Mental Health Bill [ Lords ] (Sixth sitting)

Josh Dean Excerpts

Tuesday 17th June 2025 Public Bill Committees

[Stephen Kinnock]

This amendment seeks to overturn the previous amendment tabled—sorry, I should have said “the clause”. The clause seeks to overturn the previous amendment, tabled by Earl Howe and Lord Kamall. Although we support the intention of the amendment, our view continues to be that it would be duplicative.

There are already many ways in which service user feedback is used to inform policy and practice. For instance, every year the Care Quality Commission conducts thousands of interviews and visits with people detained under the Mental Health Act 1983. That may result in the CQC investigating a complaint or requiring an action statement from providers about service improvements. Although there may be room to enhance existing feedback mechanisms, we would prefer to improve what we have rather than create something new that would risk confusion.

If the objective is to provide time and space for the person to reflect on their past experiences post-discharge, I reassure the Committee that that should already form a part of co-producing a person’s care in the community plan. We also intend to create space for individuals to reflect on past experiences when making their advance choice document, with facilitation from a suitably qualified person.

[Josh Dean (Hertford and Stortford) (Lab)]

Young people who have been through detention often report challenging circumstances following that detention. Rather than supporting them, that sometimes increases their trauma. Can the Minister assure me that, as part of the changes he just set out, we will still ensure that young people have the opportunity to feed their experiences back? What specific work will the Government undertake to gather those views from young people?

[Stephen Kinnock]

My hon. Friend makes an important point. We are absolutely committed to ensuring that we create a space for young people to provide feedback. Some of that will be around past experiences when making their advance choice documents, but much broader opportunities for feedback will absolutely be built into the system. We want this to be a learning process. It is important that the code of practice is not just a document that sits on the shelf gathering dust; it should be a live document. That is why the feedback is so important.

It should be noted that although reflecting on past experiences may be therapeutic for some individuals, for others it can be traumatic, so the measure should be entirely service-user led. We also continue to be concerned about the burden that the amendment would place on independent mental health advocacy services, which are already under strain.

--- Later in debate ---

[Aphra Brandreth]

I rise to speak to clause 41, which brings into sharper focus two pillars of a fair and rights-based mental health system: the provision of clear information to patients and the strengthening of independent mental health advocacy. It rightly recognises that, when a person is detained under the Mental Health Act 1983, often during a period of acute crisis and difficulty in their life, they need to feel that their clinical needs are being met, but in a way that respects them as individuals, with the same entitlements to dignity and agency as any other member of our society.

The clause provides for informal patients to be eligible for an independent mental health advocate. I welcome the extension to enable more individuals to access this vital advocacy. It empowers patients to know that independent advocacy is available, but we must ensure that there are sufficient resources so that those who choose this help are given sufficient support when they are in a potentially vulnerable position. As someone representing a constituency that is in England but borders Wales, I also welcome that these changes bring care into line so that advocacy help is offered to informal patients, regardless of which side of the border they are accessing treatment.

The clause places a renewed duty on services to ensure that information is given to patients clearly, promptly and in a form that they can understand. It introduces an obligation for advocacy providers to determine, through an interview, whether a qualifying patient wishes to use the service. This support is important; no person should be expected to navigate the complexities of mental health legislation, or their rights under it, without proper guidance. However, where there is a duty

“on hospital managers and others to notify providers of advocacy services about qualifying patients”,

can the Minister clarify who is meant by “others”? Will there be a list of people and roles who are given this responsibility?

The role of an independent mental health advocate is vital. These individuals can be a lifeline. They can help people to understand their rights and any medical treatment, and crucially, can support an individual to have their say about any treatment. Clause 41 rightly reinforces the importance of independent mental health advocates, and it is important that we match that ambition with the legal and practical steps to support them.

It is entirely right that we welcome the recognition of the role of independent mental health advocates, who serve a vital function in ensuring that patients’ voices are heard and their views represented, especially when navigating what can be an incredibly complex legal and clinical environment. Their independence is fundamental to not only their effectiveness but the confidence that patients and families can place in the system, which brings me back to my point. It is therefore important that we support independent mental health advocates with the resources that they need to do their job effectively.

