Mental Health Patients: Discharge

Debate between Lord Bradley and Lord Markham

Tuesday 5th March 2024 Lords Chamber

[Lord Markham (Con)]

The noble Lord is correct. I agree that it is important that the funds are spent on discharging mental health patients at a community level. I do not have the percentage figures to hand, but I will make sure that I provide them to him.

[Lord Bradley (Lab)]

My Lords, I declare my interests as in the register. Does the Minister think that there are lessons to be learned from the excellent RECONNECT programme by NHS England? It is being rolled out across the country and tries to ensure that vulnerable people, such as those with mental health conditions, are reconnected to local services, and that their release from custodial settings can be successfully undertaken.

[Lord Markham (Con)]

Yes, in a word. We must try to make sure that each integrated care board has a mental health lead in place and that the services are rolled out. Much of the strength of the ICBs is that they can look after the needs of their area in ways that they know best. At the same time, where there is good practice, we must make sure that it is rolled out as well.

Allied Health Professionals: Prescribing Responsibilities

Debate between Lord Bradley and Lord Markham

Tuesday 6th February 2024 Lords Chamber

[Lord Bradley (Lab)]

I beg leave to ask the Question in my name on the Order Paper and declare my interests as listed in the register.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

In September 2023, we completed two consultations to amend the Human Medicines Regulations to enable dental therapists, dental hygienists and pharmacy technicians to supply and administer medicines without the need for a prescription. We aim to publish the consultation response in the next few weeks. In December 2023, the Misuse of Drugs Regulations 2001 were amended to enable independent prescriber paramedics and therapeutic radiographers to prescribe certain controlled drugs.

[Lord Bradley (Lab)]

I thank the Minister for that response, but primary and community health services, particularly general practice, are under great work- force pressure and waiting times for patients are unacceptably long. Although the plan to extend pharmacy prescribing is welcome, an important next step must be to extend appropriate independent prescribing and referral rights to a wide range of allied health professionals, including speech and language therapists, occupational therapists, diagnostic radiographers and many more similar professions.

As the Minister will know, the Lords Integration of Primary and Community Care Committee’s recent report supported this, and there was previously an unpublished NHS scoping report. Will the Minister now publish that report and act on the Lords committee’s recommendations to quickly implement the benefits for speedy and integrated patient care?

Mental Health Act 1983

Debate between Lord Bradley and Lord Markham

Tuesday 21st November 2023 Lords Chamber

[Lord Bradley]

To ask His Majesty’s Government what plans they have to reform the Mental Health Act 1983.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

We are committed to improving the care and treatment of people detained under the Mental Health Act, including taking forward non-legislative commitments such as culturally appropriate advocacy, as well as continuing to expand and transform NHS mental health services. I am grateful to the noble Lord and his colleagues on the Joint Committee for their work on the Bill to date, and I assure him that it remains our intention to bring forward a Bill when parliamentary time allows.

[Lord Bradley (Lab)]

My Lords, for over six years, the Government have promised to reform the 1983 Act, from manifesto commitments to the Wessely report, draft Bills and consultations, and now the Joint Committee which reported to this House in January of this year— 11 months ago. Then, to the astonishment and no little anger of thousands of people with mental ill health, autism and learning disabilities, who have been supported by their tremendous advocates, there has been deafening silence from the Government. Now the proposed Bill has been completely dropped from the legislative programme. There is a real feeling of frustration across the country about this situation. Will the Minister now give a real explanation so that we can try and restore the breakdown of trust that has come about from this situation?

[Lord Markham (Con)]

I understand the frustration and disappointment about the fact that the Bill has not been brought forward. I am keen to focus on what we can do in the meantime. Of course the Bill is trying to decrease the rate of detention and, within that, decrease the racial disparities, such as the fact that a black person is four times more likely to be detained than a white person. There are a number of things that I hope we will be able to discuss more, particularly in the debates on Thursday as well, such as the things we have introduced in pilots, like the culturally appropriate advocacy. That really can make a difference here and now.

Nursing Courses: Reduction in Applications

Debate between Lord Bradley and Lord Markham

Tuesday 19th September 2023 Lords Chamber

[Lord Markham (Con)]

Yes, my understanding is that all the workings behind the long-term workforce plan are currently being analysed by another body— I am not quite sure whether it is the NAO, the ONS or whoever. The point is that all the modelling and the underlying assumptions are being analysed, and I believe there will then be a report on them so that everyone can see what we are trying to do and how reasonable those assumptions are.

