Mental Health Bill [Lords]

John Glen Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

All that is why my new clause would reintroduce a 12-month standard for community treatment orders. It would require a formal review after a year, involving the patient, their nominated person and a second doctor. It would ensure transparency, scrutiny and, crucially, a patient voice in the process. I welcome Ministers’ assurances that a code of practice can provide these safeguards, but guidance can only reflect the law; it cannot replace it. That must be what we do in this House. If we want people to trust mental health services, we must write into legislation the expectation of good-quality, tailored and reliable services; if we want people to have enforceable rights, those rights must be written into legislation; and if we want evidence-based healthcare, we must be bold enough to follow up when the evidence does not demonstrate a policy’s benefit, and reflect that in legislation.

[John Glen (Salisbury) (Con)]

I rise to support new clauses 29, 28 and 39. First, I pay tribute to the hon. Member for Isle of Wight West (Mr Quigley), who mentioned my constituents and the tragic case of the loss of their daughter, Ruth. My experience of listening to her story has made me support the new clauses.

I want to finish my remarks with what Kate asked me to say in this House. Kate Szymankiewicz is a GP in Salisbury and her husband is a surgeon. Their daughter, Ruth, took her own life aged 14. She was unlawfully killed while in a child mental health facility—that is what actually happened. That is what was exposed in the court case this summer. What happened to Ruth was a tragedy. The system did not work as it was supposed to work. I am anxious today that the Minister should not rely on the advice and understandings of officials, or on the guidance that is in place. I ask that he is really assured in his own mind that the legislation he is going to take forward will mean that this will not happen again.

I will not go into the whole story but, essentially, Ruth was placed in a facility that was a two-hour drive from her home. She was not technically placed out of area, but the family would spend more time driving to see her than they would be allowed to actually spend with her. These are wonderful, loving parents who did everything they could—everything in their power—to support their daughter through a condition that she could and should have recovered from. But because she was sectioned under the Mental Health Act to allow her to be force fed, her parents technically lost many of their rights to involvement in their daughter’s care. They had a wonderful, loving relationship with their daughter. She was a happy child who was determined to get better, and her family were keen to see that that happened. She was sectioned only to allow her to be fed, but the knock-on consequence was that the dynamic between the parents and their daughter, who was a patient, changed as adult protocols were put in place.

When Kate visited Parliament yesterday, I asked her, “What would you like me to say on your behalf?” And she said this:

“If your child is unwell and must go into hospital, whether that is because of a physical illness such as cancer, or a mental health illness like an eating disorder, they need to know that their mum, or dad, or caregiver, can be there with them, whenever they need, to help them through a scary and vulnerable time.

Children cannot be treated in isolation. They need the support of those who love and know them best—their family. Families need to be at the heart of our health system in order for children to heal and for their families to heal with them.

When the next child is in crisis, which is right now, I ask you all not to turn away, but to grasp this opportunity to make the Mental Health Act a champion for their wellbeing. Please include all these…amendments to safeguard this generation of young people”.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

The Bill addresses fundamental flaws in our current mental health legislation in relation to the rights of people with learning disabilities and autistic people. I will focus my comments on new clauses 32 and 33, which I have tabled. They are also about vital rights within our mental health legislation and relate closely to the powerful comments made by the right hon. Member for Salisbury (John Glen) and by my hon. Friend the Member for Isle of Wight West (Mr Quigley).

New clause 32 would provide for mandatory independent care, education and treatment reviews for patients detained in long-term segregation. In her report, “My heart breaks”, Baroness Hollins highlighted the harms and sufferings that are so often associated with long-term segregation, and assessed how introducing care, education and treatment reviews can reduce the incidence and use of segregation. I very much welcome the provisions on reviews of care and treatment that Ministers have already included in the Bill, but it has now been demonstrated that independently-chaired reviews are making a real difference and lead to inappropriate long-term segregation being challenged and addressed. The human impacts are substantial. New clause 32 would make such reviews a requirement when someone has been placed in segregation for 72 hours.

New clause 33 seeks to introduce a new level of scrutiny in cases where patients with autism or learning disability have been detained for more than five years. I believe there is a very strong case for an additional check and balance when people have been under detention and compulsory measures for so many years. I understand that the latest data for England shows that 350 people with a learning disability or autism who are currently in in-patient units have been detained there for more than 10 years.

