Building an NHS Fit for the Future

Rosena Allin-Khan Excerpts

Monday 13th November 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

“A profound betrayal”, “An insult”, “Incomprehensible”, “A major breach of trust”, “A huge blow”, demonstrating “what little regard the current UK government has for mental health”, having “broken its promise to thousands of people”—not my words but those of mental health experts in response to the Government’s scrapping of the reform of the Mental Health Act.

Back in 2017, there was hope of real change when the Government pledged to reform the Act. Six years later, and after much posturing from Government Ministers, that promise has sadly been broken. I sat for many months with colleagues from across the House on the Joint Committee of the draft Mental Health Bill. We took evidence from experts and those with lived experiences. Many had to unpick painful, traumatic experiences, and did so willingly so that no other person would have to endure the same. That would all be for nothing. Trauma relived for nothing. Recommendations made for nothing. The Government never even bothered to respond to the Committee’s report.

Black people are five times more likely to be sectioned. More than 2,000 people with learning disabilities are held in mental health hospitals, of whom 200 are children. That is the reality of the Mental Health Act in modern Britain. All that is set amid years of Tory failure on mental health. Waiting lists are through the roof, standards of care are falling and staff are burnt out. Poor standards of social housing, the cost living crisis, the decimated benefits system and growing job precarity are the social ills driving the mental health crisis we now face. Those ills have been intensified by a Conservative Government who have underfunded our NHS and public services. That is the hallmark of a Government who simply do not care.

This Government do not care if children languish on waiting lists. They do not care if parents have to give up their jobs to sit at home on suicide watch because their children cannot get the help they need. They do not care about people in all our communities. Health is something that bridges the economic divide and the class divide. It is a factor that matters to every single one of our constituents in some way or form.

But the failures are not just in health. Across Tooting, whether they live in a council house, rent privately or are a homeowner, the Government have failed everyone. Not content with selling off over 20,000 council homes in Wandsworth, leaving thousands of children homeless each winter, the Conservatives then made it impossible for people to get on the housing ladder. Average rent in Tooting for a two-bedroom flat is £2,300 a month, with bills. In what world is that feasible or even acceptable? Homeowners are no better off either. After the previous Prime Minister crashed the economy, which Conservative Members all supported, homeowners across Tooting are having to pay hundreds of pounds more on their mortgages. Everyone deserves the security and safety of their own home.

Speaking of safety, talk to people across Tooting and they will tell you of their worries about antisocial behaviour and crime, with multiple incidents of children—children—being mugged after school and of drug dealing not being addressed. Why? Because the police are under-resourced and overstretched. My local police teams are absolutely incredible. Local police teams do their best and I pay tribute to their efforts, but we all know that most low-level crimes go unsolved, and they are often a feeder for the most serious stuff, such as drug dealing. This the direct result of real-terms budget cuts and a cut to safer neighbourhood teams.

The Government are record breakers, but it is not something to be proud of. Waiting lists for NHS treatment have reached a record high of 7.7 million people. That includes many people from across Tooting. They are waiting in pain for a hip replacement, worried their cancer might spread, or stuck in a bay for many, many hours in A&E, where I do shifts. Back in 2010, patients waiting more than 12 hours in A&E were pretty much non-existent, but that was the sad reality for 44,000 people last month alone. In 2010, when Labour left office, doctors like me were not having to perform intimate exams in cupboards and patients were not having to line the halls waiting to be seen, lying on the floor. With yet another Health Secretary coming into post, nothing will change and Tooting people will continue to be let down by the Government.

This was a King’s Speech lacking in ambition and failing to address the problems faced by people across the country on a daily basis; a King’s Speech that is truly a testament to broken Britain and the Government who caused it. We now need a Government willing to give Britain its future back. We need a Labour Government.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 17th October 2023 Commons Chamber

[Maria Caulfield]

I have met with 3 Dads Walking; I have not met the mums group but am very happy to do so. Because of their intervention and campaigning, we were able to successfully put their campaign about improving mental health awareness in the school curriculum into our suicide prevention strategy. It is a cross-Government strategy, and the Department for Education has very much taken their points on board.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Over 1.8 million people languishing on mental health waiting lists, black people five times more likely to be detained under the Mental Health Act 1983, and over 2,000 people with learning disabilities detained in hospital, all while the Government are dragging their feet on mental health and suicide prevention. You will be interested to know, Mr Speaker, that we had cross-party support to tackle these burning injustices through the draft Mental Health Bill, yet since the Joint Committee on the Draft Mental Health Bill published our report in January we have heard nothing from the Government, so will the Minister today commit to including reform of the Mental Health Act in the King’s Speech?

[Maria Caulfield]

I was going to pay tribute to the hon. Lady for her work on mental health campaigning, and she will know we have done a huge amount. The suicide prevention strategy is a cross-Government piece of work, which makes sure suicide is everyone’s business, not just that of health and social care. Whether by supporting families bereaved by suicide or rolling out mental health support schemes in schools, it is this Government who are delivering on mental health services.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 11th July 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

As my hon. Friend the Member for Leeds North East (Fabian Hamilton) highlighted, all too often, children are stuck on long waiting lists for treatment. In West Yorkshire, 30,000 children are currently stuck waiting for mental health treatment, and more than 9,000 people have had their mental health referral closed without accessing treatment. Does the Minister find that acceptable? If the answer is no, what will her Government do about it? This picture is not unique to West Yorkshire, but replicated across England. This Government are letting patients down. When is the Minister going to act to tackle the crisis in mental health services?

