Spending Review: Health and Social Care

Danny Chambers Excerpts

Thursday 12th June 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need.

When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket. Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages.

We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about. We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system.

Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues. I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.

[Karin Smyth]

I thank the hon. Gentleman for welcoming, on behalf of his party, the commitment that the Chancellor has made and the extra funding that she has identified, but I think his party still opposes the way in which we have raised the funding to do just that. It is good to have your cake and eat it, but we are clear that the funding does come with reform. As I said in my statement, we are committed to improving the front door—primary care—as well as social care and discharge. That is why the NHS contribution, as part of the settlement to the better care fund, increases. He will be aware that we previously revised the better care fund to make it better and more targeted on discharge, which is important.

The urgent and emergency care plan that we published a couple of weeks ago also confirms our recognition that flow through the hospital system is important for patients and staff; we must ensure that we do not face that continued crisis of corridor care over many years. We are committed to the fair pay agreement, and our colleagues in the Ministry of Housing, Communities and Local Government will make more statements in the coming weeks about how that will work.

Mental Health Bill [ Lords ] (Second sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[Stephen Kinnock]

I see where the shadow Minister and the amendments are coming from, but there is a risk of over-embroidering the Bill if we try to load additional duties on to something that we believe is already happening. It is a very well-established duty that clinicians, integrated care boards and other public bodies are used to applying, and this already exists within the Act. I think there is an element here of “If it ain’t broke, don’t fix it.”

If there is compelling evidence that it is not working, clearly we need to intervene as a system, which is about real leadership at the ICB level. As things stand, we feel that this amendment is surplus to requirements for the reasons I have set out. I thank the hon. Members for Winchester and for Guildford for this exchange of views, and I hope that they are content to withdraw amendment 1.

[Dr Danny Chambers (Winchester) (LD)]

It is an honour to serve under your chairpersonship, Ms Furniss. I know that the hon. Member for Farnham and Bordon will have spent his lunch time anticipating the responses to his long series of questions. The tension is palpable— I hope he is excited to hear our replies.

[Gregory Stafford (Farnham and Bordon) (Con)]

Thrilled.

[Dr Chambers]

Unfortunately, I was busy meeting Brian May and talking about farming, so I have not had a chance to work up a really good response.

The point of the Liberal Democrat amendments is to recognise that mental ill health requires holistic care and that many non-clinical factors directly influence mental health. Although the Bill’s scope is understandably narrow, very much focusing on people once they are admitted to hospital for treatment, we need to recognise that, if someone is discharged back into the situation from which they were admitted, they are very likely to have a relapse and to need treatment again. Some of those factors are non-clinical. For example, people living in poverty—those in the lowest 20% of income—are more than twice as likely to suffer mental health issues than those on an average income.

We strongly support the Bill, but we need to recognise that, on its own, it will not improve mental health or do anything to prevent people from developing mental health issues. If our amendments are not within scope or are not appropriate for the Bill, we urge the Minister to work with other Departments, such as the Ministry of Housing, Communities and Local Government, to ensure that this good piece of legislation, which we support, can be successful.

The hon. Member for Farnham and Bordon made a point this morning about local authorities. He is right that local authority reorganisation is a challenge, especially when it comes to providing accommodation for young people and for people being discharged from mental health care centres. It is also an opportunity, because the current situation is not fit for purpose. Hampshire county council is struggling to provide the care these people need. Housing, which often affects young people’s mental health, is probably the single biggest issue that comes up in my inbox and when I knock on doors.

I thank the hon. Member for Hinckley and Bosworth. As a clinician, his point about the evidence base, especially when it comes to reviews, is really important. We are discussing a Mental Health Bill that may not be changed significantly for another 40 years, so it is important that we use the best evidence. As a long-time trustee of an evidence-based medicine charity, I am passionate about this.

I thank the hon. Member for Thurrock for pointing out that clinical guidelines suggest six-month reviews. Yearly reviews are used for many medical conditions, and I would argue that a year is also an arbitrary period, rather than one based in evidence. Why six months and not a year, or why a year and not six months?

[Dr Evans]

The hon. Member is correct to establish the evidence base and the guidance. Broadly, we need to balance that with the logistics and the impact on the clinician, the patient and the resources. Move too far one way and it becomes a tick-box exercise or more resource-heavy; move too far the other way and the safeguards that we are trying to implement are lost or watered down.

When I look at the amendments, that is the balance I am trying to understand; if the guidelines are written with that in mind, that makes sense. The job of this House is to scrutinise the numbers and decide whether we agree that they are right, or whether we should push a bit harder—whether we should tighten the safeguards or relax them a little to allow clinicians more freedom of choice.

I guess that is the purpose of the Bill—getting the right boundary between the safety of the individual patient, support for the wider public, and making sure that clinicians have the freedom to make their judgment so that we are not stepping on expert opinion or, worse, creating bureaucratic processes. I hope the hon. Member understands that is why we are probing further on the rationale.

[Dr Chambers]

I completely agree with everything the hon. Member just said. Atul Gawande did a fantastic piece of work on checklists that emphasised the need for them not to become tick boxes. They are meant to involve active thinking and decision making.

I thank the Minister for reassuring us about housing. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Dr Chambers]

I beg to move amendment 8, in clause 4, page 8, line 27, at end insert—

“(ba) the person is under 18 years old and satisfies the conditions in (b)(ii).”

This amendment inserts a new subsection that extends the duty on integrated care boards to establish and maintain a register for those at risk of detention to all children and young people under the age of 18.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 47, in clause 4, page 9, line 20, at end insert—

“(6) The risk factors specified in regulations under subsection (5) must include—

(a) homelessness;

(b) addiction;

(c) domestic abuse;

(d) miscarriage and traumatic birth;

(e) experience of armed conflict; and

(f) bereavement.”

This amendment would specify risk factors for detention for people on the register of people at risk of detention under Clause 4.

Amendment 9, in clause 4, page 9, line 29, at end insert—

“(c) seek to ensure that the needs of children and young people can be met without detaining them under Part 2 of this Act.”

This amendment extends the duty on integrated care boards and local authorities to exercise their marketing functions in a way that seeks to ensure that children and young people’s needs can be met without detaining them.

[Dr Chambers]

Amendments 8 and 9 would insert a new subsection to extend to all children and young people under the age of 18 the duty on integrated care boards to establish and maintain a register of those at risk of detention. Amendment 9 would extend the duty on integrated care boards and local authorities to exercise their marketing functions in a way that seeks to ensure that children and young people’s needs can be met without detaining them.

Far too many children are unable to access the mental health care they need, leaving them more vulnerable to experiencing a mental health crisis that then requires detention, which all too often ends in tragedy. Child and adolescent mental health services are in a state of near collapse, with many children unable to access the care and treatment they need until their mental ill health has reached the point of crisis. Waiting 15 months in great mental distress is far too long, especially for children. It is a huge disruption not only to their personal development but to their education. Waiting up to two years for treatment is a huge proportion of a 12-year- old’s life.

We are pleased that the Bill, as it currently stands, includes specific provisions to prevent people with learning disabilities from requiring detention under the Act. The Government should take that approach for more people, especially our young people. Early intervention, delivered through regular check-ups and cutting waiting times for treatment by community services, is critical. We should not pretend that acute mental health services and in-patient care exist in a vacuum. The pressures they face are directly impacted by the quality of community services. We need stronger steps to ensure that fewer people require detention in the first place, especially children.

We are pleased that the Government are taking steps towards having mental health support in every school, for which we have long campaigned. We would like them to go further by ensuring a dedicated professional in every school. We are alarmed that the targets for mental health are being dropped, so I press the Government for assurances that the upcoming 10-year plan will ensure that children who are referred can expect swift and efficient support and treatment, with binding duties on health bodies to deliver that.

