Mental Health Bill [Lords]

Judith Cummins Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Zöe Franklin (Guildford) (LD)]

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

[Madam Deputy Speaker (Judith Cummins)]

With this it will be convenient to discuss the following:

New clause 3—Impact assessment: children and young people in temporary foster care—

“(1) The Secretary of State must, within 18 months of the passing of this Act, publish and lay before Parliament an impact assessment on the impact of this Act on children and young people who are in temporary foster care.

(2) The impact assessment under this section must consider—

(a) whether the ordinary residence provisions result in delays or inequities in accessing treatment or after-care under this Act;

(b) the effect of transitions between placements on continuity of treatment under this Act; and

(c) any unintended consequences for children and young people in temporary foster care arising from the application of subsections (3) to (5) of section 125G of the Mental Health Act 1983.”

This new clause would require the Government to publish an impact assessment on the impact of this Act on children and young people in temporary foster care.

New clause 4—Adequacy of accommodation: review—

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

(2) After Section 131A (Accommodation etc. for children) insert—

‘131B Adequacy of accommodation

(1) The Secretary of State must, within 12 months of the passage of the Mental Health Act 2025, publish a review of the quality of accommodation for any patient who is—

(a) liable to be detained in a hospital under this Act;

(b) admitted to, or remains in, a hospital in pursuance of such arrangements as are mentioned in section 131(1) above.

(2) The Secretary of State must, within six months of the publication of the review under subsection (1), publish a strategy to implement the recommendations of that review.’”

This new clause would require a review of the quality of accommodation for people detained or admitted to hospital under the Mental Health Act 1983 and require the Secretary of State to publish a strategy to implement the recommendations of this review.

New clause 5—Review of impact of this Act on detention—

“(1) The Secretary of State must, within a period of 12 months following the day on which this Act is passed, commission an independent review into the impact of relevant provisions on reducing the number of people detained under Part 2 of the Mental Health Act 1983.

(2) In subsection (1), ‘relevant provisions’ include—

(a) sections 4, 5 and 6,

(b) section 8,

(c) section 21, and

(d) sections 46 and 47.

(3) The Secretary of State must, within 12 months of the publication of the review in subsection (1), publish a strategy to implement the recommendations of that review.”

This new clause would require the Secretary of State to commission a review into the impact of relevant provisions in the Act in reducing the number of people detained, in particular the provisions relating to people with autism or a learning disability, on grounds for detention and for community treatment orders, medical treatment, care and treatment plans, and on after-care, and to implement any recommendations within 12 months of the publication of the review.

New clause 6—Transfer of patients: out of area placements—

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

(2) After section 19 (transfer of patients), insert—

‘19A Transfer of patients: out of area placements

(1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of patients transferred to a hospital outside of the area in which the patient is ordinarily resident.

(2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.’”

This new clause would require the transfer of patients to hospitals outside of their area to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.

New clause 7—Children detained on adult wards—

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

(2) After section 131A (Accommodation, etc. for children), insert—

‘131B Children detained on adult wards

(1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of children detained on adult wards.

(2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.’”

This new clause would require the number of children detained on adult wards to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.

New clause 8—Report on the impact of this Act on patients with eating disorders—

“(1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must publish a report on the impact of relevant provisions in this Act on patients with eating disorders.

(2) In subsection (1), ‘relevant provisions’ include—

(a) section 5 (Grounds for detention),

(b) section 11 (Making treatment decisions),

(c) section 17 (Urgent treatment to alleviate serious suffering),

(d) section 21 (Care and treatment plans), and

(e) section 47 (After-care services).”

This new clause would require the Secretary of State to report on the impact of this Bill on patients with eating disorders within 12 months of the passage of this Bill.

New clause 9—Report and Guidance: Improving Outcomes for LGBT Patients—

“(1) The Secretary of State must, within 12 months of the day on which this Act is passed, prepare and lay before Parliament a report on the mental health outcomes of patients who are treated under the Mental Health Act 1983 and who identify as lesbian, gay, bisexual, or transgender (LGBT).

