Tobacco and Vapes Bill

Sajid Javid Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Sir Sajid Javid (Bromsgrove) (Con)]

When I was appointed Health Secretary in 2021, we were still in the midst of the pandemic. That challenging time taught us so much about the strength and resilience of our nation, but it also cast an uncomfortable light on truths that we have too often chosen to ignore. In the past, this country has been at the cutting edge of preventive healthcare, but while we have talked a good game on that issue in recent decades, in truth, we have not always delivered.

I would argue that we still face a public health emergency in this country—one that consumes 40% of the NHS budget, ensures that regional inequalities persist, and limits the life chances and opportunities of individuals right across our country. This public health emergency has many causes, and at the top of the list must be smoking, especially of cigarettes. That is why I commissioned Javed Khan to lead an independent review of smoking. I am immensely grateful to him for his excellent work and I am proud that he has led us to this legislation. The title of his report, “Making smoking obsolete”, is the right mission for us to deliver on, especially given this Government’s commitment in 2019 to a smoke-free Britain.

One of the most important problems Javed Khan identifies is the dual impact of tobacco and nicotine. First, it is incredibly damaging to the health of individuals. As we have heard from so many right hon. and hon. Members, no amount of tobacco is safe. Secondly, it is corrosive of personal liberty and agency. Smoking remains the biggest single cause of preventable illness and death in this country, causing, as we have heard, some 80,000 deaths a year. Smokers are 36% more likely to be admitted to hospital and to need social care 10 years before non-smokers. It causes one in four cancer-related deaths. Behind each of these statistics is an individual life, a family and a community impacted by poorer health. It is therefore only right that we take robust action to protect future generations from these harmful products.

As Javed Khan rightly highlighted in his report, the public are often led to believe that smoking is a personal choice, whereas the reality is that nicotine is a highly addictive drug that corrodes personal agency. Four in five smokers start before the age of 20 and remain addicted for the rest of their lives. As we have heard, many people want to give up smoking, and we have heard some personal stories in the House about just how hard that has been, and how many people, sadly, do not succeed. Many struggle to break free from addiction, and the average number of attempts of those who eventually do successfully quit is 30.

I know that some hon. Members have publicly expressed their reservations about the proposal before us, and we have heard that in this debate, but can we honestly say that this drug enhances personal liberty and freedom? It is a nonsense argument. Anyone who makes that argument is choosing to stand up for big tobacco against the interests of their constituents, and to erode people’s personal liberty and remove their freedom to choose by giving them access to a drug. This drug diminishes economic freedom, and it diminishes the wealth of individuals and of our country. Its overall impact across the country is to reduce opportunity and to drive social challenges. Indeed, if cigarettes were first manufactured today, they would obviously never get through consumer product safety testing.

Given that we are where we are and given what we know, it is of course right to protect future generations from this drug and this addiction. Freedom from pain, disease and inequality is one of the greatest freedoms there is, and whether it is tackling burning injustices, levelling up or even the big society, these missions are more than compatible with the legislation before the House. This is a world-leading proposal backed by clinical evidence and supported by a strong moral cause. As surveys have shown again and again—and, again, just recently—it is strongly supported by the general public of all ages. It is the right approach to public health, it is the right approach for our country and it is more than worthy of the support of this whole House.

Oral Answers to Questions

Sajid Javid Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Victoria Atkins]

We are ensuring that community pharmacists have an even greater role in primary care than they have already. For example, we saw the first stage of the roll-out of Pharmacy First in December, with blood pressure checks and contraceptive care being rolled out. I am very pleased that we are on track to deliver the full roll-out of Pharmacy First by the end of the month.

[Sir Sajid Javid (Bromsgrove) (Con)]

The colour of someone’s skin should not have an impact on the reliability of medical devices, but we know that that is what happened during the pandemic for many black and Asian patients. When I was the Health Secretary, I commissioned an independent review of the equity of medical devices from Professor Dame Margaret Whitehead. Her report was handed to the Department in June last year, but the Department has not yet published it or responded to it. I know that my right hon. Friend cares about health inequalities as much as I do, so may I ask her to publish the report, along with a full Government response, as a matter of urgency?

[Victoria Atkins]

I thank my right hon. Friend for commissioning that vital piece of work. I am giving the matter my closest attention, and I hope very much to be in a position to respond to his points in due course.

Urgent and Emergency Care Recovery Plan

Sajid Javid Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

We recognise the huge pressure on social care; that is why, at the autumn statement, the Chancellor set out the biggest-ever increase in funding into social care of any Government, £7.5 billion over two years. We are putting more funding in. On the workforce more generally, the Prime Minister and Chancellor have committed themselves to bringing forward the workforce plan, which will set out the longer-term ambition on workforce and will be independently verified. In addition, we are recruiting more staff, as I updated the House, whether that is the 3% more doctors this year than last year, the 3% increase in nurses, or the 40% more paramedics and 50% more consultants compared with 2010. We are recruiting more staff, but the grown-up position is to recognise that there is also more demand.

[Sajid Javid (Bromsgrove) (Con)]

I warmly welcome the plans set out by my right hon. Friend today, but he will know that one reason emergency care faces so much pressure is that successive Governments have not focused enough on the prevention agenda. Indeed, last week’s news that the Government will not go ahead with individual focused plans on cancer, dementia and mental health has concerned many. Can he assure this House that the Government’s new major conditions strategy will be published promptly and will be comprehensive and significant?

[Steve Barclay]

I am happy to give my right hon. Friend that assurance. I assure the House that our commitment to the cancer mission and the dementia mission through the Office for Life Sciences is absolutely there. He is right that we are bringing that together in one paper—I think we should take a holistic approach—but I share his ambition on prevention. In early January, I set out a three-phased approach: first, the £250 million immediate response to the pressures we saw from the flu spike over Christmas; secondly, as I announced today, building greater resilience into the system looking ahead to next winter; and thirdly, the major conditions paper on prevention, which is about bringing forward the innovative work that colleagues are doing through the Office for Life Sciences to impact the NHS frontline much sooner than might otherwise have been the case.

