Mental Health Bill [ Lords ] (Second sitting)

Aphra Brandreth Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

The new clause also requires a formal consultation process, ensuring that the plan is developed with the people it affects the most: individuals with learning disabilities, autistic people, their families, clinicians and advocates. I know that the Government will point to ongoing engagement with stakeholders and that is, of course, welcome. What we are asking for here is guaranteed participation that is enshrined in law.

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

My hon. Friend is making an excellent speech. The new clause is incredibly important. We do not want vulnerable people to slip through the cracks and not receive the right support, and it is really important to ensure that there is consultation with the right stakeholders. I recently met with Down Syndrome Cheshire, and last year I met with the Cheshire West and Chester SEND accountability group. They said that one of the things they value most is being listened to so that they can inform the process. Does my hon. Friend agree that that is a really crucial part of new clause 11?

[Dr Evans]

My hon. Friend speaks to the heart of what we all know from our constituency day jobs, where many of us here in this place speak to outside organisations and families. On Second Reading, the hon. Member for St Neots and Mid Cambridgeshire talked passionately about the impacts and the sorry stories that we have all heard about. The whole point of this Bill is to make mental health care patient-centred, but also family and advocate-centred. That is a driving thrust of what the Secretary of State for Health and Social Care was asking us for, and it is why we have enshrined the individual in the first clause of the Bill.

My hon. Friend is absolutely right: if we are committed to the principle enshrined on the front of the Bill, we need co-production. That must be more than a tick-box exercise. If the Government believe that the necessary plan is already in place, will the Minister say where that is covered, and would he put that plan in the House of Commons Library? Is it fully costed? Has it been fully consulted on? Will it be published within 18 months and incorporated in the NHS long-term plan? If not, how will the ICBs and local authorities be expected to deliver? How will the changes to NHS England affect plans to deliver the legislation? Having the legal duty to produce a costed plan will provide a focal point and fulcrum to build around, to ensure that the most serious mental health conditions receive the attention they need.

I know the Minister cares deeply and wants to do his best. He wants the legislation to be enacted as swiftly as possible. I also recognise the commitments and priorities facing the country, but this new clause is about turning good intentions into action. I simply aim to strengthen the hand of the Minister when it comes to negotiating with the Chancellor about funding, so that he has the evidence base required to bolster his position. I hope hon. Members across the Committee, especially on the Government Benches, see it as a supportive, sensible, balanced and practical solution to have this debate and then campaign with the Chancellor to get the money needed for the services.

Turning to the Lib Dem amendments, I begin by recognising the genuine intent behind amendments 10, 22, 24 and 21. Addressing the needs of people with autism and learning disabilities, particularly ensuring appropriate crisis accommodation and reducing unnecessary detention, is unquestionably important. That said, I have specific concerns about legislating for service provision in the Bill.

I understand why we do not legislate for the number of intensive care units, hospices or detox centres in the health system. There is an argument that that might be a good idea. Those are critical services, yet their commissioning and capacity are generally managed through policy funding decisions and local planning, rather than through statutory duties. Introducing a statutory duty for crisis accommodation risks unintended consequences. It may limit the flexibility of integrated care boards to respond to local needs, and could impose significant new resource burdens without clear funding commitments. That risks setting a precedent for increasingly prescriptive legislation across health and social care, which we should approach cautiously. We do not want to pit one condition against another.

On the proposed requirement on the Secretary of State to produce a commissioning plan within four months, I acknowledge the desire for a timely response. The choice of a four-month deadline, however, seems arbitrary and may not allow sufficient time for robust consultation and realistic planning. We need to be mindful that rushed plans can undermine long-term success.

On the proposed reporting requirements, although transparency is vital, I highlight that new clause 11, which we are proposing, would provide stronger and more detailed mechanisms to hold the Government to account on implementation and resource allocation, while allowing flexibility. We should focus on supporting those provisions rather than layer on multiple overlapping reporting duties, which risk duplication and confusion. In conclusion, the amendments raise important points and I look forward to the Minister’s response.

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[Aphra Brandreth]

I rise to make a few remarks on new clause 11, which would require a costed plan to ensure that ICBs and local authorities are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under part II of the 1983 Act.

