Mental Health Bill [Lords]

Kevin McKenna Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I commend the hon. Member for Dorking and Horley (Chris Coghlan) on a powerful and vital contribution to this debate. In fact, I commend everyone who has spoken so far, often from personal experience and expertise. This is unfinished business, and this Bill is long overdue.

I have been reflecting on my first placement as a pre-registration student nurse. I went straight into a mental health ward. I am not a mental health nurse; that was not the route I took, but not because anything I saw there particularly turned me off it. However, it was a remarkable experience. When I walked into the unit for the first time, I was shown a burned pool table; it had been burned down the day before. The staff apologised and we moved on. The staff were full of compassion, but also frustration, and one of the things that they were frustrated with was the Mental Health Act 1983. This is some time ago; we are talking about 1996. In one of my very first teaching sessions on that unit, I was told about all the things that needed to be changed in the Act, so it is slightly surprising that I have wound up in this place, with the opportunity to change and challenge those elements.

The points made to me then were particularly about the challenges for different communities, and the way that people from different ethnicities and cultures were assessed for mental ill health. The Bill will help to adjust that, and hopefully we can mitigate those problems, and move beyond and progress from the 1983 Act. Some things were not even properly on people’s radar then; for example, there was less understanding of neurodiversity, autism and learning disabilities, and the inappropriate way that they were covered by the Act. Many Members have talked about the large number of people who are autistic or have learning disabilities who are incarcerated. That has been described as an offence against human rights, and I believe that to be true, but I also believe that it will be challenging to overcome.

In 2019, the long-term plan for the NHS was brought forward by Baroness May, and several Members of this House had a key part in driving forward that change. It said that we should challenge the detention of people who are autistic in mental health locations that people are left in for a very long time. We heard from my hon. Friend the Member for Penistone and Stocksbridge (Dr Tidball) that the average length of stay of someone who is autistic or has learning disabilities and is detained under the 1983 Act is 4.7 years. That is a lot longer than many people with psychotic illnesses would need to be detained.

That long-term plan for the NHS had great intentions, and made suggestions for overcoming the issue and liberating people from detention. It was not just the pandemic that came soon afterwards that kiboshed them: it is really hard to drive change in the system when the Mental Health Act protects clinicians and senior people in the NHS in not driving forward that change that is needed. To drive it forward, we need a change to the Act, and that is what we have in front of us. I commend everyone who has worked hard on the Bill to ensure that patients’ voices are heard.

In my constituency of Sittingbourne and Sheppey, we have big mental health challenges. We have the highest suicide rate in Kent and, I think, the 37th highest suicide rate of any local authority area in the country. That means that 37 other Members in this House have even bigger challenges when it comes to suicide and mental health provision. I am sure that what many of those places and Members have in common is the challenge of economic deprivation and inequality, which—let us face it—is the biggest driver of poor mental health outcomes. That was mentioned admirably by the hon. Member for Runnymede and Weybridge (Dr Spencer), who talked at length about the complexities of the 1983 Act. I commend him for his insight on the challenges of changing that. We have to change things across the board—in housing, access to employment and transport, things that are way beyond the bounds of the Bill. We should use this Bill to drive that forward. We should look around our communities and see the creative approaches that we can use.

On Saturday, I had a lovely day out in the sunshine at Curly’s farm on the Isle of Sheppey in my constituency. It is an active farm, set up by two fathers to support their son, who has profound learning disabilities and autism. It brings in children with learning disabilities, autism, mental health challenges and behavioural challenges generally. It is something like the Challenging Behaviours Foundation, which my hon. Friend the Member for Rochester and Strood (Lauren Edwards) talked about, and which is also very active in my constituency; I was glad to host an event for it. The farm really shows us that when we get people out of institutional settings and outdoors into different environments, they can thrive in a way that they do not in school, or in healthcare settings. It is transformational to the lives of the children and young people who go there, who often go on to work in agriculture. I am sure that many other hon. Members see that.

[Sojan Joseph]

My hon. Friend is absolutely right to say that patients with challenging behaviours should not be detained in a mental health ward for many, many years. They should be in a different setting. Does he agree that we do not have enough support or accommodation for patients? We need to invest more in community settings for some of these patients with challenging behaviours.

[Kevin McKenna]

My hon. Friend has jumped ahead of me on that—not surprisingly, given his background as a mental health nurse. That is absolutely true. We do need to invest more, but we need to think beyond the NHS. Although this is the Mental Health Bill and it has “health” in its name, this issue is much bigger than the services that the NHS can provide.

