Queen’s Speech

Lord Bradley Excerpts

Wednesday 12th May 2021 Lords Chamber

[Lord Bradley (Lab) [V]]

My Lords, I first add my congratulations to the maiden speakers and wish the right reverend Prelate the Bishop of Portsmouth all the very best for his future outside the House.

In declaring my interests in the register, I am pleased to make a short contribution to this Queen’s Speech debate, with a particular focus on the legislation presented on health and especially mental health. First, the health and care Bill is underpinned by the NHS Long Term Plan, which sets out the ambition to achieve parity of esteem between physical and mental health. But despite this commitment, mental health services are struggling to meet demand, and this has been exposed and exacerbated by the pandemic. As the Royal College of Psychiatrists pointed out, there are record numbers of referrals to mental health services. The most recent figures for December 2020 show an 11% increase compared to the same time the previous year. Similarly, in parts of the north-west, calls to mental health crisis teams by children and young people have doubled during the pandemic, as BBC North West movingly reported this very week. Therefore, it is essential that the new integrated care system gives equal weight to mental health by making it a legal requirement that NHS mental health trusts sit on their boards, and that non-statutory bodies, allied health professionals—such as speech and language therapists—and the voluntary sector providing mental health and related services for people with complex needs should also have a statutory right to be on the boards of these bodies.

Further, the key policy paper, Integration and Innovation, makes it clear that the Bill will bring forward several measures to improve accountability in the system in a way that will empower organisations and give the public confidence that they are receiving the best care every time they interact with it. This is clearly welcome, but so far these measures seem extremely top down government-heavy, with an emphasis on the powers and responsibilities taken back to the Department of Health and Social Care and, specifically, to the Secretary of State. Crucially, it seems silent on how the views of the public will actually be represented on ICOs and ICSs. To ensure public confidence at a local level, their voice must be heard and have a direct role in influencing and determining the priorities in each local community, especially guaranteeing that mental health services and provision for people with learning disabilities and complex needs are given equal consideration. Again, I believe this should be explicit in the forthcoming legislation.

I turn briefly to the proposed mental health reform Bill, for which I hope the pre-legislative scrutiny of a draft Bill will be quickly brought forward by the Government. I will make two small but important initial comments on the interface between mental health and the criminal justice system. First, it is proposed that a statutory time limit is introduced for the transfer from prison to mental health settings for those requiring mental health care. I made a similar recommendation in my report in 2009 and therefore strongly support it. However, it needs to be emphasised that such transfers can be extremely problematic due to lack of appropriate beds. This can particularly affect women and lead to transfer far from home. The Government must invest quickly in appropriate, secure and specialist provision to ensure that they deliver on this statutory time limit recommendation.

Secondly, the Government have committed that by 2023-24, investment in mental health services, health-based places of safety and ambulances should allow for the removal of police cells as a place of safety. Again, it is essential that the gaps in current provision in health-based places of safety are addressed, perhaps with a specific capital allocation to honour the 2023-24 target.

I conclude by making the point that to ensure that the NHS can continue to develop as an integrated system and meet the growing demand for healthcare, particularly in mental health, sustained investment will be required, predicted to be over £100 billion over the next decade. The first test of this will be the comprehensive spending review in the autumn. It will set the direction of travel and will allow an early assessment to be made of whether the levelling-up agenda is real or just rhetoric and whether the repeated claims of the Secretary of State for Health and Social Care that this is a Government who deliver have any real substance. I look forward to further debate on these matters.