Mental Health Bill [ Lords ] (Ninth sitting)

Debate between Anna Dixon and Stephen Kinnock

Committee stage
Tuesday 24th June 2025 Public Bill Committees

[Stephen Kinnock]

I am grateful to the hon. Member for Winchester for bringing this issue, which was also debated extensively in the other place, before the Committee. Our view has not changed: the functions of the proposed commissioner clearly duplicate existing responsibilities of other organisations, most notably the Care Quality Commission. The Children’s Commissioner has expressed concerns that introducing a new mental health commissioner risks interfering with her own role in relation to children and young people’s mental health.

We recognise that the patient quality and oversight landscape is not working effectively, but I strongly doubt that inserting another body whose role overlaps with those already in place would help to address that issue. The landscape is already cluttered and fragmented. That is why last year we asked Dr Penny Dash to assess whether the current range and combination of organisations deliver effective leadership, listening and regulation for the health and care systems in relation to patient and user safety, or whether a new delivery model is needed. We will shortly see the results of her much-anticipated review.

We appreciate that our argument that the proposed mental health commissioner’s role would be duplicative of the CQC has previously been met with concerns about the effectiveness of that organisation. I reiterate that two major independent reviews into the wider role of the Care Quality Commission have reported under this Government, the recommendations from which the CQC has accepted in full. While we are confident in the progress that the CQC is making, we recognise that those reviews did not closely inspect the CQC’s statutory role and responsibilities in relation to monitoring the use of the Mental Health Act.

Therefore, in response to an amendment tabled in the other House, we committed to report on the CQC’s monitoring functions under the Act in the first of the Government’s annual reports on the implementation of the Bill. That will include reflections from the new chief inspector of mental health, Dr Arun Chopra, on the CQC’s statutory functions and its role as a key partner in delivering the reforms. I am looking forward to meeting Dr Arun Chopra very shortly in his new role.

Lastly, creating a mental health commissioner with a supporting office would require significant resources that we simply cannot justify. The original Mental Health Act commission was brought within the CQC to reduce Government spending and realise the benefits of aligning the CQC’s functions under the Mental Health Act with its functions under the Health and Social Care Act 2012, and to give it new powers to monitor via potential enforcement. Bearing in mind the radical reforms that we are making to the national health system to rid it of duplication, inefficiency and waste, we believe that now is not the time to reverse course on these matters.

[Anna Dixon]

I commend the work that the Minister and Penny Dash are doing to look at patient safety and the changes going on at the CQC. Could he reassure us that, within scope, he is also looking at the role of the Parliamentary and Health Service Ombudsman? There seems to be some confusion about whether complaints under the Act fall to the CQC or the PHSO.

[Stephen Kinnock]

The Dash review is looking at the landscape regarding all the different institutions and organisations, including the PHSO and the CQC, to map out how they interact with each other. Our view is that there is a lot of confusion and a lack of clarity, but we await the outcome of the review. I can confirm, however, that Penny Dash is looking at those matters. For those reasons, I ask the hon. Member for Winchester to withdraw the motion.

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[Stephen Kinnock]

I am grateful to the hon. Member for Winchester for bringing this issue before us. We are committed to closely monitoring the quality of in-patient care and driving continuous improvement in services. Indeed, we are already in the process of doing that, and a further review is not necessary to drive the changes forward.

The CQC’s role is to monitor the quality of in-patient services. Its annual “Monitoring the Mental Health Act” report specifically discusses the in-patient environment, and considers the quality of accommodation under the 1983 Act. The independent review in particular made a recommendation to replace dormitory provision with private rooms. To date, the NHS has invested £575 million in doing that, and we are committed to completing our programme of investment.

[Anna Dixon]

I draw attention to Lynfield Mount hospital in my constituency, which provides mental health in-patient care. It has a fantastic plan for upgrading its facilities, but at the moment it has secured only a proportion of the capital funding. Will the Minister meet me and local NHS leaders to see whether we can close the gap in the capital funding for that facility?

