King’s Speech

Baroness Watkins of Tavistock Excerpts

Thursday 9th November 2023 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, it is a pleasure to contribute to this debate on the King’s gracious Speech, and to acknowledge His Majesty’s Government’s commitments for this Session. I declare my interests as chair of Look Ahead, a housing association that supports homeless people, and as a non-executive director at NHS England.

First, I turn to education. The Children’s Commissioner emphasises that school attendance is an absolute priority if children are to be offered the best start to further their ambitions, relationships and learning when in school. However, current data demonstrates that, since schools have reopened after the pandemic, one in five children remains persistently absent, on average missing at least one day in school a fortnight or 1/10th of the academic year. This means that 1.8 million children are regularly missing education.

It is suggested that the social contract between schools and parents had been broken following the lengthy period of school closure and that many children are waiting for mental health support and education, health and care plans. The wait is reportedly two years in some situations. So, while I support the Government’s intention to introduce a register of children not in school, can the Minister explain how this information will be used to support those children and their families to increase school attendance? Will there be a national or local authority register of waiting times for assessment for education, health and care plans, with clear targets for achievement in the way that there is, for example, for NHS cancer targets? We know that the future health and happiness of those children regularly missing school are severely impacted if mental health intervention and tailored educational support are not available within—shall we say, conservatively—six months of regular absence.

Secondly, what early years entitlement will be made available for younger children? The Early Education and Childcare Coalition reports that only 17% of nursery managers say that they are likely to increase the number of places they provide due to the difficulty in recruiting staff. Can the Minister say whether it is the Government’s intention to re-establish a career development hub at the Department for Education for a national apprenticeship scheme in early years education that will encourage not only women but men into this important area of work? There is probably a need to restart the graduate-led grant scheme.

The King’s Speech was deeply disappointing in having no reference to reforming the Mental Health Act 1983. Others have spoken about this, but in 1983 I was a junior lecturer introducing the changes to staff in the Lambeth health authority. I distinctly remember a slide that said, “This is a really interesting review, but remember that it is only a review of the 1959 Act, and we will have a proper, new Mental Health Act soon”. That was 40 years ago. There was a manifesto commitment in both 2017 and 2019 to reform this. It seems to me that this particular revision has been on a waiting list for a minimum of 40 years. Yet over 53,000 people were detained under the Mental Health Act in 2021-22, many, of course, for appropriate assessment, support and treatment.

However, significant disparity between ethnic diversity and detention under the Act continues, with white people five times less likely to be detained than those from different racial communities. Does the Minister agree that, while reforming the Act is long overdue, that should not stop us enhancing patients’ rights and strengthening safeguards for those admitted to hospital much sooner than an Act might come? I believe it is essential that we find sufficient resources to ensure that we can deliver high-quality, compassionate care—which is often in the community—before we review the Mental Health Act, if we are not to get it in this Session.

We know that many people with significant mental health needs are in prison, when many would be far better served by proper community support and treatment in safe, secure housing—particularly before they offend. Sometimes, individuals who have significant mental health challenges offend because they are homeless and have difficulty in claiming benefits and accessing the healthcare system.

I acknowledge other noble Lords’ contributions to this debate on the proposed reforms associated with housing, leasehold and renters; I will leave it to others to speak on that. I hope that this will result in fairer systems, but it will not result in a significant increase in social housing, which is completely vital to improve healthcare in this country.

Finally, I welcome the Government’s commitment to supporting the NHS workforce plan and hope that, in the longer term, this will have a positive effect on current waiting lists, which are in part due to a shortage of qualified staff as well as the Covid pandemic. However, I was concerned to hear the Minister say that he believes that the pandemic was a once-in-a-generation situation; I only hope that he is right, because we need to be ready in case we get a second wave. Do not let us be complacent; we need the right social care to support people if that happens.

I commend the proposals relating to tobacco and vapes. As many noble Lords know, my concern about the use of alcohol by young people remains, and I wish that there had been something about that too in the Speech.