Mental Health Bill [Lords]

Ian Sollom Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Sojan Joseph]

I would like to speak in support of new clause 37, tabled by my hon. Friend the Member for Thurrock (Jen Craft). On Second Reading, I warmly welcomed the changes that this legislation will introduce regarding autistic people or those who have a learning disability. As a result, it will no longer be possible for someone to be detained in a mental health hospital indefinitely simply because they have autism or a learning disability. In the current system, autistic people and those with a learning disability have experienced inappropriate care, over-medication and extended periods of detention because of a lack of facilities in the NHS and social care, so this change is welcome and long overdue.

The Government have confirmed that the changes will be implemented once the necessary community provision is in place. Establishing strong support in the community is essential for not only enabling safe discharge from hospital settings but preventing unnecessary admissions in the first place. I recognise that the Government are working on setting out what strong community services look like and what resources they require to implement them. From serving with the Minister in Committee, I have no doubt about his commitment to ensuring that this community provision is introduced in a timely manner, but I support the proposal of my hon. Friend the Member for Thurrock that there should be a road map in the legislation that will provide a clear framework outlining how those services will be introduced. After all, ending inappropriate detention requires robust community-based alternatives to ensure that people with autism or a learning disability who would have previously been detained do not fall through gaps in the system.

Having a road map developed in conjunction with autistic people, people with learning disabilities, their carers and healthcare professionals will help to identify and address any gaps in service provision and workforce capacity. I also believe that it will help to reduce the risk of people with autism or a learning disability needing police intervention or emergency hospital care because the support is inadequate. By putting in place a road map, new clause 37 would help to ensure that we end all the sooner the injustice of people with autism or a learning disability being detained.

[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

I will speak to amendments 24 to 28 and 36 to 38 in my name, which address gaps in crisis provision and accountability for autistic people and people with learning disabilities.

On Second Reading, I told this House about Declan Morrison, my constituent who died aged just 26 after spending 10 days in a section 136 suite that was wholly inappropriate for his complex needs. I remind the House that section 136 suites are designed for 24-hour stays, or a maximum of 36 hours in extreme cases. The coroner who investigated Declan’s death found that

“there is a risk that future deaths could occur unless action is taken.”

The timeline of what happened in the run-up to Declan’s death shows a cascade of systemic failures. Declan’s family, Graeme, Sam and Kaitlyn, have asked me to ensure that Parliament learns from what happened. These amendments in my name reflect those lessons and the coroner’s recommendations.

In Committee, the Minister made several points about earlier versions of these amendments, which I have tried to address in these revised versions. In particular, on crisis accommodation, the Minister argued that existing duties on ICBs already cover crisis provision and that the amendment was too prescriptive, potentially restricting ICBs in designing provision, emphasising the importance of flexibility for ICBs to meet local needs. I understand the desire not to be overly prescriptive, but in Declan’s case, over 100 places were contacted and no suitable accommodation could be found anywhere in the country. Flexibility failed Declan.

The revised version of the amendment allows for regional solutions beyond the ICB, but I suspect that the Minister will still find it too prescriptive. However, the fundamental question remains: should there not be a duty to ensure that provision exists somewhere? The Cambridgeshire and Peterborough ICB established a crisis service after Declan’s death that operated at 98% capacity, demonstrating both need and viability, but it closed when funding was withdrawn, highlighting the challenge with voluntary provision.

[Steve Darling (Torbay) (LD)]

On funding, the Devon partnership NHS trust looks after people with mental health challenges in the Torbay community, where levels of depths of despair are particularly high. The trust is facing a £21 million cut, so does my hon. Friend agree that changes will be irrelevant if we do not have adequate funding?

--- Later in debate ---

[Ian Sollom]

I agree that resources need to be put in place to support the many good measures in the Bill and in many of the proposed amendments. In Declan’s case, services were created in the wake of tragedy and funding was found, but too often such services disappear when attention moves elsewhere.

I recognise that the implementation challenges are real, and I appreciate that the Minister has committed to providing annual written statements on progress, but I believe the principles in the amendments around crisis provision, proactive intervention, accountability and co-production with autistic people merit consideration. As much as I would like him to, I do not expect that the Minister will have a late change of heart on the amendments today. However, I hope he will be willing to meet me after the Bill receives Royal Assent to discuss how we can work together to ensure the systemic failures that led to Declan’s death are properly addressed during implementation of the measures in the Bill. In stopping those systemic failures, we would honour the memory of Declan.

[Josh Dean (Hertford and Stortford) (Lab)]

In the interest of time, I will turn straight to new clause 25, tabled in my name.

The Bill sets out a range of situations where the competence of a patient aged under 16 will be relevant, but it does not set out a framework for how it should be determined. That puts patients under 16 years old at a huge disadvantage. Unlike those aged 16 and over, there is no clear mechanism for determining whether a child under 16 can make decisions and the law assumes that under-16s cannot make decisions for themselves, unless they demonstrate they are able to do so. That means that under-16s may not benefit fully from the rights and safeguards set out in the Bill because they are assumed to lack competence to make the relevant decision. For example, they may not be able to exercise their right to choose a nominated person or to access enhanced safeguards around treatment.

There is currently no statutory test for determining a child’s ability to make decisions. While some may refer to Gillick competence, the Joint Committee on the draft Mental Health Bill noted that Gillick competence is “broad”, “ambiguous” and that there were significant inconsistencies in its application. A similar observation was made by the Court of Appeal in a decision earlier this year, which also indicated the Court’s approval of a functional test to determine a child’s competence.

New clause 25 addresses this disparity by introducing a “functional test” to determine an under-16’s ability to decide. This reflects the suggested approach in the current code of practice, adopted by some judges. The Law Commission has recommended a similar test as part of its proposed legal reform concerning disabled children’s social care. This test fills a significant gap in the Bill, providing important clarity for professionals when a child’s competence needs to be determined. Crucially, the test set out in new clause 25 is explicitly limited to decisions made under the reformed Mental Health Act. It does not cover decisions falling outside of the Act, so does not affect the existing decision-making powers of the courts or those with parental responsibility. A clear and consistent approach to assessing a child’s competence can only be achieved by including a test on the face of the Bill, as the code of practice can only reflect the law—it cannot prescribe a test for competence. I would be grateful if the Minister addressed that point at the end of this debate, and if he would consider meeting me to discuss my amendment in more detail. This Bill has many strengths that will deliver for people and modernise mental health care, and it is crucial that we ensure children and young people can benefit from those strengths in the same way adults can benefit.