Mental Health Bill [Lords]

Melanie Ward Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Chris McDonald (Stockton North) (Lab)]

I echo the remarks of previous speakers; it has been a privilege to listen to the depth of personal and professional expertise expressed in this debate. I do not share that expertise, as I think will become abundantly obvious in a short moment.

What do you get if you put a group of men in a room and ask them to talk about mental health? Half of them leave, and the other half run into the corners of the room. I do not know whether that rings true for the men in your life, Madam Deputy Speaker, but when I heard that, it reminded me of myself. I heard it from a chap called Graham in Norton in my constituency, rather than from Graham Norton. Graham has set up a men’s shed in Norton, which is a national scheme. It is a remarkable place where men can come together and talk about mental health, but they do so by engaging in other activities.

For those who have not been to one, a men’s shed is just like your shed—it has all the great things your shed has—but your mates are there as well. In the men’s shed in Norton, you can make model boats, or make things using the 3D printer, and it has the most amazing workshop, which includes a fantastic pillar drill. It made me think that I need a pillar drill for my workshop, to help my mental health. I met many men there; some were bereaved, some were suffering from serious or terminal illnesses, and others were feeling lonely. They gave me plenty of tea, and we had a really good chat—a really positive and uplifting chat—and there was a great deal of mickey-taking as well, which you always find when you get a group of men together.

That sort of facility is incredibly important for all the reasons we have heard about in discussions about men’s mental health. Not least among those, as we have heard a number of times this evening, is the fact that for men of my age, suicide is the most prevalent reason for death. We heard that from my hon. Friends the Members for Darlington (Lola McEvoy) and for Whitehaven and Workington (Josh MacAlister). In my constituency of Stockton North, men wait more than three months over the national average for treatment for mental health conditions—as do women; in fact, everyone does. Some form of talking therapy would really help with many conditions, which is why I want to take a moment to talk a bit about psychotherapy.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

My hon. Friend mentioned men’s sheds. I was delighted to visit the Kirkcaldy men’s shed in my constituency recently to see the amazing work that the people there do. Listening to this debate, I have been struck by the positive changes that this Bill will bring, and by the contrast with Scotland. The people I speak to from almost every local service raise the issue of the mental health crisis across Fife, be they from the NHS, charities or the police. NHS Fife has asked for funding from the Scottish Government to sort out our mental health crisis and was told to not even ask. That is such a contrast with where we are in this place, and I am sure my hon. Friend agrees that action needs to be taken in Scotland and in Fife.

[Chris McDonald]

I absolutely agree with my hon. Friend. It will not be very long before voters in Scotland have the opportunity to contrast the Scottish Government with what a Labour Government deliver, and hopefully they will chose the latter.

I mentioned psychotherapy. For a profession that has been around since the time of Freud, it is remarkably unregulated; there is no professional register, no form of legally enforceable complaint, and no way to ensure that someone found guilty of misconduct is stopped from practising. In fact, anyone can call themselves a therapist. In 2007, the previous Labour Government considered some form of regulation for therapists, and I encourage the Government to include such regulation in the Bill; it would be the ideal place for it. Since 2007, there has been a strong increase in private practice, and in legal cases arising from issues to do with psychotherapy. Of course, there are also online influencers. Professor Dame Til Wykes—an expert in this area—described them as “selling snake oil”. As my hon. Friend the Member for Southampton Itchen (Darren Paffey) mentioned, that is another reason why we need stronger safeguards and regulation of social media for children.

Essentially, an unqualified psychotherapist could do harm, but the issue is more likely to be the missed opportunity to do good—perhaps a failure to diagnose a more serious condition or, frankly, a missed chance to save somebody’s life. Regulation is supported by the profession. Chloe, a professional, urged me to raise this issue with the Secretary of State; I am doing that now, as he is in his place. This is an opportunity to restore confidence in the profession, and for us all to pick up where the last Labour Government left off.