Oral Answers to Questions

Sajid Javid Excerpts

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

We are absolutely committed to addressing health inequalities. Rather than simply looking at 10 years’ time, we are looking at the immediate actions we can take, because what matters—[Interruption.] Those on the Opposition Front Bench chunter about White Papers, but what I am interested in is immediate delivery—what we can be doing now, rather than speculating about what is done in 10 years’ time.

[Sajid Javid (Bromsgrove) (Con)]

We are seeing a sad increase in suicide rates across the country. In 2012, the then Government published a 10-year cross-Government suicide prevention plan. Earlier this year, the Government under the leadership of my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson) committed to a new 10-year plan that would be published before the start of 2023. There is no sign of that cross-Government 10-year suicide prevention plan, but maybe I am wrong, and perhaps the Government are about to publish it, because I know that so much of the work has already been done. May I ask my right hon. Friend the Secretary of State to show that he takes suicide prevention seriously and publish this plan as soon as possible?

[Maria Caulfield]

I thank my right hon. Friend and pay tribute to him for all his work in this area; he has driven this agenda forward. I want to reassure him that we are looking at that. He will understand that we have had some changes in recent weeks, but I assure him that tackling the issue of suicide is a high priority, and we will make an announcement shortly.

Women’s Health Strategy for England

Sajid Javid Excerpts

Wednesday 20th July 2022 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

And now I call Sajid Javid.

[Sajid Javid (Bromsgrove) (Con)]

There was a time when I would follow right after the shadow Secretary of State, but not any more. However, I am very pleased to follow my right hon. Friend the Secretary of State, and I welcome him to his new role. He has the privilege of running a fantastic Department that is so important to the British people. He has excelled in every role he has held in Government so far, and I know he will do so again.

I strongly welcome the women’s health strategy—as we heard, it is the first published by any Government. I congratulate everyone involved, including all the officials and especially the excellent Minister of State, Department for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who is sitting on the Treasury Bench, and the previous Minister of State, my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries).

Does the Secretary of State agree that, when it comes to women’s health, early diagnosis is essential? I absolutely welcome the commitment in the strategy on mandatory training in women’s health issues for new doctors, but will my right hon. Friend say a little more about what can be done on training for existing doctors and clinicians?

[Steve Barclay]

The work on this strategy was done before I arrived in the Department, so it was down to my right hon. Friend and to the Minister of State, my hon. Friend the Member for Lewes (Maria Caulfield). It is great to have this opportunity to pay tribute to my predecessor for all that he did to drive this agenda forward. He is absolutely right about the importance of training and early diagnosis. That is why addressing the issue of fragmented services is so important. As a respondent said, where women raise concerns, they often feel like a lone voice in the wind—that was a phrase in the strategy that really resonated with me. Having hubs, centres of excellence and the ability to look at that data and identify it early, alongside the other initiatives in which he played a major role as Secretary of State, such as the diagnostic hubs, are all a key part of the delivery of this strategy.

Gender Recognition: Disclosure of Information

Sajid Javid Excerpts

Thursday 30th June 2022 Written Statements

[The Secretary of State for Health and Social Care (Sajid Javid)]

Today, I have laid the Gender Recognition (Disclosure of Information) (England) Order 2022 in Parliament. This statutory instrument will make a minor change under the Gender Recognition Act (GRA) 2004 in order to facilitate the invaluable research being undertaken as part of Dr Hilary Cass independent review of gender identity services for children and young people (the Cass review).

Under the Gender Recognition Act 2004, it is an offence for a person acting in an official capacity to disclose information about the gender history of a person with a gender recognition certificate (GRC). The Act calls this “protected information”, with some existing exemptions, such as where disclosure is to prevent or investigate crime, or the subject of the information agrees to the disclosure.

The order I have laid today will add a further exemption to the GRA so that a closely defined class of people who facilitate, assist and carry out the research for the Cass review will be able to disclose protected information to each other during the course of their work. Without access to information currently protected under the Act, a significant portion of the available data on health outcomes would have to be removed from the study. This would subsequently prevent Dr Cass review from being able to provide robust recommendations rooted in the best available clinical evidence about how this care can best be provided.

This data will allow us to plan the provision of these services from a world-leading clinical evidence base, to promote better health outcomes for those who use these important services. I firmly believe that this will help enable further debate on these issues to be informed by the best available clinical evidence which will better serve everyone, not least children.

I remain committed to upholding the rights and privacy of transgender people, so this data will be carefully controlled. Only those working for a small number of organisations listed in the order and who are involved in the research will be able to access protected information and share it with each other. Furthermore, those within this closed circle will only be able to access and share the data if doing so is genuinely necessary in order to facilitate, assist or carry out research as part of the Cass review.

As an additional safeguard, the order will expire after a period of five years which is the maximum amount of time that we believe the project will take. The order does not allow patient identifiable information to be made public through the course of this research, and any research outputs subsequently published will be fully anonymised.

[HCWS170]

A Plan for Digital Health and Social Care

Sajid Javid Excerpts

Wednesday 29th June 2022 Written Statements

[The Secretary of State for Health and Social Care (Sajid Javid)]

I would like to inform the House that “A Plan for Digital Health and Social Care” has been published today. This document sets out how we will build a more digitised, more efficient and more personalised health and care system.

Earlier this year, I made a speech setting out my four priorities for reform in health: prevention, personalisation, people and performance. We cannot deliver the change We need to see, unless we embrace the opportunities from digital technologies.

We are now embarking on a transformative programme of reforms that will make sure the NHS is set up to meet the challenges of 2048, not of 1948, when it was first established, and also to make the vital changes that are so urgently required in social care.

On 13 June we published a strategy for a data-enabled health and social care sector, “Data Saves Lives”, which draws on lessons learned about the power of data from the response to the covid-19 pandemic. Data Saves Lives includes a range of commitments that will help connect systems and details how we will use data flowing through the digitised health and social care system to continually improve services while maintaining the highest standards of privacy and ethics.