If we are to rely further on advocates, we need to ensure that they are in a position to deal with that, so that we do not create statutory entitlements that are difficult to act upon. Actions, as well as words, are needed. At present, many areas already struggle with advocacy coverage. If we now place additional expectations on the service, and I believe that we will through this provision, we must ensure that there are sufficient numbers of trained, experienced independent mental health advocates across the country to meet rising demand. Can the Minister reassure the Committee that the necessary people with the skills and training are available to fulfil this expanded role?

We must also consider the patients’ experience, as has been the focus of so many of the remarks made in the Committee today. Again, I emphasise the vulnerability of patients at times of crisis. If we are to tell patients that support in the form of an advocate is there for them, we need to ensure that it is accessible and easy to reach and understand. Clause 41 moves us in the right direction, but implementation is everything. It must be backed by local accountability, adequate funding and clear operational guidance. This includes ensuring that all patients, regardless of background, language or capacity, are given support that is appropriate and effective.

It is vital to consider the wider implications of this clause. The reinforcement of the independent mental health advocate’s involvement should be mirrored by greater investment in advocacy services, stronger integration with care planning and more regular engagement with patients themselves on how these services work in practice. In our earlier discussions, my hon. Friend the Member for Farnham and Bordon suggested that we use trials, which could also be considered here to ensure that, as changes are brought in, they are matched by appropriate service levels.

I am largely supportive of clause 41, which I think moves us in the right direction towards a transparent mental health system that is there for patients, ensuring that they have a voice and are not an afterthought. As long as it is deliverable in practice, and does not give false hope to patients, the clause strengthens the Bill.

[Josh Dean]

It is a pleasure to see you in the Chair, Mrs Harris—when I wrote my speech, it said “this afternoon”, but it now says “this evening”. I rise to speak to clause 41 and schedule 3. I welcome the role that they will play in extending the right to access the services of an independent mental health advocate to voluntary patients in England not detained under the Mental Health Act, and ensuring that all detained patients are offered these services through an automatic referral, creating an opt-out system.

Independent mental health advocates play an important role in supporting patients detained under the Act to understand their rights and participate in decisions around their care and treatment. Clause 41 and schedule 3 seek to ensure that the individual needs of each patient are taken into account, even where they may not be able to engage in decision making about themselves. In doing so, they recognise the patient as an individual. This provides for important safeguards for patients and reinforces the Bill’s principles of autonomy and least restriction, which is a crucial part of bringing mental health legislation into the 21st century. I similarly welcome Government amendments 42 and 43, which seek to further strengthen the important safeguards in the Bill.

I hear the points that the Minister has made on children and young people admitted informally, but I would be grateful if he could address the matter further. As we know, informal patients are those who consent to an admission to a mental health hospital or whose parents consent to an admission on their behalf. Often, they are treated under the same or similar conditions as those detained under the Act. While detained patients will receive an automatic referral to advocacy services under the new opt-out scheme, my understanding is that that will not be the case for those admitted informally, meaning that informal patients would still be required to ask for the support of an independent mental health advocate.

Children admitted informally are likely to experience the same conditions as another child detained under the Act, but without the parity of access to advocacy services through the opt-out system. Because a parent is able to consent to informal treatment on their child’s behalf, they are one of few groups, if not the only one, able to be admitted informally without their own consent. Therefore, there is a concern that children and young people admitted informally may continue to experience problems accessing the support of an advocate. I seek the Minister’s assurance that the Government have considered fully the provision of advocacy services for informally admitted children and young people, and how this gap might be addressed.

I welcome how these parts of the Bill will embed those important principles of individuality, autonomy and least restriction, expanding the important safeguards offered by independent mental health advocates. I would be grateful if the Minister could touch on those points about children and young people in his response.

Parkinson’s Awareness Month

Josh Dean Excerpts

Thursday 1st May 2025 Commons Chamber

[Josh Dean (Hertford and Stortford) (Lab)]

I thank my hon. Friend the Member for Dunfermline and Dollar (Graeme Downie) for securing this important debate and for his eloquent speech. There was not a word that I would disagree with. As he described, Parkinson’s is the fastest-growing neurological condition in the world and around 153,000 people live with the condition in the UK.

