Mental Health Bill [ Lords ] (Fifth sitting)

David Burton-Sampson Excerpts

Committee stage
Tuesday 17th June 2025 Public Bill Committees

[Dr Chambers]

I hope that that is the case. I know that is the aim, but I suppose we will see in four, five or six years’ time what the mental health resources are. No one aims to underfund these services, but the demand on them changes and they need to be resilient. Darzi said that in April 2024 there were 1 million people on mental health waiting lists, and we know that some children wait 15 months, so we must not just maintain the current investment standard, but try to catch up on the huge backlog, which will not change unless we reform the system or invest in more staff and resources.

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

The hon. Gentleman makes a good point—mental health services are in a very bad place—but does he agree that the Government have already announced investment in mental health specialists in all schools, and in mental health crisis centres? I have no doubt that once the 10-year plan for the NHS comes out, there will be an even clearer path for how we tackle mental health issues.

[Dr Chambers]

I am really looking forward to the 10-year plan and reading about how it will improve mental health. We shared Labour’s manifesto commitments to mental health practitioners in each school and mental health hubs, so we certainly support that.

The hon. Member for Hinckley and Bosworth made some very good points and said that this proposal should possibly not be in primary legislation. I accept that integrated care boards do not have control over how every part of the service is delivered, so I am happy not to press the new clause to a vote, but I think the second part, which says that integrated care boards should have a duty to assess and report on the resource needed to meet the demands on services every two years, is important.

--- Later in debate ---

However, I invite the Lib Dem spokesperson, the hon. Member for Winchester, to answer some questions. First, will the role expansion be backed by additional resources or training for IMHAs, and if so, what is the proposed plan for that? Secondly, does this already cross the remits of, for example, care co-ordinators or social workers? How do we ensure clarity of roles in the multidisciplinary team? Could existing codes of practice simply be strengthened to reflect these aims without requiring legislative support? None the less, the Opposition are pleased to engage with the Government on this issue. We think that the clauses broadly go in the right direction in dealing with patient welfare. The question really revolves around ensuring that children are protected.

[David Burton-Sampson]

It is a pleasure to serve under your chairship, Sir Desmond. I rise to speak to clauses 24 to 28, and I will start by sharing the story of two of my constituents: Carol and her husband John.

John had been an active member of the local community before he was sadly diagnosed with dementia. As his dementia progressed, John was settled into a good care home and Carol was happy with the care that he was receiving. Due to a change in his medication, Carol was told that John had become more agitated and aggressive than usual. She was asked whether she would agree to John being assessed. Although she did not really understand what that meant, she did not see any reason to refuse.

From that point on, Carol says that she felt like she had lost control over her husband’s care. John was assessed by four strangers, and Carol was told that she could not be present. Following the assessment, Carol was told that John would need to be detained under the Mental Health Act within the next two weeks. Carol was very concerned to hear that John would be detained, but despite having power of attorney, she was not able to overrule that decision. She hoped that he would be able to get help with his medication and that he would be discharged.

In the end, Carol had only half an hour’s notice that John was going to be detained. She rushed to the care home to see her husband, who had been sat in the garden having a cup of tea with some friends, being abruptly put into a van by two men and taken away. She was not allowed to come with him, and for the first time in her life, Carol had a panic attack. She could not imagine how traumatic it was for John, who was disorientated and confused because of his dementia, to be taken by people he did not know to a strange place.

John was taken to a secure mental health ward that was very different from the familiar environment of his care home. Carol was told that she could not visit him, but she was insistent and turned up anyway. She was then allowed to meet his doctors on his first day and was reassured to hear that he would be detained for only two weeks while his medication was reviewed.

In the end, John was detained for eight months. Carol continued to visit every day, spending as much time as possible with him. She had specially adapted her home to accommodate John’s needs, but she was not able to have him discharged to either his home or a care home. Precious time was taken up with the endless fight to get John into a more appropriate environment. Sadly, John’s health significantly declined while he was detained. He lost the ability to walk and speak, and Carol felt that, in his declining state, he could not pose any danger to himself or anyone else. However, it was only after he was admitted to hospital for a catheter fitting that Carol was able to get him discharged, thanks to a doctor telling her that she could use her power of attorney to take him home—something she was told she was unable to do in the mental health facility.