Alongside this Bill, what requirements and resources will ICBs have for preventing mental health crises? As part of that, will the Department make specific changes to CAMHS?

[Dr Evans]

The hon. Gentleman makes a pertinent point about the pressure on CAMHS. In Leicestershire, about 45% of CAMHS referrals are for things like autism and ADHD, and the problem is that it takes a lot of services away from those who have eating disorders or depression, or who self-harm. Does he believe there is scope to reorganise services to make sure they are appropriate where there needs to be treatment? A child suffering with severe anxiety and self-harming tendencies should not be on a pathway with someone who has autism, for example. Has he given any thought to how this Bill might be a way of opening that door?

[Dr Chambers]

On the surface, what the shadow Minister says seems logical and makes sense. I am not a mental health clinician, so I want to be really careful about pushing in one direction. Whether someone has an eating disorder or is waiting for a diagnosis of something like ADHD, the waiting times are too long. We must better structure a system that ensures that everyone gets healthcare when they need it, rather than prioritising what we perceive as most important.

One of the most heartbreaking things that I hear from parents in Winchester, who are worried sick, is that young teenagers with an eating disorder have been told that they have to hit a lower BMI to reach the threshold to qualify for treatment. That is essentially saying that someone has to be sicker for longer. No one would ever say, “We’ll wait until your cancer reaches stage 4 before we start treatment,” but that is happening with eating disorders. The treatment will end up being longer, more complicated, more costly for the taxpayer and maybe less successful.

A question often comes up—the hon. Member for Farnham and Bordon alluded to this—about the pressures on local authorities to deliver mental health care. Actually, the question is “How we can afford not to deliver it?” People with mental health disorders are ending up in A&E or prison and costing police time. It costs £52,000 a year to keep someone in prison, yet apparently we cannot afford to give them the community interventions that might stop them going there in the first place.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

The Labour Government are working on a range of early interventions for young people in the area of mental health and to stop them spiralling into crime, such as the Young Futures hubs and introducing mental health support in every single school. The hon. Gentleman makes a valid point, but it sits outside the Bill, and there is plenty that the Government are doing. Regrettably, there will always be a need, at certain times, for a young person to be under a section 2 notice and to be brought into care for a period of time, for their own safety. That is unavoidable and will be the right thing for that individual, but there is so much work being done outside this Bill to help young people and others with their mental health.

[Dr Chambers]

We support all efforts to keep young people happy and healthy in their communities. I visited Winchester Youth Counselling recently, where pupils can self-refer to talk through their issues. That does not involve any clinical personnel. It is hugely impactful and cost-effective and is part of the community. We support those community hubs.

Amendment 47 would specify risk factors for detention for people on the register of people at risk of detention under clause 4, including homelessness, addiction, domestic abuse, miscarriage and traumatic birth, experience of armed conflict, and bereavement. For anyone, including people with learning disabilities, life events can have a profound impact on mental ill health and can drive mental disorders. Well over a third of women with mental health problems have been a victim of domestic violence, and 50% of rough sleepers have mental health problems. The disastrous impact that bereavement can have on anxiety and depression, which are key factors in suicide, has been well documented.

It seems obvious, frustratingly, that public services do not currently reflect that key fact. There are no registers of bereaved children to ensure that they get the right support in the community and in school. There are no registers of veterans, despite their far higher risk of mental ill health and suicide. Women who have suffered a miscarriage do not receive an automatic referral, including to mental health services. The Government need to ensure that people can get mental health assessment and support at key points in their life, including the most traumatic moments.

[Dr Evans]

We have certain registers of carers, for example in primary care. There is a stipulation about moving towards veterans being included. Who does the hon. Gentleman think might hold the register, in the light of his amendment?

[Dr Chambers]

I do not know the best place for it to be held. That is an important point. For a lot of the issues that Members are bringing up, we are not expecting there to be answers today. However, we want to ensure that they are all being considered, given that the subject might not return to Parliament for another 40 years.

[Jen Craft (Thurrock) (Lab)]

I have a question about the list of risk factors that has been provided. Is there not a concern that it might be too prescriptive or restrictive, and that putting it in primary legislation prevents local authorities or ICBs from widening it, from having registers and risk factors that might be appropriate to their areas, and from focusing on what the appropriate level of care is that they are best placed to meet?

[Dr Chambers]

That is a very insightful point. The list could be longer and is not meant to be exclusive. I am not sure of the answer to the hon. Lady’s question but, taking a step back, we know that the single most common cause of death in women 12 months after giving birth is suicide, and there is no proactive automatic care. If a person is addicted to alcohol, they are admitted to hospital for treatment for their physical symptoms. When they are physically well enough to go home and they are discharged, there is no automatic enrolment or follow-up in mental health care. I would not want to bring in a system, as the hon. Lady says, that ends up being too prescriptive. However, at the moment, we have one that is not prescriptive enough. I could list a handful of demographics of people who desperately need that proactive care.

[Sojan Joseph (Ashford) (Lab)]

The purpose of this part of the legislation is for ICBs to keep a register of anyone who is diagnosed with autism or a learning disability. Patients who are already under a clinical team already have a risk assessment, which covers all the areas that the hon. Gentleman is specifying. As a result of the amendment, would we not be duplicating information about risks that already exists for most patients with their clinical teams?

[Dr Chambers]

The point of having an at-risk list is that ideally there is proactive contact with people—perhaps in quite a soft way, and perhaps through community hubs, as we have discussed—before they demonstrate a severe mental health crisis. I assume that the people the hon. Gentleman is talking about have already been admitted to hospital and have received treatment, and that they are being followed up after they have been discharged. That is not a proactive list; it is a reactive register. Am I correct? I apologise if I have misunderstood his question.

[Sojan Joseph]

Anyone who is under the care of a clinical team for their mental health has a risk assessment. That is basic paperwork, which is completed by the clinicians. That risk assessment covers everything that is specified in the amendment. The purpose of this part of the legislation is for ICBs to have a register. However, ICBs will not be providing direct care; that will be provided by the clinicians. Those patients who are under any clinical team have a risk assessment that covers all the points in the amendment. My point is that the amendment would duplicate some of that paperwork.

[Dr Chambers]

I will not argue with an esteemed Member who has the hon. Gentleman’s background in mental health. I take his point as it stands.

[Gregory Stafford]

I have been listening carefully to the hon. Member’s argument. I do not disagree with anything in it; I just fail to see how the amendment fits with the clause that we are discussing, which I think may be the point that the hon. Member for Ashford is making.

As far as I can tell, clause 4 is about producing a register of people who have a learning disability or autism, who are at risk of being detained for a mental health episode and for whom those risk factors are active, for example because they have been sectioned before or have presented at A&E. Those are specific incidences. What the hon. Member for Winchester is talking about is more wide-ranging; it is not about touchpoints in the same sense. I can see how he could potentially say, “Well, domestic abuse has led to a mental health episode and therefore to a presentation at A&E or in the system.” However, if we put in societal factors, for want of a better phrase, we could end up putting most people on the list, because most people will have experienced a bereavement. I get what the hon. Member is trying to do, but I fail to see how the amendment matches the overall purpose of clause 4.

[Dr Chambers]

I thank the hon. Member for his intervention. In my maiden speech, I focused primarily on mental health and on the fact that there are so many demographics of people who we know are at significantly higher risk of suicide and mental ill health than the general population. Whether the issue is more appropriately addressed in the Bill or outside it, but using the Bill as a mechanism to highlight it and to cause the proactive engagement of other relevant Departments and other pieces of legislation, I am determined that we are not going to discuss the biggest piece of mental health legislation in 40 years and not even have a discussion about how we proactively engage with groups of people who we know are at very high risk of mental health issues.