There is a weakness in this Bill. The concern I have, which several other Members have mentioned, is that it does not tie us down to a tight timeline for this transformation. The Bill provides a get-out. That is done to ensure that services in the community are properly set up, but I worry that that the timeline will slip and slip. The time to move is now. People have been languishing for too long in settings that do not offer them a therapeutic way forward, and in places that are frankly inhumane and breach what we would all consider to be our human rights. The Minister is here and listening, and I recommend that he thinks about how we can get an active plan, so that we do not let this issue slip, but actively ensure support for services in the community, invest in them where needed, and foster them.

[Jen Craft]

I very much support what my hon. Friend is saying about making sure that there is an active plan. One of my concerns is that implementation of this Bill will be delayed until community support is ready. Does he agree that it would be welcome if the Minister offered a reflection on what good looks like in this space, and what ready looks like, so that we know what we are aiming for?

[Kevin McKenna]

I absolutely agree. We should flip this around from a delay until we are absolutely ready to an active process of deciding what good looks like.

Two weeks ago in my constituency, I ran a mental health conference. That was largely because, as I was going around as a new MP talking to every different organisation I could, mental health was right at the top of nearly all their worry lists, whether it was the food bank, the schools, the police, the prisons, or organisations in my community that had set themselves up to support people with mental health. I have a MenTalk in Sittingbourne and a MenTalk in Sheppey; they work in different ways, but that shows the level of pressure that exists locally. All of those organisations brought out mental health as their biggest worry, even if it was not their primary purpose.

Just bringing people together and getting them to talk together—people who perhaps had not talked to each other until that point—really made a difference. You could see it in the room on that day. I am sure I am way behind the curve compared with a lot of other Members who have been doing this sort of stuff already, but for me, it really showed that we have got to be active in pushing this forwards. What we have learned from 2019 and the long-term plan for the NHS is that it is the implementation that matters. It is not the words in the strategy; it is getting an implementation plan really tight and fast on the ground. Given that the impact assessment talks about 2027 as a key point, I would like to see a commitment in the Bill to produce a workable plan by 2027 at the latest—one that can give us the road map we need for the future. That has been called for by organisations such as Mencap and the National Autistic Society, so I really commend it to the Minister.

Oral Answers to Questions

Kevin McKenna Excerpts

Tuesday 25th March 2025 Commons Chamber

[Ashley Dalton]

This is a really important issue. We have reinstated the children and young people cancer taskforce, which I visited a couple of weeks ago. We have tasked it with ensuring that children and young people are a part of its work. The Department will be marking Teenage and Young Adult Cancer Awareness Month appropriately. We encourage all children and young people to get the checks that they need and be aware of cancer symptoms.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

6. What steps his Department is taking to help tackle inequalities in nursing career progression.

[The Minister for Secondary Care (Karin Smyth)]

I know that this subject is very close to my hon. Friend’s heart, after many years of NHS service. Ensuring great careers for NHS staff, including nurses, has been a key theme of our engagement with staff to shape the 10-year plan. I will shortly set out further measures to improve progression for nurses and their colleagues in other key NHS professions.

[Kevin McKenna]

I thank the Minister for her answer. Nurses across the profession are increasingly taking on complex roles and responsibilities, yet many do not have access to higher pay bands that reflect these changes, and there is too much variation around the country. As well as looking at this, will the Minister ask the Department of Health and Social Care to implement a consistent model for supported, structured progression from band 5 to band 6 for early career nurses based on the completion of key competencies and the acquisition of necessary experience?

[Karin Smyth]

My hon. Friend is right that NHS staff, including nurses, should be paid appropriately for the work they are asked to do and will be asked to do in future. We are working with the NHS Staff Council to ensure that the national job evaluation scheme is implemented fairly and consistently across nursing and all professions.

NHS England Update

Kevin McKenna Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

I can give my hon. Friend that assurance. That is the objective of what we are doing: to make better use of taxpayers’ money so that we can deliver better care for patients. That is not through bloated central bureaucracy, but through more frontline capability and services.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I draw Members’ attention to my entry in the Register of Members’ Financial Interests. Of the more than 26 years that I worked in the NHS, six and a half were in NHS England, in its brilliant strategy team and with brilliant people. That is why my heart goes out to so many people who will have insecurity about their jobs following this announcement, even though I believe it to be the right one. This comes after years and years of chopping and changing at NHS Improvement and NHS England, as political leadership has switched from one person to another.

One of the things I am concerned about is the need to ensure that clinical leadership is still heard at the centre. As a nurse, I found it harder to get into NHS England. Doctors find it easier in their career structures. Moving NHS England functions into the Department, and moving off NHS terms and conditions, will make it harder for nurses, allied health professionals and other clinicians working in the NHS. What will my right hon. Friend do to ensure that the clinical voice comes right into the centre of Whitehall, along with the patient voice?