In a previous role, I provided advocacy for the family of a young man, Kyle, who has a learning disability. He is a patient in the State hospital in Carstairs in Scotland, but his family live in the north-east of Scotland. His mother and grandmother have to make a round trip of nearly seven hours to see Kyle for visits which have in the past been restricted to a single hour. Kyle was convicted of no crime when he was admitted to Carstairs in 2009. He has been there for 16 years. The toll that this has taken on his family has been horrendous. The situation is devastating for them, and there is no end in sight. Although it is a case for the Scottish mental health system, it has provided me with an insight into what many people with learning disabilities and their families will be experiencing in England today, and the limitations of mental health tribunals in dealing with these issues.

People with learning disabilities have been losing their liberty for years because of their disability; this is a human rights emergency. It is clear that we have to do far more to prevent these situations from happening. The Bill will help to do that with its welcome measures on prevention, but where these cases are happening now, I believe there should be an additional level of scrutiny—an extra check and balance so that after so long, someone with the right level of authority and expertise can challenge providers to do better and to ask the question, “How can it be that someone has lost their liberty and their right to a family life, because we cannot make their care and treatment work in a community setting?” Although I very much welcome the introduction of the care, education and treatment reviews, I believe we should go further in these circumstances. That is why new clause 33 would make provision for notification to the Care Quality Commission when someone has been detained for more than five years.

This is an excellent Bill. It will do so much for the rights of people with learning disabilities and autism, but there are several areas where I hope the Minister can outline what further ambitions the Government have to ensure that our mental health system is fit for purpose and based on human rights.

--- Later in debate ---

[Stephen Kinnock]

I can give my hon. Friend that assurance. One of the core purposes of this Bill is to ensure that we catch such issues, particularly around the identification of children in cases where parents are required to be detained. We will reaffirm that children should be treated in the least restrictive, most age-appropriate environment and close to home and family, and that all services would work towards alternatives to admission, such as day care and intensive home treatment, with better support for visits, including with dedicated family areas and overnight stays. We have committed £75 million for systems to invest in reducing out-of-area placements, and I am pleased to report that the number of children placed on adult wards is now decreasing, and that trend must continue.

We have also committed in the Bill to reviewing the existing CQC notification requirements, including whether notification should be extended to other incidents and whether the time period remains appropriate. We will work with families, clinicians and MPs as part of that review. Indeed, following recent conversations with my hon. Friends the Member for Isle of Wight West and for Lowestoft (Jess Asato), I have asked officials to host a roundtable next month with Members and experts on how we can provide greater clarity in the code. The focus will also be on NHS England’s service specifications and regulations on the placement of children and young people in adult wards, including determining if a placement is suitable.

The revised code, on which we will engage extensively with—among others—children and their families and carers, will provide further opportunities to address concerns raised in amendments 33 and 39 and new clause 28. The code will also address the issue of competency. We believe that that is more appropriate than a test for competency in the Act, as proposed in new clauses 15 and 25.

[John Glen]

Will the Minister give way?

[Stephen Kinnock]

I will, but can the right hon. Gentleman please make his intervention very short?

[John Glen]

I am grateful to the Minister, and I am also grateful to him for what he said about my constituent. There are so many codes of best practice, and so many guidelines. Can he say a little more about what force the code would have, so that we can have some reassurance that the risks that were so tragic in the case of my constituent will be eliminated?

[Stephen Kinnock]

The code of practice will be statutory. It is better to have these provisions in the code, because clinical practice evolves, and it is much easier to revise a code of practice than to go through primary legislation.

We understand the concerns expressed about young carers in new clauses 26 and 27, and recognise that despite existing duties, the right questions are not always being asked to identify children when someone is detained. While we do not agree that additional legal duties are needed, especially as multi-agency working is already being strengthened through the Children’s Wellbeing and Schools Bill, we do agree that we need to make the requirements more explicit. The revised code of practice will therefore specify that when someone is detained, steps must be taken to identify the children of the patient. Information about support that is available must be shared, and if a young carer’s needs assessment is required, the appropriate referral must be made.