Mental Health Bill [ Lords ] (Eighth sitting)

Debate between Anna Dixon and Stephen Kinnock

Committee stage
Thursday 19th June 2025 Public Bill Committees

[Stephen Kinnock]

Police stations are not appropriate places to hold people in need of mental health treatment. The Mental Health Act 1983 (Places of Safety) Regulations 2017 amended the 1983 Act to set a high threshold for using police stations as places of safety. Uses have reduced from over 8,000 in 2012-13 to just 322 in 2023-24 across England and Wales. While that number is mercifully low, the Bill will, under the principles of therapeutic benefit, end the use of police cells as places of safety. Instead, when police exercise powers to remove a person from a public space or private premises for the purpose of a mental health assessment, they will take them to a suitable place of safety, such as a hospital.

[Anna Dixon (Shipley) (Lab)]

I declare an interest: my sister practises as a psychiatrist within the NHS, as the Minister knows. She has seen the important shift away from the use of police stations as places of safety and towards making sure that all patients have access to a place of safety in a healthcare setting. I know from my local police that, while they do their best to support people in distress in a police station, it is not the right place. This is the right thing to do, and I support the Government’s move.

[Stephen Kinnock]

I ask my hon. Friend to pass on our thanks to her sister for the vital work that she does in what I know can often be a challenging environment—we appreciate it. My hon. Friend is absolutely right that this is an important principle. There has been a remarkable drop in the use of police cells, which is to be warmly welcomed. We think that now is the time to make it clear, on the face of the Bill, that a police cell is not an appropriate place for these purposes.

The clause’s amendment to sections 135 and 136 of the Mental Health Act will not change the police’s ability to intervene when someone is in a mental health crisis, nor their ability to detain someone in a cell when exercising their powers in relation to criminal, or suspected criminal, activity. The clause will prevent courts from temporarily detaining people with severe mental illness in prison as a place of safety while they are waiting to access a bed for treatment or assessment under the Mental Health Act. Under the reforms, a defendant or convicted person who meets the criteria for detention under the Mental Health Act for treatment or assessment must be transferred directly to hospital, or, in the case of children, to a hospital, surgery, community home or other place that the court considers suitable, ensuring that they receive swifter access to the care they need. I commend the clause to the Committee.

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[Anna Dixon]

It is clear from what the Minister is saying that there are widespread concerns among health professionals about the change that was proposed in the other place, which would effectively give police powers to health and care professionals. Can he reassure psychiatrists such as my sister, and others working in mental health services, that they will always be able to rely on and work closely with their police colleagues to have that back-up when they are entering somebody’s home to potentially detain them?

[Stephen Kinnock]

I absolutely can give my hon. Friend that assurance. There has to be a team-based approach to this work. In any successful team, it is about ensuring that everybody knows their role and that everybody’s role within that team is appropriate. There has to be good collaboration and co-ordination.

That is why I must say that I am quite taken aback by the attempts in the other place to insert these clauses; I do not think that is a safe way to make legislation. That is why it is so important that we remove the clause from the Bill.

The statement that I referred to earlier, by all those eminent organisations, called it a

“radical proposal with a number of serious and potentially dangerous consequences”.

It also says:

“Delegating police powers to professionals without consulting them, or patients would be a very damaging way to make policy.”

It is important to restate what I said in an earlier sitting, namely that the majority of assessments under the Mental Health Act happen without police involvement, and that action is already under way to further reduce the amount of police involvement. However, we of course recognise the pressures that the police are facing and that police involvement can be stigmatising for people who are detained. Almost all police forces in England and Wales are implementing the “right care, right person” approach, a police-led initiative to reduce inappropriate police involvement in cases where people have health or social care needs. There has already been a 10% decrease in section 136 detentions in the year ending March 2024.

There remain certain circumstances in which the police play a vital role in keeping particular people and the wider public safe. A blanket approach of extending powers in sections 135 and 136 to other professionals may not necessarily address the issues being faced by police officers and could create other unintended challenges. For example, while the current Act deliberately sets out who has what powers in what situations, a blanket extension of the police’s powers under sections 135 and 136 to other professionals—giving multiple agencies the same powers—risks confusion over who should respond in an emergency situation and could lead to delays in action as services try to decide who should act. That would be counter to our shared aim of ensuring that people in a mental health crisis get the right support as rapidly as possible.

We are also concerned that giving health and social care staff statutory powers that increase the number of situations in which they may have to use reasonable force could have unintended risks for the safety of staff, patients and the public.

[Dr Shastri-Hurst]

I rise to speak briefly to clause 50, which expands the authority to remove individuals under Mental Health Act powers by allowing trained and authorised non-police personnel to carry out removals that previously could be carried out only by police constables. A couple of key changes arise from the clause.

