Mental Health Bill [ Lords ] (Ninth sitting)

Aphra Brandreth Excerpts

Committee stage
Tuesday 24th June 2025 Public Bill Committees

[Aphra Brandreth (Chester South and Eddisbury) (Con)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I rise to speak in strong support of new clause 13, tabled by the shadow Minister. The new clause would place a duty on the Secretary of State to review the functions and effectiveness of the regulatory authority, which is currently the Care Quality Commission, within one year of the passage of the Bill. The new clause is a timely, necessary and constructive addition to the Bill.

As colleagues will know, the Care Quality Commission plays a dual role in relation to the Mental Health Act. First, as the regulator of services, it ensures that providers meet fundamental standards of care and safety. Secondly, through its specific responsibilities in visiting and speaking to those detained under the Act, it ensures that people’s rights are protected and that the law is used appropriately and humanely. That is no small task. It is a balance that requires the CQC to be not only reactive but proactive, and not only independent but responsive to the lived experiences of patients—especially to the voices of the most vulnerable. That is why the new clause matters. As we bring forward significant reforms to the Mental Health Act through the Bill, and rightly modernise and improve safeguards and place greater emphasis on autonomy, dignity and therapeutic benefit, we must also ensure that our system of oversight and regulation is fit for purpose.

I welcome the direction that the Bill sets. Its four core principles are rightly placed at the heart of the legislation: choice and autonomy, least restriction, therapeutic benefit, and seeing the person as an individual. Those principles must shape the way that care is delivered on the ground. That means they must also shape the way that care is monitored, inspected and held to account. A review of the regulator’s role is not about criticism for its own sake; it is about ensuring that the regulatory framework supports and reinforces the ambitions of the Bill and that it can respond to emerging challenges, shine a light where services are falling short and, crucially, act to protect patient rights.

[Gregory Stafford]

My hon. Friend is being slightly charitable to the CQC. Given Penny Dash’s review, we all know that the CQC has significant problems, otherwise we would not be reviewing it. Does my hon. Friend agree that the new clause is absolutely vital because of the failures of the CQC up to this point, and our lack of faith in it being able to meet the challenges that this legislation will bring to the mental health sector? Does she also share our concern about the CQC’s ability to regulate and scrutinise properly?

[Aphra Brandreth]

My hon. Friend is absolutely right. We have seen examples where regulators have not intervened quickly or robustly enough, and where systemic issues went unnoticed or unaddressed for far too long. We need to strengthen the remit and ensure that the CQC is properly equipped and held to the high standards that we expect of it.

I am an economist by background, so evaluation is something I think about a great deal. Reform, however well intentioned, must be followed by evidence, scrutiny and a willingness to learn and improve. The new clause ensures that we do not just set change in motion, but that we stop to ask whether it is working, whether the right things are being done, and if not, how we can improve.

The review required by the new clause would look not only backwards at whether the regulator has effectively carried out its existing duties under the Act, but, crucially, forwards, assessing whether it is ready to meet the responsibilities placed on it by the new reforms. I particularly welcome the requirement for the review to be published and laid before Parliament. Transparency is essential. It would allow Parliament to scrutinise but also gives patients, families, professionals and the public confidence that those questions are being asked seriously and answered publicly.

Ultimately, the new clause is about improving outcomes. When regulation works well it safeguards dignity, prevents harm, identifies and spreads good practice, develops trust and helps us build a system where the principles of this Bill—choice, autonomy, less restriction and greater therapeutic benefit—are not just written in statute, but visible in practice. That is especially important in mental health care, where so often the people subject to the Act are among the most vulnerable. Those in in-patient settings, particularly those who are detained, are often not in a position to advocate for themselves. They rely on a system that is vigilant, takes its safeguarding responsibilities seriously and puts patients’ rights first.

I hope that all members of this Committee will support the new clause. It is collaborative in its intent, constructive in its purpose and essential to delivering the meaningful reform that we all want to see. It reinforces the importance of accountability, transparency and listening to those most affected by this legislation. We owe it to those individuals and their families to make sure that we not only change the law, but also the culture and oversight that surrounds it. This review would help us do exactly that.

[Stephen Kinnock]

I am grateful to the Opposition spokesman, the hon. Member for Hinckley and Bosworth, for bringing this issue forward.

Two major independent reviews into the Care Quality Commission have reported under this Government: one by Dr Penny Dash, on the CQC’s operational effectiveness as a regulator of all health and social care providers including those in mental health, the other by Professor Sir Mike Richards on its single assessment framework. The CQC has accepted those recommendations in full, and although we are confident in the progress that the CQC is making, we recognise that the reviews did not closely inspect its statutory role in relation to monitoring the use of the Mental Health Act.

Those powers and duties are entirely distinct from those that the CQC uses to regulate the health and social care sector under the Health and Social Care Act 2008. In recognition of that gap, as the Opposition spokesman pointed out, we committed in the other place to report on that specific aspect of the CQC’s role in the first of the Government’s annual reports on the implementation of the Bill, which will be laid before Parliament one year after Royal Assent.