She took him to a care home, where, sadly, he died two weeks later. John’s cause of death was listed as Parkinson’s, but Carol feels strongly that the anxiety and fear of his final months contributed to his death. Carol understood that her husband was dying; all she wanted was to be included in making decisions about his care. She knew very clearly what she wanted for him. She told me:

“I wanted him to die in a bed with clean sheets, with a window open and with me by his side.”

Those wishes were not taken into account.

As John’s wife and carer, Carol spent every day with him, yet she felt excluded from the decision-making process for his care. She should have been able to focus on what was important: spending time with him. The changes in clauses 24 to 28 would have helped Carol to feel more involved in representing John during his time in care. Clearly, there were failures to allow Carol, as John’s nearest relative, the rights that she was entitled to in order to support him.

With the move from “nearest relative” to “nominated person”, the new rights afforded by the Bill would have given Carol even greater engagement. Given that she had power of attorney, it is likely that she would have been appointed the nominated person by the AMHP. However, moving forward, it is important that those rights are properly afforded to the nominated person, so that we do not have another situation like John and Carol’s.

Although I welcome and fully support the changes in clauses 24 to 28, I seek an assurance from the Minister that all efforts will be made to ensure that the rights of nominated persons are fully recognised and assigned, and that nominated persons will be made fully aware of their responsibilities and powers, allowing advocacy for the patient under care.

I turn briefly to amendments 54 and 55 and Government amendments 40 and 41. I agree with the Government’s view that if a child has capacity, they should be able to have the choice to appoint their own nominated person. I appreciate the intent of the amendments from the hon. Member for Runnymede and Weybridge, but I think that the Government’s approach is more appropriate.

[Gregory Stafford]

I appreciate that the hon. Gentleman sees the potential benefit in the amendments standing in the name of my hon. Friend the Member for Runnymede and Weybridge. However, my hon. Friend the Member for Hinckley and Bosworth gave an example, which I do not think is entirely distanced from reality or possibility, in which a person could well choose someone who is deeply inappropriate. In that situation, the person or people—that is, the parents—who had in every other part of life had responsibility for that child would now potentially not have responsibility for the child, in what is probably the most important part of that responsibility.

Does the hon. Member for Southend West and Leigh really not have any concerns about that? If he does, does he not support at least the intentions behind those two amendments, if not the exact wording or drafting? If he does accept those intentions, would he like to see the Government table similar amendments, drafted in a way that he would find more appropriate?

[David Burton-Sampson]

I appreciate the hon. Member’s intervention. He makes the point that there may be situations in which the young person’s request might be inappropriate. However, on the flip side, there may be a situation in which it might be inappropriate for the person with parental responsibility to be the nominated person. They could have been involved in the situation that has led to that young person entering a mental health spiral—an abuse situation, for example, which has not been discovered by the authorities. That person would still have parental responsibility at that time. I think it is important that the young person can choose the person to support them in their ongoing care. I will be supporting clauses 24 to 28 and Government amendments 40 and 41.

[Dr Chambers]

Amendment 49 extends the support offered by mental health advocates to cover social and financial stresses and to family carers and other members of the household when the patient is discharged.

Other hon. Members have today discussed how social and financial struggles can play a major role in someone’s mental ill health and in blocking their recovery, and how those are often the areas where someone can most benefit from advocacy and advice. As we are all aware, patients should not be viewed as a collection of symptoms, but within their whole context, including the situation they are living in. Addressing someone’s housing insecurity, debt or family breakdown should not be viewed as a separate consideration, but as a core part of supporting them to live happily, healthily and independently. Furthermore, family carers and the wider household are absolutely critical for people’s wellbeing and recovery, and should be properly equipped to prepare for their loved one returning from hospital. They, too, may need advocacy and may be missing out on support that they can and should receive.

A good example comes from Winchester, where Winchester Citizens Advice has a member of staff—a former mental health nurse—based at Melbury Lodge in-patient mental health unit. Often, someone may be admitted for two, three or four months, and when they are discharged, they go home to all their life admin—there will be final demands for credit cards or requirements to repay personal independence payments and that type of thing. It is very overwhelming, particularly for those who already have fragile mental health, to have to sort out a whole backload of administration—especially financial and complicated administration. For two days a week, that staff member supports in-patients in sorting out all their administration from anything that needs to be done.