[Maria Caulfield]

I thank the shadow Minister for her question. To highlight another initiative in West Yorkshire, the Night OWLS—Overnight West Yorkshire Living/Advice Service—helpline has been set up for children and young people. It is open between 8 pm and 8 am seven days a week for young people to access, in addition to the 24/7 helpline that is available. I am sure that the shadow Minister will also welcome the fact that we have more than 400 mental health support teams in schools in England, covering 3 million children, so that they can access mental health support directly at school.

Defibrillators: Public Access

Rosena Allin-Khan Excerpts

Tuesday 4th July 2023 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to close for the Opposition with you in the Chair, Sir Charles. I thank my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) for bringing forward this debate. She never ceases to bring the voice of her constituents right to the heart of this place, and today is yet another shining example her doing her community incredibly proud.

It is welcome that there is such unity and consensus on this issue. As we have heard, tremendous progress has been made towards making defibrillators accessible to the public, thanks to the many incredible charities and people who have been working hard to do so. The Community Heartbeat Trust, the Oliver King Foundation and SADS UK are just some of the organisations that are doing brilliant work to provide education and information about automatic external defibrillators, AEDs, and to ensure that more defibrillators are easily accessible in public spaces.

The British Heart Foundation’s Circuit project has ensured that thousands of defibrillators and their locations are registered online, but, as we have heard, that work needs to go further. People who experience the very worst in the heart of their communities need to know that they are able to find and access an AED when they so desperately need it. The Premier League defibrillator fund will provide AEDs to grassroots clubs, which is very welcome and will ensure that lifesaving treatment can be rolled out to even more stadiums.

As we have heard, in the UK one person dies every three minutes from heart or circulatory disease, and 60,000 out-of-hospital cardiac arrests occur every year. Take a minute to think about that. My hon. Friend the Member for Erith and Thamesmead quoted research published by the National Institute for Health and Care Research, which found that just over 8% of people suffering a cardiac arrest outside hospital survive—just 8% of the 60,000 out-of-hospital cardiac arrests. The same research found that the odds of survival increase to 32% if a bystander has access to a public AED, and some studies place that figure even higher. It is simple: AEDs save lives.

According to the British Heart Foundation, the low cardiac arrest survival rate in Britain can be attributed to a lack of access to defibrillators. This critical technology must be accessible to work. With my medical hat on, I will take a moment to explain how it works. CPR works to send the blood around the body to take oxygen to the tissues as a holding measure, but the AED is required to shock the heart and try to restart it again so that it can pump the oxygen around the body. Imagine somebody providing non-stop CPR for hours on end. Not only would that be far too long and the person would be brain dead at the end, but without an AED—without that shock delivered to the heart—CPR is actually pointless.

We must be clear: AEDs are simple, safe and effective. They are portable, have plain instructions and the user cannot give a shock accidentally or hurt somebody. From my professional experience in the emergency department, I know how important quick access to treatment is for patients in cardiac arrest. There can be no doubt that patients who are admitted to hospital after having received prompt treatment with chest compressions or, even more effective, a defibrillator have far improved chances of making a recovery. There is also an economic benefit, because the people whose chances of recovery are worse may spend a long time in an expensive intensive care bed, often not surviving at the end of it. That makes the argument for giving people a better outcome in the first place, which prevents those protracted stays in intensive care and saves money in the long run.

When the heart stops beating, every second counts, and a person’s chance of survival decreases by approximately 10% with every minute that defibrillation is delayed. That speaks to the importance of everyone knowing where the AEDs are. With our NHS in crisis and emergency care at breaking point, lives are being endangered. In December last year, the average ambulance wait for category 1 patients had increased to 10 minutes—the worst performance on record. Those stats make a very clear argument: the painful fact is that people are dying as a result of not being able to get the shock they need from a trained person, whether they arrived in an ambulance or came from an AED in the vicinity.

Category 1 patients are the most serious and life-threatening cases, including cardiac arrest. In a category 1 scenario, every second is the difference between life and death, and longer ambulance waits are costing lives. Sadly, after 13 years of Conservative governance, patients can no longer rely on an ambulance arriving in time. At the end of last year, one in 10 urgent cases waited over 11 hours for an ambulance. How can we in all conscience say to people who lost loved ones in such cases that their loss could not have been avoided, when we know full well that it could have been?

Last year, the Government committed to funding a defibrillator in every state-funded school in England by the end of the academic year. As the academic year is nearing its end, will the Minister outline what progress has been made on that commitment? The Government also committed last year to £1 million of funding to provide an estimated 1,000 public access defibrillators across communities in England. I note that the Department re-announced that policy just last week, so has there not been any progress on that commitment? Will he update us on how the application process is progressing and whether any PADs have been installed, and if they have, in which communities? It is crucial that they are placed in communities where the need is greatest to tackle growing health inequalities, which we have heard about extensively today.

It is really important that health inequalities are not allowed to widen any further through a lack of access to equipment that could save lives. That has to go hand in hand with training people in how to use them. I would be interested to know what work the Department is doing to encourage uptake in the communities that are most in need. While many of us will agree that public access to defibrillators will be a fantastic step towards saving lives, we must not forget that our country also deserves a well-funded, well-resourced and well-supported NHS. It is heartening that there is widespread, cross-party support for publicly accessible AEDs. I hope that the Government will build on the support from across the House and do what is needed to ensure that access is available.

[Sir Charles Walker (in the Chair)]

I remind the Minister that if he takes up the full time he must leave two minutes for the mover of the motion to wind up.