[Wes Streeting]

I am extremely grateful to my hon. Friend, and I echo what he said about the talents of people at NHS England. I did not take this decision with the Prime Minister lightly. Indeed, it was not my instinct coming into government, but it has been shaped by what I have seen and experienced over the past eight months. Clinical leadership is vital, and that is not just doctors; it is also nurses and other clinical leadership. We have a brilliant chief nursing officer, who remains in place and will be part of that clinical leadership team. I can assure my hon. Friend that we do not want any political interference in what should be decisions for clinicians. What we need is the right political leadership to give that clinical leadership the tools, power and freedom to do the job that only they can do, and that they do best.

HIV Testing Week

Kevin McKenna Excerpts

Thursday 13th February 2025 Westminster Hall

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

It is a pleasure, Dr Allin-Khan, to serve under your chairmanship.

I say a massive thank you to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for securing this debate. I thank everyone involved in the all-party parliamentary group on HIV, AIDs and sexual health, and every organisation that has already been mentioned today, from the Terrence Higgins Trust to the Elton John AIDS Foundation. Actually, I also thank all those small, everyday champions: people who are positive; people who have been allies of people who are positive; everyone who has worked in the bioscience sector; and everyone who has worked in the health sector. This has been a collective effort, involving thousands and thousands of people in this country, to get us to a point where we are potentially only a few years away from eradicating all new transmissions of HIV.

As the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale said in opening this debate, we are also in LGBT+ History Month. In the LGBT community we are used having a lot of clashes, such as Pride happening at the same time as Wimbledon and Glastonbury; we are just used to it.

This debate has put me in a very reflective mood, as did being elected to Parliament and moving from nursing into this world. I was 11 when I realised I was gay; that was in 1985. It was just as everything was hotting up around the AIDS pandemic. It was a pretty scary world to step into. By the time I was properly coming out in the early 1990s, I met lots and lots of friends, including friends and lovers who had AIDS or HIV. I spent a lot of time going to hospitals, and it was there that I realised nursing would be something that suited me. So, it was partly in response to the AIDS epidemic that I was driven along the career path that I was. I also remember the abject terror of getting early HIV tests, particularly before I became a student nurse; a positive test could have stopped that career dead in its tracks at that point.

I will not comment on the age of everyone in this room, but I think like many people in this room I have lived right the way through this pandemic. Of course, by the time I was finally diagnosed with HIV it had changed again, but that was still 20 years on. So I have lived for a long time as an HIV-positive man. There was a time in my life when friends were taking tablets that did have quite severe side effects, some of which were actually very unpleasant and led to them still suffering from HIV and then AIDS. Now, it has whittled down to one tablet a day, and as I get into my 50s it sits alongside my statins and my arthritis medication—all the other medications that we all have at a certain point in our lives. That is the difference.

[Florence Eshalomi]

I commend my hon. Friend so much for his passionate speech and his lived experience. Earlier this week I attended another event, and the Elton John AIDS Foundation was there. Richard Pyle, one of its directors, mentioned how great it would be if in a few years we could have an injectable form of PrEP. Does my hon. Friend think that that is the advancement we need to see to help address HIV/AIDS?

[Kevin McKenna]

We already have injectable forms of HIV medication, particularly for people with chaotic lifestyles. They only need to take a jab once every couple of months. It is a real way forward, which will further help us eradicate this.

I have also been reflecting on, in my nursing career, those patients I have nursed for who did not know that they were positive, who became incredibly sick. They developed AIDS without knowing they were positive, coming straight into an intensive care unit and waking up to find out that they were positive. It was a massive disruption to them and their families, and it was stigma that was driving that. People do not have to live that way; people do not have to suffer that way.

A very strong message today is: everyone, just get tested. Everyone, do it. It is absolutely fine; it is just a little scratch on the finger. There should be no stigma. You will not pass this disease on when you are treated, you will not actually suffer and, honestly, it is boring and mundane. In the community of gay men, it has been very boring and mundane for quite some time. In wider communities, just catch up with the rest of us, frankly. If everyone is tested, we will get there.

The one thing I would say to Ministers is that opt-out testing has been extremely successful. There are diseases out there such as hepatitis C that can be completely eradicated. People do not have to be on a tablet for their whole lives; the course is just a few weeks. If we can identity those people through opt-out testing, we can tackle several diseases with one effort and eliminate those as well. I would like to hear that from the Minister.

