Mental Health Bill [ Lords ] (Seventh sitting) Debate
Full Debate: Read Full DebateDanny Chambers
Main Page: Danny Chambers (Liberal Democrat - Winchester)Department Debates - View all Danny Chambers's debates with the Department of Health and Social Care
(1 day, 22 hours ago)
Public Bill CommitteesI agree on the notion of a right; where we vary is that I think that the Bill as written, and Government amendments 32 and 33, enshrine the notion of a right without it having to be spelled out as such. Local variation includes localised populations, such as those from marginalised communities. We might consider different translations of support that is available. That will not be the case across the board—it will vary from area to area. This does not remove people’s ability to make an advance choice document; it simply gives local commissioners the ability to determine what is most appropriate for their area, how that support should look and how it will be targeted.
Without getting ahead of the Minister, I hope that he will say what guidance on best practice for local commissioners and ICBs will be set out, particularly in relation to those with learning disabilities and autism. We have spoken about easy-read documents, for example, which should probably be made available, as should advice on how commissioners can best make sure that all those who might benefit from an advance choice document are meaningfully engaged and informed of their right and ability to do so.
The Minister has agreed previously to make sure that he works with disabled people’s organisations, including those run by and for people with learning disabilities and autism, on bringing forward a code of practice on the Mental Health Bill. Input on patient experience into how best to contact and meaningfully engage people who would benefit from an advance choice document would be particularly beneficial.
Very briefly, the aim of Liberal Democrat amendment 18 is to include consideration of financial circumstances in an advance choice document. I have looked into this—in my opinion, it is outside the scope of what an advance choice document does. An advance choice document sets out how an individual would wish to be treated if they became so unwell that they were unable to make those decisions for themselves. I am not fully sure how one’s financial circumstances fit into how one would be treated relative to detention or, potentially, in a community-based setting. I understand that financial circumstances have an impact on people’s mental health—we have talked about that in debates on other clauses—but they do not necessarily have a place in this specific part of the Bill.
I encourage the Committee to support clause 45 and to adopt Government amendments 32 and 33. This is, once again, a big step forward in ensuring that those with serious mental illnesses are able to input into their care and treatment in a real and meaningful way.
It is a pleasure to serve under your chairship, Sir Desmond. In the previous sitting of the Committee, I spoke extensively about the close link between money worries and poor mental health. That link is why I have sought, through amendment 18, to ensure that advance choice documents include a specific section on money. This would give people greater choice and control over their finances when they are in crisis. Without that provision, financial worries could be an even greater hurdle to recovery.
We have talked a lot about financial problems being a major contributor to mental health crises, and they can make it much more difficult to recover from one. I will not go through all the details again, but the numbers show how significant the problem is. Last year, nearly 21,000 people in England alone were struggling with problem debt while in hospital for their mental health, so it is not a small cohort of patients for whom this is a specific issue. Ensuring that people’s finances are taken into consideration when they are in a mental health crisis will prevent future illness, reduce waiting lists and help people to return to daily life more smoothly, including to work. If we ignore it, that will end up costing the NHS more in time and resources.