In April, we marked World Parkinson’s Day and Parkinson’s Awareness Month. As part of Parkinson’s UK’s event here in Parliament, I had the opportunity to hear directly from people affected. I am especially grateful to Angie, from Parkinson’s UK, for taking the time to share her experience with me, and discuss how we can improve care and support for people living with Parkinson’s disease. It is for people like Angie in Hertford and Stortford that I wanted to contribute to today’s debate. For me, as I know will be the case for other hon. Members, it is personal. Through the experiences of friends and loved ones, I have seen at first hand the impact of a Parkinson’s diagnosis. I would like to briefly share their stories today.

First, the mum of one of my closest friends was diagnosed with Parkinson’s in 2018, a person whom it would be no exaggeration to describe as one of the warmest, kindest and most generous people you could meet—the kind of mum who makes you feel like part of the family and always insists you stay for dinner. She, too, has benefited hugely from the Movers and Shakers group. With the support of Parkinson’s UK, she and a group of friends—all working-age people diagnosed with Parkinson’s—set up the Herts Parkinson’s wellbeing directory. Working with the NHS and other local organisations, their work ensures that Hertfordshire residents diagnosed with Parkinson’s can quickly and easily find information and access local support to help them manage their condition. Residents can access their directory by visiting hertfordshire.parkinsonsuk.group. I thank them for their inspirational work supporting others with their diagnoses.

I also want to talk about Andy. When I first met Andy, he was introduced to me as the husband of my local Labour party’s long-standing—or perhaps long-suffering—election agent, Brenda. I was about 19 at the time, standing in a local council election, in what used to be true blue Hertfordshire, that I was destined to lose. Little did I know just how important Andy and Brenda would be to me by the time I was elected to this place in July last year. In so many ways, I would not be stood here today as the Member of Parliament for Hertford and Stortford were it not for Andy and Brenda.

When I was preparing for this debate, I reflected on the fact that I could not pin down when or how Andy had told me about his Parkinson’s diagnosis. That is a testament to Andy’s innate ability to turn topics that others might find difficult to discuss into everyday conversation—indeed, I learned much about myself through simple conversation while travelling from visit to visit with him during the general election—but it is also a testament to his willingness to speak openly about his Parkinson’s, breaking down the stigma for others with a diagnosis, and knowing that it does not define him and that it can make it easier for others to talk about their condition. Today, Andy Pellant is not just a mentor to me, but a friend. It is my privilege to put his name on the record in this debate.

I would like to take this opportunity to pay tribute to Julie Walker, who has been writing her regular “Parkinality” column in our local newspaper, the Bishop’s Stortford Independent, for the past seven years to help people to better understand life with Parkinson’s. Diagnosed aged 44, every year Julie does something to mark Parkinson’s Awareness Month in the hope that a cure will be found and that there will be no need for another. This year, Julie has compiled all the poems she has written about living with the condition into a book, with the proceeds going to Parkinson’s UK and Cure Parkinson’s. I encourage everyone in Hertford and Stortford, and in this Chamber, to support her work.

I would like to take this opportunity to highlight some of the positive work being done in our community to support those living with Parkinson’s. I was really pleased to read this week that Everyone Active is partnering with Parkinson’s UK for the fourth year running to provide residents with Parkinson’s with free fitness memberships. That means patients in our community will be able to access gym facilities, swimming pools and exercise classes at Hartham leisure centre in Hertford and Grange Paddocks leisure centre in Bishop’s Stortford, alongside up to three of their carers. I encourage any residents in Hertford and Stortford living with Parkinson’s to take advantage of that support.

I welcome the work that this Labour Government are undertaking to deliver the 10-year health plan for England, which will radically reform how people in Hertford and Stortford with long-term conditions like Parkinson’s are treated on the NHS. With hundreds of thousands of patients in England still on the waiting list for neurology services, and almost half waiting for more than 18 weeks to start their treatment, I similarly welcome how the elective reform plan will help to deliver more neurology appointments every year. No one should lay awake at night worrying that their condition is getting worse while they wait to see a specialist. By providing extra appointments, scans and operations in the evening and at weekends, I know this Labour Government will clear the backlog for neurology appointments. However, we can go further, and I do have a few policy questions I would like to raise; I would be grateful if the Minister could reflect on them in her response.

