Mental Health Act 1983

Steve Reed Excerpts

Thursday 25th July 2019 Westminster Hall

[Mr Steve Reed (Croydon North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Ms Buck. I congratulate my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle) for a very moving opening speech. It was a very brave speech, because he was sharing difficult personal experiences, and that made it all the more compelling.

I want to focus on the use of restraint, which is one of the four key issues that the review covers. Last year, Parliament passed my private Member’s Bill, which became known as the Mental Health Units (Use of Force) Act 2018, but is better known as Seni’s law. I was very grateful to the Minister for her support on the Bill, which introduced a system for reducing the use of abusive and coercive restraint in mental health settings. It establishes in law, for the first time, some very important principles, including the need for trauma-informed care. Some of the principles in the Act, which was of necessity relatively narrowly drawn, could and should be applied more widely. That is the point I hope to impress on the Minister this afternoon.

Perhaps I can remind colleagues of the human story behind Seni’s law—the Minister knows it, but other colleagues might not. Seni Lewis was a young graduate aged just 21. His parents found him having a traumatic mental health episode at home one Sunday morning, something he had never experienced before. They took him to the local hospital, expecting to find the care that he needed and deserved. He ended up at the Bethlem Royal Hospital, where his parents stayed with him until late evening before leaving to go home. Seni became very alarmed when he found out that he was alone, and he tried to leave. The hospital staff decided to section him and therefore tried to stop him leaving.

There were never any allegations that Seni threatened or assaulted anyone, but the hospital called the police. It ended up with 11 police officers dragging Seni, with his hands cuffed behind his head and legs in braces, into a seclusion unit, where they took turns sitting on him as he was pinned down on the floor. Seni’s spinal column was broken and he went into cardiac arrest, then into a coma. He died shortly afterwards.

Looking at the pictures of people who have died in mental health detention, we see many young black faces like Seni’s. Widely held prejudices about young black men and psychosis, drugs and aggression lead them to be subject to more severe treatment than other patients. In extreme cases such as Seni’s, it leads to death. It is a form of institutional racism, and we need to call it out and confront it.

I first met Seni’s parents three years after his death, just after I had been elected to Parliament in a by-election. They came to see me three years after this terrible incident because there had still been no inquest into his death, no public explanation of how or why their beloved son had died, no learning to prevent similar deaths in the future, no closure and no justice for Seni’s deeply distraught family. It was only after a very long public campaign and the intervention of the then Minister for mental health, the right hon. Member for North Norfolk (Norman Lamb), and the then Home Secretary, the right hon. Member for Maidenhead (Mrs May), that an inquest was finally opened, seven years after Seni’s death. It found that Seni had been subject to severe and prolonged restraint that had caused his death. It castigated the police and the mental health services and warned that, without change, other people in the mental health system would die in the future, just as too many have died in the past.

Seni’s law began as a cross-party attempt to start the process of change by creating a new national system for recording the use of restraint in mental health settings. We will soon be able to see what is happening in different mental health trusts and hospitals, and compare like with like to identify and spread best practice in reducing the use of abusive and coercive restraint. However, the same system needs to be extended to all settings where people with mental ill health might be subject to restraint, and I invite the Minister to comment on any plans she has to do that.

[David Hanson in the Chair]

The review makes it clear that we need to do more. Deaths in mental health settings should be investigated in the same way as deaths in any other form of state detention are investigated. When someone dies in prison or in a police cell, there is an automatic external investigation by an independent national body, which publishes a final report and shares what it has found. However, when someone dies in a mental health setting, as Seni Lewis did, there is no such fully independent investigation. In Seni’s case, the health trust investigated itself, and lessons that needed to be learned were not learned. Owing to errors by the Independent Police Complaints Commission, the Metropolitan police were able to block an inquest for a full seven years after his death. It should not be possible for the organisation under investigation to control the scope, timeliness, quality and content of the report on their own potential failure, because of the risk of a cover-up.

I pay special tribute to the powerful campaigning work on this issue that has been carried out by the charity Inquest. I fully support its demand for non-means-tested legal aid to be available to families at inquests, so that there is a level playing field between the bereaved family and the well-funded organisations accused of potential wrongdoing. Such investigations must be conducted by fully independent bodies that command the confidence of the public and bereaved families. By failing to learn from preventable mental health deaths, we condemn other vulnerable people to the same tragic fate.

Seni Lewis died in the most horrific circumstances, and his parents then had to fight for justice over seven years, just to find out what had gone wrong. Seni’s law stands as a testament to his life, but it is time to go further. The review of the Mental Health Act 1983 creates an opportunity to do so. We need to ensure that every bereaved family can get the justice they deserve. We need to ensure that, through a fully independent system, every lesson we need to learn is learned and acted on, so that we can keep every vulnerable person with mental ill health safe in future.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

This is probably as well informed and good a debate as I have ever had to respond to. I hope I can do justice to all the good points that have been made, because we have covered all the key issues relating to how we better support people will mental ill health.

I associate myself with the comments about the personal speech of the hon. Member for Bermondsey and Old Southwark (Neil Coyle), which he made in such a dignified way that I was incredibly moved by his story. What struck me about the experiences that he detailed was that they were his normal, which brought it into stark relief that we are talking about the real day-to-day lives of human beings. It is incredible to hear what people have to cope with on a daily basis. He reminded us that the 1980s had the best pop music, and I was reminded of the “Karma Chameleon” lyric:

“Every day is like survival”.

When we are talking about people with severe mental ill health, every day is like survival, so I thank him for that.

The hon. Gentleman’s speech covered everything that we need to tackle and I do not disagree with anything he said. Obviously, some of the charges that he levelled at me are challenging and I do not want to duck them. Everybody is impatient that we are perhaps not doing as well as we would like in helping people with mental ill health. I share that impatience, but I will not promise that it can be sorted overnight. We are rolling out a significant increase in services and in the workforce to deliver them, which takes longer than anyone would wish.

