing law on single-sex facilities. In these cases, a common-sense and empathetic approach is needed. It is important that service providers have clear guidance about the Equality Act. We will consider whether further guidance is needed, including on how lawfully to apply its single-sex exemptions.

[Baroness Fox of Buckley (Non-Afl)]

I thank the Minister for that reply. I know that the Government value front-line health workers and I am sure that they are concerned to hear that NHS trusts are allowing ideology to deny nurses safety, privacy and respect at work. I am disappointed, however, that action is not more immediate. The Secretary of State, Wes Streeting, said that he was horrified by the case of the Darlington nurses being forced to share their changing facilities with a male colleague who identifies as female. Does the Minister agree that trusts need urgent guidance on this issue? I know that the Darlington nurses have submitted draft guidance to the department—

[Baroness Fox of Buckley (Non-Afl)]

Okay, the question is: can that guidance be brought forward, because nurses are being bullied and harassed at work around this issue?

[Baroness Merron (Lab)]

I am not sure that I can agree with the noble Baroness about trusts being driven by NHS ideology. All staff should be and must be treated with dignity, with their safety and privacy respected. Much of this is about practicalities and working with staff in the same way that other policies are worked with, and I would expect a common-sense and sensitive approach to prevail. The Secretary of State did indeed meet with the five nurses from Darlington regarding their concerns about single-sex spaces. We have indeed received a draft version of the guidance that they have produced and will reply to them at the earliest opportunity. However, the guidance that I would focus on is from the Government. We are looking at how we can assist all employers in complying with legislative requirements.

Puberty-suppressing Hormones

Debate between Baroness Merron and Baroness Fox of Buckley

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I do not recognise the last point that the noble Baroness made about the time. The aim is to start recruiting participants in spring next year and, as I mentioned, the National Institute for Health and Care Research is working with NHS England to develop the clinical trials. They are the first in the world and I will be very pleased to provide further information as and when it is available.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I commend the Secretary of State—and, indeed, the Minister. I commend the Secretary of State for his very clear Statement and for his courage, because he has had to stand his ground. He kept his cool, despite receiving unpleasant smears and abuse not only online, but even, to a certain extent, from the Back Benches in the other place.

I am slightly confused about something. I think we can see now that puberty blockers are a medicalised euphemism for chemical castration. The same kinds of drugs, when given to Alan Turing, were used as punishment for being gay. I am still not convinced, and do not really understand why the Government still think it is appropriate to conduct a clinical trial on children with these drugs. The Minister emphasised “uncapped” as though that was positive, whereas I thought that was scary.

As this medical scandal unravels, more and more young people are de-transitioning, but the NHS has no services to deal with this. I wonder whether the Minister would agree, perhaps, to meet some of the charities that are doing this kind of thing—there is Genspect’s Beyond Trans and its special service providers—just to discuss what the NHS might need to look at, moving forward in a different way.

[Baroness Merron (Lab)]

I very much welcome the generous and supportive comments of the noble Baroness, Lady Fox, in respect of the Secretary of State’s Statement. I am grateful for those. I note that she finds the reference to “uncapped” scary. I presented it as the way to gather the widest amount of relevant evidence, because that is a clinical trial; that is what is so important. The reason it is being done is that there is insufficient evidence and there has not been such a trial, and we need to do one for this particular situation.

In respect of meeting charities and others, the Secretary of State has been very keen to—what I would call—reset the relationship with various groups which all have different sets of thoughts on this. I have joined him in those meetings. He has also been meeting those with lived experience. We continue to do so. We have wanted to detoxify the debate, and those meetings have helped immensely. We will continue to have that listening ear.

National Insurance Contributions: Healthcare

Debate between Baroness Merron and Baroness Fox of Buckley

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with the comments of my noble friend Lady Taylor, who set out the government response very clearly in the last Question. I also share the view of my noble friend Lord Foulkes that it is important to be honest; I believe we have taken that on board as a new Government. That is why, for example, we commissioned the independent review by the noble Lord, Lord Darzi, to find out the state of the NHS in order that we could move forward. What the noble Lord found did not make for pretty reading, and it is our job to put this mess into a rather better shape than it is now.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, what has been described as “groans” might, in another language, be described as holding a Government to account. The Government are in charge now and have to answer the charges as put.

If the Minister is correct that the Treasury evaluated what the changes to employers’ national insurance contributions would be, the Government will have known that this was going to affect not just big nasty bosses but a wide range of employers—hospices, care homes and all sorts of charities. The hairdressing sector is being decimated as we speak. I just went and stood in the rain for two hours at the farmers’ demonstration, where tenant farmers pointed out that these national insurance changes will mean they will have to sack farm workers. This is having a wide decimating impact. If the Government are going to be honest, I hope they will talk to each and every one of the sectors and tell them that this is going to be resolved one way or another.

[Baroness Merron (Lab)]

This Government are very committed and are indeed talking to all sectors, including in my own department. As to the point the noble Baroness rightly raises about holding Governments to account, I welcome that. It gives me and my noble friends an opportunity to set out the plans, responsibilities and concerns of this Government. We will take them seriously and continue to work to get consensus wherever we can.