As I say, half the men in a room will run out of it when mental health is mentioned. What is the answer to that? Graham gave me the answer: “Put a broken lawnmower in the middle of the floor. A big conversation will ensue, and two hours later, all the men will know each other’s names, and the names of each other’s families. They’ll have talked about how they are feeling and whether they are doing okay. You probably will not have a repaired lawnmower, but you will have lots of suggestions.” There is a good reason for that: men generally are not good speaking face to face, but they can speak shoulder to shoulder.

--- Later in debate ---

[Stephen Kinnock]

We are already working to reduce inequalities under the Mental Health Act. The patient and carer race equality framework is now a contractual requirement for all providers of NHS-commissioned care. It will support trusts to improve their interaction with racialised and culturally diverse communities and improve governance, accountability and leadership on improving experience of care for those communities and drive concrete actions to reduce racial inequalities within mental health services.

Given that our first priority after Royal Assent will be to draft and consult on the code of practice, it is essential that we listen both to practitioners and to those with experience of the Act when drawing up the statutory guidance that supports the Act’s application. We will therefore engage with people with lived experience, their families and carers, staff and professional groups, commissioners, providers and others to do this. The code will be laid before Parliament before final publication.

Alongside the code, we will develop secondary legislation that will be laid before Parliament, subject to the parliamentary process as set out in the legislation. We have already published policy papers that set out more information on some of the delegated powers in the Bill and provide an early indication of what we intend to set out in regulations. We recognise the appetite to deliver after years of delay and the importance of parliamentary scrutiny and accountability in this crucial work. We have therefore committed to laying an annual written ministerial statement on progress, so that hon. Members will have ample opportunity to hold us to account for progress made and milestones achieved.

We have covered a wide range of topics and questions this evening, and I will not be able to cover all of them in the time allocated to me. I will therefore limit my comments to two areas that have come up repeatedly, namely the implementation plan and the treatment of people with autism and learning disabilities.

[Melanie Ward]

I thank the Minister for giving way. He is talking, rightly, about the importance of the implementation of legislation. He will be aware that new measures came into force two months ago under the Online Safety Act 2023, which introduced legal powers to remove online content that promotes suicide. Ahead of this, I wrote to Ofcom about a platform that is actively promoting suicide and suicidal ideation, and has been linked to the deaths of almost 100 young people and adults. The Ofcom chief executive replied to say that Ofcom was opening an investigation. Does the Minister agree that it needs to get on and remove this kind of content across the UK?

[Stephen Kinnock]

Of course, we have the Online Safety Act, and there are measures within that legislation that address this issue. However, my hon. Friend is absolutely right that it is time to crack on and deal with this deeply troubling issue. I pay tribute to her excellent work, and I hope she will continue to press Ofcom to do the right thing, and to do it rapidly.

We know that implementation will take time, as the pre-legislative scrutiny Committee recognised. We estimate that it will take around 10 years to fully implement all Bill’s measures, due largely to the time needed to train specialised workforce groups, including second opinion appointed doctors and tribunal judges, and the need to ensure that the right community support is available for people with a learning disability and autistic people. This timeframe necessarily spans multiple spending reviews and multiple Parliaments, so I am limited in the detail I can give today about future spend and timelines.

However, we have set out in the impact assessment what we think is required in both time and funding. We expect the process of drafting and consulting on the code of practice to take at least a year. Alongside the code, we will develop secondary legislation, which will be laid before Parliament. We have already published policy papers, which contain more information on some of the delegated powers in the Bill and provide an early indication of what will be set out in regulations.

We will then need time to train the existing workforce on the new Act, regulations and code, which will likely be in 2026 and 2027. Although we will commence some clauses, such as on supervised discharge, two months after Royal Assent, the first major reforms, including clauses concerning grounds for detention—excluding the changes to part 2 for people with learning disability and autistic people—and nominated persons, are expected to follow the training in mid-2027. The timelines for later phases are inevitably less defined, but we will expand the workforce and improve community support with the aim of implementing the reforms increasing the frequency of mental health tribunals from 2030-31. These timelines are indicative, and we will iterate the plans as we get more certainty on future funding and wider workforce plans.

