Mental Health Bill [HL]

Lord Bishop of Manchester Excerpts

Committee stage
Wednesday 22nd January 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, as has already been acknowledged, I have put my name to Amendment 63, tabled by the noble Baroness, Lady Whitaker, and Amendment 65, tabled by the noble Baroness, Lady Tyler. Both of them have done a comprehensive job of introducing the amendments so I will be extremely brief.

The noble Baroness, Lady Whitaker, is well known in your Lordships’ House for championing the many issues affecting Gypsy, Roma and Traveller people. I particularly wanted to sign Amendment 63 because it is a very broad-ranging amendment—it is crucial that everybody gets culturally appropriate forms of explanation. It struck me as we were debating that we are focused now on mental health, but I think this probably would also apply right across the NHS to physical health because there are, of course, cultural differences in understanding our bodies, et cetera.

If we imagine the case, perhaps, of a refugee who suffers mental health difficulties, having fled their home country, where they were subject to abuse by the authorities. It is important to make sure, if they are to be sectioned, that that is carefully explained to and understood by both the patient and potentially the patient’s family. There needs to be an extra level and a sensitivity to that person’s circumstances. We will all have different circumstances, but it is important to look at it in that broad frame.

On Amendment 65, we have already canvassed quite extensively the way in which minoritised communities are currently seeing significant disparities in the way they are treated under the law in the area of mental health, particularly in community treatment orders. The noble Baroness, Lady Tyler, described this as a probing amendment. Whether this is the exact means or not, it is clear that we have to have much better data and to make sure that as soon as trends and patterns emerge in that data, they are acted on. It is encouraging to hear that this is being piloted and work is being done but it is crucial that this becomes standard and that is why it is tempting to feel that it really has to be in the Bill.

[The Lord Bishop of Manchester]

My Lords, I support all the amendments in this group. I also want to communicate the support of my right reverend friend the Bishop of London, who apologises that she cannot be in her place this evening.

Turning to the amendments led by the noble Baroness, Lady Whitaker, on culturally appropriate care, I appreciated the noble Baroness’s references to the Gypsy, Roma and Traveller community. I have worked with that community much over many years and very much enjoyed my interactions with it.

These amendments highlight issues that my right reverend friend has spent a lot of time considering, particularly from a faith perspective. I do not think we have heard that in the debate so far tonight. It is sometimes hard to grasp just how differently our health, especially our mental health, is culturally understood across different communities and faith groups. While our ability to discuss our own and others’ mental health may be generally improving—I think it is—it remains an extremely difficult discussion point for many cultures and many communities.

When you combine that with the extensive inequalities of outcomes that we find, and many people’s experiences of culturally inappropriate care in mental health and other settings, it is inevitable that many people are reluctant to engage with preventative services. It was said at Second Reading that minoritised communities are likely to engage at a crisis point rather than seek early interventions. My wife worked for many years as a maths specialist in the home and hospital tuition service of a large urban authority. She regularly found that she was working with pupils whose mental health needs had been picked up late, if at all, because the culture of the parental home saw mental health issues as shameful, and not something you could raise with external service providers. So culturally appropriate care is a crucial step if we are to build the trust that is ultimately vital to reducing health inequalities.

In order that culturally appropriate care is deliverable, training on faith literacy, as well as different cultures and beliefs, will be crucial. Again, I have found that myself; I have been working with my fellow faith leaders in Greater Manchester, including the excellent Caribbean and African Health Network. I make no apology for banging on about religious literacy in your Lordships’ House on yet another occasion: it does really matter. Service providers in all sectors do us a huge disservice when, through their own faith illiteracy, they operate with a presumption that religion matters only in the realm of private affairs. Getting it right in this Bill will of course necessitate additional resource. In supporting these amendments, I hope that sufficient resources will be allocated to this work.

I turn finally to Amendments 65, 133 and 138, in the names of the noble Baroness, Lady Tyler, and the noble Lord, Lord Kamall. I am a statistician by background. We know the importance of good and useable data to ensure that we have an understanding not just of the gulfs of inequality of outcomes but of the more nuanced and complex patterns that lie underneath them. Amendment 133 recognises the need for regular training and has a consultation element as part of the policy. I hope this will be taken up and I hope that will include consultation with faith groups. We must commit to work with such groups to build trust with communities that service providers are wont to call hard to reach. I do not believe we should call any group in our society hard to reach. What we do have, all too often, are service providers who just do not make enough effort to reach. So instead, let us work with organisations such as CAHN, which I mentioned earlier, to ensure earlier interventions than those we often see.

I also warmly welcome Amendment 138, which, as others have said, highlights an appalling scandal in our society. I thank the noble Lord, Lord Kamall, for tabling that amendment.