First, the clause provides for the inclusion of authorised persons by amending sections 135 and 136 of the 1983 Act. That will allow individuals other than police officers, if they are authorised—“authorised” is the important word—to remove and transport people under Mental Health Act powers. That provides wider operational flexibility, and includes removals under warrant, by virtue of section 135, and without a warrant in public places. It is predicated on the fact that those authorised persons are appropriately trained and designated. Prior to the clause being inserted into the Bill, only police officers could carry out removals.

Mental Health Bill [ Lords ] (Second sitting)

Debate between Anna Dixon and Stephen Kinnock

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[Anna Dixon]

I thank the Minister for setting out so clearly the importance of the annual ministerial statement. Does he envisage that the statement will also give an update on the extent of community provision available and the execution of the transition of people with learning disabilities and autism from institutional settings to community settings closer to home? Is that within scope of the statement?

[Stephen Kinnock]

I think the short answer to my hon. Friend’s question is yes. The written ministerial statement will be an update on the work done over the preceding 12 months, but it absolutely will also be a forward plan, so it will set out the next actions that the Government will take, what the broader, long-term change delivery process will be, the institutions that will need to change and how they will change.

A number of colleagues have also asked the question, “What does good look like?” In many ways, it is absolutely right that we, as a Government, are being held to account on the content of the Bill, but there will be a really important accountability moment 12 months after it gets Royal Assent, which will be that written ministerial statement. I fully expect every colleague in this room to read that in great detail and hold the Government to account, both on what has been achieved over the preceding 12 months and, importantly, on what the forward plan looks like.

I think that covers most of what I wanted to say, although one additional point I would make is that the amendments could have the unintended consequence of requiring Government and local areas to set out unfunded or speculative plans ahead of any funding settlements, which would affect their credibility. It is more effective to set out plans when they are ready, when we have a clear line of sight on funding and deliverability.

We also need time to engage with expert stakeholders to inform implementation planning. We know that sufficient community services cannot be achieved without wider system reforms beyond health, and details contained in any plan must also consider the context of the 10-year health plan and the independent commission into adult social care, chaired by Baroness Casey. For that reason, I thank hon. Members for their contributions and invite them to withdraw amendment 20 and not to press amendments 24, 10, 22, 21 and new clause 11.

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[Stephen Kinnock]

That does clarify it. I will absolutely discuss that with officials. It is clear that we need a complete picture of the prevalence of people reporting to emergency departments and then having to be extracted from them and put into other facilities. That is an important point. We clearly need to think more about this issue and consult further. Obviously, understanding the data is a very important part of that. I cannot give the hon. Gentleman a nailed-on commitment to do that, but I give him a nailed-on commitment to discuss it with officials. It is possible that the data is already out there. We need to find that out.

We have heard concerns that there is a lack of clarity about what legal powers are available to health professionals to hold someone in emergency departments until they can be assessed. However, it is a complex issue that requires extreme care and caution. We have committed to continue to explore the issue. We will engage with stakeholders to understand how the current legal framework is applied, and identify solutions to the problems raised. We will provide further guidance on the existing legal framework, including the handover process from police to health, in the next revision of the code of practice. We are also taking steps to address current operational pressures. NHS operational and planning guidance for this year tasks local health systems to improve patient flow through mental health crisis pathways and to reduce waits of more than 12 hours in emergency departments.

[Anna Dixon]

Will the setting up of more health settings—places of healthcare and of safety—help to address the issue?

[Stephen Kinnock]

Yes, I think that is right. We have a commitment to creating—either building or repurposing—facilities for more acute mental health settings. We have also created the 111 mental health line. We have a commitment to 8,500 more mental health specialists. We are committed to having a mental health-trained person in every school in the country.

I hope that all those wraparound measures will help in the overall role that we play in the community, and identify people with challenges in a way that will help to support them and, one hopes, avoid them getting to the acute stage. My hon. Friend is absolutely right to point to some of the wraparound measures that the Government are pushing forward.

For the reasons that I have outlined, I ask the hon. Member for Solihull West and Shirley not to press amendments 52 and 53 and new clause 24 to a vote.

Hospitals

Debate between Anna Dixon and Stephen Kinnock

Wednesday 23rd April 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I am glad you recognised me from the Chair, Mr Speaker. I have lost some hair since we last spoke.