The long-term sustainability of health and social care is dependent on having the right digital foundations in place, and so digital transformation is crucial in achieving and delivering these reforms.

This plan sets how the delivery of health and social care will change, taking forward what we have learnt from the pandemic, and from tech pioneers across the world. The aim is something that we can all get behind: a health and social care system that will be much faster and more effective, and delivers more personalised care.

Digital is not, and will not, be the only means of access to health and social care services, but through it we can ensure that the needs and preferences of individuals are reflected in the services we provide.

Health and social care organisations and partners from industry can use the plan to help shape their strategies to digitally transform services for their populations.

The NHS app will be at the heart of these plans. We saw during the pandemic how people grasped the opportunity to have healthcare at their fingertips.

I am determined to make this app the front door to NHS services, and this plan shows how we will add an array of new features over the coming months and years, with new functionality and more value for patients every single month. My vision is one in which the app is an assistant in your pocket and a permanent feature of how we do healthcare in this country.

With digitised services and a connected system that supports integration and harnesses the power of data, technology can create a transformed health and social care system that is more responsive to the needs and preferences of all people, identifies and reduces health disparities and delivers improved outcomes for everyone.

We have already made huge progress. Over 28 million people now have the NHS app in their pocket, over 40 million people have an NHS login, and most NHS trusts have an electronic patient record system in place. This is on top of unprecedented investment in the digitisation of adult social care, including £150 million of funding for digital adoption that we announced in our recent White Paper.

This plan sets out the next chapter of this story of digital transformation. It sets out a vision of how we will build a more connected and much more efficient system.

The opportunities offered by digital transformation are huge, with benefits over the next decade running to billions of pounds in efficiencies, economic growth and private investment.

That plan includes a raft of other initiatives, £2 billion of funding to support electronic patient records to be in all NHS trusts, and help over 500,000 people to use digital tools to manage their long-term health conditions in their own homes.

Just as we are putting the right technology in place, we also need to make sure that people are confident and supported in using it. The plan also shows how we will relentlessly focus on digital skills, leadership and culture as well as building patient trust, at all levels, so we can make transformation durable right across the board.

This agenda matters more than it did when this pandemic began. I am determined to use the power of technology and the skills, leadership and culture that underpins it, to drive a new era of digital transformation. So that our health and care system, and our country, will thrive long into the future, delivering vast benefits for patients.

I will deposit a copy of the plan in the Libraries of both Houses.

[HCWS159]

Draft Mental Health Bill

Sajid Javid Excerpts

Monday 27th June 2022 Written Statements

[The Secretary of State for Health and Social Care (Sajid Javid)]

I have published the draft Mental Health Bill today for pre-legislative scrutiny and delivered an oral statement to the house.

The draft Bill will enable the Government to deliver on two manifesto commitments:

to ensure that patients suffering from mental health conditions have greater control over their treatment and receive the dignity and respect they deserve; and,

to make it easier for people with learning disabilities and autism to be discharged from hospital

It contains provisions to increase the autonomy and dignity of people who need inpatient support for their mental health, including people subject to the criminal justice system. These reforms are intended to benefit everyone who may be subject to the Mental Health Act, and to address the racial disparities associated with its use.

The draft Bill is also intended to limit the extent to which people with learning disability and autistic people may be made subject to the Mental Health Act, while ensuring adequate community care and support is available for people with these conditions.

The draft Bill heralds a major step change in the rights available to people who may be made subject to the Act. Furthermore, they represent a significant step forward in the Government’s work to respond to the recommendations made by Sir Simon Wessely’s independent review of the Act.

The draft Bill will cover England and Wales.

We look forward to working openly with the committee to ensure that this important Bill is developed with input from stakeholders and all interested parties. This is a once in a generation chance to develop the Mental Health Act to ensure the autonomy and dignity of people who need inpatient support for their mental health.

[HCWS141]

Draft Mental Health Bill

Sajid Javid Excerpts

Monday 27th June 2022 Commons Chamber

[The Secretary of State for Health and Social Care (Sajid Javid)]

With permission, Mr Speaker, I would like to make a statement on our plans to bring the Mental Health Act 1983 into the 21st century. Today, just as we pledged in the Queen’s Speech, we have published a draft Mental Health Bill to modernise legislation that was passed by the House almost 40 years ago and make sure that it is fit for the future.

Last year, we invested £500 million to support those with mental health needs who were most affected by the pandemic and, as we set out in the NHS long-term plan, we are investing record amounts into expanding and transforming mental health services. That will reach an extra £2.3 billion each year by 2023-24. Later this year, we will also publish a new 10-year mental health plan followed by a 10-year suicide prevention plan, which, as I set out in a speech on Friday, will place a determined focus on this major source of grief and heartbreak so that fewer people will one day get the news that turns their lives upside down. But we cannot make the critical reforms that we need and that are so essential to the country’s mental health system without making sure that the law that underpins our country’s mental health system is up to date, too.

Since the 1983 Act, our understanding of and attitude towards mental health has transformed beyond recognition, and it is right that we act now to bring the Act up to date. The Mental Health Act was created so that people who have severe mental illnesses and present a risk to themselves or others can be safely detained and treated for their own protection and that of those around them, but there are a number of alarming issues with how the Act is currently used. Too many people are being detained. They are also being detained for too long, and there are inequalities among those who are detained. The previous Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), asked Professor Sir Simon Wessely to lead a review into the Act. I pay tribute to my right hon. Friend for her tireless commitment to this most important of issues and to Sir Simon for his illuminating report, which made a powerful case for reform and was rightly welcomed on both sides of the House. It made for uncomfortable but essential reading, vividly showing how currently the Act fails patients and their loved ones and deprives people of autonomy and control over their care.

The draft legislation that we have published today builds on Sir Simon’s recommendations as well as those in our White Paper, which was published in partnership with the Ministry of Justice last year. Just like Sir Simon’s report, the White Paper was welcomed by both sides of the House. It was also welcomed by leading charities including Mind, the National Autistic Society and Rethink, countless mental health professionals and, critically, the people who use mental health services and their loved ones. Today, we are showing how we will put the vision into action. The Bill is a once-in-a-generation reform, and I would like to set out briefly to the House the important themes that sit behind it.