First, as other hon. Members have said today, a number of residents have written to me calling on the Government to implement the five steps set out in the Parky charter, which my hon. Friend the Member for Dunfermline and Dollar set out eloquently. The points around speedy specialists, instant information, a Parkinson’s passport, comprehensive care and a quest for a cure are incredibly important. I will touch on the Parkinson’s passport, because a number of constituents have written to me raising the matter of free prescriptions, to which people with Parkinson’s are entitled in Scotland, Wales and Northern Ireland, but not in England.

Supported by major Parkinson’s charities, delivery of the charter would help to deliver timely diagnoses, comprehensive care and dignity for all those living with Parkinson’s disease. I know the Minister takes these matters incredibly seriously and will have read the charter in detail, so I would be grateful if she could share what consideration she has given to it in her response.

When I spoke to Andy ahead of today’s debate, he highlighted how almost everyone he has met with a Parkinson’s diagnosis recognised that with the benefit of hindsight, the signs of their condition were present years before they were diagnosed. Has the Minister therefore considered the potential benefits of a national education programme to help people to identify the early signs of Parkinson’s disease?

I know that hon. Members across the House will have their own experiences or will have known someone with Parkinson’s disease. We have heard many moving speeches today, and I am sure we will hear more. The unity shown across the House today in support of those living with Parkinson’s and in support of finding a cure is to be commended, and I am grateful for the opportunity to have contributed to the debate.

Eating Disorder Awareness

Josh Dean Excerpts

Tuesday 1st April 2025 Westminster Hall

[Josh Dean (Hertford and Stortford) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I thank the hon. Member for Bath (Wera Hobhouse) for securing this important debate, and my hon. Friend the Member for Camborne and Redruth (Perran Moon) for his deeply moving and courageous speech.

As with many mental illnesses, eating disorders often present first in children and young people. Like other hon. Members, I am alarmed by the NHS England statistics that show that in 2023, 12.5% of 17 to 19-year-olds in England were living with an eating disorder. According to YoungMinds,

“Young people can use their behaviour around food and eating to try to cope with…difficult thoughts, feelings and experiences.”

YoungMinds also states:

“Over time, these kinds of thoughts and behaviours around food become very fixed and difficult to change—and may start to take over daily life.”

Early intervention for a young person struggling with an eating disorder is clearly critical if we want to support them to live a healthy, fulfilling life.

I was politicised at school by the disparities in the mental health support received by my peers, and we know that young people today are at the sharp end of the mental health crisis. I, too, have had friends who struggled with eating disorders and disordered eating, and during the general election last year I was contacted by a young woman who had waited four years for her first child and adolescent mental health services appointment. Sadly, that has become the norm, rather than the exception, for young people with mental illnesses.

I welcome this Government’s commitment to cutting NHS waiting lists and investing in talking therapies. I also welcome the commitment this Government have made to getting mental health support into our schools and delivering a network of Young Futures hubs with trained youth workers and drop-in mental health support, so that we can address eating disorders and mental health conditions early, and support our young people.

I have a few specific questions for the Minister, and I would be grateful if he could address them in his response. First, could he set out what the Government are doing to improve the early identification of eating disorders? For example, in 2023, Place2Be called for every professional working with children and young people, including in the healthcare workforce, to be trained to identify young people with potentially impairing eating behaviours. Has the Department had considered that?

Given the huge impact of the pandemic on the mental health and wellbeing of young people, could the Minister further set out what action the Government are taking to specifically support individuals who developed an eating disorder or mental health condition during that time? Finally, could the Minister set out what cross-departmental work the Government are undertaking to ensure a joined-up approach to supporting young people with eating disorders?

Those struggling with eating disorders deserve support and they need action, and we must treat eating disorders as the emergency that they represent. I was particularly moved by the words of the hon. Member for Bath, given her important work on the issue over a number of years, about the frustration of seeing things get worse, not better. I reflect on my experience as a young person going through school and watching my peers struggle with eating disorders and mental health conditions. Now I come into this place to represent my community, knowing that young people today are struggling so much more. That makes the urgency of the task even greater, so I thank the her again for her work and for securing the debate.

[Graham Stuart (in the Chair)]

Last but not least on the Back Benches, I call Luke Charters.