[Gregory Stafford]

Will the hon. Member give way?

[Dr Chambers]

I will carry on, if that is okay.

Our social and health services need to see the whole person, including their social needs and the factors in their environment that threaten their wellbeing. Trying to treat a mental disorder but failing to account for that person’s lack of housing, which drove their anxiety and depression in the first place, is doomed to fail. A lack of support for a child who has lost their parents at a young age could lead to significant harmful consequences further down the line.

There are a huge range of areas that require change, but for now we would like to press the Minister on three specific issues. We understand that some of them may turn out not to be within the scope of this Bill, but it is still important that they be addressed in some capacity.

Will the Government finally implement a register of all bereaved children to ensure that they get the support they need? Will the Government ensure that all women who go through miscarriage, stillbirth or traumatic birth access mental health support quickly and effectively? Will the Government establish a veterans register to ensure that those who have served in the armed forces and who face particular challenges as a result get the tailored mental health support that they need and do not reach the point of requiring detention?

[The Chair]

I need to remind the hon. Member that issues that are not within the scope of the Bill are not within the scope of the debate—but we have let you get away with it this time.

--- Later in debate ---

[Stephen Kinnock]

The hon. Member makes an interesting point. I am certainly happy to discuss that with officials, just as long as everybody is clear that there are two very different things going on here, with different types of risk and therefore different agencies. But I am all in favour of joined-up government wherever we can deliver it.

I turn now to amendment 47. It is important that robust measures are in place to support people with a learning disability and autistic people who are at risk of admission. That is why the Bill will, for the first time, put dynamic support registers on a statutory footing and, via regulations, set out the factors that the Secretary of State considers increase the probability of someone being detained. That is the most appropriate approach in order to provide sufficient flexibility for updates in line with emerging best practice, evidence and clinical and commissioner understanding.

As the factors are likely to be updated regularly, returning them to Parliament at every such instance would be disproportionate and unmanageable. Additionally, although putting them in primary legislation would not prevent the Secretary of State from providing and updating a longer list in regulations, having some factors but not others in the Bill could be perceived to give them primacy—for example, having a history of in-patient admissions or presenting in A&E in crisis. That could have unintended consequences and divert support from those most at risk.

We will of course engage with expert stakeholders, who are best placed to advise on what the list of risk factors for detention should be, taking into account the existing NHS England policy on dynamic support registers. I am pleased to provide assurance to the Committee that current NHS England policy provides examples of factors such as those in the amendment—for example, having no fixed address, having drug and alcohol addiction and having had significant life events such as bereavement and abuse. For those reasons, I hope the hon. Member for Winchester will not press his amendments.

[Dr Chambers]

I know how much the hon. Member for Farnham and Bordon enjoys speaking in Bill Committees—we were on the Tobacco and Vapes Bill Committee together a few months ago—and I am really pleased that our amendments have given so much material for discussion. I really appreciate the input from Members on both sides of the Committee; it has been really insightful, useful and constructive.

It has been rightly pointed out that the current state of local authorities—their funding and their capacity—means that they might not be able to deliver the more holistic care we are pushing for in the amendments, but I do not think that the Mental Health Bill should be limited by the current state of local services and funding. If that is the underlying problem, that is what should be addressed, not the measures in the Bill.

[Gregory Stafford]

I accept that we should aim for the pinnacle and the best. What I was trying to say was that because the amendments restrict us, rather than giving us the space to, hopefully, reach the pinnacle, or to explore other options if we cannot, they could have unintended consequences if we cannot reach that pinnacle.

[Anna Dixon]

rose—

[Dr Chambers]

I give way to the hon. Lady.

[Anna Dixon]

The hon. Gentleman may want to take these points together. We drew attention to proposed new section 125. Subsection (1) relates to integrated care boards, while subsection (2) relates to local authorities. They do exactly what he wants: strengthen the requirements on ICBs and local authorities to better meet the needs of people with autism or learning disabilities in order to avoid detention. The very essence of the Bill therefore provides the duties that the Minister reassured us on in response to my earlier point. The expectation is that commissioners will meet needs as identified in these dynamic registers.

[Dr Chambers]

I thank both hon. Members for their input and their valid points. We appreciate the Minister addressing these concerns. We will not press amendment 9 or 47, but we would like to vote on amendment 8.

Question put, That the amendment be made.

--- Later in debate ---

[Stephen Kinnock]

I think the short answer to my hon. Friend’s question is yes. The written ministerial statement will be an update on the work done over the preceding 12 months, but it absolutely will also be a forward plan, so it will set out the next actions that the Government will take, what the broader, long-term change delivery process will be, the institutions that will need to change and how they will change.

A number of colleagues have also asked the question, “What does good look like?” In many ways, it is absolutely right that we, as a Government, are being held to account on the content of the Bill, but there will be a really important accountability moment 12 months after it gets Royal Assent, which will be that written ministerial statement. I fully expect every colleague in this room to read that in great detail and hold the Government to account, both on what has been achieved over the preceding 12 months and, importantly, on what the forward plan looks like.

I think that covers most of what I wanted to say, although one additional point I would make is that the amendments could have the unintended consequence of requiring Government and local areas to set out unfunded or speculative plans ahead of any funding settlements, which would affect their credibility. It is more effective to set out plans when they are ready, when we have a clear line of sight on funding and deliverability.

We also need time to engage with expert stakeholders to inform implementation planning. We know that sufficient community services cannot be achieved without wider system reforms beyond health, and details contained in any plan must also consider the context of the 10-year health plan and the independent commission into adult social care, chaired by Baroness Casey. For that reason, I thank hon. Members for their contributions and invite them to withdraw amendment 20 and not to press amendments 24, 10, 22, 21 and new clause 11.

[Dr Chambers]

I thank everyone for all their insights into our amendments; they were very useful and constructive. I will address a couple of them briefly.

First, I thank the hon. Member for Ashford; we totally agree that we want to be moving mental health care—any care, actually, but mental health care specifically—back into the community and have more community care. We are not advocating for more hospital care. There is a specific point to amendment 20: my hon. Friend the Member for St Neots and Mid Cambridgeshire, who is in the Public Gallery, had a tragic case of a constituent, which resulted from there not being enough available safe places for someone in crisis to be cared for.

A lot of our amendments have rightly been criticised for possibly being outside the scope of the Bill, because this Bill is for when people are in a mental health crisis, and a lot of our amendments are about how we can improve community care. To me, amendment 20 appears to be very in scope, because it addresses a failure of someone who was admitted for mental health care.

I thought that the insightful comments on most of our amendments from the hon. Member for Solihull West and Shirley, given his legal and medical background, were very useful, and we will take those on board. The only one that I would disagree with, and I think he might feel the same, is on amendment 20 specifically. His main criticisms of that were that it might result in variability across the nation, that there are currently staff shortages and that there could be implementation delays. I do not see any of those three reasons to be strong enough to not want to maintain crisis accommodation.

I thank the Minister for his comments and his serious consideration of all our amendments. We will press amendment 20 to a vote, but will not press any of our other amendments.

Question put, That the amendment be made.

Mental Health Bill [ Lords ] (First sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Vickers.

I thank the many hon. Members who spoke on Second Reading. It is clear that in this place, as in the other place, the Bill will proceed in a collaborative and constructive spirit, with the single motivation of getting the reforms right. On Second Reading, we heard numerous powerful accounts from hon. Members arising from their personal experience of supporting family, friends or constituents with a serious mental illness, a learning disability or neurodiversity, or drawing on their own experiences to underscore the importance of the need for reform. I was heartened to hear from so many Members who set out the positive impact of the changes that the Bill will introduce, particularly the vital changes to ensure that patients’ voices are heard and that—as we would expect in any modern mental health service—the patient is at the heart of all decision making.