--- Later in debate ---

[Will Quince]

Absolutely. The hon. Lady pre-empts me: I am coming on to The Circuit, because that point has been made by nearly all hon. Members, but I will first conclude my remarks about the fund.

Successful applicants will be encouraged to train or facilitate CPR training in the local community. That is an important element. To expedite the distribution of funding, and in readiness for the appointment of our partner organisation—this touches on the hon. Lady’s question—on 28 June the Department published an invitation for those organisations that wish to bid for an AED to submit an expression of interest.

My hon. Friend the Minister for Social Care wrote to all hon. Members informing them of the AED expression of interest and setting out how organisations can register their interest. It is incumbent on all Members of Parliament to ensure that community groups, organisations and local authorities across our constituencies spread the message loud and clear so that we get as many expressions of interest as possible. I urge any organisation that may benefit from a defibrillator, whether it is a sports club, a local theatre or a community hall, to register and have that opportunity. It is also important that we encourage local councillors to get involved.

The hon. Member for Erith and Thamesmead asked specifically about the Department for Education. I was Schools Minister at the time the decision was made and signed off. On 17 July, the Department for Education announced that it would provide defibrillators to schools in England that do not already have access to one. That is expected to be completed by the end of the 2022-23 academic year. The scheme, of which I am very proud, is the largest distribution of defibrillators to be rolled out across England to date. It will provide more than 20,000 devices, backed by £19 million of funding.

[Dr Allin-Khan]

The end of the academic year is in two weeks’ time, on 17 July. May I ask for an update on the progress to meet the target?

[Will Quince]

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.

Mental Health In-patient Services: Improving Safety

Rosena Allin-Khan Excerpts

Wednesday 28th June 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank the Secretary of State for advance sight of the statement. However, it beggars belief that it has taken the Government so long to address the House on this matter. It seems that every month there are new scandals regarding needless loss of life and dehumanising behaviour in in-patient mental health settings. That must be stamped out now—these are people’s lives.

That brings me to the subject of Essex Partnership University NHS Foundation Trust. I welcome the announcement today that the inquiry will be given vital statutory powers, because for several years families who have lost loved ones at the trust have been calling for the inquiry to be given those powers. The grieving families I have spoken to have told me about the pain and anguish they have felt during their fight for answers, and that has only been compounded by an inquiry that lacked the necessary powers to seek the truth.

I must pay tribute to those families for their tireless campaigning and effort. In particular, I thank Melanie Leahy, who has fought for too long to achieve the announcement that has finally come today. I hope that Melanie, and every other family, will now start learning the truth.

Dr Strathdee has been a powerful advocate for the Essex inquiry, and we want to express our thanks to her for the work that she has already put in. The next inquiry chair must continue her work, and hold the confidence of the families who have been impacted in Essex.

I have repeatedly called on the Secretary of State to give the Essex inquiry statutory powers, and I am pleased to see that he has finally listened to our calls, but why were families left in the lurch for so long? Following months of scandals in in-patient mental health hospitals, public confidence is falling. More than one in three people say that they do not have faith that a loved one would be safe if they needed hospital mental health care, but every patient must be treated with dignity. I have repeatedly asked Ministers whether they have visited failing trusts. The Minister refused to answer, so will the Secretary of State commit himself to greater transparency? The Secretary of State has announced that urgent mental health support will be made available through 111, but 1.6 million people have been left languishing on waiting lists for mental health treatment, their condition deteriorating and reaching crisis point.

It is welcome that we will finally see the publication of the rapid review today—better late than never—but Labour has been calling for in-patient mental health settings to be reviewed in the light of these serious failings, and any rapid review should have had patient voices at its centre rather than being simply the data exercise that the Government commissioned. When we look at the planned national investigation into in-patient services that they will conduct alongside the Health Services Safety Investigations Body, we see that, yet again, there is no mention of working with patients and their families. Where is the learning? Where is the focus on what staff need in these settings? Are the Government looking at additional training needs, given that mental health care relies on staff and not simply on shiny equipment?

Let me turn briefly to the planned consultants’ strike, about which the Health Secretary has said absolutely nothing. Yet again he has been missing in action. For my consultant colleagues to have voted to strike is extraordinary, and the risk to patients of seven days of strike action is intolerable. Next week marks the 75th anniversary of the NHS, and it has never been in a worse state. The country is clear about who is to blame. It is not nurses, it is not junior doctors, it is not consultants, and it is not paramedics; it is this Conservative Government. They have lost control of the NHS, they have lost the confidence of NHS staff, and they have lost the support of the British people. The only ballot that we need now is a general election.

[Steve Barclay]

It is a shame that the hon. Lady chose to conclude her remarks in such a way. Let me address that head-on. It is bizarre to accuse a Minister who is literally at the Dispatch Box of being missing, particularly when the shadow Health Secretary, having managed to turn up for Prime Minister’s Question Time, has failed to turn up for this statement. It is even more bizarre that, although we are constantly told that the Labour party sees parity between mental health and physical health as a key priority, when it actually comes to debating the issue, the contrary is clearly on show.

This debate is not about the issues normally raised during Prime Minister’s questions about the politics of the day; it is about the families who have tragically lost loved ones, about how we can learn the lessons from that, and about how we can ensure that we get the data right, get the support for staff right, and get the procedures right so that other families do not suffer loss. We have responded to the excellent points made by Dr Strathdee through her rapid review about data. There are two elements to that: there is data that is collected that does not add value, is often duplicative and takes staff away from giving care—that is somewhere that we can free up staff—but there is other data that is needed to better identify issues early, and we need to look at how we improve that data. Specific issues arose in respect of engagement by staff, and we have actively listened and responded to the concerns raised by families and by many Members of the House, particularly about the Essex inquiry. I will come on to those as I go through the wider issues.

