Mental Health Act Reform
Debate between Rosena Allin-Khan and Matt Hancock(3 years, 10 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I thank the Secretary of State for an advance copy of the statement. This overhaul of the Mental Health Act has been long-awaited, and we welcome the White Paper and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Mental Health Act.
Without a doubt, people need to be at the heart of this legislation. Service users must be involved in framing the legislation going forward, and when we talk of numbers and statistics, we must remember that these are real people with real lives and real families. There is a web of individuals who are affected when things go wrong. Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult of situations, whose voices often are not heard when decisions are being made. It is an important step that learning disabilities and autism will no longer be grounds for detention under the Act, and I am sure that we all welcome that. It is also very welcome that the recommendation on nominated persons has been included.
The best way to reduce coercion and detention is to have alternatives to admission. Will the Secretary of State please outline how that will be achieved? Community provision is vital for mental health services that are truly joined-up and, crucially, work well for patients, so will he also give reassurances on community care?
It is in our communities where we witness the harsh reality of health inequalities, which so desperately must be addressed. Social inequalities and adverse childhood experience are the drivers of mental ill health, and they cannot be ignored. Children from the poorest 20% of households are four times more likely than those from the wealthiest 20% to have serious mental health difficulties by the age of 11. That will not be solved simply by mental health legislative changes; there must be a commitment to addressing the vast chasm of health inequalities across the country.
At present, black people are over four times more likely to be detained. We need to advance the mental health equality framework, and there must be culturally appropriate services and freedom for local areas to look at their specific population in order to have the most suitable approaches.
Mental health staffing levels are crucial to ensuring that mental health services are fit for purpose. The proposals set out by the Secretary of State go well beyond what has been committed in the long-term plan. We need to see true understanding from the Government that mental health is not about promising fancy equipment; it is about people. The promises in the White Paper rely on the workforce—our fantastic frontline mental health staff, of whom there are simply too few at present. Will the Secretary of State please outline when we will get the workforce settlement? What reassurance can he give on filling training places?
It has already taken so long to get to this point—it was the former Prime Minister who started this process, back in 2016—so will the Secretary of State provide some clarity on the timeframe going forward? Given the complexities of the legislation and the need for it to be robust, what are the plans for a joint prelegislative Committee? It is vital that the blueprint that Sir Simon Wessely’s report sets out is implemented in full. I would like to take this opportunity to thank him and everyone involved for all the work they have done on this review.
We must act, and quickly. Covid has shown us how all the pressures on mental health are building. We need action now. We all know how rare these pieces of legislation are; this is a once-in-a-generation opportunity to get it right for some of the most vulnerable in our society. We simply must get this right for everyone who depends on these services.
Matt Hancock
I thank the shadow Minister for her thoughtful approach. I agree with the way that she described the challenge, and with her insistence that we must not just improve the legislation—and we will—but improve and continue to strengthen service provision, in particular community service provision, as an alternative to admission. That is how we turn legislation from dry words on a page into real action on the ground.
The shadow Minister is absolutely right, too, that service users must be at the heart of framing the legislation. If I may link that point to her question about the timeframe, the challenge of the timeframe is to ensure that we move fast enough to help people and get the new legislation on the statute book as quickly as reasonably possible, but at the same time continue with the consensus-based approach that we have taken.
I am very grateful, as I said, for the work of Sir Simon and the NHS team, and I am grateful that we have managed to develop this White Paper with broad consensus among those who provide mental health services and service users, and politically across the House. I think that is an important consensus to keep, and I want to try to keep it by ensuring that we take as open an approach as possible to the legislation. I am absolutely open to joint prelegislative scrutiny, and I am absolutely open to the publication of a draft Bill. Let us get the details right, and let us work together on this and keep it as consensual as possible.
I also agree with the hon. Member’s point about the need to tackle broader health inequalities, and covid has laid bare some of those. That is a core part of our levelling-up agenda, and it is an important consideration for both physical and mental health. I am glad to say that this landmark White Paper, which will lead to a once-in-a-generation Bill, is proceeding with the support of the Opposition. I am really pleased about that, because this is for everyone. It is to make sure that some of the most vulnerable people in our country get the support they need and deserve.