The other issue that came up a lot is the treatment of people with autism and learning disabilities. Again, implementation should be well planned to ensure that the proposed legislative changes have the intended effect. The proposed changes to the detention criteria will be commenced only when strong community services are in place so that the alternatives to hospital care are robust. Members will understand that robust implementation plans are dependent on the final legislation that is passed and on future funding, which is subject to future spending reviews.

However, local systems do not need to wait for legislative changes to come into force to begin putting in place the necessary community services for people with a learning disability and autistic people. There is renewed funding in 2025-26 within ICB baselines to continue improving community support provision for people with a learning disability and autistic people.

We should recognise that the Bill is the result of the independent review commissioned by the now Baroness May of Maidenhead during her premiership. Many important contributions have also come from those with lived experience of the Act and their loved ones. It takes real courage to speak openly about those experiences and to channel pain into change.

As my right hon. Friend the Health Secretary said in his opening speech, the Government have demonstrated their commitment to funding mental health properly, and that commitment has been translated into real, tangible delivery: the £150 million multi-year capital investment to improve mental health urgent and emergency care pathways; 600 new or expanded crisis alternative services nationally, including crisis cafés, safe havens and crisis houses, providing an alternative to A&E or psychiatric admission; £26 million in capital investment to open new mental health crisis assessment centres, which aim to provide accessible and responsive care for individuals in mental health crisis; and 8,500 more mental health workers.

We are also committed to improving early intervention and shifting care to the community to support people to live well and thrive. We have committed to improve support for young people, with Young Futures hubs, making support workers more accessible to children. We are piloting in England the 24/7 neighbourhood mental health centre model, which builds on learning from international exemplars.

It is a privilege to be leading this transformational legislation through the House. I know that, because it matters so much, many people will have views on what is needed to get it right, and I look forward to further debates in that constructive and improving spirit. I commend the Bill to the House.

Question put and agreed to.

Bill accordingly read a Second time.

Mental Health Bill [Lords] (Programme)

Motion made, and Question put forthwith (Standing Order No. 83A(7)),

That the following provisions shall apply to the Mental Health Bill [Lords]:

Committal

(1) The Bill shall be committed to a Public Bill Committee.

Proceedings in Public Bill Committee

(2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 26 June 2025.

(3)The Public Bill Committee shall have leave to sit twice on the first day on which it meets.

Consideration and Third Reading

(4) Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.

(5) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.

(6) Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading.

Other proceedings

(7) Any other proceedings on the Bill may be programmed.—(Anna Turley.)

Question agreed to.

Mental Health Bill [Lords] (Money)

King’s recommendation signified.

Motion made, and Question put forthwith (Standing Order No. 52(1)(a)),

That, for the purposes of any Act resulting from the Mental Health Bill [Lords], it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable under or by virtue of any other Act out of money so provided.—(Anna Turley.)

Question agreed to.

Hospitals

Melanie Ward Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Dr Simon Opher (Stroud) (Lab)]

I must confess that I am slightly surprised that the Lib Dems have brought forward an Opposition day debate about hospitals and are stating their case in such a way, because the last thing we need in this country is a load of promises we cannot keep. I am proud that we Government Members have provided sustainable and affordable plans for the new hospital programme. I have been on the doorstep the last few weeks in the run-up to the county council elections, and the No. 1 priority that comes up is GP access. We have provided 1,500 new GP posts in this country, and waiting lists have been going down for the last five months. Emergency dentistry is also very commonly brought up on the doorstep, and we have provided 700,000 new dentist appointments.

There are many other parts of the NHS that are crumbling. I see the crumbling of the hospital buildings as a metaphor for what has happened to the NHS over the last 14 years.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

My hon. Friend is talking about the important work done by Lord Darzi, and the findings on crumbling hospitals in England. He may be interested to hear that recent figures show that the bill for the high-risk repairs needed to Scottish hospitals stands at £64 million. Those repairs have not been carried out under the SNP. They include two high-risk repairs that are badly needed, and have been outstanding since 2016, at Cameron hospital in Fife, which is used by some of my constituents. Does my hon. Friend agree that the Scottish Government should use some of the record funding provided to them by this Labour Government to fix our hospitals in Scotland?