What is interesting is that when these patients are discharged from Melbury Lodge in Winchester, if they have had that help, they end up being hospitalised and on medication for a shorter time. They are also more likely to engage with various support and community services once they have been discharged and are much less likely to be readmitted to hospital. For every £1 spent on that initiative, £14.08 is saved in cost avoidance. That initiative run by Melbury Lodge and Winchester Citizens Advice was up for an NHS award last year. It is a proven concept and something that should be done across the entire country. It has been running for two years and has proved how much money can be saved. Unfortunately, it was a pilot project and is struggling to secure money to continue indefinitely. I urge the Government to look at how that type of initiative could be rolled out around the whole country.

Mental Health Bill [ Lords ] (First sitting)

David Burton-Sampson Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[Stephen Kinnock]

Absolutely, and I pay tribute to my hon. Friend for her outstanding work in the all-party parliamentary group; I am looking forward to meeting with the APPG as soon as diary time can be organised.

There is absolutely no point in the Government making policy in an ivory tower in Westminster or Whitehall. Policy must be evidence-based and based on the real, lived experience of patients—we are very committed to building a patient-centric national health service—and practitioners. If we try to make policy without involving the voices of those people, the policy will fail; we know that from bitter experience.

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

It is a pleasure to serve under your chairship, Mr Vickers. I, too, have received messages from organisations in my constituency that welcome clause 3 and clause 4, which I will speak to later. On the implementation, however, they have made it very clear that it is really important to hear the voices of the individuals who will be impacted and their families. As we work with the ICBs, local authorities and commissioners to implement these new regulations, I seek an assurance that the voices of the community will be heard.

[Stephen Kinnock]

My hon. Friend is absolutely right that those voices must be heard. One example is that we must produce a code of practice to ensure that approved mental health professionals are better supported in their decision making, including when assessing whether somebody with a learning disability or an autistic person has a co-occurring mental disorder. At the heart of the process are the assessment and the definition, and the pathway that flows from that. That code of practice can be developed only on the basis of dialogue and engagement with precisely the people he has talked about.

Mental Health Bill [ Lords ] (Second sitting)

David Burton-Sampson Excerpts

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[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.

Mental Health Bill [Lords]

David Burton-Sampson Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

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

I thank all Members who have spoken so far to share their professional experience, leaving me feeling very under-qualified to speak on this matter, and those who shared their deeply personal contributions. We all know the shocking statistics associated with mental health. Indeed, the cost of poor mental health is calculated at £300 billion a year in England, and the life expectancy of people with a severe mental illness is around 15 years shorter than for those without one.

I wish to draw Members’ attention to men’s mental health, which is an often neglected and overlooked area. Men’s mental ill health frequently goes unrecognised or untreated, leading to severe consequences. Men face unique challenges and are often less likely to seek help. About 12.5% of men in England have a mental health disorder. Only 36% of NHS referrals for psychological therapies are for men, and many men fear judgment for discussing mental health. Men can feel pressured to appear strong, leading to shame, fear of judgment and a reluctance to take time off work for mental health reasons.

To add to that list of mental health disparities, we must add racial inequalities, as has been pointed out by many hon. Members. Black people in Britain are nearly four times more likely to be sectioned than their white counterparts, and the NHS’s race watchdog has warned that discrimination is playing a part in those high figures. Racial discrimination can prevent black and minority ethnic communities from accessing the care they need. We know that black African and Caribbean communities face particular barriers to accessing specific mental health services. They are less likely to self-refer to psychological talking therapies and less likely to be referred to such services by their GPs.

In addition, the racism, racial violence and hate crimes that threaten many such communities have an additional impact on the mental health of community members, often leading to more severe mental illness, compounded by social injustices, discrimination and disadvantage. I recently visited Rochford hospital, a community and mental health unit that serves my constituency, where I saw for myself the disparity; there were a significant number of young black people on the ward—a mix that certainly does not match the make-up of our local area.

We know the terrible toll that poor mental health can have, which can wreak havoc on people’s lives. My constituency of Southend West and Leigh lies within Essex, a county that is unfortunately the unwelcome focus of England’s first public inquiry into mental health deaths. The Lampard inquiry is investigating 2,000 mental health deaths in Essex between 2000 and 2023, which is yet another shocking statistic. It aims to examine the failures in care in Essex and hopefully ensure that they are not repeated elsewhere.

The inquiry has reported that the alleged failings are on a deeply shocking scale and the Essex partnership university NHS foundation trust has had to apologise for the harm caused to those affected. The director of the charity Inquest, Deborah Coles, which provides support on state-related deaths, told the inquiry that

“many NHS trusts were more concerned about their reputation”

than about the care that they provided for their patients. She pointed to an “overuse in restraint”, segregation and seclusion, once again especially with black patients.