First, the Bill rebalances the criteria for detention so that it will take place only as a last resort when all other options have been explored and considered. Under the new criteria, people will be detained only when they pose a significant risk of harm to themselves and others, and patients should be detained only if they will benefit from the treatment that is made possible by their detention.

Secondly, the Bill shows how we will give patients more control over their care and treatment. It will ensure that, in most cases, clinicians can administer compulsory treatment only if there is a strong reason to do so. In future, all patients formally detained under the Act will have a statutory right to a care and treatment plan, drawn up between the patient and their clinician, and personalised based on the patient’s needs. It will give them a clear road map to their discharge from hospital.

There are some cases when patients are not able to make decisions about their own care or feel that they could benefit from greater support. Currently, patients are not always able to choose who can represent them, as their nearest relative automatically qualifies to act on their behalf. The Bill will change that, allowing patients to choose a nominated person who they believe is best placed to look after their interests. The Bill will also increase the powers of that nominated person, so that they can be consulted about the patient’s future care.

Thirdly, the Bill will tackle the disparities in how the 1983 Act is used. Black people are four times more likely to be detained under the Act than white people, and 10 times more likely to be placed on a community treatment order. The Bill provides for greater scrutiny of decision making, including through greater use of second opinions on important decisions, and through expanded access to independent tribunals; that will help us to address the disparities in the use of the Act.

Fourthly, the Bill will enhance support for patients with severe mental health needs who come into contact with the criminal justice system. Under the 1983 Act, too often, people in prison experience delays in getting treatment in hospital. Courts are sometimes forced to divert defendants who require care and treatment, some of whom have not been convicted, to prison as a so-called place of safety. The Bill will make crucial improvements so that vulnerable offenders and those awaiting trial can access the treatment that they need. It will tackle delays and speed up access to specialist care by introducing a new statutory 28-day time limit for transfers from prison to hospital, and it will end the use of prison as a so-called place of safety, so that patients can get the care that they need in the appropriate hospital setting.

The Bill will also amend the Bail Act 1976 so that courts are no longer forced to deny a defendant bail if the judge’s sole concern about granting bail has to do with the defendant’s mental health. The Bill will allow the judge to send them to hospital instead, so that they can be in the best environment for their mental health and can receive any treatment that they need.

Finally, the Bill will improve the way that people with a learning disability and autistic people are treated under the 1983 Act. One of my priorities in my role is personalised care. The current blanket approach cannot be allowed to continue; it means that too many autistic people and people with a learning disability are admitted into institutional settings when they would be better served by being in the community. The Bill will change this. It limits the scope for detaining people with learning disabilities and autistic people for treatment unless they have a mental illness that justifies a longer stay or they are admitted through the criminal justice system. It also gives commissioners of local authorities and integrated care boards new duties to make sure that the right community support is available instead.

I look forward to working with hon. Members in all parts of the House as we take these plans forward. This momentous Bill deals with one of the most serious and sombre responsibilities of any Government: their responsibility for the power to deprive people of their liberty. Mental ill health can impact any of us at any time. It is essential that we all have confidence that the system will treat us and our loved ones with dignity and compassion. That is what the Bill will deliver. I commend the statement to the House.

--- Later in debate ---

[Dr Allin-Khan]

We need to advance the mental health equality framework and there must be culturally appropriate services and the freedom for local areas to look at their specific populations in order to have the most suitable approaches. Culturally appropriate community provision is vital for mental health services that are truly joined-up and effective and that, crucially, work well for patients. Will the Secretary of State also provide reassurances on the future of community care and on how they will work with local authorities across the country to deliver community provision that works?

Mental health staffing levels are absolutely crucial to ensuring that mental health services are fit for purpose. More than a year and a half ago, I asked the Secretary of State’s predecessor about the future of mental health staffing. The proposals that have been set out today go well beyond what has been committed to in the long-term plan. Labour has a plan: to recruit an extra 8,500 mental health staff to treat 1 million additional patients a year by the end of our first term in office. Will the Secretary of State outline when we will get the workforce settlement? What reassurance can he give on filling training places?

For too long, the Government have had their head in the sand when it comes to mental health. They have failed on eradicating dormitories from mental health facilities, failed on cracking down on the use of restraint, and failed on getting on top of waiting times. We cannot have this kicked into the long grass and, if it gets lost in the political quagmire of Conservative in-fighting, should the Government call an early general election, people will suffer. We cannot have the Government fail on mental health legislation any longer. This is a once-in-a-generation opportunity; we simply must get this right for everyone who depends on these vital services.

[Sajid Javid]

I thank the hon. Lady, particularly for her remarks at the start of her response about my personal experience.

I think the hon. Lady agrees with me, as does everyone in this House, that the 1983 Act is outdated. Society has learned since then, rightly, that people’s mental and emotional wellbeing is as important as their physical wellbeing. That was recognised in the Health and Care Act 2022, which came before Parliament recently, and this draft Bill does a lot to change the situation as well.

The hon. Lady talked, rightly, about the importance of mental health services. The NHS is putting record funding into NHS services. Some 1.25 million people were seen through the NHS talking therapies service, despite the pressures of the pandemic, and an additional £500 million of resources was put into mental health services because of the pandemic.

On the workforce, today in the NHS, we have around 129,000 health professionals focused on mental health. That is the highest number ever, and the number has gone up by some 20,000 since March 2016. As for the NHS’s strategic workforce plan—the 15-year plan on which it is currently working—having the correct provision for mental health will, of course, be a very important part of that.

[Mrs Theresa May (Maidenhead) (Con)]

I commend my right hon. Friend for his statement and thank him for his kind comments. I also join the Opposition Front Bencher, the hon. Member for Tooting (Dr Allin-Khan), in commending him for sharing his family’s experience. It shows that this is not just a piece of legislation from a Secretary of State; it comes from somebody who understands the issue.