Oral Answers to Questions
Debate between Rosena Allin-Khan and Matt Hancock(4 years, 6 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
Thank you very much, Mr Speaker. If I may, I would like to start by saying a huge thank you, on behalf of us all in the Chamber today and all those watching, to our NHS and care staff, who are working so hard on the frontline.
Frontline workers like me have had to watch families break into pieces as we deliver the very worst of news to them: that those they love most in this world have died. The testing strategy has been non-existent. Community testing was scrapped, mass testing was slow to roll out and testing figures are now being manipulated. Does the Secretary of State commit to a minimum of 100,000 tests each day going forward? Does he acknowledge that many frontline workers feel that the Government’s lack of testing has cost lives and is responsible for many families being unnecessarily torn apart in grief?
Matt Hancock
No, I do not. I welcome the hon. Lady to her post as part of the shadow Health team, and I think she might do well to take a leaf out of the shadow Secretary of State’s book on tone. I am afraid that what she said is not true; there has been a rapid acceleration in testing in the past few months in this country, including getting to 100,000 tests a day. We have been entirely transparent on the way that has been measured throughout, and I have confidence that the rate will continue to rise. Currently, capacity is 108,000 a day, and we are working to build that higher.
Of course, we have been working very hard to make the testing capacity grow as fast as possible, and as more tests are available, so we are able to make them available to more people and test people right across the NHS. I pay tribute, too, to the work of NHS and social care staff on the frontline; nothing should take away from the team spirit with which we approach this.
Covid-19
Debate between Rosena Allin-Khan and Matt Hancock(4 years, 8 months ago)
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Matt Hancock
On that last point, no—the shielding policy is only for those with existing health conditions. Those whom we are going to ask to participate in shielding, from next week, will receive a contact from the NHS, and we will publish the list of conditions that we consider necessary for shielding. On the point that my right hon. Friend makes about testing and isolating, I strongly agree with the World Health Organisation about the need for testing. I spoke at the weekend to Dr Tedros, head of the World Health Organisation, and we strongly agree on the need for testing. The question is how fast can we ramp up testing capability for the tests that we need—the blood tests to know who has had coronavirus and the bedside test or the home test, so that these tests can be expanded rapidly across the whole country? The first has yet to be invented, although we hope that it will be fairly soon, and the second has just been invented in the past few days, and we are in intense negotiations about rolling those out very rapidly.
Dr Rosena Allin-Khan (Tooting) (Lab)
Today I bring a message from my colleagues who are working hard on the NHS frontline. They say that they do not have the protective equipment that they need, nor do they have the capacity to manage the spread of infection in their own departments. There is clear concern among hospital staff and the wider public alike about the transparency of the plan to tackle the virus. Does the Secretary of State agree with me that our incredible staff must immediately have the protective equipment that they need to be safe; that they should be tested if they show symptoms of virus infection, as currently not all of them are being told that they can; and that more information must be transparent so that medical teams across the country can prepare their departments for the very worst?
Matt Hancock
The whole of our action plan is based on the science and on as much transparency as possible. We have exhibited unprecedented transparency in this crisis so far, and I pledge again to full transparency, publishing, for instance, the modelling that underpins the scientific advice, and also publishing the action plan two weeks ago. At the time, that felt as if we were looking at some things that were quite out of the ordinary, and I do not think that anybody then anticipated that we would have to bring them in in the way we have, and as many countries have now brought them in. I pledge once again to that transparency.
The hon. Lady is completely right about PPE, and we need to expand the amount of PPE. Again, we are buying it, as with ventilators, as fast as we possibly can, and part of our call for a national effort to manufacture includes PPE.
I want to end my answer to the hon. Lady by saying something about those who work in the NHS. The NHS will face an extraordinary period and many people will do extraordinary things, but it will be very, very difficult. I pay tribute in advance to the service that every single person who works in the NHS will give.
Matt Hancock
The hon. Lady is right to remind me. Of course we want as much staff testing, as soon as possible. We are using the testing capacity we have to save lives, and that includes saving the lives of medics.
Oral Answers to Questions
Debate between Rosena Allin-Khan and Matt Hancock(4 years, 10 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
Throughout the election there were empty promises from the Conservatives, and one of those promises was to tackle the social care system—but there is still no Green Paper. There are dementia patients who are trapped in hospital due to an inadequate social care system, and yet this Government still do nothing. How many more families have to suffer before this Government act?
Matt Hancock
The Government will deliver on all of our manifesto commitments.