We need to ensure that there is a fully cost-effective plan with accountability to support those with learning disabilities. For instance, Cheshire West and Chester council, one of the local authorities in my constituency of Chester South and Eddisbury, has let down parents, families and those with learning difficulties because of its poor management. It has come at the cost of adequate provision, particularly in school places, and therefore puts more people at risk of mental health problems because they are not getting the support they need in the community.

With the measures outlined in new clause 11, we could go a long way to ensuring accountability. I am sure the Minister will agree that we need to ensure that commitments are backed by funding for the good of those who need SEND support. I urge all those on the Committee to reflect on the value of the new clause. Crucially, it would also require the costed plan to be informed by a consultation with a range of stakeholders. That is incredibly important, because we need to listen to the lived experience of those who are often extremely vulnerable to ensure that they receive the right support. In my intervention, I referred to some of the important groups in my constituency. Down Syndrome Cheshire and the Cheshire West and Chester SEND Accountability group are just two examples, but there are so many more. They are clear that they value being listened to, so that they can inform the process.

The new clause would ensure a costed plan, where commitments are not just words, but backed by funding. Crucially, it would mandate a formal consultation process to inform the plan, incorporating the view of a broad range of stakeholders, including those with lived experience such as those I mentioned in my constituency. There are individuals, carers, healthcare providers and advocacy groups whose voices all matter. We need a plan that is costed so it can be delivered, and that, crucially, reflects the needs and rights of those most affected. I fully support the new clause.

[Stephen Kinnock]

I thank hon. Members for this set of amendments, which draw attention to the important matter of implementation and community support for people with a learning disability and autistic people. I heard this issue raised many times on Second Reading.

I will begin with amendment 20. I am grateful that this important issue has been raised. Although he has not been appointed to the Committee, I know that the hon. Member for St Neots and Mid Cambridgeshire has spoken powerfully and movingly about the tragic circumstances surrounding the death of Declan Morrison, his constituent, and the need to ensure effective and timely community-based support.

Proposed new section 125E of the Mental Health Act, provided within the Bill, already requires integrated care boards and local authorities to seek to ensure that the needs of autistic people and people with a learning disability can be met without detaining them. That should be driven by the specific needs of the local population, informed by the dynamic support register. That requirement already covers any relevant needs for crisis accommodation. We expect, and will set out in statutory guidance on dynamic support registers, that they will cover any relevant needs for crisis accommodation.

In contrast, the amendment seeks to place a prescriptive legal requirement to ensure provision of a specific service in all circumstances, irrespective of what people in the area actually need. That would have the unintended effect of restricting integrated care boards in designing provision and allocating resources in the most effective way to meet people’s needs.

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[Chris Bloore (Redditch) (Lab)]

On a point of order, Ms Furniss. Could we have some clarity on what adjourning the Committee right now would mean? Several members of the Committee have not returned from the Division, and it would be good to know the implications if we adjourn now.

[Aphra Brandreth]

The Conservative members of the Committee all came back at 5.40 pm, when we were asked to return.

Oral Answers to Questions

Aphra Brandreth Excerpts

Tuesday 25th March 2025 Commons Chamber

[Stephen Kinnock]

I absolutely agree. The state of NHS dentistry in our country is shameful. The golden hello scheme enables 240 dentists to receive a £20,000 joining bonus payment to work in dental deserts, and we are negotiating with the British Dental Association the long-term reform of the contract. The issue is not the number of dentists in the country, but the paucity of dentists who are doing NHS work.

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

The north-west has some of the worst levels of children’s oral health in England, with Cheshire and Merseyside falling below the national average. In rural villages in my constituency like Bunbury, where bus services have been cut, and Kelsall, where a dentist is keen to open an NHS practice but faces barriers due to city centre prioritisation, residents are struggling to access NHS dental care. Given the challenges of rural access, what steps is the Minister taking to ensure that NHS dental provision is available in those rural communities?

[Stephen Kinnock]

I find it quite striking when Conservative Members stand up and describe the abysmal state of NHS dentistry. It makes me think, “Well, who created this mess in the first place?” But that is as an aside. The fact is that we have the golden hello scheme for dentists to come and work in so-called dental deserts. We recognise that the fundamental problem is around incentives for dentists to do NHS work. That is why we are doing a long-term contract negotiation to ensure we have an NHS dentistry contract that is fit for purpose and where every penny allocated to NHS dentistry is spent on NHS dentistry.