(2) The report under subsection (1) must include an assessment of—

(a) any differences between non-LGBT patients and LGBT patients in—

(i) the extent of the use of detention measures under the Mental Health Act 1983; and

(ii) treatment outcomes following detention, and

(b) the availability and accessibility of ‘culturally competent’ mental health treatment under the 1983 Act for LGBT patients.

(3) Following publication of the report under subsection (1), the Secretary of State must publish guidance for responsible bodies and individuals working with patients under the Mental Health Act 1983, including but not limited to those working in—

(a) mental health hospitals;

(b) places of safety;

(c) crisis accommodation; and

(d) relevant community mental health services.

(4) The guidance under subsection (3) must include—

(a) provisions about updated training standards for staff regarding the specific mental health needs and experiences of LGBT individuals, including training on non-discriminatory practice and inclusive communication approaches;

(b) steps to improve safety for LGBT patients in relevant mental health settings, with particular regard to addressing discrimination and harassment; and

(c) a definition of ‘cultural competent mental health treatment’ for the purposes of subsection (2).

(5) Responsible bodies and individuals working with patients under the Mental Health Act 1983 must have regard to guidance published under subsection (3).

(6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—

(a) patients with a mental disorder who identify as LGBT;

(b) the families or carers of patients with a mental disorder who identify as LGBT;

(c) relevant professional bodies;

(d) integrated care boards;

(e) local authorities;

(f) providers of mental health treatment; and

(g) such other persons as the Secretary of State considers appropriate.

(7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

This new clause would require the Secretary of State to report on mental health outcomes and disparities for LGBT patients in treatment under the Mental Health Act 1983 and publish guidance covering training and safety for this specific group.

New clause 10—Report and Guidance: Transition to Adult Mental Health Treatment—

“(1) The Secretary of State must, within 18 months of passing of this Act, prepare and lay before Parliament a report on improving provision for patients transitioning from treatment in a hospital environment for children and young people to one for adults when they attain the age of 18.

(2) The report under subsection (1) must include an assessment of—

(a) the current pathways and outcomes for young people transitioning between hospital environments for children and for adults;

(b) any gaps in care or support experienced by patients during this transition;

(c) best practices for ensuring safe and effective transitions.

(3) Following the report under subsection (1), the Secretary of State must publish guidance for integrated care boards, local authorities, and providers of mental health treatment on improving outcomes and ensuring continuity of care for patients transitioning to a hospital environment for adults.

(4) The guidance under subsection (3) must include—

(a) specific steps to guarantee continuity of care for patients transitioning between treatment in a hospital environment for children and young people and one for adults;

(b) measures to identify young people requiring transition support at an appropriate stage;

(c) provisions for joint working and information sharing between providers of treatment for children and young people and for adults;

(d) requirements for the review and updating of care and treatment plans to reflect the needs of patients transitioning to a hospital environment for adults.

(5) Integrated care boards, local authorities, and providers of mental health treatment must have regard to guidance published under subsection (3).

(6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—

(a) young people with experience of transitioning between children and young people’s and adult mental health services, and their carers and guardians;

(b) relevant professional bodies;

(c) integrated care boards;

(d) local authorities;

(e) providers of mental health treatment;

(f) such other persons as the Secretary of State considers appropriate.

(7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

This new clause would require the Secretary of State to review and report on the transition of patients from children's to adult mental health settings for treatment at age 18 and publish guidance for relevant bodies on improving provision and ensuring continuity of care during this transition.

New clause 11—Reporting: racial disparities relating to community treatment orders—

“(1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must undertake a review of racial disparities which relate to the use and administering of community treatment orders.

(2) The review under subsection (1) must include, but is not limited to—

(a) an assessment of whether certain racial or ethnic groups are disproportionately represented among individuals subject to community treatment orders compared to their representation in the general population;

(b) a review of the outcomes and effectiveness of community treatment orders across different racial groups, including health outcomes, and patient experiences.

(3) The Secretary of State must lay a report of the findings of the review before Parliament within 18 months of the day on which this Act is passed.”

This new clause seeks to gauge the Government’s view on prevalent racial disparities as they relate to the use of community treatment orders under the Act.

New clause 12—Mental Health Crisis Breathing Space—

“(1) Any person detained under sections 3, 37, 41 or 47 of the Mental Health Act 1983 must be offered support from the mental health crisis breathing space debt respite scheme.”