Health and Social Care: Winter Update

Kevin McKenna Excerpts

Wednesday 15th January 2025 Commons Chamber

[Wes Streeting]

I welcome the hon. Member’s question, and I agree with the thrust of his question that we need healthcare to shift from hospital into the community, with care closer to, and in, people’s homes. The configuration of services locally is a matter for local NHS leaders. I encourage him in the first instance to be in touch with his local integrated care board. If he gets a particularly unsatisfactory or unreasonable answer, he should feel free to raise it with Ministers.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I associate myself with the comments about the nursing colleague who was so brutally attacked in Oldham. I am thinking of her and her team at this time.

I have been thinking back to when I was starting out as a junior nurse. We faced the same problem—it was just after Labour had taken over from a Conservative Government, and the backwash of winter crises caused by that failed Government was very similar in the first few years. Improving staff pay and the NHS plan made a difference. What else has my right hon. Gentleman learned from the successes of his forebears about tackling this winter crisis now and tackling such crises in future?

[Wes Streeting]

My hon. Friend brings expertise and experience to the House, and I am particularly grateful for his support and concern for the colleagues of the nurse who was so brutally attacked in Oldham, because I know that they will be acutely affected. In fact, the NHS workforce right across the country will have felt the shiver down the spine that I felt when I read about that horrific case.

My hon. Friend is right that I am fortunate to be able to call on every single one of my Labour predecessors, from Alan Milburn to Andy Burnham, to ask for their advice, experience and insight. As our great late friend John Prescott said, we need

“traditional values in a modern setting”.

I am bringing that modernising tradition to our approach to investment and reform, because the combination of both delivers results. That is how the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history.

Oral Answers to Questions

Kevin McKenna Excerpts

Tuesday 7th January 2025 Commons Chamber

[Mr Speaker]

Order. I call Kevin McKenna to ask the final question.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I strongly welcome yesterday’s announcement about using initiatives such as community diagnostic centres to move services closer to the public. In the Isle of Sheppey, we are particularly exposed as a coastal community, but thankfully a new CDC will really help. Unfortunately, my experience in the NHS over the past few years shows that while the previous Government talked the talk about shifting care to the community, they failed to deliver. Will the Secretary of State set out what steps will be taken, so I can show my constituents that this shift will actually happen?

[Wes Streeting]

I am delighted to have my hon. Friend and his experience in the House, standing up for his community and giving us his advice and wisdom as we develop our 10-year plan. We are already walking the talk on the shift to community, not least through the big uplift in funding for general practice announced before Christmas. Many people assume our elective reform plan is just about hospital waiting lists, but a big part of it is about delivering the left shift by asking and funding general practice to do more to manage patients in the community.

Income Tax (Charge)

Kevin McKenna Excerpts

Tuesday 5th November 2024 Commons Chamber

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

Thank you, Madam Deputy Speaker, for calling me to speak in this debate about the Budget—a Budget I am very proud to support as the first Labour Budget in 15 years.

I also thank the various Members who have made their maiden speeches in this debate, particularly because like myself, so many of them have worked in the NHS. Many of us have felt the urge to get selected for, and elected to, this House because of our experiences over the past 14 years. I understand that among Opposition Members, there is a feeling that Labour Members do not understand business, but I can tell them that we understand the public sector, public services and our communities—and actually, that is a disservice to all the Members on the Labour Benches who have run businesses. It is particularly important to me that a couple of Labour Members have previous experience as NHS managers. In his report, Lord Darzi made it very clear that one of the problems the NHS has faced is an undervaluing of the management side, as opposed to the clinical side, so those Members’ voices will be really important in this debate.

This Budget gives us solid foundations for investment and rebuilding this country—of that, I have no doubt. This Budget is also what people in my constituency have been crying out for, because they know that our public services are frayed to a point that is almost beyond repair. Honestly, that is what people in my constituency keep telling me. Unlike some Members, who have apparently had some very negative responses to the Budget, I can tell those Members from canvassing at the weekend and from what is in my inbox that I have seen a really positive response to this Budget. People are really glad to see that the investment has started, and frankly, there is a sense of reality—a recognition that this is not going to be a quick fix.

On the health service and social care in particular, I applaud the fact that the Secretary of State has not just commissioned the diagnostic investigation from Lord Darzi, but has now commissioned a 10-year plan for the NHS.

[Graham Stuart]

Will the hon. Gentleman give way?

[Kevin McKenna]

I do not think so.

That plan will be needed to get the NHS back on its feet, and as a counter to some of the comments about national insurance and burdens on businesses, the Secretary of State was very clear that he is going to look at the NHS allocations to GPs and other people supplying the NHS—that comes with the plan. Beyond that, it is really important to recognise the damage that has been done to businesses over the past 14 years by all the other costs that have been accrued. The mental health crisis damages recruitment and retention, and businesses have had to cope with all those extra costs across the board.