In our manifesto, we committed to modernising the Mental Health Act 1983 to give patients greater choice, autonomy, enhanced rights and support, and to ensure that everyone is treated with dignity and respect throughout their treatment. I am proud that we included this critical Bill in our first King’s Speech, and I look forward to constructive engagement with the Committee on this important legislation.

I will also take a moment to thank the Liberal Democrat Member, the name of whose constituency escapes me, and other MPs who have shone a light on the experiences of Fiona Laskaris and other families. No one should lose a child in that way. I thank Fiona for meeting me and I commend her tireless campaign efforts. The engagement that my officials and I have had with Fiona and the hon. Member has been incredibly valuable. Unfortunately, the Bill is not the appropriate vehicle to address those concerns, but I have committed to continuing engagement with Fiona and the hon. Member to further explore those issues and how we might tackle them.

[Dr Danny Chambers (Winchester) (LD)]

I know that my hon. Friend the Member for Dorking and Horley (Chris Coghlan) has been pushing forward on that very emotive and difficult issue of capacity; he brought it up in his maiden speech and has been campaigning tirelessly on it. My hon. Friend said that the Minister was very constructive in his engagement on the issue, which we very much appreciate. Even though we cannot include it in the Bill, we look forward to working on it.

--- Later in debate ---

[Stephen Kinnock]

I do not know whether I will be able to answer the hon. Gentleman’s question in its entirety, because quite a lot of that is being led by my colleagues in the Ministry of Housing, Communities and Local Government—in the English devolution Bill, for example. On the part of his question relating to the Department of Health and Social Care, we came to the view following the general election last year that NHS England was an unnecessary layer of bureaucracy. We think it is important that there is a clear line of accountability from the Secretary of State to Ministers, to ICBs, to trusts and to the system per se for delivery. That line of accountability was being blurred by NHS England, which is why we have removed it from the equation.

The hon. Gentleman is right that there are a lot of moving parts, but, by definition, a reform agenda creates change and some turbulence. We believe that is the only way we will get the system to where we need it to be so that we can deliver the three big shifts in our 10-year health plan: the shifts from hospital to community, from sickness to prevention and from analogue to digital. Many of the questions he is asking will be answered in the 10-year plan. He does not have long to wait for that to be published; it is coming very soon.

I reiterate that the principle underlying all of this is about empowering, devolving and giving agency to those closest to the communities they serve, because they are best placed to deliver. That all has to fit into the Bill, but the fundamental principle underpinning the Bill is the right one: it is about devolution, and about being patient-centric. The Bill deals with a cohort of people whose needs should drive the services that we design and deliver.

Question put and agreed to.

Clause 3 accordingly ordered to stand part of the Bill.

Schedule 1 agreed to.

Clause 4

People with autism or learning disability

[Dr Chambers]

I beg to move amendment 1, in clause 4, page 4, line 41, at end insert—

“(iv) housing.”

This amendment ensures that housing needs are considered as part of care, education and treatment review meetings.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 51, in clause 4, page 4, line 41, at end insert—

“(iv) accommodation and relocation, and”.

This amendment ensures that the impact of accommodation and relocation is considered in care and treatment reviews for patients with autism or learning disabilities.

Amendment 2, in clause 4, page 5, line 23, at end insert—

“(v) the patient,

(vi) the patient’s nominated person, and

(vii) the patient’s independent mental health advocate.”

This amendment would ensure that nominated persons and independent mental health advocates receive copy of a care, education, and treatment review meeting report for children and young people with autism or a learning disability.

Amendment 3, in clause 4, page 5, line 31, for “12” substitute “six”.

This amendment would shorten the length between care and treatment reviews from 12 months to six months.

Amendment 4, in clause 4, page 7, line 6, at end insert—

“(iii) housing, and”.

This amendment ensures that housing needs are considered as part of care and treatment review meetings.

Amendment 5, in clause 4, page 7, line 32, at end insert—

“(v) the patient,

(vi) the patient’s nominated person, and

(vii) the patient’s independent mental health advocate.”

This amendment ensures that nominated persons and independent mental health advocates receive a copy of a care and treatment review meeting report.

Amendment 6, in clause 4, page 7, line 40, for “12” substitute “six”.

This amendment would shorten the length between care and treatment reviews from 12 months to six months.

Amendment 7, in clause 4, page 8, line 12, leave out “must have regard to” and insert

“have a duty to carry out”.

This amendment ensures that integrated care boards and local authorities responsible for a patient's treatment and care have a duty to implement recommendations arising from a care and treatment review.

[Dr Chambers]

It is an honour to serve under your chairmanship, Mr Vickers. I will speak to amendments 1, 51 and 4 together, as they all relate to housing. Amendment 1 ensures that housing needs are considered as part of care, education and treatment reviews. Amendment 51 ensures that the impact of accommodation and relocation is considered in care and treatment reviews for patients with autism or learning disabilities. Amendment 4 ensures that housing needs are considered as part of care and treatment reviews.

Appropriate housing is critical for people’s wellbeing and cannot be viewed as separate from effective and safe care. Ensuring that housing or any temporary or crisis accommodation supports the safety and independence of people with a learning disability should be a key part of care, education and treatment reviews. We believe that it is essential for fulfilling the duties of the Bill.

Without that provision, it will be far harder for patients to leave detention and for care to be facilitated in the community. If people with learning disabilities who are detained risk being discharged into insecure or inappropriate housing, their recovery from mental ill health could be jeopardised. Patients should be viewed in their whole context, not just as a collection of conditions or symptoms. Housing is among the most fundamental social needs that should be considered.

[Zöe Franklin (Guildford) (LD)]

I rise to speak to amendments 2 and 5, which, in summary, would ensure that patients, named persons and independent mental health advocates would receive a copy of a care, education and treatment review meeting report for children and young people with autism or a learning disability.

Patients, along with all those tasked with helping to represent their wishes, should be able to see transparently what has been judged to be safe and appropriate care for them. Being given the opportunity to understand why their care or treatment is changing or remaining the same should be a basic right for patients, yet as it stands they are often frozen out of seeing that final report. Similarly, the nominated person, whether that is a friend, a mother, a sibling, or another parent, often has care of the patient; they know the whole person better than any NHS institution, and will often have a far fuller understanding of the patient’s history.

Dementia Care

Danny Chambers Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Dr Danny Chambers (Winchester) (LD)]

I thank my hon. Friend the Member for South Devon (Caroline Voaden) for securing this important debate. Listening to the stories from Members on all sides of the House, it is clear that this is not simply a political debate; it is deeply personal to pretty much everyone here.

My father had dementia. He was a typical Irish farmer; he was very strong-willed, physically tough and fiercely independent, and he was used to working all hours of the day. Watching that man slip away, becoming increasingly confused, anxious and very often unreasonably angry, was one of the most heartbreaking experiences of my life. I know I am not alone in experiencing that, as we have heard very similar stories.

Many Members have said that with dementia we lose the person we love twice—first slowly, piece by piece, and then again at the end. The final loss can feel like a relief, because it is a prolonged bereavement; the grief starts sometimes years before. Dementia is a brutal disease, not just for those who are experiencing it but for those who are caring. For spouses, children and families, it is relentless emotional toil, sleepless nights and endless juggling of tasks.