I beg to move an amendment, to leave out from “it” to end and insert:

“also notes that the Chancellor has announced new fiscal rules to ensure capital budgets can no longer be cannibalised, with transfers from capital to resource budgets not permitted; recognises that the previous Government left a New Hospital Programme which was unfunded, unrealistic and undeliverable; welcomes that the Government has taken action to review that Programme and has published the New Hospital Programme Plan for Implementation, to put the Programme on a sustainable footing; supports the Government’s investment in the Plan, which will increase to up to £15 billion over each consecutive five-year wave, averaging around £3 billion a year from 2030; and further supports the work being done to bring forward construction of the reinforced autoclaved aerated concrete replacement schemes wherever possible, to ensure that patient and staff safety is prioritised.”

The amendment on the Order Paper is in the name of my right hon. and learned Friend the Prime Minister. I thank the Liberal Democrats for using their Opposition day to address a matter of vital importance for so many Members, including many colleagues right across the Chamber and their constituents. I sincerely hope that the Liberal Democrats will work with us on solutions, not on soundbites, because we need to be realistic about the problems we face and serious about how we tackle them.

The new hospital programme was announced by the last Government to much fanfare in October 2020, with a promise to deliver 40 new hospitals by 2030. We were told that there was a plan and a timetable, and we were glibly assured that it was fully funded, but from the outset it was clear that there were not 40 new schemes—some were just refurbishments or extensions. To put it simply, there were not 40 projects, they were not all new and many of them were not even hospitals.

The spin around the programme was widely questioned and challenged before the general election, but nevertheless we were truly shocked by what we found on entering the Department of Health and Social Care. The programme was hugely delayed, by several years more than had already been revealed by the National Audit Office. There was no credible plan to deliver the building projects, let alone to deliver them all in the next five years, and there was not even enough construction capacity in the UK to build all the hospitals in the new hospital programme by 2030. That is why when the hospitals with reinforced autoclaved aerated concrete were brought into the NHP in 2023, even the last Government had the sense to admit that nine schemes would have to be delivered past 2030 in order to prioritise the RAAC hospitals.

Perhaps most shocking of all, the funding for the programme was due to run out a month ago, with no provision whatsoever for future years: the money simply was not there. The programme was built on nothing more than false hope, dodgy claims and disingenuous press releases.

[Anna Dixon (Shipley) (Lab)]

Does the Minister share my constituents’ anger at the failure of the Tories to back up any of their promises about new hospitals? Will he reassure me that my constituents who are served by Airedale general hospital will finally get a new hospital to deal with the RAAC in an affordable, deliverable timetable, unlike the false promises of the Conservatives?

[Stephen Kinnock]

My hon. Friend is a doughty champion for her constituents, and she is absolutely right. The point she makes raises the even bigger issue of trust in politics and the trust that her constituents have in this place. That trust was fundamentally undermined by the disingenuous nature of what went on with the previous hospital programme. The British people are grown up enough for us to be able to level with them, be straight with them and say, “This plan is credible and affordable. It’s based on facts, not fantasy.”

Oral Answers to Questions

Debate between Anna Dixon and Stephen Kinnock

Tuesday 7th January 2025 Commons Chamber

[Stephen Kinnock]

My hon. Friend raises an important point, which provides an opportunity for us all to reflect on the incredible work of those working in our health service; they are, in many ways, heroes, and we should absolutely acknowledge that fact. We need to explore the point he has raised—we could meet to discuss it further, or I would be happy to write to him.

[Anna Dixon (Shipley) (Lab)]

In England, more than 200,000 people were waiting for an autism assessment in September 2024. In my constituency, some adults have waited more than two years for an autism assessment, and one child has been waiting eight years—and is still waiting—to receive support from child and adolescent mental health services. These delays have a profound impact on people’s lives. Will the Minister commit to the mental health investment standard and ensure that as the Government reduce waiting times, they do so for both physical and mental health services for young people and adults?

[Stephen Kinnock]

We remain absolutely committed to the mental health investment standard. We have prioritised the expansion of NHS talking therapies and individual placement and support schemes, and provided £26 million of capital funding to open new mental health centres. However, we are not complacent on this issue. My hon. Friend spoke about autism assessments, which is a red light that is flashing on my dashboard. I would be happy to discuss that further with her.