Draft Mental Health Bill

Debate between Lord Duncan of Springbank and Baroness Merron

Tuesday 28th June 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I start by thanking Professor Simon Wessely for his independent review of the Mental Health Act 1983, an outdated piece of legislation that far too often has facilitated the inexcusable treatment of those with mental health problems.

Yesterday, the Secretary of State for Health said that the report made “uncomfortable but essential reading”, and indeed it did. When it is at its best, legislation supports the saving and improvement of people’s lives, and I am sure that all sides of your Lordships’ House intend that this Bill will get us to this point.

In supporting this overhaul of the legislation, pre-legislative scrutiny will be crucial, not least because it gives an opportunity to build consensus. Can the Minister provide details of timescales and arrangements for this scrutiny? While the Government have adopted most of the recommendations of the review, can the Minister comment on the ones that have not been accepted and the reasons for doing so?

It is welcome that this Bill contains a number of improvements. It gives people more say over how they are treated. It prevents the use of Section 3 of the Act on those who are autistic or have a learning disability but do not have a mental health condition. There is the new duty on clinicians to consider a person’s wishes and feelings and involve them in decision-making before deciding whether to treat them. There is access to advocacy and statutory care and treatment plans, which will give more transparency and accountability to clinical decision-making and put people’s choices first. All of these and others are welcome.

However, there is a need for the Government to go further. In the debate in the other place, the Secretary of State replied to many of the concerns raised by saying that the new, cross-government Building the Right Support plan would answer a lot of them. Can the Minister confirm when we can expect the plan and what it is likely to cover? When will we see the proposed new 10-year mental health plan and 10-year suicide prevention plan?

Black people are over four times more likely to be detained under the Mental Health Act. Can the Minister confirm whether the Government have any intention to review community treatment orders, which are evidenced as coercive, as not reducing readmissions, and being disproportionately applied to black people? Will the guiding principles suggested by the independent mental health review be included, as these would strengthen people’s rights and help focus decision-makers on eliminating racism? How will the mental health equality framework be advanced so that there are culturally appropriate services and the freedom for local areas to respond to the needs of their specific populations?

On young people, will the Minister look to see the Bill strengthened in making reforms for those young people? Will he address the failure to give under-18s the right to make advance decisions to refuse treatment? Without this, they will be unable to access enhanced treatment safeguards in the same way as adults. Will he also look at the lack of a statutory decision-making test for those who are under 16 which could also render many of these reforms ineffective for the youngest and often most vulnerable people in the system? It is of note that Anne Longfield, the former Children’s Commissioner for England, said that the profit-driven care system was failing vulnerable children. Following reports in today’s media and the MacAlister social care review, what action will the Minister take to put this right?

On the new criteria for detention, will the Minister review this too? Ensuring that fewer people are inappropriately detained is a crucial intention of the reforms, and changes are very much needed to significantly reduce this practice.

Staffing levels are crucial to ensuring quality mental health services. These Benches have been calling for the recruitment of 8,500 mental health staff to treat 1 million additional patients a year, so can the Minister confirm when we will get the Government’s vision for their workforce strategy?

I look forward to the Minister’s response, and if he is unable to answer all my questions today, I would be grateful if he would write to me. Modernising the Mental Health Act will undoubtedly help make mental health services more equitable, compassionate and effective. I am sure that these are aspirations we all agree we must work towards.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely.