Mental Health Act 1983

Debate between Alex Cunningham and Lord Beamish

Thursday 25th July 2019 Westminster Hall

[Alex Cunningham (Stockton North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hanson, and to follow not just the contribution from my hon. Friend the Member for Croydon North (Mr Reed), but the other speeches. Great expertise and understanding has been brought to the debate. I congratulate my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle) on securing the debate, and I thank him for sharing a very powerful and personal testimony as well as offering solutions to the crisis in mental health. So often we can blather away in places such as here in Westminster Hall; we can talk about the problems, issues and suffering, but sometimes we do not offer solutions. It is our job to come up with solutions, and my hon. Friend the Member for Bermondsey and Old Southwark and others have offered some.

As some colleagues might know, I have the privilege of chairing the all-party parliamentary group on social work. As my right hon. Friend the Member for North Durham (Mr Jones) said, we recently undertook an inquiry on the role that social workers play in upholding the principles outlined in the independent review of the Mental Health Act 1983, and on how that role can be recognised and enhanced in new legislation.

I believe that social workers are regularly, if not always, undervalued, yet their work is incredibly valuable in supporting and helping the most vulnerable people in our society—be it children at risk, older people in need of a bit more support, or families who experience breakdown and need the independent support that a social worker can provide. Of course, social workers also support people with mental health needs, although many people do not realise the tremendous role that they play in that. They ensure that mental health problems are not a barrier to anybody achieving the things they want, and that people get the appropriate treatment and care that they need.

Back in 2018, I met with two approved mental health professionals in my role as the chair of the APPG on social work. They are known as AMHPs—perhaps it is something to do with their electrifying personalities. They explained that there was a need to promote the role of social workers in mental health services, and I now understand why that is necessary. The legislation and policy often skim over the work of social workers, perhaps because it is so varied and hard to pin down.

In December, the independent review of the Mental Health Act 1983 published its report and recommendations. In preparation for a Government response, the APPG decided to have our own inquiry and add to that great piece of work. Some 9,000 social workers work in a defined mental health role, accounting for about 4% or 5% of the core mental health workforce, and 95% of AMHPs are social workers. I know it will take more than legislation to embed the kind of changes we would like to see, and work will have to be done by CCGs, local authorities, the NHS and social work leadership—to name but a few—if we are to succeed and get the change that is needed. I am hopeful that the APPG’s report and recommendations will act as a staging post on the way to cultural and legislative change.

[Mr Kevan Jones]

Was my hon. Friend impressed, as I was, when we met various people giving evidence to the inquiry? The best practice was where local authorities and the NHS were co-located and working closely together, rather than when it was being divided.

[Alex Cunningham]

Yes, that was most certainly the case. I shall remark on that a little later in my speech. I was really concerned to find that the number of joint working arrangements was diminishing rather than increasing across the country, but I will address that a little later.

I was surprised to hear in the evidence sessions that health and social care integration, which the Government are officially pursuing, is going backwards. My right hon. Friend spoke about that in detail. A key message from the APPG is that the Government need to urgently examine how they can better support the integration programme, arrest the decline and ensure that people work together. Social workers in health and in local authorities need to work much more closely together.

Integration in mental health services is about bringing the social mode into healthcare settings, where social approaches sometimes struggle to gain acceptance and respect when compared with the medical model. We do not suggest replacing one with the other but, as integration implies, a full marriage of the two models so that the needs of the individual are met in one place. Better still, a properly integrated social model would make sure that treatment and care planning were guided by the person in their own context, rather than fitting them into a pre-existing diagnostic box. Such an approach means greater consideration of the social determinants of mental ill health—factors such as socio-economic background, education, housing and family dynamics. We have heard examples of that throughout the debate.

The APPG report made several recommendations. The new mental health legislation should open with a definition of the social model and the importance of addressing the social determinants of mental illness alongside biological and psychological determinants; it should explicitly name social workers as the key professionals doing the work; Ministers should ensure that the team preparing new mental health legislation also produces guidance on how it is intended to interact with other legislation such as the Mental Capacity Act 2005 and the Equality Act 2010; the CQC should be mandated to provide an annual report to Parliament on the progress of health and social care integration; and social work leadership—this is particularly important—on trust and CCG boards is necessary. I think it is more than necessary; it is essential. They are professional people with a major and specific role and they should be at the table where the decisions are made.

The report also recommended that new mental health legislation must have greater regard to both health and local authority resources. My right hon. Friend the Member for North Durham talked about the lack of resources within the system. CCGs should be held transparently accountable for their duties under section 140 of the current Mental Health Act, or any new legislation, making sure that there are enough beds in the right places. The people detained under section 3 of the Mental Health Act should be reviewed by a social worker, and families and carers of all people detained away from home because of a lack of local provision should be provided with financial support. That point was raised by my hon. Friend the Member for Bristol East (Kerry McCarthy), who talked about the effect that it can have on families when a family member in crisis is 150 miles or more away. A national dataset on the number of Mental Health Act assessments should be established as part of the DHSC mental health services dataset. Those recommendations are not unreasonable. I hope that the Department for Health and Social Care will take note and address the gaps where professionals say that they are.

I recently had the opportunity to serve on the Bill Committee for the Mental Capacity (Amendment) Bill, and key issues that I and other colleagues raised still need to be looked at. During the passage of that Bill, I was quite surprised to find out that the Bill had not been subjected to any pre-legislative scrutiny, despite its central role of redeveloping the laws of this country for depriving people of their liberty. I said that I thought the Government needed to pause and think again about the implications of the plans that Ministers were putting before us, listen to the countless charities, other organisations and professionals who work with the legislation every day, and come back with a Bill fit for purpose. It should not have been about a basic political argument between the Government and the Opposition. It is about a debate between the law makers and the people, some of whom at a particular time in their life can be subject to some of the most restrictive legislation that we have. Sadly, at that time the Minister did not listen, and the legislation we are left with will need to be reviewed before too long. I feel the same about moving forward with reviewing our legislation in general around mental health, and perhaps putting new legislation to this House, but whatever it is, it needs to reflect wide views.

The legislation that we create or amend affects the most vulnerable in our society, as I have said before, but it should be considered with extra care and attention. I do not think that we did that in the recent Bill Committee, so we must include those who know what they are talking about, such as the professionals, the experts and the social workers—those who have worked on the frontline of mental health care and know where the gaps are and how we can ensure that we do better for those who receive care under mental health provision. We must and can do better. I hope that as we move forward, Ministers will listen and get it right.

Public Finances: Scotland

Debate between Alex Cunningham and Lord Beamish

Wednesday 3rd February 2016 Commons Chamber

[Alex Cunningham]

rose—

[Mr Kevan Jones (North Durham) (Lab)]

rose—

[Stewart Hosie]

I am conscious of the time, but I will take an intervention from the hon. Member for Stockton North (Alex Cunningham).

Further Education Colleges (North-east)

Debate between Alex Cunningham and Lord Beamish

Tuesday 26th January 2016 Westminster Hall

[Mr Kevan Jones]

rose—

[Alex Cunningham]

Will the Minister give way?

Local Government Finance Bill

Debate between Alex Cunningham and Lord Beamish

Tuesday 31st January 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I support the amendments on the impact of the scheme. This debate is about people’s lives, about families and people who live on the edge financially, but it is also about local authorities’ ability to deliver services at the standards we have come to expect in our communities. It is a debacle: the Government’s proposals on council tax benefit will simply heap greater burdens on the most vulnerable households and families at a time when the Secretary of State for Work and Pensions is already making life tougher for them. I would have hoped that the Secretary of State for Communities and Local Government had at least talked to his counterpart at the Department for Work and Pensions to ensure that their policies did not conflict in the way they clearly do. The amendments would help to deal with some of that conflict.

“Make work pay.” That is what the Prime Minister has said over and over again, and he is determined to make that happen. No one could or should argue with that statement, but it is vital to create incentives so that it is always better to be in employment than on benefits. The Government’s proposals on council tax benefits will totally undermine that objective. They are simply yet another attack on hard-working families.

I know that council tax benefit is available to those on low incomes who need financial help to pay their council tax bill, but I am shocked that Ministers appear to believe that a 10% cut to the benefit will somehow—perhaps magically; we talked about magic earlier on—reduce the number of people who need it. In these harsh economic times, with high and rising unemployment as well as rising energy and food bills, this tax relief is to be squeezed precisely at the point when there is the greatest need for help among low-income households. As others have said, pensioners and vulnerable households are to be protected, and rightly so, from the cuts, but that means that the whole of the 10% saving that local authorities must make will fall on the unprotected group—mainly the working poor.

[Mr Kevan Jones]

In his response to the previous debate, the Minister suggested that gap could be filled by councils being able to levy extra tax on second homes, and his hon. Friend the Member for Bradford East (Mr Ward) said there were plenty of those in Bradford. How many does my hon. Friend think there are in Stockton?

[Alex Cunningham]

That is an interesting question, which I wish I could answer. I do not see many empty homes, never mind second homes, in our area, so I think it might be a challenge for us to find some. I am sure we have a few, but I doubt they would fill the gap as the Minister suggests they could. In an authority such as Stockton, with high numbers of older people, the burden on the people the measure hits will be tremendous.

The burden will get higher and higher on ever fewer people. In many cases, the gains made by the working poor from the recent £1,000 increase in the income tax personal allowance will be completely wiped out by the reduction in council tax benefit and the knock-on effects. Surely that is exactly the opposite of what the DWP says it is trying to do? Are the Secretaries of State talking to each other? I wonder. Alongside the rise in VAT and other benefit changes, we are faced with these regressive policies that will hit some people extremely hard—people who already work hard for little reward. These proposals are simply a slap in the face for their efforts to improve their lives.

The Local Government Association has calculated that councils are being asked to share the £500 million cut among 1.3 million claimants, which works out at an average loss of £320 each. That is a significant sum for low earners, especially when the Government claim they are trying to protect work incentives for them. It has been estimated that council tax support for pensioners makes up 50% of the total funding, and roughly a further 25% recipients would also be exempt from the reductions in support because of councils’ duties to support vulnerable groups and tackle child poverty. Such people should of course be exempt, but that could lead to the 10% budget cut falling on the remaining 25% of recipients—on the support provided to low-paid people in work. Those people are working hard for their families, trying to do their best. They have pride in what they are doing, yet this Government are just kicking them.

Local Government Finance Bill

Debate between Alex Cunningham and Lord Beamish

Tuesday 24th January 2012 Commons Chamber

[Mr Jones]

They did. If local authorities have to lay people off mid-year and sever contracts, that costs local government more. In County Durham, when we had those in-year cuts, it cost the council more money to sever contracts than it would have cost to allow them to fulfil them. No money was saved, but things were made very difficult for local councils, not only to plan their budgets but to manage services.

[Alex Cunningham]

My hon. Friend mentioned Alcan—a major organisation—and the tragedy in Northumberland. Does he recall when Samsung walked out of the Wynyard Park estate on Teesside, devastating the business rates in that area and throwing many people on the dole? Does he agree that a local authority’s fortunes could rest on the whim of multinational corporations, which can move in and out at will? There is all the more need for a proper safety net for local authorities that face that sort of dilemma.

[Mr Jones]

My hon. Friend makes a good point and Samsung is a good example. Its inward investment provided jobs and income to the local authority. Such situations are more relevant in rural areas or constituencies such as his and mine in the north-east of England. When one single, large employer leaves, there is a disproportionate effect. I do not want to talk again about Westminster city council, but a single employer leaving that area does not have as devastating an effect on the employment base and on the local tax take.

Another thing that the Bill does not take into account is the increased demand on local government services when there are large closures such as the one to which my hon. Friend referred. There is bound to be more take-up of, for example, council tax benefit, even though the Bill cuts it by 10%. The Minister was on the letters page of The Journal in Newcastle trumpeting the Bill and saying how great it is, but he did not mention that it would come with a 10% cut in council tax benefit. He will be pleased to know that I have written to the paper to correct him and to ensure that readers of The Journal have the full facts about the Bill rather than the propaganda he is trying to put out.

Another concern is the centralisation of powers. The Bill gives power to the Secretary of State to decide the levy. In addition, as we have no definition of “disproportionate effect”, that is down to the Secretary of State’s whim. When we look at what the Secretary of State has used his powers for in the past 18 months, we see that he supports and rewards people who vote for his party—I take my hat off to him, because he is quite political. If we do not have a definition of “disproportionate”, what is to say that he will not use the Bill to assist regions that he wishes to assist for political reasons?

The Bill means that the current or a future Secretary of State could punish councils that he or she does not favour, or that do not support one of his or her central diktats—the current Secretary of State talks about decentralisation but intervenes quickly to decide what local councils should do. If we do not have a definition of, or explanation for, “disproportionate” in the Bill, a lot of council chief executives and treasurers will be in fear each year of not keeping in with the Secretary of State, because he or she will determine whether they will get the budgets that their councils need.

Business of the House (Thursday)

Debate between Alex Cunningham and Lord Beamish

Wednesday 8th December 2010 Commons Chamber

[Mr Jones]

We will have to see what happens, but a very important point was raised earlier about the amount of time that will be available for Government Front Benchers to reply to the debate tomorrow. If we have a packed House with a lot of speakers, there will be limited time for Ministers to explain to the British public the policy that they are putting forward.

[Alex Cunningham (Stockton North) (Lab)]

I am grateful to my hon. Friend and fellow north-east MP for giving way. Tonight I have spent some time with the North East of England Process Industry Cluster, which tells me that it recruits many graduates in the north-east. I am sure that it will share my concern that those graduates—its feedstock—may not be available in future if these student fees are imposed. Does my hon. Friend agree that that is another good reason why we need more time to debate this important issue?

[Mr Jones]

My hon. Friend makes a good point. I told the Whips tonight that I was giving up the opportunity to dine with people from north-east industry, so I have given up that very nice dinner and an opportunity to discuss with those individuals, who are very important to the north-east, higher education and other issues.