I will try to address the points that have been made. It was a great pleasure to hear from the hon. Member for Croydon North (Mr Reed) and to support him in delivering Seni’s law. In connection with that law, he has reminded us that when deaths happen to people who are detained by the state, we absolutely owe it to their loved ones, and to the person who died, to be open with them. The truth is often anything but, because the associated institutions of the state collude to protect themselves. Other Ministers and I are determined that we are the servants of the people, and those institutions that are there to deliver services for the people should remember that and should engage in a spirit of openness.

I have met Seni’s parents and I could not admire them more for the dignity with which they have borne their experience and the good use that they have put it to. I genuinely feel guilty, however, that we have let them down. Hon. Members will be pleased to know that we have a ministerial board that investigates deaths in custody and what can be learned from them, but I emphasise that we—including colleagues in the Home Office and the Ministry of Justice who, along with me, sit on those boards—are becoming rather concerned that not enough progress has been made. I am glad to be in continued engagement with Inquest, which does a fantastic job advocating on behalf of bereaved families. We need to do more to learn from events when they go wrong.

[Mr Reed]

It is clear from the Minister’s comments that she cares passionately about the issues that we are talking about and for which she has responsibility. A consultation on the serious incident framework started in March 2018 with a promise that the findings would be published in spring 2019. From the temperature today, we know that we are way past spring and into summer, but we still do not have a date for when they will be published. Can the Minister share a date by which we might expect that to happen?

[Jackie Doyle-Price]

I cannot give the hon. Gentleman a straightforward answer to that question but I will write to him with a commitment. It is very boring, but Brexit has diverted officials in the Department. Obviously, no-deal preparations in the health service are a matter of public concern, so we need to make them, but we still need to get on with business as usual. It is an important issue.

The hon. Member for Worsley and Eccles South (Barbara Keeley) mentioned the case of Matthew Leahy. I will go away and reflect on that, but I will give the same message as I gave in response to Seni’s law. Generally, we need to get a proper grip on how we learn from deaths that happen when somebody is in the state’s care, because that is clearly unacceptable. We have coronial reports of all those occasions. People should not be waiting the length of time that they are waiting for inquests. When inquests happen, again, there is usually representation from the various institutions involved and the family can be left feeling very under-represented against a mass of organisations trying to avoid liability. We need to tackle that properly.

We have had those discussions at the ministerial board. My ministerial colleagues in other Departments and I want to get a grip on how we properly hoist in the learnings from coronial reports. I look forward to engaging with hon. Members on that, but I will write to the hon. Lady specifically on the issue of Matthew Leahy. It is worth noting that we are looking at the principles of sexual safety in wards, which is not just about getting rid of mixed-sex wards. People are very vulnerable in those situations and it is all about the care regime.

--- Later in debate ---

[Jackie Doyle-Price]

This comes back to housing. One challenge is getting access to a bed, and another is when the person comes to leave, because we need to discharge people into safe living environments. Are there enough supported housing solutions? No, not always, so the bed remains full. I am having conversations with colleagues in local government to see what more we can do to deliver more supported housing so we can get the pathway going. We could fix it by making more beds available, but that is not really the answer. I am concerned that the longer we leave people in in-patient care, the more harm we do. We have to get that movement through the system. Hopefully, if we do that, people will be less likely to grab the first bed because they can be confident that more will become available more frequently. That is where we need to get to. I appreciate that right now it feels desperate.

There is an issue with quality. The Care Quality Commission has a challenge in deciding whether more harm will be done by taking enforcement action on a place rather than working with it to improve. We see that writ large in TV programmes such as “Panorama”. There is a massive disparity in the quality of care. I challenge the CQC to be a lot more aggressive when we see poor standards of care.

The hon. Member for Bristol East mentioned private providers. People have heard of The Priory. They hear that celebrities go there and they think it is a centre of excellence. The truth is that the care there is less than optimal, but someone with a loved one who needs hospital treatment will not know that. We need the CQC to have a lot more teeth in terms of improving what comes out of its inspections. The system generally needs to support it in doing that.

[Mr Reed]

I am grateful to the Minister for giving me another opportunity to ask a question. While she is on housing, there is a growing issue of vulnerable young people and looked-after children being placed in unregulated, semi-supported homes or hostels. Some of them have severe mental ill health. When they are placed in such settings, they do not receive the support they require and become a danger to other people residing there. That happened in the awful case of Lance Scott Walker, a looked-after teenager in the care of Islington Council. He was placed in a hostel in Ealing, where he was stabbed to death by another young person with schizophrenia. It is clearly inappropriate for young people to be put in those kinds of setting. Is the Minister intervening with local authorities and the Department to try to prevent a repetition of that case?

[Jackie Doyle-Price]

I thank the hon. Gentleman for sharing that case. I was not aware of it. Some local authorities are not as good as they should be in discharging their responsibilities as corporate parents. It is clearly their duty to ensure that looked-after children are housed in an appropriate setting. That issue lies outside my purview, but I will take it up with colleagues in the Department for Education to ensure that we are properly enforcing our obligations towards looked-after children in relation to housing. That is clearly a concern to us.

Gosh—I have so much to get on to. The hon. Member for Bermondsey and Old Southwark talked in particular about Southwark and rightly challenged me by saying that seeing perhaps only 35% of children was not enough. I agree, but I have been really impressed by the efforts made by Southwark on mental health support for the school population. It illustrates the importance of good leadership and working collaboratively with other organisations. I was pleased to visit Charles Dickens Primary School—I do not know whether it is in his constituency.