Mental Health Bill [ Lords ] (Ninth sitting)

Jen Craft Excerpts

Committee stage
Tuesday 24th June 2025 Public Bill Committees

[Natasha Irons]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 26

Use of restraint and restrictive intervention

“(1) The Mental Health Act 1983 is amended as follows.

(2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 7, insert—

‘7A Use of force in connection with admission for assessment or treatment

(1) A relevant organisation that operates a hospital must appoint a responsible person for the purposes of this section.

(2) The responsible person must—

(a) be employed by the relevant health organisation, and

(b) be of an appropriate level of seniority.

(3) The responsible person must keep a record of any use of force by staff who work in that hospital against a person (“P”) who—

(a) has been admitted for assessment or treatment under sections 2 to 5 of this Act; or

(b) is on the hospital premises and is at risk of detention under this Act.

(4) The Secretary of State must by regulations provide for the risk factors to be considered under subsection (3)(b).

(5) A record kept under this section must include—

(a) the reason for the use of force

(b) the place, date and duration of the use of force

(c) whether the type or types of force used on the patient formed part of the patient's care plan;

(d) the name of the patient on whom force was used;

(e) a description of how force was used;

(f) the patient's consistent identifier;

(g) the name and job title of any member of staff who used force on the patient;

(h) the reason any person who was not a member of staff in the hospital was involved in the use of force on the patient;

(i) the patient's mental disorder (if known);

(j) the relevant characteristics of the patient (if known);

(k) whether the patient has a learning disability or autistic spectrum disorders;

(l) a description of the outcome of the use of force;

(m) whether the patient died or suffered any serious injury as a result of the use of force;

(n) any efforts made to avoid the need to use force on the patient; and

(o) whether a notification regarding the use of force was sent to the person or persons (if any) to be notified under the patient's care plan.

(6) The responsible person must keep the record for three years from the date on which it was made.

(7) The Secretary of State must ensure that, at the end of each year, statistics are published regarding the use of force by staff who work in hospitals under the conditions set out in this section.’”—(Jen Craft.)

This new clause would require hospitals to record information on all incidents in which force is used against patients with mental disorders, in line with the reporting currently required in mental health units, including force against those at risk of detention for assessment or treatment. It would also require the Government to publish annual figures on the same topic.

Brought up, and read the First time.

[Jen Craft (Thurrock) (Lab)]

I beg to move, That the clause be read a Second time.

I will speak briefly to the new clause, which was tabled by my hon. Friend the Member for Sheffield Hallam (Olivia Blake). Its aim is to close a loophole in the current framework by which use of restraint is recorded. Currently, the use of restraint is governed by the Mental Health Units (Use of Force) Act 2018, which mandates that where force or restraint is used in a mental health unit, that must be recorded and reported. There are, however, a number of patients who are treated outside mental health units and therefore do not fall within the scope of the Act. My hon. Friend the Member for Sheffield Hallam has spoken about the issue, to which her attention was particularly drawn in the context of the treatment of patients with eating disorders. This happens quite often, either where there is a shortage of beds in a mental health unit or where the patient in question has co-occurring physical health conditions that require treatment outside such a unit.

Restraint is used regularly and often on patients with eating disorders, by which I mean restraining them to force them to eat, but there is currently no mechanism by which its use must be recorded. If a patient, particularly a young person, who is in hospital but is not in a mental health unit is subject to this restraint, which may be deemed necessary to preserve life and in their best interests, there is currently no mechanism by which that is recorded.

[Josh Dean]

We touched earlier on the safeguards around electroconvulsive therapy. Does my hon. Friend agree that when someone with an eating disorder is restrained, particularly in circumstances that involve the administration of nasogastric tube feeding, such safeguards are really important because of the invasive nature of the treatment and the potential restraint used in delivering it?

[Jen Craft]

My hon. Friend is absolutely right. The crucial purpose of the new clause is to ensure that the use of restraint is recorded at all times, as well as highlighting that quite often the restraint may be carried out not by a member of the medical staff, but by hospital security, for example. I think we can only imagine the real horror and force involved in that.

[Anna Dixon]

I thank my hon. Friend for drawing attention to this gap in the current law. Would she acknowledge that there is now evidence that the use of restraint and restrictive interventions can have serious long-term effects on a patient’s health and wellbeing? Indeed, there can also be an impact on those staff members who are required to carry it out, often with poor training.