As we have heard, the Government are committed to driving down poor mental health, and the Bill is among the steps they are taking. I welcome the measures outlined in the Bill, particularly the involvement of patients in decision making throughout their care and the strengthening of their voice. For too long, patients have been ignored. Given some of the emerging themes from the Lampard inquiry, I also welcome the measures on increasing the scrutiny of detention to ensure that it is used only where necessary and only for as long as necessary, and on the importance of having a nominated person in place. The Secretary of State talked about prevention, and I welcome the other measures that the Government are bringing in, such as the first men’s health strategy, which will also focus on mental health.

The most tragic figures are on the terrible toll of people who take their own lives as a result of poor mental health. Men are disproportionately affected by suicide—the statistics are horrifying. Of the 6,069 registered deaths caused by suicide in 2023, 75% were men. Suicide remains the leading cause of death for men under 54. These are not just statistics: real lives are being lost. Sadly, I have had personal experience of the trauma caused by male suicide and the devastating impact that it has on the family and friends who are left behind.

In November, my close friend Sam, a bubbly, charismatic, well-liked and much-loved guy, with a whole future ahead of him, unexpectedly took his own life, two days before his 34th birthday. His loss is still felt by many, and there are so many unanswered questions. We must fix this system. I speak today in Sam’s memory, and in memory of everyone else who has been let down by the level of mental health support available. I never again want to receive a call to say that someone close to me has been lost in this way. We must do better, and I am hopeful that we are starting to head in the right direction.

World AIDS Day

David Burton-Sampson Excerpts

Wednesday 27th November 2024 Westminster Hall

[Danny Beales]

I definitely pay tribute to Martyn Butler and to everyone like him who has tirelessly campaigned for change. It is the perfect example of progress being made through the sheer determination of those affected by HIV and of their loved ones—those who unfortunately they left behind. My hon. Friend and I have had the pleasure of meeting many tireless campaigners and fantastic organisations such as THT.

Before entering Parliament, I worked for the National AIDS Trust, another fantastic organisation in the sector, campaigning to end new transmissions of HIV and improve the lives of those who are already living with HIV. That included working on a campaign for equal fertility rights for people living with HIV. I was delighted that just last month the law was finally changed to allow equal access to fertility treatment. That life-changing development means that people I met during that campaign can now have a family. It is not often that we can say that children will be born because of a statutory instrument, but in this case it is true. I thank the Minister for his swift leadership and action on the issue and every single person who campaigned to make that possible—thank you.

The first project that I worked on at the National AIDS Trust was a collaboration with the Elton John AIDS Foundation and the Terrence Higgins Trust: the independent HIV Commission. It heard from experts and from those with lived experience and toured the country to look at good practice. Its recommendations laid out a framework for turning into a reality the goal of ending new HIV cases in England by 2030. One of the independent commissioners was a little-known, shy and retiring Back-Bench Labour MP who is now my right hon. Friend the Member for Ilford North (Wes Streeting). He went on to somewhat bigger and better things in the world of healthcare.

A lot has changed since 2021 when the report was launched. Unfortunately, when it comes to progress on ending transmissions, a lot has not. To their credit, the last Government should be proud of the investment that they made in piloting opt-out HIV and hepatitis testing in emergency departments in London, Manchester and Brighton—the one key action in the last HIV action plan that was delivered on. That investment has changed many, many lives. In my constituency, opt-out testing at Hillingdon hospital has picked up 15 new cases of HIV, 28 of hepatitis C and 140 of hepatitis B. Those are people whose lives have been changed and who now have access to vital treatment. The story is the same across all the hospitals delivering that amazing programme.

The programme is working, but it is facing a funding cliff edge. I welcome the commitment to expand the programme further to other towns and cities, but I hope that the Government will commit to continuing the pilot where it is already in place and working.

We now know for certain that opt-out testing works. We cannot find everyone with undiagnosed HIV if we rely only on a system of people thinking that they may be at risk and then actively seeking out a test, navigating the complex system and overcoming the stigma of HIV to ask for a test. Instead, we must test, test, test. We need an opt-out testing programme that goes right across the health service and into primary care.

Unfortunately, the reality is that despite the success of the testing programme, overall progress towards ending HIV transmissions has been far too slow. Recent figures suggest that this year we are potentially moving backwards. Recent data showed an increase in cases; we have seen poor outcomes around late diagnosis; and the disproportionate outcomes for women and people from black and Asian backgrounds continue. The gap has not closed.