[Sarah Dyke]

My hon. Friend shares his experience of losing his father. I lost my father in the same way, and he too was a proud farming man. I want to raise an issue from a constituent who contacted me about her father James. He is currently alone in a room in a hospital, and he is scared to mix with other violent dementia patients. He wants to be at home, and the family want him to be at home, but there are barriers in social care in Somerset at the moment. Does my hon. Friend agree that dementia patients should be able to live independently at home, with dignity, and receive the care—

[Madam Deputy Speaker]

Order.

[Dr Chambers]

Yes, I agree that empowering people to live as independently as possible is hugely important.

For me, there was guilt—for many years actually. I felt guilty about the moments of resentment at how my job and career were affected, and for losing patience when faced with the anger of someone you are trying to care for. I remember that my dad did not really understand that all we were trying to do was help. I want to mention the very insightful piece of advice from the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) not to argue with people who have dementia. I wish I had understood when we were caring for my father that there was no need to correct his current understanding of the world. My grandfather was born in 1870, and my father kept asking where he was. We tried to explain that he would have been aged 130 if he had still been alive, but I wonder why we had those discussions. That was a hugely important and emotive piece of advice.

[James Naish (Rushcliffe) (Lab)]

When I led a district council, one thing we tried to do was take initiatives to make us more dementia-friendly. There is some excellent training run by the Alzheimer’s Society. Does the hon. Member agree that all MPs’ offices should be seeking to take such initiatives so that we can be compassionate in the way that he describes?

[Dr Chambers]

I completely agree with what the hon. Member has just suggested. There is no way that we can approach dementia without a huge amount of compassion and empathy.

[Joe Robertson (Isle of Wight East) (Con)]

I thank the hon. Member for drawing attention to the issue of not seeking to correct those with dementia on where they think they are. In that respect, dementia care and understanding have come a long way, and in fact it is now standard not to try to do that. I thank the hon. Member, along with my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke), for raising that issue in the Chamber.

[Dr Chambers]

I remember trying to explain to my father about the sheepdog, which he loved to train but which he did not recognise as his own any more. That is unusual for a farmer. There was no need to have that discussion; it was heartbreaking. The dog loved my dad and dad not recognising him any more was very upsetting. This all still feels very raw, but as we have heard today, my story is not in any way unique. There are so many families in Winchester and around the country who are experiencing that similar, heartbreaking journey.

Caring for my father is one of the hardest things that my family has ever done. I pay tribute to my mother, who bore the brunt of caring for my father for many years; to my sister Irene, who helped hugely for years and years; to my cousin Patrick; and to our neighbours James and Deborah Hodgson—we could not have managed without them. However, especially nearer the end, we could not have done without the extraordinary support of the care workers who came to help on a regular basis. Their compassion, skill and dedication helped get us through some of the darkest days.

That dedication was extraordinary. Dad loved singing and one of our care workers had printed out some of the songs that he knew—some old Methodist hymns, “The Old Rugged Cross” and “Danny Boy”, which was his favourite song and the song that I am named after. He might not have remembered our dog, but he could remember every word of “Danny Boy” when he was singing it. The dedication of the care workers, to find out someone’s favourite song and then sing it with them, was quite extraordinary.

Care workers, who are vital and skilled, are often underpaid, undervalued and stretched beyond endurance. We just cannot allow that to continue. That is why the Liberal Democrats call for urgent and meaningful reform of social care—reform that starts with recognising and properly rewarding and supporting the workforce who underpin it. We have been calling for a national social care workforce plan—not for the can to be kicked further down the road, but a real plan to address recruitment, retention and training, with practical steps to fix the staffing crisis. We want to establish a royal college of care workers to give care professionals the recognition and career development that they deserve. I pay tribute to Liz Blacklock from Winchester, who runs Lapis Care based in Bishop’s Waltham, where I went on some visits a few weeks ago. Liz has long been calling for a formal register of care workers, which would be one of the functions of any new royal college of care workers.

Liberal Democrats also call for a national carers register, so that all unpaid family carers can be better supported, for example with statutory respite care. We also call for a higher carer’s minimum wage, because paying poverty wages for such emotionally and physically demanding work is not only unjust but short-sighted and drives burnout, turnover and, ultimately, worse care.

Let us be clear: dementia is not going away. One in three people born today will develop dementia. The hon. Member for Worthing West (Dr Cooper), with her public health experience, was insightful in her advice on how we can help to prevent it from developing.

The financial pressures on local authorities, driven in large part by adult social care, are among the most urgent political challenges of this decade. In Winchester, the Chesil Lodge day centre provides essential care for older adults, including those with dementia, and importantly provides respite care for family members. Hampshire county council is threatening to withdraw funding. That could overwhelm unpaid carers, forcing loved ones into residential care, which in the end will cost the council and taxpayers more.

With the political will, proper investment and genuine commitment to value and care work, we can build a system that supports people with dementia with dignity and gives their families the help and hope they so desperately need.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

Access to NHS Dentistry

Danny Chambers Excerpts

Thursday 22nd May 2025 Commons Chamber

[Dr Danny Chambers (Winchester) (LD)]

I thank the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) for securing this really important debate. Before I was elected, I drove around Winchester, the Meon valley and the beautiful New Forest treating horses as a veterinary surgeon, and a key part of that role is providing regular dental treatment. Horses do not like going to the dentist any more than humans do, but they need to have their teeth brushed every six months—at least every year—or they get ulcers in their mouths and they can get infected tooth roots. When we have to remove a tooth with a root that is three inches long—especially on a hot day like today—we work up a sweat and it takes a long time, but it is really painful for the horse, even though we use painkillers and nerve blocks. Often, all of that would have been avoidable had they had regular dental treatment, and it costs the owner a lot more money. It is exactly the same with human medicine.

There is cross-party agreement, with no one disputing that prevention is better than cure, and when it comes to dental care in the NHS we are failing at even the most basic level of public health. I am not going to go through all the stats that hon. Members have repeated about the numbers of children needing general anaesthetics for dental care.

[Alex McIntyre]

Will the hon. Gentleman welcome the Government’s partnership with Colgate on tooth- brushing in schools so that we can tackle prevention with children and make sure they are not going into hospital with tooth decay because they are learning how to brush their teeth and doing so properly?

[Dr Chambers]

I absolutely welcome that fantastic initiative.

I visited two dental practices in Winchester, and both told me exactly the same thing: they want to do more NHS work, and they want to be there for their communities, but because of the current NHS dental contract they simply cannot make it financially viable. They are effectively subsidising their NHS patients with income from private work. The British Dental Association estimates that private dentistry in England cross-subsidises NHS care to the tune of £332 million a year, which is due to rise to £425 million if NHS practices are not offered any help with the tens of thousands in additional staff costs brought in by the increase in national insurance. With the NHS work they do perform, they do not have time for the education—the proactive, holistic healthcare— that they want to do. Instead, they have to get people through in a quick turnaround. I say this clearly: dentists are not the problem. They are doing their best within a contract that is outdated and damaging.

I also want to speak to something that is often overlooked in this conversation: oral health is not just about teeth. I know that my dentist colleagues, as in veterinary practice, routinely identify serious conditions such as oral cancers and squamous cell carcinomas during routine dental checks. Those cancers are often aggressive but spotted early, they can be treated. We also know that infections in the mouth can lead to things such as endocarditis, which is not a trivial condition, and there is good evidence that periodontitis can contribute to the onset of dementia. How many cancers are we missing? How many heart problems are we not avoiding by not having routine dental checks?