[Lord Bradley (Lab)]

My Lords, the University of Salford, where I am chair of council, has seen applications for adult nursing down by 28%, children’s nursing down by 27% and mental health nursing down by 6%, with an overall drop of 23%. From the feedback the university is receiving, the main barrier is that the financial support needed to undertake a highly intensive course, which leaves little time for part-time working, is insufficient to meet the current cost of living. Does the Minister accept that this is a factor in the drop in applications, and will the Government review the financial package of support available to nursing applicants to ensure, as we have heard, that the NHS workforce plan is deliverable?

[Lord Markham (Con)]

Clearly, as the largest employer in the UK—if not most of the world—the NHS always has to be looking at the whole package that it is offering its staff to make it an attractive place to recruit good talent and retain it. The point that the noble Lord makes is absolutely correct, and those are all things that need to go into the mix. As I say, recent data is encouraging. We have increased the numbers by 45,000 and are on course to hit the 50,000 target, but, as ever, we need to be vigilant because we want to recruit a lot more.

Mental Health In-patient Services: Improving Safety

Debate between Lord Bradley and Lord Markham

Monday 3rd July 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness. The points she rightly makes are exactly what we believe is the remit of the new HSSIB review starting from October. One of the specific points is about developing safe therapeutic staffing models for all mental health in-patient services. I think and hope that the exact points raised by the noble Baroness will be addressed by the review.

[Lord Bradley (Lab)]

My Lords, the Government’s draft mental health Bill proposes—and I and the Joint Committee support this—the banning of prisons as a place of safety and the transfer of patients within 28 days of the mental health assessment to a safe mental health secure unit. Will the Minister ensure that this is included in the national review, so that there are sufficient local safe secure facilities to implement the 28-day recommendation and that these patients are cared for in genuine places of safety?

[Lord Markham (Con)]

I understand the concern brought, quite rightly, by the noble Lord. It would be best for me to write on that, so that I can give the specific position and he can have the detail he requires.

Adult Social Care

Debate between Lord Bradley and Lord Markham

Monday 20th February 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely, and that is the whole intention behind the ICSs: the ability in their areas to know local needs and invest in the right places—that is, in social care rather than having people in beds in hospitals, because it is a much more effective use of resources, and also in primary care. We all know that a lot of people go to A&E because they have not got primary care services, so the whole point of the ICSs is that they start to invest where demand is in the area, rather than using hospitals as the place of last resort to go to.

[Lord Bradley (Lab)]

My Lords—

--- Later in debate ---

[Lord Bradley (Lab)]

My Lords, I too was a member of the Select Committee. One of the other key recommendations of our report was the establishment of a commissioner for care and support, to act as a champion for older adults, disabled people and, crucially, for unpaid carers, and that we should prioritise to ensure a review, update and implementation of the Care Act. Do the Government support these proposals?

[Lord Markham (Con)]

Again, we welcome the report and many aspects of it. What I and my ministerial colleagues care most about is having the results and the impact. I think—and hope that noble Lords will agree when they see the work that she is doing in this space—that Minister Whately is gripping it and providing results. Let us see how that progresses first, because I think that that will have the impact that we need.

Mental Health Act Reform

Debate between Lord Bradley and Lord Markham

Thursday 26th January 2023 Lords Chamber

[Lord Markham (Con)]

No, I hope that all noble Lords will see that there is no sense of delay on this side—and we are not waiting for the legislation to introduce a lot of these measures. It is very important, and we are ready to push on as soon as parliamentary time allows.

[Lord Bradley (Lab)]

My Lords, declaring my interests in the register, particularly as a trustee of the Centre for Mental Health and a member of the Joint Committee, perhaps I might press the Minister on one of our key recommendations: to establish a statutory mental health commissioner to oversee the implementation of the draft Bill, which we fully support, and to have a laser focus to ensure consistency across the country in the services required, underpinned by investment in community services. Unless those are forthcoming in a timely way, the Bill’s intentions will be undermined. Will the Minister confirm today that he will accept the recommendation for a mental health commissioner?

[Lord Markham (Con)]

I hope noble Lords accept that the report came out only last week and we need a little time to consider it. What I can say is that we are all focused laser-like on making sure that change is happening in this space. If the best way to do that is by appointing a mental health commissioner, that will have my support. At the same time, I am very aware that ICBs are responsible for this, and I want to give them the space to make sure they can properly manage mental health and other health services in their area.