The shadow Minister mentioned speed. Of course, there is a balance to be struck between the completeness of a statutory inquiry and the greater speed that is often offered by other independent inquiries. Indeed, the Paterson inquiry was a non-statutory inquiry commissioned through the Department, and that is another vehicle that is often successfully used. There are also inquiries commissioned through NHS England, such as the Donna Ockenden review. There is often a balance to be struck between those inquiries, given the speed at which they can proceed, and a statutory inquiry, which has wider powers but often takes longer.

It was because of our desire to move at pace to get answers to families that we initially commissioned a non-statutory inquiry, in common with Bill Kirkup’s inquiry into Morecambe Bay and inquiries into many other instances in the NHS. However, we have listened to families and to right hon. and hon. Members who have raised concerns about the process and, in particular, the engagement by staff, and decided to make it a statutory inquiry.

The shadow Minister asked about our commitment to transparency. The very reason that we set up the rapid review in January was to bring greater transparency to the data. That is why I will be placing in the Libraries of both Houses the outcome of the rapid review. That speaks to the importance of transparency as we learn the lessons of what went wrong in Essex and in other mental health in-patient facilities.

The shadow Minister made a fair point about waiting times. We are committed to cutting waiting times, including in mental health. That is why we are spending £2.3 billion more on mental health this year than four years ago, we have commissioned 100 mental health ambulances, we have 160 different schemes looking at things such as crisis cafés to support people in A&E, and we have schemes such as the review through 111 and the funding the Chancellor announced in the Budget for mental health digital apps to give people early support. Of course, that sits alongside other mental health interventions, such as our programme to train more people to give mental health support in schools.

The shadow Minister made an important point about working with families. I agree with her about that. HSIB will be meeting families—indeed, Ministers have been doing likewise—and we are keen that that should feed into the terms of reference, both for the statutory inquiry and for the HSIB review.

We have touched on consultants, but let me make a final point on that. As far as I am aware, the Opposition do not support a 35% pay rise, whether for junior doctors or for consultants, but if that is their position, perhaps they will tell us whether this is yet another area that the stretchable non-dom contribution will reach to. Exactly how will it be funded?

This is a serious issue. The measures that we are taking address the concerns of families who have suffered the most tragic loss. It is important that we learn the lessons, both in Essex and more widely. We have actively listened to the points raised by Dr Strathdee, who has done a fantastic job. It is right that the work moves on to a statutory footing, but it is also right that we look more widely at the lessons from other mental health in-patient facilities. That is exactly what we intend to do.

Mental Health Treatment and Support

Rosena Allin-Khan Excerpts

Wednesday 7th June 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I beg to move,

That this House notes with concern the scale of the mental health crisis facing the country with patients suffering with mental health issues waiting more than 5.4 million hours in accident and emergency last year; further notes with concern the mental health crisis facing young people with nearly 400,000 children currently waiting for treatment; recognises the health inequalities within the use of the Mental Health Act 1983; and calls on the Government to adopt Labour’s plan to recruit thousands of mental health staff to expand access to treatment, to provide access to specialist mental health support in every school, to establish open access mental health hubs for children and young people and to bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.

After 13 years in office, this Government have delivered the worst mental health crisis in our history. We are becoming a brittle, anxious, fractious society, the very bonds of which are frayed and torn. The causes of mental ill health are complex: poverty, homelessness, neglect, loneliness, debt, bereavement, domestic violence and child and adult trauma. Our understanding of mental health is developing all the time. We have moved on in the years since I trained as a doctor. We can now see how interlinked and enmeshed the range of factors is: warm and safe homes, fulfilling work, strong relationships, safe streets, opportunities to learn, fresh air and green spaces are policies for good mental health.

Nye Bevan talked about the serenity in knowing that medical care is free at the point of need. After 13 years of Conservatives, we are far from serene. For many of the families I meet, the future is filled with dark clouds, fear of displacement and debt, and a sense that society is going to hell in a handcart—a Britain where nothing works, where everything is broken and where everything costs more than six months ago. Zero-hours contracts, boarded up high streets, rapacious landlords, rising lawlessness and antisocial behaviour and the long-term effects of covid—no wonder we are in the grip of a mental health crisis.

[Mr Toby Perkins (Chesterfield) (Lab)]

I am very pleased with the way my hon. Friend has started her speech, because she is absolutely right. Alongside the additional healthcare staff needed and the many measures that my hon. Friend the Member for Ilford North (Wes Streeting) and I have been spelling out for the health service, the society that has been created over the past 13 years of austerity has had massive impact on the mental health crisis. I am glad that my hon. Friend has focused on that. It will be the job of the entire future Labour Government to support her and her colleagues to reduce the mental health crisis.

[Dr Allin-Khan]

I thank my hon. Friend for his intervention; he is right. I will talk about the need for mental health not to exist in a silo later in my remarks. Frankly, it is the problem of every single Government Department.

One in four people experiences a problem with their mental health each year in England. One in six people experiences a mental health condition, such as anxiety or depression, each week. Three in four people with mental ill health in England receive little or no treatment for their condition. And people with the most severe mental illnesses die up to 20 years sooner than the general population. I ask the House to reflect on that for a moment. Tragically, in 2021, over 5,000 suicides were registered, up by 300 on the previous year. The Government should wear these statistics like a badge of shame.