I welcome the publication of the draft Mental Health Bill. While it is necessary for it to be given proper scrutiny, does my right hon. Friend join me in believing that we need to get these new provisions on the statute book as quickly as possible, to ensure that all those who are going through a mental health crisis can indeed be treated with the dignity and compassion that they deserve?

[Sajid Javid]

Let me thank my right hon. Friend again for the crucial role that she has played in getting the House to this point today with the publication of the draft Bill. It was her commitment to giving mental health parity with physical health that has led us to this important point. I agree absolutely with her. The draft Bill is before the House today. No doubt there will be prelegislative scrutiny, which I strongly welcome, to have the Bill ready as quickly as possible for First Reading in this House and to make sure that it becomes legislation as quickly as possible.

[Janet Daby (Lewisham East) (Lab)]

I welcome this statement from the Government, but I am concerned about constituents who have a mental health crisis and present at A&E departments. Because of long waiting times, they are usually unable to wait to be seen by a psychiatrist. Can the Secretary of State say how that will be addressed in the Mental Health Bill to make sure that people get the urgent treatment they need when they present at A&E departments?

[Sajid Javid]

The hon. Lady is right to raise the matter. I can tell her— helpfully, I hope—that the Bill is not that important in terms of getting what she wants to see, which is more care for people when they present themselves at A&E with mental health challenges. That is work that is already prioritised with the NHS. During the pandemic, as she and other hon. Members will understand, there were increased issues around mental health and people not getting care in the normal way; that is why we have put record resources into the NHS, including into A&E provision of mental health services.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I commend my right hon. Friend’s courage in talking about his family’s tragedy, which is one of the most difficult things to do in politics. I also thank my right hon. Friend the Member for Maidenhead (Mrs May) for her commitment to mental health, which is unparalleled among any Prime Minister I have known in this place; it made an enormous difference to me when I was Health Secretary.

I support wholeheartedly what the Health Secretary has said today. I hope that he does not mind my saying that in one instance it does not go far enough: there are still 2,000 people with autism and learning disabilities in secure institutions, effectively incarcerated, even though they would be better off in the community. It is a human rights scandal. As part of the remedy, would he consider changing the rules on sectioning so that, after a short period, anyone who wanted to keep someone in a secure unit would have to reapply for sectioning every week or two, so pressure is put on the system to find a better solution?

[Sajid Javid]

We are determined to reduce the number of people with learning disabilities and autism who are in mental health hospitals. As part of those plans, we will shortly publish the cross-Government “Building the right support” plan to drive progress; I will have more to say about that shortly. I listened carefully to my right hon. Friend’s suggestion and would be happy to meet him to discuss it further.

[Daisy Cooper (St Albans) (LD)]

I was incredibly moved to learn of the Secretary of State’s personal experience with this issue. I commend his courage in talking about a deeply personal issue.

In his statement, the Secretary of State outlined that patients will be able

“to choose a nominated person who they believe is best placed to look after their interests.”

Could he outline what rights that nominated person might have? I have a particular issue in my constituency: somebody has been moved from one part of the country to another, but their next of kin was not asked for permission and only found out after the event. I think that it is incredibly important not only that there is a nominated person, but that that person has outlined rights that can be enforced in these situations.

[Sajid Javid]

I am pleased that the hon. Lady welcomes the change that will come about through the Bill. The draft version has only just been published, and I appreciate that she will need time to digest it, but it does explain how the nominated person—who does not have to be a family member, but can be anyone whom the individual chooses and trusts—will be able to co-produce the treatment plan for that individual and work with him or her very closely.

[Robert Halfon (Harlow) (Con)]

Will my right hon. Friend look at a book published this week by Liz Cole and Molly Kingsley of the UsForThem parents group, which discusses the damage to children’s mental health during lockdown? We know that the number of referrals has increased by 60%, and that eating disorders among young girls rose by 400% during lockdown. Will my right hon. Friend set out measures to help children with their mental health? Given the damage that social media companies do to children’s mental health, will he consider a social media levy to raise money to fund mental health resilience, and will he also consider introducing a longer school day with extra sporting and wellbeing activities to help those children further?

[Sajid Javid]

My right hon. Friend has made the important point that children need full mental health support in normal times, but need it particularly when experiencing the impact of a pandemic. I will take a look at the book that he mentioned. Levies, as he will know, are a matter for the Treasury, but I am sure that he welcomes some of the measures in the Online Safety Bill. I should be happy to meet him and discuss some of his other proposals further.

[Clive Lewis (Norwich South) (Lab)]

I think the whole House will welcome many of the changes that the Bill represents. I especially welcome the section on black mental health and on the situation of people who are being incarcerated in the mental health system, but many of my constituents have suffered the effects of eight years of systemic and catastrophic failure on the part of their mental health trusts. What provisions in the Bill will make a difference to them following nearly 1,000 excess deaths in our mental health trusts? I know that he has committed himself to meeting me to talk about this, but will he also commit himself to meeting many of the victims of those eight years of failure who will be coming to Parliament next Tuesday to discuss what has happened to them? Perhaps he will be able to tell them how the Bill will turn their lives around and make a difference to them and their families.

[Sajid Javid]

I hope the hon. Gentleman agrees with me—as I think he does, given the way in which he framed his question—that the Bill is a huge step forward, especially in respect of the important issue of dealing with some of the inequalities in provision which we all know have existed, and which he mentioned at the beginning of his question. The way in which we change things will be not just through the Bill but through continued investment, and by ensuring that, when trusts are failing, those failures are addressed. As the hon. Gentleman said, I will be meeting him, but the Minister for Care and Mental Health will be happy to meet the constituents he mentioned.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

I commend the statement, and I commend my right hon. Friend’s bravery in sharing that story. After speaking to friends, I decided to share my own story: twice I attempted to take my own life. Thankfully I did not succeed, but when I needed help, I was lucky enough to be able to get that help. Sadly, that is not the case for too many people throughout our United Kingdom, at a time when 40% of GP appointments are related specifically to mental health.