[Dr Opher]

Of course it is essential that we maintain hospitals so that they are safe to treat patients in, so I agree with my hon. Friend about spending the money. In fact, the backlog bill for repairs in the NHS runs to £13.8 billion. I work as a GP in a GP practice, and I note that Lord Darzi estimates that £37 billion more should have been spent on the NHS since 2010, but was not. For those of us working in the NHS, it does feel like that. There is a massive building project ahead of us.

I point out that the previous Labour Government built 100 new hospitals. One was the Vale hospital in Dursley, which we started in 2008, and which I had a hand in. As hon. Members have said, community hospitals such as Vale hospital are crucial to how the NHS works. We must invest in our community hospitals and use them properly. The Vale hospital provides excellent minor injuries unit services, a specialist stroke service and in-patient beds for the community. We must invest in our community hospitals going forward. As we have heard, there were meant to be 40 new hospitals in the last few years, but none of them got built, and it turned out that they were not even funded.

We need to get care out of hospitals and back into the community. The hon. Member for Oxford West and Abingdon (Layla Moran) talked about GP premises; 20% of GP premises were built before the inception of the NHS, and I inherited one of those premises in Dursley. Twenty years ago, we opened a purpose-built surgery at May Lane, and we are still enjoying the benefits; it provides patients with excellent services. We must therefore invest. I was glad to see the Government investing £100 million in GP surgeries. I was pleased to see £80 million put into GP advice and guidance; that will allow consultants to give GPs advice, so that they can care for patients in the community. I am also really delighted with the push for neighbourhood health centres; that must be the way. We must bring back the family doctor, as that continuity of care is what really makes patients better. That is so important.

We must also integrate health and social care in the community, so that we can pull patients out of hospital. That also applies to emergency care, as far too many people are having to go to overwhelmed A&Es at big district general hospitals. At the moment, only 20% of acute admissions go through GPs, who are the best people to ensure that we avoid admissions. We have to change all of this. Our NHS staff and patients deserve better; they deserve facilities that reflect the excellence of the care provided within them. The Labour Government are committed to rebuilding not just our hospitals, but trust, and the integrity of our public services.

Health and Social Care: Winter Update

Melanie Ward Excerpts

Wednesday 15th January 2025 Commons Chamber

[Wes Streeting]

I thank the Liberal Democrat spokesperson for her usual constructive contribution to proceedings. She is absolutely right to raise the issue of variation in performance across different parts of the country. It is not acceptable, and one thing we will be doing as a Government is to ensure that, as well as creating a rising tide that lifts all ships, we raise the floor in performance so that we see far less unwarranted and unwanted regional variation. She talked about the Shrewsbury and Telford trust, which has had a number of challenges over many years. We have seen some signs of improvement as recently as this week, and we continue to support local leaders as they strive to improve the performance of their system overall.

The hon. Member raises some good and interesting questions about the frequency with which we publish data. It is right that we ensure that data is properly validated so that accurate data is put into the public domain, even as NHS England’s control room monitors live reporting into the centre. I will take into account what she said about her requests both for more live data—collected and published data—about critical incidents and for more localised data in individual trusts, including ambulance services, to monitor variations in response times within a region. Although the points she has raised are interesting, I add the caveat that we would not want to burden the system with more reporting requirements if that causes a distraction from improvement. I tend to lean towards more transparency in data and reporting, however, and I will take into account the representations she has made as we put together our urgent and emergency care plan.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

At the Victoria hospital in Kirkcaldy, paramedics have had to establish a makeshift ward outside as ambulances queue up outside A&E. The number of people presenting in December 2024 was roughly the same as in December 2019, but there has been an increase of almost 300% in those waiting over four hours at A&E. Does the Secretary of State agree that this is a dreadful indictment of 18 years of SNP rule in Scotland, and that the SNP Government must use some of the additional £4.9 billion from the UK Labour Budget to get a grip? My constituents deserve so much better than this.