[Andrew Bridgen (North West Leicestershire) (Reclaim)]

The shadow Minister makes an accurate assessment of the size of the mental health crisis facing our nation, but her words would have more resonance if she and her party had not voted in lockstep with the Government for the disastrous lockdowns that damaged mental health, especially that of our young people. Will she apologise?

[Dr Allin-Khan]

I will take no lectures from the hon. Member, because he proudly sat as a Member of a Government who oversaw hundreds of thousands of unnecessary deaths. Families are still feeling the ongoing mental effects of losing loved ones because of the mishandling of the pandemic by his then Government.

My right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), the Leader of the Opposition, launched Labour’s mission for health in May. He said:

“Suicide is the biggest killer of young lives in this country, the biggest killer. That statistic should haunt us, and the rate is going up. Our mission—must be and will be—to get it down.”

He is right. Across the House, we are increasingly hearing brave, moving and revealing testimonies about our own experiences and struggles. It is vital that we challenge the stigma and talk openly about mental health.

[Dan Carden (Liverpool, Walton) (Lab)]

My hon. Friend and I have worked on these issues over the last couple of years. She knows that 70% of people who enter treatment for alcohol issues also experience trouble with their mental health. The Public Accounts Committee recently released a report on alcohol treatment services, and recommendation 4 called on the Government to set out, without delay

“what it is doing to help improve integrated care for people with co-occurring alcohol and mental health problems.”

Will she use her position today to encourage the Government to act on that recommendation?

[Dr Allin-Khan]

I could not be more proud to work with my hon. Friend in this space. He is a powerful advocate and I wholeheartedly support all his efforts, and those of Members across the House, to support people who are living with alcoholism, and their families. I thank him; we will continue to support his work.

[Jim Shannon (Strangford) (DUP)]

I commend the shadow Minister and the Labour party for bringing this issue forward. Support for mental health across this great United Kingdom of Great Britain and Northern Ireland is a massive issue, including in my constituency. For example, one of my constituents told me they finally found the courage to seek help for their mental health, only to be told by health professionals, “We can’t do anything for you just now as your condition is not severe enough yet—you have no thoughts of suicide.” Does the hon. Lady agree that supporting those with mental health issues at the earliest stage—right away—is more beneficial, instead of forcing them to wait until it may be too late? At that stage, the situation cannot be turned back.

[Dr Allin-Khan]

I thank the hon. Member; it has been a pleasure to work with him in every single debate about mental health that I have held in the past three years, since I started my role. He speaks to the important point that prevention is the watchword that counts when it comes to mental health.

[Janet Daby (Lewisham East) (Lab)]

My hon. Friend is making a powerful speech. Does she agree that the Government are failing people who are experiencing mental ill health, or even a mental health crisis? Psychiatrists are leaving the country because they are finding jobs overseas more accessible. People experiencing mental health crises are having to wait in A&E departments for too long; they waited for a total of 5.4 million hours during 2021, which is entirely unacceptable. Things need to change.

[Dr Allin-Khan]

I thank my hon. Friend for assisting me in writing my speech; she has pre-empted much of what is to come. She is a powerful advocate for her community and I am proud to share the Opposition Benches with her.

[Laura Farris (Newbury) (Con)]

On that point, will the shadow Minister give way?

[Dr Allin-Khan]

I will make some progress, but I would be happy to take further interventions after that.

Amid all the anguish and pain, one thing comes through: people cannot access the mental health services they need. The stark fact is that the way the UK’s mental health services are funded and distributed can exacerbate the problem, so instead of making people better, they are making them worse.

The current reality is that 1.6 million people are waiting for treatment. More than 1 million people had their referral closed without receiving any help in the last year alone. Last year, children in mental health crisis spent more than 900,000 hours in A&E and almost 400,000 children are on waiting lists. In the same period, adults experiencing a mental health crisis spent over 5.4 million hours in A&E. Black people are five times more likely to be detained under the Mental Health Act 1983 than white people. People with eating disorders are being put on a palliative care pathway.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Will the shadow Minister join me in welcoming the work the Government have done to bring forward the draft Mental Health Bill? We both sat on the pre-legislative scrutiny Committee. Hopefully, the Bill will right some of those wrongs.

[Dr Allin-Khan]

It has been a pleasure to work with the hon. Member on the draft Mental Health Bill. However, as I will say later in my speech, I have little confidence that the draft Mental Health Bill will move beyond the draft stage. We need to debate the issues in the House, to ensure that what we know needs to be fixed is actually fixed, so that we can help people in our communities, including black people, who are more likely to be detained under the Mental Health Act, and people with autism and neurodiversity, who are mistreated simply as a result of having that diagnosis, so that their lives can be better lived. We need these issues to come before the House, so that we can debate them and move forward.

[Jeff Smith (Manchester, Withington) (Lab)]

My hon. Friend is making an important point about the demand on A&E, but there is demand on other public services as well. When I have been out with the police in south Manchester, I have been shocked by the sheer amount of time they spend dealing with people in mental health crisis. I am sure we all know the amount of time our staff spend dealing with people in mental health crisis. Does she agree that it is a false economy not to invest properly in mental health services, because of the impact on other public services?

[Dr Allin-Khan]

My hon. Friend makes a powerful point; he is right. It is also a false economy because of the impact mental ill health has on families. Not investing in one person’s mental ill health not only has an impact on their working and earning potential, but has a knock-on impact on that of their parents, siblings and other family members. People are currently sitting at home on suicide watch for their children because they cannot get access to the timely help and treatment they need. This is Tory Britain.