As my right hon. Friend will know, I am supporting the No Time to Wait campaign, led by my good friend James Starkie, who is trying to ensure that there is a mental health nurse in every GP surgery in the country to help with the early intervention that we know is so critical. There is a great example in Norfolk and Suffolk NHS Foundation Trust, led by Lisa Dymond. Will my right hon. Friend, in the course of his work on this draft legislation, engage with that trust to see the work that it is doing to ensure that we can provide the access that people so desperately need?

[Sajid Javid]

May I first commend my hon. Friend for sharing his story and for being so open about it? There is no doubt that that will help a great many other people. I am sure he will welcome the Government’s plans for a new 10-year suicide prevention plan. I agree with him about the need to continue to work on improving provision, and I believe I will be having a meeting with him and Mr Starkie to discuss his campaign further.

[Chris Bryant (Rhondda) (Lab)]

I warmly commend what the Secretary of State said over the weekend. Many of us have experienced suicide in our own families, and it is good when people like him can share their experience; I think it helps an awful lot of people around the country.

Can I ask the Secretary of State about brain injury, which he knows I am a bit obsessed with? I visited three units—in Newcastle, Birmingham and Sheffield—the week before last. The big problem is that people are being given what is called a neurorehabilitation prescription, which is very similar to what he has described, but unfortunately, the moment they leave the trauma unit, the services that they require simply are not available in vast parts of the country. There are not enough occupational therapists, speech and language therapists, physiotherapists or psychiatrists to do that work.

The most distressing thing I heard was at the Birmingham Children’s Hospital—it does not have a hydrotherapy pool, which would be useful; nor does any other children’s hospital in the UK—which saw a 70% increase in brain injuries in children during covid from parents attacking their children. How are we going to get the workforce we need in order to make a difference to those people’s lives?

[Sajid Javid]

The hon. Gentleman will know that the investment already going into the workforce is at record levels. As the NHS sets out its 15-year workforce strategy, it will look into acquired brain injury, and rightly so. I thank him for the work he is doing with the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), on the ABI strategy. I understand that the call for evidence has just closed. That process will also help to bring about the change that he seeks.

[Sally-Ann Hart (Hastings and Rye) (Con)]

I met some amazing young people from my constituency last week during the “It’s our Care” lobby of Parliament, and one issue they raised was mental health among looked-after children. What steps is my right hon. Friend taking to ensure that the mental health needs of looked-after children are taken into account, so that they, too, can thrive?

[Sajid Javid]

My hon. Friend raises an important issue. We have increased to a record level resources for mental health services for children, including looked-after children, but we need to ensure that the strategy is fit for the future. This will be a key part of our 10-year mental health strategy.

[Charlotte Nichols (Warrington North) (Lab)]

Global research into psilocybin has shown that it has significant potential for the treatment of mental health conditions, including depression, post-traumatic stress disorder, anorexia and alcohol addiction. However, its schedule 1 status under the Misuse of Drugs Regulations 2001 is hindering research in the UK and condemning thousands of people to unnecessary suffering. The organisation Heroic Hearts, which supports military and emergency services veterans with PTSD, has to facilitate patients’ travel abroad to access treatment that they should be able to receive here, where appropriate. Can the Secretary of State please tell the House what conversations he has had, or intends to have, with the Home Office about the rescheduling of psilocybin to ensure that this vital area of mental health research can be progressed and treatment can be brought into the 21st century with this Bill?

[Sajid Javid]

The hon. Lady has raised an important issue. As she has said, rescheduling is an issue for the Home Office, and I will make sure that I take this up with the Home Secretary.

[Huw Merriman (Bexhill and Battle) (Con)]

I chair the all-party parliamentary group on autism, a role I took on after we lost Dame Cheryl Gillan. From her position in this place, she was tireless in highlighting the fact that there is a difference between those who suffer lifelong development disabilities such as autism and those who have mental health conditions, although it is fair to say that those with autism suffer with a higher proportion of mental health conditions. As things stand, 61% of those in mental health hospitals have autism as a condition—that is 1,200 people—and the figure used to be 38%.

I welcome the Secretary of State’s draft mental health Bill. Will he meet members of the all-party parliamentary group to discuss what the Bill will do for those with autism? Can I also parrot the call from the Chair of the Select Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), about the need to review the sectioning of those in mental health provision? There are far too many people languishing, and they need our help.

[Sajid Javid]

I agree with my hon. Friend. The reforms that we have set out today in this draft Bill mean that, in the absence of a mental health condition, learning disability and autism will no longer be a reason for people to be detained in a mental health hospital after an initial period of assessment. I would be happy to meet him and his APPG.

[Marsha De Cordova (Battersea) (Lab)]

I am disappointed that, yet again, the Department has not produced all the papers for me in large print; it has produced all the papers in standard print. I hope the Secretary of State will take that away and ensure I receive my papers as soon as possible.

I am sure the Secretary of State will share my disappointment that, in England, 24% of all children’s mental health referrals are closed before the child receives any support. In my Adjournment debate last week, I highlighted the importance of children’s mental health services and trauma support and care, so will he reassure the House and me that he will do everything in his power to make sure children receive timely mental health support?

[Sajid Javid]

Of course the hon. Lady should get the Bill and any other documentation she needs in large print, and I am sorry that she has not. I will take that up. I apologise to her, and she makes a very important point.

Support for children, even before the pandemic, was rightly a priority. Funding will increase to record levels by 2023, with an additional £2.3 billion in total so that an additional 345,000 children and young people can be seen. We put in an additional £79 million during the pandemic, and we will set out in our new 10-year mental health strategy exactly how we will do more.

[Robbie Moore (Keighley) (Con)]

I commend the Secretary of State for bringing forward this draft Mental Health Bill. I have met key individuals across Keighley in recent months who provide mental health and wellbeing support and advice, including Nick Smith, Ryan Anderton, Bill Graham and one of our hard-working GPs, Caroline Rayment. They are all passionate about this subject, and I am sure they will be pleased to see greater autonomy in providing personalised care. A key issue they have raised with me is that of adults and children with learning difficulties. Can my right hon. Friend confirm that the Bill will help those with learning difficulties to engage further with mental health and wellbeing services?

