Mental Health Act 1983

Baroness Buscombe Excerpts

Tuesday 21st November 2023 Lords Chamber

[Lord Markham (Con)]

I understand the frustration and disappointment about the fact that the Bill has not been brought forward. I am keen to focus on what we can do in the meantime. Of course the Bill is trying to decrease the rate of detention and, within that, decrease the racial disparities, such as the fact that a black person is four times more likely to be detained than a white person. There are a number of things that I hope we will be able to discuss more, particularly in the debates on Thursday as well, such as the things we have introduced in pilots, like the culturally appropriate advocacy. That really can make a difference here and now.

[Baroness Buscombe (Con)]

As the chairman of the inquiry, I reassure noble Lords that my noble friend the Minister is very aware of our frustration. However, I am pleased to hear—I am sure others are too—that, along with others in the department, he is looking to see what we can achieve without primary legislation. Could he and his officials focus on the further development and implementation of, for example, advanced choice documents, which would really make a difference to the dignity and choice that people with mental health issues thoroughly deserve? Could he also, as he touched on, really research and respond to why a highly disproportionate number of black men are unfairly detained?

[Lord Markham (Con)]

I thank my noble friend for her question and for her work on this. The advanced choice documents are a perfect example, like a birth plan, of where people can put in place what their hopes are for the future. There are good examples at King’s College and at South London and Maudsley of what they are doing in this direction, and I am really keen to learn from those and expand them further. I am also keen to invite all the participants to a round table that Mental Health Minister Caulfield has agreed as well, where we can really talk about the action that we can take on the ground to implement as many things as we can to rectify the problems in this space.

Mental Health In-patient Services: Improving Safety

Baroness Buscombe Excerpts

Monday 3rd July 2023 Lords Chamber

[Baroness Buscombe (Con)]

My Lords, I would like to begin the questions, as chair of the recent Joint Committee on the Draft Mental Health Bill. I say to my noble friend the Minister that we accept—I accept, certainly—that this Government are committed to improving mental health care across England. However, there is a strong sense of disappointment. Having published this report on 15 January, after a huge amount of work—I am proud to say it was an incredibly collegiate cross-party committee, across both Houses, and we came up with 55 recommendations with great care—we have had one short note from the Minister in another place, Maria Caulfield MP. It said that there was much consideration going on, and obviously both the Department of Health and Social Care and the Ministry of Justice are involved. The note said the response was in an advanced state and that we would be hearing from her in due course. However, we are now in July.

I believe it is hugely important that the Government demonstrate, rather more than they have so far, their commitment to improvements across the piece in mental health care. We are in a good place on support, but that support will wane unless the Government can really show commitment. I know there is an issue with the parliamentary timetable and so on, but the Government could at least respond to our 55 recommendations.

In addition, I have suggested to the Secretary of State a couple of things that could be done prior to legislation—in fact, a number of things in our report could be implemented without primary legislation. For example, on 26 February, I was actually quite unwell but I still met some civil servants at the Department of Health to discuss an incredible app that has already been developed for the palliative care world to support people in crisis. This app could be easily translated at very reasonable cost to support people having a mental health crisis. I was accompanied by—

[Noble Lords]

Question!

[Baroness Buscombe (Con)]

A question is coming. I was accompanied by a brilliant consultant, Julia Riley. She has not even had a cursory note of thanks from those civil servants. Could the Minister therefore please respond by giving a little more detail on the timing? Could he also let me know whether there has been any progress on developing that particular app? I would also like to know about the implementation of safe places, where people can go when they are in crisis.

[Lord Markham (Con)]

I thank my noble friend for her tireless work in this space. We believe that a number of constructive points were made in the committee report, which I know Maria Caulfield is working on and looking to get a timely response to. Maybe that is something on which we can meet up and discuss later.

Mental Health Act Reform

Baroness Buscombe Excerpts

Thursday 26th January 2023 Lords Chamber

Asked by

[Baroness Buscombe]

To ask His Majesty’s Government what reforms they are proposing to the Mental Health Act 1983.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Government published their draft mental health Bill on 27 June 2022, which contains our intended reforms to the Mental Health Act 1983. I am grateful to the joint pre-legislative scrutiny committee on the Bill for its report, which was published last week, on 19 January. The Government will now review the committee’s recommendations. We will respond in the coming months and introduce a revised Bill when parliamentary time allows.

[Baroness Buscombe (Con)]

I thank my noble friend the Minister for his comments on the Joint Committee’s report. I had the privilege of chairing its inquiry and I am grateful for the contributions of Members of both Houses. The Government must of course spend time considering with care our recommendations, but as a committee we feel strongly that a Bill should be introduced to Parliament as soon as is practicable to bring about the really important reforms to the mental health system that people so dearly deserve. Will my noble friend give an assurance that the Government will introduce a formal Bill to Parliament in the current Session?

[Lord Markham (Con)]

First, I thank my noble friend and all noble Lords who took part in the pre-legislative scrutiny committee. I think all noble Lords agree that what we are trying to do with the mental health Bill is a very good thing. We would like to bring it forward as soon as we can. From my side, I know that we are ready to go, but we are working with the parliamentary authorities to make sure that we can get the legislative time. We want to do it as soon as possible.