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

My hon. Friend is quite right: a disproportionate number of black, Asian and minority ethnic individuals are becoming infected with HIV. Does my hon. Friend think that it is right to raise awareness of things like PrEP in communities that may be disproportionately affected, so that we can put them in the same position as the majority of the country, whose infection rates are declining?

[Danny Beales]

I thank my hon. Friend for that vital point. HIV is a condition that knows no boundaries. It does not affect any one type of person: there is no one community that is alone affected by HIV. It knows no boundaries; it affects everyone.

After 14 difficult years for the health service, we are not on track to reach the 2030 goal. At every single stage of the HIV treatment process, we are missing critical opportunities to get people on PrEP, test for HIV and ensure that everyone living with HIV has the support that they need.

Pre-exposure prophylaxis—we can see why it is called PrEP for short—is an incredible advance in HIV prevention. It is a simple daily pill, now in generic form and therefore incredibly cheap, that prevents HIV completely if taken correctly. I have spoken before about how life-changing a drug it is in removing the fear and stigma of HIV. As a gay man who grew up in the 90s and noughties, the legacy of HIV has always weighed on me and, I am sure, on many others like me. Our sense of self, our sexuality and our relationships were always intertwined with the stigma and presence of HIV. Being able to take PrEP is game-changing, and not just for the individual and their wellbeing: it has a massive public health benefit. It has driven the significant falls in new transmissions, particularly among gay men, who have largely been the people who have accessed the drug to date.

It is unacceptable that the drug is not being accessed by everyone who could benefit. The average wait list for this preventive medicine is 12 weeks. We know from research that people have acquired HIV while waiting to access the drug. That is a significant failure that I hope the new HIV action plan will address, as well as turbocharging access outside sexual health services—the only place where it can currently be accessed. It is entirely wrong that NHS silos are holding back access to PrEP in primary care, including in pharmacy and other settings.

It is also unacceptable that people cannot get a postal test for HIV and sexually transmitted infections in 30% of rural England. It makes no sense that my borough of Hillingdon—not so rural, but on the edge of London—has a completely different postal testing system from the 30 other London boroughs that have their own system. Far too often, the patient is left to navigate complex systems. What test they get will vary depending on where they live. In vast swathes of the country, there is no option to test at home, although sexual health services are often inaccessible and chronically overwhelmed. Far too often, the individual has to fight for an appointment, and only those with the sharpest elbows, or persistence, get access to the sexual health services that they need.

Income Tax (Charge)

David Burton-Sampson Excerpts

Tuesday 5th November 2024 Commons Chamber

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

This Budget starts to deliver the change our country voted for, the change our country needs. It is a tough Budget that makes the right choices to start repairing the foundations of our economy, while investing in our public services where investment is most needed. After 14 years of the last Government, it is now clear that the adults are back in charge. Looking at the attendance, or lack thereof, on the Opposition Benches, it is very clear that the Tory party called a general election, handed back the keys and ran away from any responsibility. However, this Government will fix our NHS and invest in our hospitals—something that is badly needed in my constituency of Southend West and Leigh.

Things are so bad in my local hospital that just recently, hospital staff have been banned from ordering new uniform as part of new cost-cutting measures. Excluding cancer pathways, Southend University hospital has average waiting times of 29 weeks for out-patient appointments and 26 weeks for general surgery. They are sometimes much longer. That is simply unacceptable, as people wait suffering in pain. This Budget will start to fix that.

There are huge gaps in local mental health provision. I am sure Members agree that we need parity of care, with as much emphasis on mental health as physical health. For young people in need of mental health services in my constituency, the aim is for assessments within 12 weeks and treatment within 18 weeks, but the reality is that waiting lists can be as long as 18 to 24 months. Practitioners, such as The Lighthouse in my constituency, are working very hard to bring those numbers down, so it is really pleasing to see included in the Budget, on top of the money committed, the £26 million for new mental health crisis centres.

Families waiting for assessments for special educational needs are being let down, so I am delighted to see the £1 billion uplift in SEN provision. New funding for the NHS, mental health services and SEN provision will provide much needed help to my constituents. Without our health, our nation will struggle to rebuild our economy, so the long-term plan for the NHS will develop as a result of the current consultation and through our 10-year plan for national renewal.

The days of sticking heads in the sand are over—hope is not a plan. I thank the Chancellor and her team for putting in place a credible plan to fix our NHS.