I will sum up now as I know that we are pushed for time. The Liberal Democrats will continue to fight tooth and nail for an NHS that includes dentistry. I managed to avoid making any jokes about equine dentistry, and Members will be glad to hear that straight from the horse’s mouth. We do not want NHS dentistry to be an afterthought; it has to be a core part of a truly universal, holistic health service. Everyone deserves access to routine dental care. Many Members have said that they live in areas that are dental deserts, where NHS dentists are rarer than hen’s teeth. It is clear that we have cross-party consensus. Let us get the dental contract reformed and let us make this Parliament the last one during which anyone has to extract their own teeth.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

Mental Health Bill [Lords]

Danny Chambers Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Dr Danny Chambers (Winchester) (LD)]

I thank the Secretary of State for introducing this really important Bill, and the Minister for his proactive engagement with us earlier this week. Before I entered Parliament, I was a trustee of the veterinary mental health charity Vetlife, which cares for the mental health of the veterinary profession—I have had to clarify before that it is not a mental health charity for animals with mental health issues. I became a trustee of the charity because my really close friend Sarah, at the age of just 31, when she had her whole life and career ahead of her, took her own life; I took her place as a trustee. Getting the news that I had lost her was one of the most painful experiences of my life. Many hon. Members in the Chamber will have suffered similar experiences with their friends and loved ones.

I speak about Sarah because while we are in this place, we rightly often discuss mental health issues using statistics—we talk about waiting times, workforce shortages and the economic impact—but we must never forget that there are individual lives behind the numbers, and nearly every person in the country is affected in some way. That might be through their own struggles or those of a loved one, or through grief after someone they care about has lost their battle with depression.

To return briefly to statistics, veterinary medicine—the profession I come from—has a suicide rate four times the national average. It is a small profession where everyone knows everyone, and everyone has lost a friend or a colleague to suicide. I share that not just for awareness, but because it reminds us that certain groups are at much higher risk—they are more vulnerable than others—and we should do much more to identify and support them.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

My hon. Friend, as a veterinarian, will know that farmers also suffer with significant mental health issues. My constituents are under immense pressure following the family farm tax and the sudden closure of the sustainable farming incentive. Alongside that, they work extremely long hours, and the unpredictability of farm work means that it is more difficult for them to access mental health support and doctors’ appointments. Does he agree that we should introduce regular mental health MOT checks at key points in people’s lives—when they are most vulnerable to mental ill health—particularly for those in rural areas where there are barriers to accessing support?

[Dr Chambers]

My hon. Friend will not be surprised that I agree with her; she may as well have read the next bit of my speech. She is completely right. Farmers, those working in agriculture, military veterans and their families, mothers in the first year after childbirth, people living in poverty and the LGBTQ+ community are just a few of the groups that we know are at heightened risk.

We already take a proactive approach when it comes to physical health; we have targeted cancer screenings for at-risk demographics. We should take the same approach to mental health. That is why the Liberal Democrats have long called for properly resourced community mental health hubs, which could reach people before they reached crisis point. We are also calling, as my hon. Friend just did, for regular mental health check-ups at key life stages—for example, when someone has just given birth or just been discharged from the Army.

[Freddie van Mierlo (Henley and Thame) (LD)]

My hon. Friend is outlining the treatment options for patients. New medicines are also incredibly important, and groundbreaking research is happening at the Warneford hospital in Oxfordshire, a mental health hospital that is in desperate need of investment. Treatment options and new medicines go hand in hand, so does he agree that the Government should get behind the Warneford and invest in it?

[Dr Chambers]

I agree with my hon. Friend and thank him for his intervention.

Mental health MOTs could help to catch at-risk people early, so that we can start treating them before the problems develop further. I am sure that for all Members present mental health issues are among the top areas in our email inboxes and our correspondence. We receive emails from desperate parents of young people who are left on waiting lists for years throughout their schooling, and from adults falling between the cracks of an overstretched system. We should probably acknowledge that these are not anomalies. They are the symptoms of a system that is under immense strain. This long-awaited Mental Health Bill is a very welcome step, but it cannot be the only step, because at the heart of our approach must be the simple principle that prevention is better than cure.

[Victoria Collins (Harpenden and Berkhamsted) (LD)]

I absolutely support the idea that we need to invest in prevention—I am 100% behind that—but I have also spoken to many constituents who have issues with emergency health care. One of my constituents, Ed, sadly took his own life. He went into A&E undergoing a psychotic episode and was left simply with a phone number and no assessment. Hours later, he was lost. We need to ensure that those who need emergency treatment get it on the spot, as well as investing in prevention. Does my hon. Friend agree with that principle?

[Dr Chambers]

I totally agree, and I will come on to the care of people once they have been discharged after an acute mental health episode, because it is a hugely emotive and problematic situation.

We need a comprehensive mental health strategy that sees mental health not just as a clinical issue but, as the Secretary of State said, something that needs to run through housing, education, employment and justice. Good clinical services are vital, but we cannot medicate or refer our way out of a mental health crisis. Many mental health issues are often rooted in deeper challenges including poverty, housing, insecurity, loneliness, debt and trauma. These are not medical problems, but they put people at huge risk of developing mental health issues, and if we are serious about prevention we must tackle these root causes head-on.

The Bill focuses very much on the rights and treatment of people once they are admitted to mental health units, which is essential, but what is just as important—as my hon. Friend the Member for Harpenden and Berkhamsted (Victoria Collins) has just highlighted—is what happens when they are discharged and what support they get in the community to prevent a relapse. In Winchester, we have seen a brilliant initiative between local NHS mental health teams and Citizens Advice. Teams from Citizens Advice are in a mental health unit called Melbury Lodge, and they help mental health patients with all their life admin—the bills, the correspondence—so that they are not discharged back into the community only to come home to a load of outstanding credit card bills and demands to repay their personal independence payments, for example.

What is remarkable is that every pound spent on that initiative saves £14.08 in cost avoidance for the NHS through shorter in-patient stays, fewer readmissions, better engagement of services once they are discharged and a reduction in medication use. This is a win-win for staff, patients and the taxpayer, but it is a pilot project and there is no funding secured for it to continue, despite the proven cost-saving benefits. We urge the Government to look seriously at rolling out such initiatives nationwide.

My hon. Friend the Member for Dorking and Horley (Chris Coghlan) has been passionately campaigning since entering this House to ensure that families have a greater input into medical decisions when there are questions over the mental capacity of vulnerable patients, and I invite him to make an intervention now.

[Chris Coghlan (Dorking and Horley) (LD)]

I thank my hon. Friend. As he knows, in my maiden speech eight months ago I pledged that Fiona Laskaris would succeed in changing the law that had prevented her from saving her autistic son, Christopher, from murder. Fiona is here today. Despite pleading for years, she was never able to obtain a mental capacity assessment for her son. As we heard from the Secretary of State, the Government are now seriously looking at an amendment that would both honour Christopher’s legacy and save lives. Does my hon. Friend support that amendment?

[Dr Chambers]

I thank my hon. Friend for that moving intervention and offer my condolences to those in the Gallery. We appreciate that the Secretary of State is seriously considering an amendment that might help save lives.

Early intervention cannot just be a slogan; it has to be the foundation of a functional system. Last week, I sat around a campfire with the amazing team at the Winchester youth counselling services. That charity has a nature therapy programme in which 11 to 16-year-olds can go camping, have walk-and-talk therapies and do bushcraft and outdoor cooking. While we were toasting our marshmallows, the team were talking about the free, confidential mental health support that they offer, providing services such as one-to-one counselling and a weekly wellbeing walk-in session. By immersing young people in nature, this programme helps to reduce stress and anxiety and fosters emotional wellbeing and resilience. Crucially, the services are accessible without the need for a doctor’s referral or diagnosis. Young people can self-refer, ensuring that support is available promptly when it is needed most. This is why Liberal Democrats have been calling for mental health hubs for young people in every community. We support the Government’s campaign for a mental health professional in every primary and secondary school—not just an occasional visit or a pilot scheme, but a permanent funded presence.