[Wes Streeting]

I thank my hon. Friend for that question. The conditions she describes at her local hospital are truly shocking. As I have said, and this is often quoted by the SNP, all roads lead to Westminster, and I am happy to report that up that road from Westminster to Holyrood lies a record uplift in funding for the Scottish Government. They have no excuses for inaction. They need to grip the crisis in the NHS in Scotland, as we are here. The difference, as my hon. Friend states, is that they have a record of 18 years that they cannot defend, and I hope people will consider that record very carefully when they decide who should govern in Scotland at the next set of Scottish elections.

Hospice Funding

Melanie Ward Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

I have to say that dancing is more my style than marathon running, so I wish the hon. Lady luck with that. At least she did not ask me for any money. I refer her to my earlier answer: this is additional money to support the hospice sector. It is a £100 million boost for adult and children’s hospices to ensure that they have the best physical environment for care, and £26 million in revenue to support children and young people’s hospices. We look forward to working with the sector in order to best deploy that in the New Year.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

Merry Christmas to you and your team, Mr Speaker.

Our hospices do an amazing job, and I look forward to visiting my local hospice in the next few days, but Scottish hospices have warned that they might have to turn patients away because of the funding crisis that they face under the SNP. Does the Minister agree that the Scottish Government must at least match the level of investment that she has announced today? They must have a similar level of ambition for Scottish hospices, and provide fresh investment for our hospices, which do an amazing job in Scotland.

[Karin Smyth]

As my hon. Friend highlights, this is a devolved issue for the Scottish Government. We hope that they match our ambition, as she rightly puts it. I wish her well with her local hospice, and I hope that the Scottish Government take note of what we are doing here in England.

Lobular Breast Cancer

Melanie Ward Excerpts

Tuesday 10th December 2024 Westminster Hall

[Helen Hayes]

I thank the hon. Gentleman—who is my hon. Friend—very much indeed for that intervention.

Heather died in St Christopher’s hospice near her home on 30 August. She was 48 years old. Shortly before she died, Heather’s daughter, who was due to start secondary school in September, visited her mummy in the hospice, so that she could see her in her school uniform. In that unbearable heartbreaking detail is why we must do better on lobular breast cancer: better on awareness of symptoms and better at research into treatments.

The heartbreak of Heather’s story and the impact on her family and friends is sadly replicated for too many women and their loved ones throughout the UK. Lobular breast cancer is the second most common type of breast cancer, accounting for 15% of all breast cancers, and 22 women a day are diagnosed with lobular breast cancer in the UK. It behaves differently from other forms of the disease, mostly strikingly because it does not cause lumps, and it is often completely invisible on a mammogram.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

I thank my hon. Friend for securing this debate on such an important topic, and for so movingly sharing the story of her friend Heather. I want to raise the case of my constituent from Dalgety Bay. Just days before her surgery for lobular breast cancer, a mammogram was still unable to pick it up, exactly as my hon. Friend describes. It could not pick up the existence of her cancer at all. Does my hon. Friend agree that this is a perfect example of why we so badly need more research and better diagnosis and treatment of lobular breast cancer for women across the UK?

[Helen Hayes]

I thank my hon. Friend for bringing the story of her constituent to this debate. This is exactly the reason why we need to find better means of diagnosis and treatment for lobular breast cancer. I will come talk about some of those means shortly.

Currently, there are no treatments specific to lobular breast cancer. This must change. The issues have been well documented by Dr Susan Michaelis, founder of the Lobular Moon Shot Project. Susan was 50 when she noticed a small, pale, 1 mm mark on her left breast in 2012. She had no lump and both a mammogram and an ultrasound were reassuring. Six months later, the small mark had become redder and Susan had a biopsy that confirmed she had invasive lobular breast cancer. Susan’s cancer had spread to her neck, the back of her head, the eye area and her ribs. She is now on her sixth line of treatment.

Dr Michaelis is a qualified air accident investigator. She focuses on how accidents can be prevented by learning from past mistakes, and has used these skills to look at how treatments have failed her. In doing so, she has identified the need for a new approach.