[Sajid Javid]

Yes, it will. I set out in my earlier answers some of the Bill’s changes for those with learning difficulties and autism. I think my hon. Friend will also welcome the publication of the new 10-year mental health plan.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Secretary of State may recall that I am very much involved with the Autism Commission, and I hope he has seen our recent report on autism’s lifelong impact on families. I support everything he has said this afternoon, except one thing. We need a deep cultural change in this area, whether it is GPs understanding more and having more proficiency, or teachers and schools recognising early signs of difficulty and struggle. If we believe in levelling up, why do only wealthy people get easy access to therapy? As I found when I chaired the Education Committee, we need more therapists and more therapy to be available.

[Sajid Javid]

I agree with the hon. Gentleman about cultural change. Whether we are talking about teachers or healthcare professionals, we need to make sure they have a certain level of training on autism. I am sure he knows the NHS has started rolling out a type of mandatory training on autism, and I would be happy to meet him to discuss how we can go further in the light of that report.

[Duncan Baker (North Norfolk) (Con)]

This is an enormously welcome Bill, not least in my constituency, where I have campaigned endlessly for better mental health services and for a hub at our wonderful Cromer Hospital. As Norfolk has the slowest ambulance response times and the most mental health referrals in the UK, how can we access the £7 million-worth of specialist mental health ambulance services?

[Sajid Javid]

First, I commend my hon. Friend on the work he has done. I remember meeting him to discuss this important issue, and I welcome his support for the Bill. He may know that the extra support of around £150 million announced today includes £7 million of support for mental health ambulances.

[Kerry McCarthy (Bristol East) (Lab)]

Clause 31 states that transfers from prison to hospital should take place within 28 days of a referral notice,

“unless there are exceptional circumstances”,

and makes it very clear that those exceptional circumstances do not include a shortage of staff or beds. That is welcome, but at the moment about 50% of prisoners who are assessed as needing transfer to hospital are not transferred because the beds are not available. What can the Secretary of State do to make sure that that is not an issue by the time the Bill becomes law?

[Sajid Javid]

The NHS is already preparing for this change. Of course, this is not law yet and we can make progress before it becomes law, but I believe that once it does become law, subject to the will of this House, it will galvanise more parts of the NHS to make sure that that commitment is met at all times.

[Tom Hunt (Ipswich) (Con)]

I very much welcome the Bill’s focus on autism and special educational needs. Having a learning disability often means that your brain is wired a bit differently, and often you feel like you are not understood, and that can contribute to mental ill health. On Norfolk and Suffolk mental health trust, we have been languishing for seven years and that has led to hundreds of people losing their lives. Will the Secretary of State assure me that this Bill will be part of ensuring that never again will we let failure last so long and the cost be so high?

[Sajid Javid]

I can give my hon. Friend that assurance. Sadly, we have instances around the country where certain trusts have failed local people when it comes to mental health. He mentions Norfolk and Suffolk. We need to do better. This Bill and the resources behind it will make the difference.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

Through my role as a lay manager for Birmingham and Solihull mental health trust, I know that a major problem in the west midlands is the availability of beds for individuals detained by the police under section 136 of the Mental Health Act 1983. This is having a huge impact on A&E services in our area, because that is where the police take patients if there are no mental health beds available. How does the Secretary of State plan to improve bed availability for mental health patients?

[Sajid Javid]

I know that the hon. Lady speaks with experience, and I listen carefully to her when she speaks on these important issues. She may have seen the announcement earlier today that the additional support of around £150 million will go towards addressing her exact point about more provision, including crisis houses and sanctuaries—I also mentioned mental health ambulances earlier—and I think that will help.

[Mr Richard Holden (North West Durham) (Con)]

This is an enormously welcome Bill on an issue on which I have campaigned and spoken to the Secretary of State about previously. North West Durham has an historic and ongoing issue, with suicide rates at double the national average. I commend him for speaking about his personal situation, and I look forward to the 10-year mental health plan and the 10-year suicide prevention plan. Will he outline how the Bill will reform the totally outdated Mental Health Act; how it will make a particular difference to those with serious mental health issues in my constituency, including children with anorexia issues whose parents have brought them to see me recently; and how it will deliver for people and their families as they go through really difficult treatment, making it more personalised for them?

[Sajid Javid]

I commend my hon. Friend on all the campaigning he has done on mental health and suicide prevention ever since he entered the House. The meetings I have had with him have gone directly into the publication of this Bill. The Bill will make a difference. I have summarised how it will result in more personalised care. Alongside the new resources, it will really help his constituents and many others.

[Rachael Maskell (York Central) (Lab/Co-op)]

I welcome the Bill. The acuteness of people’s mental health challenges while in the community is escalating before appropriate intervention is taken. How will the Bill ensure that earlier interventions are made, so that people do not have to go into secure accommodation for their safety?

[Sajid Javid]

Once the Bill is law, it will require the use of secure accommodation to be limited to those who absolutely need to be detained, either for their protection or for the protection of others. Alongside the Bill, we need to make sure that the right resources are there. I mentioned earlier the extra resources that are going in, to a record level, including today’s announcement of the £150 million.

[Liz Twist (Blaydon) (Lab)]

I, too, thank the Secretary of State for sharing his personal experience, which it is so important to do. Will he tell me how he will match up the welcome provisions in the Bill with the need to ensure that action is taken? How will the resources match the responsibilities in the Bill?

[Sajid Javid]

When it comes to resources for mental health, we have not been waiting for the Bill. Although the Bill is an important part of ensuring that people get the right treatment, the commitment to resources began with the NHS’s long-term plan, which means that an additional £2.3 billion a year will be going into mental health services by 2023-24. Alongside that, an additional £500 million at least has gone in to support people with mental health needs because of the pandemic.