[Edward Morello (West Dorset) (LD)]

Just to follow up on my hon. Friend’s point about the importance of mental health hubs, in West Dorset the only child and adolescent mental health services centre is in Dorchester, and for many people in my constituency, especially young people, that means at least a 30-mile round trip to access services. In rural Britain, we are lucky if transport links exist, and those that do are often limited. That makes accessing services nearly impossible, which is what makes hubs so important.

[Dr Chambers]

I totally recognise the importance of that intervention.

We also need a system that is much easier to navigate. A psychiatrist came to see me in my office in Winchester and told me that his son had been referred to CAMHS. He said that despite the fact that he and his wife worked in the medical profession, they had really struggled to access the help that they needed. He said:

“If we can’t navigate the system, what chance does anyone else have?”

That is one reason that Liberal Democrats are calling for a mental health commissioner: someone to champion families, cut through bureaucracy and help people to get the support they need before things get worse. The system needs to be simplified, both for the parents and families who are trying to access the service and to allow the system itself to function.

For years, Liberal Democrats have campaigned for mental health to be treated equally with physical health, and we welcome the commitment to parity in the King’s Speech, but it must be backed by action. The Darzi report showed that mental health accounts for around 20% of the NHS case burden—as the Secretary of State acknowledged—yet it receives just under 10% of the funding. For this reason, we want to ensure that the mental health investment standard is maintained and strengthened, and not quietly scrapped or watered down. The Secretary of State also highlighted the scale of this challenge. Around 1 million people are on waiting lists for mental health services, but importantly, 340,000 children are on mental health waiting lists and some of them are waiting an average of 15 months for care, which is a huge chunk of their educational time and personal development. This is not a crisis that is waiting to happen; it is a crisis that is already here.

In this economic crisis, some people ask how can we afford to invest in mental health, but the real question is how can we afford not to do so, because we already pay the price in lost productivity, emergency call-outs, A&E admissions and—most tragically of all—lives cut short. We must spend to save.

The hon. Member for Bermondsey and Old Southwark (Neil Coyle) spoke about spending time with police. I have done the same thing—a fascinating and informative exercise. I encourage everyone to go on patrol with their police. In Winchester, the police say they spend up to 40% of their time responding to mental health-related incidents. We know that patients turn up to A&E in mental health crisis, many already on a mental health waiting list. I heard that the average amount of time someone spends in a mental health crisis in Winchester’s A&E, often needing individual supervision, is 18 hours. That is not sustainable, because we are using the most expensive part of our health system to do the work that should be happening earlier, which would be more cost effective for the taxpayer and provide better outcomes for patients.

Finally, I pay tribute to all those on the frontline: the nurses, counsellors, psychiatrists, doctors, therapists, support staff and charities who prop up a system that should be supporting them. We very much look forward to working constructively with the Government to improve the Bill, and we support it. We will keep pushing until we live in a country where mental health gets the same attention and care as physical health.

Hospitals

Danny Chambers Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Dr Danny Chambers (Winchester) (LD)]

It seems that Members on both sides of the House have been experiencing similar problems in the hospitals that they represent. Years of under-investment has left many hospitals with leaking roofs, for instance. My hon. Friend the Member for Torbay (Steve Darling) spoke of sewage in clinical areas—I thought that sewage was the subject of the next debate; it is outrageous that we should be discussing its presence in our hospitals—and my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) told us about a room full of incubators which had to be removed because the ceiling was at risk of collapsing. It is crazy that operating theatres and hospital rooms are unused not because of a lack of staff, but because they are not safe enough for people to work in.

Like many other Members, I regularly meet hospital leaders and managers—in my case, at our local hospital in Winchester—to discuss the problems that they are experiencing. Despite the heroic efforts of the staff at the Royal Hampshire County hospital, they are facing a set of issues similar to those that have been raised time and again this afternoon, including, again, leaking roofs over treatment areas. Like the hospital mentioned by my hon. Friend the Member for Epsom and Ewell (Helen Maguire), ours has old, outdated lifts that fail, making it difficult to transport patients from wards to the operating theatre. It has no back-up power generators, so there is a risk to patients’ safety during power cuts.

[Gideon Amos (Taunton and Wellington) (LD)]

My hon. Friend has mentioned faulty buildings and roofs. In Musgrove Park hospital in Taunton, staff are fainting in temperatures of 30°C in temporary buildings where there is no cooling machinery, while mums are trying to give birth in the same ward. That is completely unacceptable. We need interim funding if the hospital—which was mentioned earlier today by my right hon. Friend the Member for Kingston and Surbiton (Ed Davey)—is to survive until 2033, when the promised funding is meant to arrive.

[Dr Chambers]

It is indeed unacceptable, in respect of patients’ safety but also health and safety at work, because the health of the staff is being put at risk as well.

These are not minor inconveniences; they are daily threats to patients’ care and they cost us dear, so why are we not fixing them? Failure on the part of the last Government is no excuse for continued delay, and saying “We cannot afford it” when the cost of inaction is higher is simply nonsensical. The longer we wait, the more it will cost the taxpayer. Much has been said about trust in politics, and we will not forget what happened in our part of Hampshire when Conservatives stood on election manifestos promising to deliver a new hospital for which they never had any funds. There was no funding secured and no shovel-ready plan, but they campaigned on the issue repeatedly, hoping that the voters would not find out until it was too late.

Other Members have pointed out that GP surgeries are being particularly neglected. The Budget allocated funds to cover additional upgrades for just 200 GP surgeries out of a total of 6,000. With the Government’s jobs tax hitting GPs, it is becoming harder for those practices to fund their own improvements. However, I was pleased that the hon. Member for Stroud (Dr Opher) mentioned the importance of primary care and mental health. This is, of course, a debate on hospitals and hospital infrastructure, but I know there is cross-party agreement on the fact that keeping people healthy in the community—whether that involves investment in primary care, mental health or public health services—is much more cost-effective for taxpayers as well as being better for patients.

We really welcome the Minister’s warm words on social care. We had a social care roundtable just yesterday, and we heard that every pound spent on social care saves the NHS £3. We urge the Government to hold cross-party talks as soon as possible, because for every year that we delay getting a plan for social care, people are languishing in hospitals on delayed discharge which is costing us a huge amount of money.

We have to end the vicious cycle of false economies and fortunes being spent on papering over the cracks. The total repair backlogs at the delayed new hospital sites could reach an estimated £5.7 billion by the time construction starts. Are the Government really of the view that keeping hospitals on life support is a good use of taxpayers’ money? Repairing and replacing crumbling NHS buildings is not just about treating more patients; it is about reviving and boosting our economy. Here is the truth: we will not grow our economy unless we reinvest in the services that support it.

Let us change course. We urge the Government to reverse the long delays in the new hospital programme, because many will not be open until the 2040s on the current timeline, and those hospitals have to be kept functioning until then; to set out a 10-year investment plan to fix hospitals and GP surgeries; to urgently release funds that have already been committed, to start construction straightaway; and to publish a plan to recruit and retain a skilled workforce to carry out the work efficiently. That is what investing to save looks like. It means improving care, lowering long-term costs and building a stronger, healthier economy. The Conservatives chose to cut investment, which led to higher costs. Our plan is to increase investment now so that we can lower costs in the future.

We urge the Government not simply to patch over the damage done to our NHS. As the Liberal politician William Beveridge, who was a visionary behind the formation of the NHS, said:

“A revolutionary moment…is a time for revolutions, not for patching.”