What has been the response from the Government to these alarming facts? Ministers have junked the 10-year mental health plan and binned thousands of responses to the consultation. Seni’s law, set out in a private Member’s Bill introduced by my hon. Friend the Member for Croydon North (Steve Reed), passed unanimously, but it has not been fully implemented. It was passed almost five years ago and there have been three subsequent Ministers, and yet we are in the highly unusual situation where it has not been commenced in full. Who exactly is against the monitoring of the disproportionate use of force? The House certainly was not against it when the Bill was passed.

The Government have announced plans for new mental health hospitals, but those new hospitals are not new. The hospitals announced on 25 May—Surrey and Borders, Derbyshire and Merseycare—were already in the pipeline.

Let us talk about the Minister’s own patch, to really see the scale of the issue. At his closest hospital, adults experiencing a mental health crisis waited 11,000 hours in A&E last year. There are over 5,000 children and 40,000 adults stuck on mental health waiting lists across his integrated care board. Thousands of local people were turned away from services before treatment; I am sure the Minister will agree that that is unacceptable. As ever, we have smoke and mirrors when we need bricks and mortar. If this seems bleak, that is because it is.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making an excellent speech about a very important issue. One of my constituents who works in psychiatric care has talked of staff having to deal with violence, verbal abuse, being swilled with boiling water and more. He says that they are under extreme pressure, which is causing some to leave and putting more pressure on those who remain. Does my hon. Friend agree that that is a shocking and unsustainable state of affairs, and that we need a Labour Government who will invest in mental health services?

[Dr Allin-Khan]

I entirely agree with my hon. Friend, who works tirelessly on this issue.

After more than a decade of Tory Governments, if people need help, all too often no one is there. Last year, emergency service workers took more than a million sick days because of stress. NHS staff are at the sharp end of this mental health crisis. I know them, I work with them, and I see what they are coping with daily. They are heroes, but they simply do not have the resources, the staff or the leadership from Ministers that would enable them to do their jobs. They themselves suffer exhaustion, depression, stress and anxiety. About 17,000 staff—12% of the mental health workforce—left last year.

You will be pleased to know that I have had a look at the Government’s amendment, Mr Speaker—I do my homework. There is the tired old £2.3 billion figure. How many times have we heard that trotted out? Actually, I can tell the House that it has been used more than 90 times over five years, and it has been spent in myriad different ways. Then there is the £150 million for mental health crisis units. But the amendment fails to mention the serious patient safety concerns that doctors have raised, and it is clear that the pressure on A&E remains as fierce as ever. There is also nothing about the recent announcement from the Metropolitan police that they will not help people in a mental health crisis.

Ministers need to get out of Whitehall and see what is really happening in our mental health service. If they did so, they would see what I have seen in recent months. They would see the junior psychiatrists whom I met recently—junior doctors who have devoted all their training to this profession, and half of whom plan to leave the NHS at the end of their training. They would see the doctor who told me of an incident in which six police officers were in A&E for 18 hours with a patient detained under section 136 of the Mental Health Act 1983. They would see a child arriving at A&E after self-harming, having been referred by the GP a long time ago but not been seen for weeks, which led to an escalation point and a crisis in A&E. We are seeing a system in crisis, people in pain and families in distress.

[Munira Wilson (Twickenham) (LD)]

The shadow Minister has referred several times to children’s mental health and the crisis that often occurs when they present at A&E departments. Does she agree that schools have an important role to play when children have moderate mental health conditions, before those conditions escalate? The role of mental health support teams in schools is critical, but their funding is due to end abruptly next year, with only about half the programme complete. Will she join me in asking the Minister to commit himself to funding the full roll-out of mental health support teams or, better still, to back the Liberal Democrats’ plan to provide a qualified mental health practitioner in every school?

[Dr Allin-Khan]

I invite the hon. Member to have a look at the plans we already have in place. She will be pleased to learn that one of our pledges is the provision of a mental health specialist in every school. I invite her to support those Labour plans—and to come and join us over here if she feels like it.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

Young people are bearing the brunt of the mental health crisis, and parents are worried sick. I see evidence of that every day in my inbox, and it is getting worse. When so little money is being spent on young people’s mental health, even though we know that the vast majority of mental health conditions appear in people under the age of 18, is the balance right between the money spent on adult mental health and that spent on young people’s mental health? If we want a preventive system that helps to cut costs for the taxpayer and helps people as well, is not investing early in young people the best way to achieve that?

[Dr Allin-Khan]

My hon. Friend is spot on in making the point, very articulately, that prevention is our watchword. It is vital that we have mental health access hubs in every community to give people the support that they need; it is essential that we have mental health specialist support in every school; and it is essential that mental health does not operate in a Health silo, because when it comes to improving adverse childhood experiences that can lead to poor mental health in later life, that is every Department’s issue.

I have asked Ministers six times to tell us of their meetings with mental health trusts where there are reported abuse scandals, but they have failed to respond. In-patient services across England must be reviewed, with patients’ voices at the centre. After a series of allegations in different settings, the Government have dragged their feet, and we are still waiting for the findings of their data exercise, in which no one even spoke to families or patients. They could start by giving statutory powers to the inquiry into deaths in Essex mental health units.

What else needs to change? First, we need to speed up diagnosis and treatment. The longer we leave a mental health disorder untreated, the worse it gets—just like cancer, sepsis and heart conditions. Delays cost patients their wellbeing and their families their peace of mind, and of course it costs the taxpayer more to treat a patient who is more acutely unwell after months and years of delay. The argument for prevention, early intervention, speedy diagnosis and timely treatment is clear. Labour will guarantee treatment within a month for all who need it, which will be better for patients and better for the NHS.