Respiratory Syncytial Virus

Baroness Buscombe Excerpts

Thursday 19th January 2023 Lords Chamber

[Lord Markham (Con)]

I can report best on nirsevimab, which has just been licensed, is shown to be 75% to 80% effective in the trials and has the approach of immunising people for six months. I am aware of Pfizer developing a maternal vaccination for whooping cough, which will give the baby immunisation through the mother. The House will also be aware of the recent announcement we made with Moderna on the investment in new R&D facilities here, so that we are at the forefront. I hope the noble Lord can see that we are looking at all these new innovations and will roll them out.

[Baroness Buscombe (Con)]

My Lords, have we not learned some lessons, from Covid and long Covid, of the need for children, babies and all of us to build our immune systems? Long Covid is proving that we have a real problem. I caught this virus from my granddaughter, a baby. I am told that the more she catches these wretched things now, the healthier she will be and the better she will be at putting off some serious diseases later in life. While accepting that high-risk babies obviously need particular regard, is it not right that we should be mindful of continually looking for a vaccine every time a new virus is discovered?

[Lord Markham (Con)]

My noble friend is correct in that, for the vast majority of people—infants in this case—it is mild, flu-like symptoms at most. At the same time, it is responsible for 35,000 hospitalisations and 20 to 30 deaths a year, so it is a serious thing that we need to get on top of. We are looking for the best of both worlds. That 90% of two year-olds will have had RSV and so will have that natural protection is a good thing. But in the most serious cases—the risk groups are those with congenital lung or heart disease or spinal muscular problems—these new treatments really will help and are very important.

Abuse and Deaths in Secure Mental Health Units

Baroness Buscombe Excerpts

Wednesday 9th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree, and I have been asking similar questions around whether we should be looking for a special measures-type regime in this space. To be fair to the new CEO, who has come in from 2020, he has set out a plan and progress is being made on many steps. It is the focus of the Minister to see whether that progress is quick enough. We understand that staffing is a key issue. We have increased the number of staff by 24,000 since 2016, and almost 7,000 in the last year alone. Clearly, part of this rapid review needs to be around staffing.

[Baroness Buscombe (Con)]

My Lords, I currently chair the Joint Committee scrutinising the draft mental health Bill. This is an important Bill and is the subject of both Houses on a cross-party basis. We hope to publish our recommendations in the middle of January. Will my noble friend reassure me and the whole House that great care will be taken to consider the recommendations we put to the Government and that an early response will be brought forward in the light of the fact that it is incredibly important that we see this legislation through as soon as possible?

[Lord Markham (Con)]

I thank my noble friend for the work that she and others are doing in this space. I agree that we need to respond rapidly. As I said, this is very high on Minister Caulfield’s agenda, and I assure my noble friend that we will be looking to respond quickly.

Covid-19

Baroness Buscombe Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The noble Baroness, Lady Meacher, is entirely right in the way that she explains things. The driver of that decision is the need to get our prevalence rates and the velocity of the infection down to a reasonable level, so that we have reasonable resources to keep R down by track and trace. I remind her that South Korea, which has used this technique most effectively, does only 20,000 tests per day, because its prevalence levels and velocity of infection are so low.

[Baroness Buscombe (Con)]

My Lords, I should like to say how encouraged I am by what my noble friend the Minister has said today on the progress made in tackling this virus. In asking my question, I stress that I have been urged so to do by many businesses, large and small, across the country—the backbone of our economy.

Will the Minister and his colleagues now accept that we must expect a second wave of the virus, even though we do not know when? If so, it is now crucial to look at working both with and beyond the science, and to take a balanced, proportionate and, frankly, brave decision, with Cabinet colleagues, to put trust in the good sense of the public to ease the lockdown as soon as possible—to allow the economically active to return to work, while retaining sensible social distancing —given that the situation is now having a devastating effect on our economy, and on our ability to afford our NHS, our welfare system, education system and other public services into the future.

[Lord Bethell]

I note my noble friend Lady Buscombe’s question, but I reject the sentiments behind it. I do not regard a second wave as inevitable; I do not share her fatalism. The priorities of the Government are to save life and to protect the NHS and our care system. That requires us to lower the prevalence level, reduce infection and put in place systems such as track and trace to keep a lid on the disease so that we can protect life and our systems.

Health: Maternity Care Provisions in East Kent

Baroness Buscombe Excerpts

Thursday 13th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend is, as ever, very wise on this. A key plank of the maternity safety strategy, launched in 2016, is a number of initiatives to improve not only clinical care but culture in maternity services. They have been designed to improve leadership and to ensure that in every trust there is a midwife, an obstetrician and a board-level maternity safety champion to spearhead improvement. It is critical that we ensure that this is delivered so that incidents such as this do not occur.

[Baroness Buscombe (Con)]

My Lords, there is no question but that our maternity services across the piece are under enormous pressure. We know that in 2017, somewhere between 30% and 40% of all babies born in the UK were born to foreign nationals. Will the Minister tell me, in broad terms, do foreign nationals, when they have babies in this country, make a financial contribution?

[Baroness Blackwood of North Oxford]

People are entitled to free NHS care if they are ordinarily resident in the UK. However, my noble friend’s wider point about the pressure on maternity services was absolutely right. That is why, in February 2018, the Government announced an additional 3,650 training places for midwives. I am pleased to say that the first 650 began their training in September 2019 to ease the pressure, and there will be 1,000 training places for each of the next three years. This should ease the pressure and address some of the concerns my noble friend raised.