[Rachel Hopkins (Luton South) (Lab)]

I refer to my entry in the Register of Members’ Financial Interests, as a vice-president of the Local Government Association.

Far too many people are sent to mental health and learning disability placements out of their area. In April 2021, the Government committed to end the practice, but in March 2022 some 670 people were in out-of-area placements and, most concerningly, 50 of them were more than 300 km away from their homes. When will the Government meet their target and end out-of-area placements? What discussions has the Secretary of State had with the Secretary of State for Levelling Up, Housing and Communities about the issue of commissioning?

[Sajid Javid]

This is a very important issue on which the Government have been working with people across the sector, including in the NHS. We will shortly publish information on how we will build in the right support in the community plan.

[Olivia Blake (Sheffield, Hallam) (Lab)]

I am afraid we are overseeing a scandal brewing in compulsory treatment as a result of covid. Because of the lack of available tier 4 beds, children up and down the country are in medical wards, and we see unsettling reports of restraint being used to feed them even though, when they get to see a mental health professional, they should not be force fed. I am conscious that the Secretary of State has answered a question about this already, but will the Government commit to starting to record restraint for feeding, no matter where patients are in the system and including in medical wards?

--- Later in debate ---

[Sajid Javid]

We of course want to ensure that children with mental health challenges, including eating disorders, get the support that they need. That is why during the pandemic—just last year—we put in an additional £79 million specifically for children’s mental health services. That is providing many thousands more children with that support.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Bill’s focus is on individuals who are sectioned under the Mental Health Act, which is important, but I refer the Secretary of State back to the issue of waiting times raised by many Members. In December, I spoke to my constituent who was concerned about the welfare of his child who suffers from an eating disorder. At every stage, it has impacted his mental health. Despite the local services, this child is still waiting, six months on, just to see a specialist. The limited staff available cannot cope. What is the Secretary of State doing now to address the issue so that we do not see more young people suffer?

[Sajid Javid]

We are putting in record amounts of new investment, with newer services. During the pandemic, we established for the first time a national 24/7 all-age mental health helpline. I would like to make that permanent, beyond the pandemic. When it comes to NHS talking therapies, I mentioned earlier that some 1.25 million people were seen last year. We aim to get that up to 1.9 million over the next couple of years. When it comes to waiting times, the hon. Lady is right that there is a waiting time for high-intensity mental health services, and the NHS is of course working to bring that down. For low-intensity mental health services we have managed to bring the median waiting time down to 14 days nationally.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his clear commitment to make things better. We are most grateful for that. I wholeheartedly welcome the strategy in his statement on mental health, but I am of the belief that the lockdown has impacted and exacerbated mental health issues in each corner of this great United Kingdom of Great Britain and Northern Ireland.

With that being the case, can the Secretary of State tell me what discussions have taken place with the relevant Minister in the Northern Ireland Assembly? Furthermore, the Secretary of State said that £2.3 billion had previously been allocated for this. How much will come to Northern Ireland through the Barnett consequentials, taking into account the fact that Northern Ireland has the largest percentage of mental health disorders in the United Kingdom and is in need of similar radical reform and, indeed, additional funding as well?

[Sajid Javid]

Much of the work that has gone into the publication of this draft Bill, such as that carried out by Sir Simon as well as the work that went into the White Paper, would apply equally to Northern Ireland. We stand ready to work with our friends in Northern Ireland to help them if they wish to go down a similar route. I can also confirm that the Barnett consequentials for the £2.3 billion would have gone to Northern Ireland.

Medical Devices Regulation: Consultation Response

Sajid Javid Excerpts

Monday 27th June 2022 Written Statements

[The Secretary of State for Health and Social Care (Sajid Javid)]

Leaving the European Union has provided a unique opportunity for the United Kingdom to improve the medical device regulatory regime and exercise our new powers as a sovereign regulator, creating a world-leading regime that prioritises patient safety while supporting innovation within the UK MedTech sector. To deliver this ambition and gather views of patients, industry and the healthcare sector, the Government published a consultation on the future UK medical device regulations, “Consultation on the future regulation of medical devices in the United Kingdom”, which is available at: https://www.gov.uk/government/consultations/consultation-on-the-future-regulation-of-medical-devices-in-the-united-kingdom, on 16 September 2021. We received 900 responses and I am grateful to all those who have taken the time to respond to the consultation.

Officials at the Medicines and Healthcare products Regulatory Agency (MHRA) have analysed the consultation responses and have worked with officials within my Department and the Office of Life Sciences to develop the Government response. The response outlines changes that will support innovation within the UK’s life sciences sector and access to medical devices, for example through improving the regulation of novel and growing areas such as artificial intelligence and offering alternative routes to market. This will help to facilitate greater opportunities for small and medium enterprises to capture real world evidence to support the conformity assessment process with the proportionate regulatory oversight, an opportunity which has not existed previously.

The Government are committed to cementing our status as a science superpower by making the UK the leading global hub for life sciences, and the response to the public consultation outlines polices that will help to achieve this.

As part of this consultation, the MHRA received strong support for proposals that will improve patient safety and safeguard public health, for example, through modernising the scope and classification rules of medical devices to deliver improvements in the safety of all medical devices. It also raised points around identified inequities within clinical investigations. I appointed Dame Margaret Whitehead to conduct a review into the potential issues related to equity in the design and use of medical devices and I am pleased that the MHRA will look to address these points within the regulations and supplementary guidance to support this review.

The new transitional measures outlined in the response will be implemented to support continued access to safe medical devices to UK patients, whilst providing time for industry and the healthcare sector to prepare for the transition. In fact, the UK Government are committed to building the UK Conformity Assessed (UKCA) marking as a global exemplar, and it is vital that the necessary building blocks are in place to ensure that the UK market remains an attractive and favourable place to innovate and do business for the benefit of patients and carers. A phased transition into the new regime is critical to its success.

The Government’s response to the consultation will be published on gov.uk today and I will deposit a copy of the response in the Libraries of both Houses.

[HCWS142]