Let us be bold, and let us invest now. It will be better for the taxpayer, it will be better for patients, and it will boost our economy.

Male Suicide in Rotherham

Danny Chambers Excerpts

Monday 24th March 2025 Commons Chamber

[Jake Richards]

That service in my hon. Friend’s constituency sounds vital—just like those in my constituency. The focus on veterans in particular is critical.

Suicide does not simply affect the person taking their own life. Families lose loved ones and towns and villages are scarred by the traumatic loss of people with great promise and talent. The number of men who kill themselves every year is eclipsed by the number of people affected by their loss. I will use my role as the local MP to press the Government to take action. There are specific policy issues that I want to raise.

I am very aware of specific issues to do with gambling and male suicide. I have met two local mothers who are fighting for justice after their sons, both of whom were hard-working, talented and honourable men, took their own lives far too young as a result of spiralling online gambling addictions. Social media and technology have allowed vulnerable users easier access to gambling. A report found two years ago that there had been a 43% annual rise in demand for NHS gambling clinics, and that one in three of those patients had already attempted to take their own lives. It is estimated that every year there are more than 400 gambling-related suicides in England—and those are the ones we know of. I have before urged the Government to consider ways in which we can empower coroners courts, and indeed place responsibilities on coroners, to look at these issues in a robust and rigorous manner. At the moment, the causative link between gambling addiction and suicide is not given appropriate recognition.

There are broader issues. Although the issue of men’s mental health is complex, there are specific policy areas that the Government must confront. First, the rates of men taking their own lives are highest in the most deprived communities. The suicide rate in the most deprived 10% of areas in England in the two years from 2017 to 2019 was 14.1%—almost double the rate in the least deprived areas. Indeed, rates of men taking their own lives in the regions of England are almost double what they are in London. Tackling poverty and insecure work across our country is a Labour mission, and it is one that will save lives.

[Dr Danny Chambers (Winchester) (LD)]

I thank the hon. Member for giving way and for speaking so eloquently about this difficult and sensitive subject. On that point, it is known that those living in poverty are three times more likely to take their own lives or have mental health issues than people on the average wage. Linking into that, 85% of homeless people are men, and their homelessness is often related to mental health issues. I appreciate all the work that he is doing to highlight poverty.

[Jake Richards]

There is a direct link and we should not shy away from acknowledging, confronting and talking about it. When we talk about tackling poverty, we are talking about saving lives, too.

Secondly, we must save our NHS. This Government inherited a dilapidated health service and a particularly severely under-resourced mental health service. Fourteen years of under-investment and chaotic reform have hindered efforts to grasp this crisis. Long delays for treatment and diagnosis mean that so many men cannot get the support that they need and face worsening mental health in the meantime.

Thirdly, in my view we must be bolder in acknowledging the role that technology and social media have played in this crisis. New technology and social media can help efforts to combat men in difficult times: the internet can allow faster access to mental health provisions and can provide a network. However, it has been clear for more than a decade now that technology and social media can be deeply damaging to mental health, eroding confidence, often siloing rather than enhancing our communities, and exposing people to potentially harmful material. I know that many colleagues in the House have been moved by the Netflix drama “Adolescence”, which shines a light on the way the internet can remould ideas of masculinity and purpose—completely unbeknown to those closest to the 13-year-old boy in that drama.

Men, especially our young men, are spending less time outside and less time meeting people and communicating in person—all things that make us far happier and healthier. They are often sat alone for hours being bombarded with algorithms showing unrealistic representations of life, or communicating through anonymous group chats. Research shows that self-harm content has sometimes been allowed to flourish on social media by companies failing to remove explicit images and encouraging those engaging with such content to befriend one another. The arrival of smartphones has taken place in parallel with sharp rises in depression and anxiety in our young people. Of particular concern is the impact that mobile phones have on our young people. The average 12-year-old now spends 29 hours a week on their phone—equivalent to doing a part-time job.

Maternity Services

Danny Chambers Excerpts

Tuesday 25th February 2025 Westminster Hall

[Dr Danny Chambers (Winchester) (LD)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Chichester (Jess Brown-Fuller) for securing the debate. She spoke movingly and eloquently, and reminded everyone that these are not just statistics, but people.

I will make three points very briefly. My hon. Friend the Member for Eastleigh (Liz Jarvis) touched on maternal mental health. As the mental health spokesperson for the Liberal Democrats, I was as shocked as anyone to know that the No. 1 cause of death for women in the 12 months post giving birth is taking their own life. That is tragic, and it is one reason why my team are organising an event in Parliament in April with the group Delivering Better to bring together women who have experienced mental health challenges during pregnancy and after childbirth. The event will provide a platform to share stories, raise awareness and discuss how we can improve support and services for mothers across the country.

I recently attended the 120th anniversary of the vet school at Liverpool, where I went to university. I spoke to the pro-vice-chancellor, Professor Louise Kenny, who is a consultant obstetrician and has done a lot of research on health during gestation and the months after birth, and we discussed the latest research. We have not touched on that today, but I will do so briefly now. Healthy gestation is the foundation of a person’s lifelong health, and it has a far greater impact than any lifestyle changes in adulthood. We need to look not just at birth itself, but at the care of the mother before birth—everything from stress to nutrition.

Maternal Mental Health

Danny Chambers Excerpts

Wednesday 5th February 2025 Westminster Hall

[Dr Danny Chambers (Winchester) (LD)]

It is a pleasure to serve under your chairmanship, Ms Furniss. I commend the hon. Member for Aylesbury (Laura Kyrke-Smith) for securing this hugely important debate and speaking so eloquently about her friend. As someone who has lost a close friend to suicide, I completely agree that they are not defined by their death, but by the impact they had during their life and the impact they had on other people.

Suicide is the leading cause of death among women in the six weeks to 12 months after giving birth, and maternal mental health in Winchester and across the UK is in crisis. As the Lib Dem spokesperson for mental health, I am hearing more and more stories about this from individual women. Every year, 600,000 women give birth, and one in five of those women will experience a perinatal mental health condition. This is a completely neglected mental health crisis, on an extremely large scale.

Polling from as recently as December 2024, commissioned by the campaign Delivering Better, representatives of which I am pleased are in the Public Gallery today, found that seven out of 10 women who have a negative birthing experience say that it has had a long-term impact on their mental health. A recurring theme is that women are not being listened to—that has been a theme in essentially every major maternity inquiry. Women are not listened to when they raise concerns pre, during and post labour, not listened to when they raise complaints with trusts about their care, and not listened to by successive Governments who have failed to treat this issue with the seriousness it demands. If this crisis is to be meaningfully addressed, far greater emphasis needs to be placed on the voices and experience of women and birthing people.

[Lola McEvoy (Darlington) (Lab)]

I thank the hon. Member for giving way and thank my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing the debate. Does the hon. Member agree that, given the scale of the problem and the barriers to new parents and new mothers asking for help, it is important that this Government focus on pre-emptive support, in case people are struggling with their mental health? We should assume that having a child will affect women’s mental health, and that assumption would force the Government to take a proactive approach to supporting women in that time.

[Dr Chambers]

I completely agree with the hon. Member and thank her for her important intervention. For years, we have been calling for better community healthcare. We know the demographics who are at high risk of mental health issues: not only women who are within a year of giving birth, but a whole load of other people, such as military veterans and farmers. Those groups of people need proactive help before they reach crisis point. It is more cost-effective to treat them earlier, rather than to pick up the pieces once they are in a crisis.

The Government recently announced that they will drop women’s health targets to avoid overspending, but it is clear that women’s health, including maternity care, has been deprioritised for too long. I urge them to reconsider.