Secondly, we need a tough new target for delivery—something for the whole system to drive for, and something for the voters to judge us on. Labour will recruit 8,500 new staff, so that 1 million more people can access treatment every year by the end of Labour’s first term in office.

Thirdly, we will reach out to our young people, and give the next generation the support that they desperately need. This is the generation who have known little or no security: children who have gone through the great financial crash, austerity and covid, robbed of their future and dismissed as snowflakes. We will open a mental health access hub for children and young people in every community, providing early intervention and drop-in services, and we will provide access to a mental health professional in every school. This is a true community, preventive approach in action.

Fourthly, we will stop mental health policy being placed in a silo. As I said at the beginning of my speech, mental health policy cannot be disentangled from social and economic policy. A decision on Bank of England interest rates takes its toll on the mental health of a family in Tooting. We are all interconnected. The economy is not an abstract concept; it is people. The next Labour Government will present a long-term, whole-Government plan to improve mental health outcomes—mental health in all policies.

Fifthly, Labour Ministers will allocate to mental health its fair share of funding, as the economy grows and as resources allow. For starters, we will close tax loopholes, putting the country’s mental health first. That is our plan and, crucially, it will not be solely the responsibility of the incoming new mental health Minister; it will be the responsibility of the whole Cabinet and the whole Government.

We have seen enough plans, we have heard enough announcements, and we have watched enough Ministers pass in and out of the revolving doors of 39 Victoria Street. Let us have no more Tory sticking plasters. Labour’s health mission, guided by prevention and anchored in community, gives children the best start and boosts the economy, with more people in better health. With a clear plan, with clear costings and with resolute leadership, we will deliver the world-class health system that our society truly deserves.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 6th June 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister for mental health.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

A 14-year old climbing out of hospital windows; a child absconding to a local railway station; a teenager with complex needs brought to A&E, requiring four police officers to spend an entire shift watching them, only for them to abscond the next day. There is a pattern here. At almost every step of the way, children needing mental health services face a perfect storm of delay and treatment in inappropriate settings, fuelled by an under-resourced service with over-stretched staff. In light of the Met’s announcement that they will stop attending emergency mental health calls, is it not time for the Government to get their act together, or simply do the right thing and step aside?

[Steve Barclay]

One can see the way the Government are responding constructively to these issues by looking at the pilots we have been rolling out in Humberside, where police are released within one hour in 80% of section 136 detentions. We intend to roll out that pilot nationally.

The hon. Lady is right on the first part of her challenge, as demand for mental health services is increasing. In fact, there was a 41% increase in new referrals to mental health services in 2021 compared to the previous year. Where she is wrong is on the resourcing. She missed my previous answer that set out how we are committing an extra £2.3 billion of investment into mental health services, compared to four years ago.

Oral Answers

Rosena Allin-Khan Excerpts

Tuesday 25th April 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

This may surprise you, Mr Speaker, but I have found evidence that the Health Secretary has got something right. He recently hailed the power of local news outlets, and he was spot on. I have here a story from his local paper, exposing the shocking length of waits in A&E for those in a mental health crisis: 5.4 million hours across England in just one year. He is very welcome to have a look if he would like to. Given his admiration for local journalism, does he feel embarrassed for his Government’s failings and will he apologise to all the people across the country who are stuck waiting in A&E?

[Steve Barclay]

There are two separate issues there: what we are doing for mental health in-patients and the point we just touched on about A&E. On mental health, it is good of the hon. Lady to give me the opportunity to remind the House of the significant increase in funding we are making to mental health. In the long-term plan, the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), made a major strategic choice to invest more in mental health—an extra £2.3 billion per year. The hon. Lady is right to highlight the need for more capacity for mental health in-patients—[Interruption.] She asked a question on what we are doing on mental health. I am able to tell her that we are spending far more and investing far more in it, but it seems that she does not want to hear that answer.

--- Later in debate ---

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I do, too.

[Will Quince]

You do, too. Mine were not through IVF, but as a Back Bencher I also campaigned on IVF issues, because there was a postcode lottery on that around the country. That still exists to some extent and I would be happy to work with my hon. Friend to make sure that wherever people are in this country they can get IVF services.

Draft Mental Health Bill 2022

Rosena Allin-Khan Excerpts

Thursday 26th January 2023 Commons Chamber

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I first draw the House’s attention to my entry in the Register of Members’ Financial Interests as a practising NHS psychiatrist.

The Joint Committee on the Draft Mental Health Bill was formed on 4 July 2022 to scrutinise this important and urgently needed reform of mental health legislation. Our Committee has been working hard since that date. We held 21 meetings in just over 12 sitting weeks, spoke with more than 50 witnesses, received more than 100 submissions of written evidence, and engaged with affected communities through surveys, roundtables and a visit to the mental health unit at Lambeth Hospital. We are grateful to everyone who took time to contribute to our inquiry, to the officials and Ministers at the Department of Health and Social Care for their engagement with our work, and to our specialist advisers and secretariat.

Working on the Joint Committee was a collaborative process as we worked together through this complex topic and learned from each other’s expertise. There were differences of opinion, which may be reflected in later debates in this place. However, the fact that we felt it important to agree the report unanimously is testament to the Committee’s dedication to getting this once-in-a-generation piece of legislation on to the statute book. Our work was supported by an excellent team of officials and Clerks from both Houses. The Committee is grateful for their expertise and support in our work and in compiling the report.