[Lord Davies of Brixton (Lab)]

I know the hour is late, but I want to note the irony that the issues covered by these amendments are central to the whole process of why we have arrived at this Bill. In a sense it is unfortunate that, because of the hour, there are so few of us present. I want to stress that we cannot assume it is job done. It is really important to keep this whole area under review, whether we do it precisely in the terms of the amendments before us or not. I urge my noble friend the Minister to give an assurance that this issue will not be left for another 17 years before we decide that we have got it right, and that the workings of the Bill in this central area will be kept under close and continued review.

--- Later in debate ---

[Baroness Merron (Lab)]

I was about to say that I do understand the need for pace, but I know that noble Lords understand the need to get this right and I know they are not suggesting that we should get it wrong. I will certainly be glad to look at the points that have been raised. I assure noble Lords that I do not want this to be warm words and I understand what noble Lords are seeking. I want to ensure that it is right and that the pace is right. I will look at the points raised because—although I do not think anyone is accusing me of this—it is the exact opposite of avoiding accountability and transparency; it is just about dealing about what is in the amendments.

The noble Lord, Lord Kamall, asked me a number of very pertinent questions and to do justice to them I will write to him. In conclusion, I hope that noble Lords—

[The Lord Bishop of Manchester]

Before the noble Baroness sits down, could I tease out from her a few words about the religious literacy point that myself and the noble Baroness, Lady Berridge, raised earlier? While we have rightly focused much on race and ethnicity this evening, which is important, I find that sometimes people take a pride in being religiously illiterate and in not paying attention to somebody’s faith in a way that they would probably not take a pride, as a professional, in not attending to somebody’s ethnic background. Does the Minister have a little word to say about that?

[Baroness Merron (Lab)]

I suspect that the right reverend Prelate knows where I would be coming from on this. He and the noble Baroness, Lady Berridge, are quite right that consideration of one’s religion and religious practices and not making assumptions about them are absolutely crucial.

Health and Social Care: Winter Update

Lord Bishop of Manchester Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Baroness for bringing her comments before the House and for acknowledging our efforts, direction and commitment, because this is not easy and, as she knows, will not happen overnight. However, we need to tackle delayed discharge, following the point made by my noble friend Lady Winterton, through the development of local partnership working between the NHS and social care and making sure that the right support is there to return home—if that is the best place for people—or for an intermediate arrangement. This should not be just an issue of hospital or home; sometimes people need facilities along that trajectory, because they have different needs and their conditions do not stay still. That is why it has to be local partnerships.

Every acute hospital has access to a care transfer hub which brings together professionals from the NHS and social care to manage discharges of people with more complex needs who need extra support. We will shortly publish the better care fund policy framework, which will drive greater impact from over £9 billion of public spending on integrated care. Reducing delayed discharge will be a key part of that. I heard the request from the noble Baroness. She will understand that we have to take account of the financial situation we inherited, but we also need innovation, creativity and practicality to find answers to these very long-standing challenges.

[The Lord Bishop of Manchester]

My Lords, the nurse who was attacked and injured at work recently and who has been kindly mentioned several times already today is a member of one of our Oldham congregations. I assure your Lordships’ House that she and her family remain very much in our prayers in Manchester.

Research by the National Churches Trust published last year shows that the ministry of the UK’s church buildings saves the NHS £8.4 billion every year. Church projects help keep many people out of hospital; they support others when discharged. Other faith communities do similar work and many of them do it in partnership with us.

Secondly, the problem in winter—even in the balmy climate of Manchester—is that it gets cold. Part of the work to prevent serious illness lies in keeping people warm and offering them social contexts where some early signs of declining health can be picked up before they become too serious. Many of my churches in Manchester, along with other places of worship all across the nation, take part in the Warm Welcome Campaign which does precisely that. They are open maybe for a morning and offer a free lunch as well as a warm space where people can just socialise and not worry about their heating bills.

Does the Minister agree with me that places of worship make a vital contribution to the nation’s health and save the NHS money? Will she not only join me in thanking them but ensure that those of her ministerial colleagues who are presently considering whether the Listed Places of Worship Grant Scheme should be extended beyond the present financial year are apprised of these facts?

[Baroness Merron (Lab)]

I made a call for creativity, and I compliment the right reverend Prelate on his creativity; I will certainly pass on his comments to my colleagues. I am delighted to agree with him about the importance not just of places of worship but of communities, including faith communities. As the right reverend Prelate said, we can find the finest examples of community provision which support the NHS and social care through churches, synagogues, mosques and other places of worship. I pay tribute to and thank all those that do this. Of course, this is overwhelmingly done by volunteers, and I pay tribute to all of the volunteers in faith communities and beyond.