[Jen Craft]

I completely agree. The long-term implications and impacts of restraint on health and wellbeing have been widely documented and acknowledged. It is vital, if a patient is subjected to these measures, that their use is recorded and the patient, in turn, can understand why.

The Committee has spent significant time talking about the importance of patient inclusion in their treatment plans. Earlier clauses, which I will not revisit at length, deal with the importance of enabling patients to select how and where they are treated, as well as advance choice documents. They are vital to the patient experience, because they involve and include them in how they are treated. We acknowledge that such involvement has a massive impact on the patient’s ability to heal, get better, recover from their mental illness and, in some cases, get well enough to go home. It is vital, if people are subject to restraint and the use of force, that it is recorded in an appropriate manner.

This new clause seeks to mandate the recording of its use by staff, as well as information such as the member of staff who applied the force, whether they are medical, and, vitally, demographic data. My hon. Friend the Member for Southend East and Leigh—I hope I have that right—

[David Burton-Sampson]

Southend West.

[Jen Craft]

My apologies; they are both lovely places. My hon. Friend spoke earlier about the impact that mental health treatment can have on people in regard to race and ethnicity, and the importance of including demographic data. We know that black people are disproportionately subject to use of force and restraint, which is why recording this data in a mental health unit is acknowledged as important. However, if a patient is subject to restraint outside a mental health unit, there is currently no mechanism to record that.

The new clause would also require the Secretary of State to publish annual statistics on how restraint has been used outside a mental health unit. I believe that the Minister’s predecessor agreed to look at closing this loophole. To date, however, action has not necessarily been forthcoming. People continue to be subject to the use of force or restraint, and we have no means of knowing how often it has occurred, to whom it has occurred or whether it has taken place inappropriately. I encourage the Minister and other members of the Committee to consider how we can ensure that the use of restraint and force is appropriately recorded in all medical settings, not just in mental health units.

[Stephen Kinnock]

I thank my hon. Friend the Member for Sheffield Hallam for tabling this important new clause, and I thank my hon. Friend the Member for Thurrock for moving it on her behalf.

The new clause seeks to recreate some of the duties from the Mental Health Units (Use of Force) Act 2018, but apply them to patients detained under sections 2, 3, 4 or 5 of the Mental Health Act or those at risk of detention under that Act. This would cover patients receiving mental health treatment who are not in specialist mental health beds, such as young people with eating disorders who are detained in general paediatric wards.

There are practical reasons why we do not support the new clause as it is drafted. For the vast majority of mental health patients, this duty would duplicate duties that already exist under the 2018 Act. Although the new clause would go further in requiring the recording of use of force outside mental health units, it does not require any further use of that data to develop policies or train staff, which is a key element of the 2018 Act. As drafted, the new clause would introduce new duties to record and report data, without there being any clear further use of that data.

I accept, however, that we need to do more to reduce the use of restraint for all patients detained or at risk of detention under the Mental Health Act. NHS England has an ongoing programme of work, overseen by the reducing restrictive practice oversight group, to address this issue for people experiencing acute distress and mental health difficulties. My officials have also written to the CQC to commission it to develop a viable and proportionate mechanism for reporting use of restraint to the CQC, drawing on the views of NHS Providers and NHS England. Any potential changes can be made in regulations and would not require primary legislation, so we can continue this work in parallel with the passage of the Bill, delivering on our commitment to reduce the use of force for mental health patients. For those reasons, I hope that my hon. Friend the Member for Thurrock will withdraw the new clause.

[Jen Craft]

I thank the Minister for his comments. I am reassured, as I am sure my hon. Friend the Member for Sheffield Hallam will be, to hear that he accepts the need to do more about the use of restraint, regardless of the setting in which it occurs. I am also pleased to hear about the measures by which he is seeking to do so in parallel with the passage of the Bill. I am content with what the Minister said, and I imagine my hon. Friend the Member for Sheffield Hallam will be, too. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

Clause 55

Power of Secretary of State to make consequential provision

Question proposed, That the clause stand part of the Bill.

[The Chair]

With this it will be convenient to consider the following:

Clauses 56 to 58 stand part.

Government amendment 39.

Clause 59 stand part.

I should say to Members that we have 10 minutes left. If they want to conclude the Committee’s business this morning, they should bear that in mind.