The Mental Health Bill has been much anticipated. Detention rates under the Mental Health Act are rising. A disproportionate number of people from black and ethnic minority communities are detained. Our attitude as a society towards mental health has changed and reform is needed. We welcome the principles contained in the draft Bill, which introduces important reforms to improve patient choice, bring down detentions and reduce racial inequality. In our inquiry we heard concerns about implementation, resourcing and possible unintended consequences of the proposed legislation. Our recommendations address those concerns and are intended to make this important Bill stronger and more workable.

However, the process of mental health reform cannot stop or even pause with this Bill; there needs to be further consideration of fusion legislation of the mental health and mental capacity laws. During our evidence it became apparent that someone needs to drive mental health reform on behalf of patients, families and carers. We have recommended the creation of a mental health commissioner to oversee that process and to challenge the stigma that still exists around serious and enduring mental illness.

Proper resourcing and implementation will be crucial for the changes to work. Mental health services are under enormous pressure, and significant changes and improvements are needed to provide high-quality community alternatives to in-patient care, particularly ensuring that there will be a sufficient workforce to deliver the proposed changes. We welcome commitments from the Government to increase spending on health and social care, but most people we spoke to, including mental health providers, were still unconvinced that current resourcing or workforce plans are adequate. The Government must publish a detailed plan for resourcing and implementation on introducing the Bill, including the implications for the workforce. They should report annually to Parliament on their progress against that plan.

The independent review structured its work around four key principles that should shape care and treatment under the Mental Health Act. Those principles were: choice and autonomy, least restriction, therapeutic benefit and the person as an individual. These principles should be included in the Bill to ensure that they endure and become a driver of cultural change.

Tackling racial inequalities in the use of the Mental Health Act must be at the core of the reform. Black people are four times more likely to be detained under the Mental Health Act than white people, and 11 times more likely to be given a community treatment order. Those figures are rising. There has been a collective failure to address this issue. We now feel that the time has come for that to be addressed. Understanding of racial inequality must be included in the Bill. There must be a responsible person in every health organisation to monitor data on inequalities and oversee policies for change. We heard evidence that community treatment orders are ineffective for most patients and disproportionately used for black patients. We have therefore recommended that they are abolished for civil patients and reviewed for use with forensic patients.

On the important issue of the detention criteria, the draft Bill makes changes to the grounds on which someone can be detained for assessment and treatment, with the intention of moving away from a risk-based model and ensuring that detention will benefit the patient. Accountability is welcome, but we heard that it may lead to people being denied the help they need when they most need it, particularly patients with psychotic illnesses and those with chronic and enduring mental illness. We recommend some changes to the criteria and greater guidance in the code of practice to prevent that.

Too many autistic people and those with learning disabilities are detained in inappropriate mental health facilities, and for too long. Change to the way the Mental Health Act works for patients with learning disabilities and autism is long overdue. The Government’s intention to address that, by removing learning disabilities and autism as conditions that can justify long-term detention under section 3 of the Mental Health Act, may lead to benefits in the longer term. However, we heard that without proper implementation, those changes could make the situation worse, and potential displacement of people with learning disabilities into the criminal justice system could occur. There must be improvements in community care before people with learning disabilities and autistic people can be supported to live in the community. It is vital that reforms are not implemented until that is achieved.

Another pressing risk is that those communities may be detained, instead, under different legal powers, and possibly criminalised. That would be the opposite of what the change is intended to achieve. The Government must address that risk before the changes are implemented. We have therefore recommended the introduction of a tightly defined power to allow for longer detention periods in exceptional circumstances, with strong safeguards in place to prevent that happening unnecessarily.

On patient choice, patients should be able to make choices about their care and treatment. The draft Bill makes welcome changes in this area but does not follow through on a White Paper commitment to give patients statutory rights to request an advance choice document. We heard almost unanimous evidence supporting an advance choices document, and made a recommendation that advance choices should be a statutory right.

The number of children and young people experiencing mental distress has risen dramatically since the covid-19 pandemic. Children and young people continue to be placed in adult wards or in hospitals far from home due to the lack of appropriate care placements. The draft Bill misses a crucial opportunity to address that. We also believe that children should benefit from stronger protections in the draft Bill to support patient choice. This is a complex area and the Government need to carefully think through their proposals, consulting further where necessary about this Bill and how it will interact with the Children Act 2004.

In conclusion, it is 40 years since the Mental Health Act 1983. This draft Bill is needed. If the Government are willing to address our concerns in the ways that we have suggested, the Bill can make an important contribution to the modernisation of mental health legislation. Given our suggested amendments, we hope that the Government act swiftly to introduce the Bill to Parliament in this Session, so that it can be further scrutinised and improved.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank all those patients, campaigners and experts who provided evidence to the Joint Committee. I give special thanks to Alexis Quinn, whose account of her own lived experience with autism touched many Committee members. I also thank the Committee members for what was an incredibly valuable experience and a true example of when cross-party working goes really well.

I am honoured to have worked on a once-in-a-generation opportunity to improve the rights of patients experiencing a mental health crisis, and to tackle the health inequalities enshrined in current legislation. For years the Government kicked updating this legislation into the long grass, and now the draft Bill still does not go far enough to tackle the health inequalities and racial disparities of those detained under the Mental Health Act. I hope the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) will agree that the Government should put patient voices at the heart of this legislation and take the Joint Committee’s recommendations on board.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 24th January 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.

[Steve Barclay]

It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:

“In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”

First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.

Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.