Obesity: Food and Diet

Aphra Brandreth Excerpts

Monday 20th January 2025 Commons Chamber

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

I am grateful to the hon. Member for Stroud (Dr Opher) for securing this debate on the important subject of the impact of food and diet on obesity. Over the past 30 years, as has been noted, obesity has been the subject of over 700 food-related health policies in England. Yet, while successive Governments have recognised the immense challenge of obesity and have sought to tackle it through various strategies, schemes and mandates, obesity rates have remained excessively high.

Although, over the past five years we have seen adult obesity rates stabilise and the number of children who are overweight or obese fall to the lowest level since 2000, there is so much more work to do to address this issue, which is having an alarming impact on people’s health. In the UK today, more than one in 20 cancer cases are linked to excess weight, and obesity is predicted to overtake smoking as the leading preventable cause of cancer in women by 2043. It is estimated that, by 2035, the cost of treating type 2 diabetes will exceed that of treating all cancers today.

Alongside this health crisis comes a phenomenal financial cost. The NHS currently spends £6.5 billion a year on obesity-related illnesses. Indeed, the independent national food strategy cited an even larger figure of £18 billion, with diabetes care alone already accounting for nearly 10% of the NHS budget. We must act now to address this issue. We do not have another 30 years to get this right; nor can we afford another 700 policies.

We cannot just look for easy wins on this subject. Rather, we should look for a meaningful, transformative policy shift and not fall foul of previous mistakes. In the past, approaches by Governments have not always been joined up in understanding the whole food cycle, from supplier to shop shelf. Political and economic decisions have contributed to that. If we are serious about reforming the food system, the Government will have to implement a strategy that engages producers of all sizes, from small businesses to large corporations, across the supply chain, to give consumers a choice when they make their weekly shop.

Although it may seem in some respects that we now have access to more food options and choices than ever before, for many people those choices are often limited by cost. Too often the cost of healthy options is increasing while the cost of ultra-processed foods decreases. In the UK, the majority of our diets are now made up of ultra-processed foods. Growing evidence links UPFs and adverse health outcomes, so it is vital that more research is done to ensure we are making informed policy decisions.

We need to ensure that it is not just the large food manufacturers that are dominating the discussion and leading the market, and that we are creating opportunities and spaces for smaller, innovative food producers to contribute to the debate and help to provide solutions to some of the challenges we face. Part of the solution means working with our farmers, who already produce some of freshest, healthiest food to high animal welfare standards of anywhere in the world. The produce of the farmers in my constituency is second to none: Cheshire beef and dairy products are some of the most nutritious, natural and tasty on the market. We need to ensure our farmers and food producers are part of the solution, and that we strive to connect people to where our food comes from.

Just as we need a joined-up approach across the supply chain, we need a joined-up approach across Government. The Department for Environment, Food and Rural Affairs and the Department for Health and Social Care can publish a strong food strategy, but it will need involvement from the Treasury to ensure the path from farm to fork or supplier to shelf is supported.

I have talked about choice and the impact of food prices for families who are trying their best to make healthy choices, but alongside cost limitations are the limitations on people’s time. My husband and I both work full time and, as a mum, I know from experience that after a long day at work, all too often the easy option is to pick up some food on the way home that is convenient but perhaps not that healthy for us and our family. I know there are thousands of hard-working parents across Chester South and Eddisbury—indeed, the country—who will know what I am talking about.

We as legislators, and supermarkets as the gateway where people buy their food, can take steps to improve choice for consumers, both financially and in relation to convenience, that will help us to become a healthier nation. For instance, supermarkets could have a section with ingredients next to healthy recipes, shortening the time the consumer would need to be in the shop and encouraging them to try new and nutritious meals.

We can and must do more to address this issue. We must connect people with where their food comes from, have a frank conversation about the impacts of ultra-processed foods and deliver research to ensure we have evidence to make meaningful change. We need to support smaller businesses, working with them as they develop innovative ways to produce and market their products, and ensuring they have a voice at the table, alongside the large suppliers and supermarkets. We need to understand the challenges that families face with the costs and time constraints of busy family life, and ensure we are doing all we can to help them navigate a path to healthy, nutritious and tasty food.

In conclusion, I hope the Government will look at delivering a food strategy based on cross-party consultation that will address the food system from supplier to shelf, because the cost of obesity for individuals and for society as a whole is unsustainable and is a health crisis we cannot ignore.