This new clause ensures that MHCBS, a debt respite scheme, is offered and available to patients detained under sections 3, 37, 41 and 47 of the Mental Health Act 1983.

New clause 13—Addressing and reporting on racial disparities and other inequalities in the use of the Mental Health Act 1983—

“After section 120D of the Mental Health Act 1983, insert—

‘120E Mental health units and services to have a responsible person

(1) A relevant health organisation that operates a mental health unit or community mental health service for qualifying patients must appoint a responsible person for that unit or service for the purposes of addressing racial disparities and other disparities based on protected characteristics related to functions discharged under the Mental Health Act 1983.

(2) The responsible person must—

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

(b) be of an appropriate level of seniority.

(3) Where a relevant health organisation operates more than one mental health unit or service, that organisation must appoint a single responsible person in relation to all of the mental health units or services operated by that organisation.

(4) A patient is a qualifying patient if they are—

(a) liable to be detained under this Act, otherwise than by virtue of section 4 or 5(2) or (4) or section 135 or 136;

(b) subject to guardianship under this Act;

(c) a community patient.

120F Policy on racial disparities and other disparities based on protected characteristics

(1) The responsible person must publish a policy on how the unit plans to reduce racial disparities and other disparities based on protected characteristics in that unit or service.

(2) The policy published under subsection (1) must cover the following topics—

(a) the application of the guiding principles to all aspects of operation of this Act;

(b) staff knowledge and competence in connection with promoting equality and anti-discriminatory practice in relation to this Act;

(c) workforce demographics, recruitment, retention and progression;

(d) implementation of the patient and carer race equality framework (England only) and any other requirements of relevant national policies;

(e) care planning and decision-making in the use of this Act including section 56A (making treatment decisions);

(f) the availability of alternatives to detention and involuntary treatment;

(g) take-up of independent mental health advocacy;

(h) the cultural appropriateness of independent mental health advocacy;

(i) access to and use of advance choice documents;

(j) what steps will be taken to reduce racial disparities and other disparities based on protected characteristics in that unit or service.

(3) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units or services.

(4) Before publishing a policy under subsection (1), the responsible person must—

(a) consult any persons that the responsible person considers appropriate;

(b) have regard to the following matters—

(i) the views, wishes and feelings of people from ethnic minority communities who have been detained;

(ii) the views, wishes and feelings of people with other protected characteristics who have been detained.

(5) The responsible person must keep under review any policy published under this section.

(6) The responsible person may from time to time revise any policy published under this section and, if this is done, must publish the policy as revised.

(7) If the responsible person considers that any revisions would amount to a substantial change in the policy, the responsible person must consult any persons that the responsible person considers appropriate before publishing the revised policy.

120G Training in racial disparities and other disparities based on protected characteristics

(1) The responsible person for each mental health unit or service must provide training for staff that relates to addressing racial disparities and other disparities based on protected characteristics in that unit or service.

(2) The training provided under subsection (1) must include training on the topics covered in section 120F(2).

(3) Subject to subsection (4), training must be provided—

(a) in the case of a person who is a member of staff when this section comes into force, as soon as reasonably practicable after this section comes into force, or

(b) in the case of a person who becomes a member of staff after this section comes into force, as soon as reasonably practicable after they become a member of staff.

(4) Subsection (3) does not apply if the responsible person considers that any training provided to the person before this section came into force or before the person became a member of staff—

(a) was given sufficiently recently, and

(b) is of an equivalent standard to the training provided under this section.

(5) Refresher training must be provided at regular intervals whilst a person is a member of staff.

(6) In subsection (5) “refresher training” means training that updates or supplements the training provided under subsection (1).

120H Annual report by the Secretary of State

(1) As soon as reasonably practicable after the end of each calendar year, the Secretary of State must conduct a review in consultation with relevant bodies with commissioning functions on the use of treatment and detention measures contained in the Mental Health Act 1983 broken down by race and other demographic information.

(2) Having conducted a review under subsection (1), the Secretary of State must publish a report on the progress made in reducing inequalities in treatment outcomes and the use of detention measures in the use of this Act on people who have protected characteristics under the Equality Act 2010.’”

This new clause requires mental health units and services to appoint a responsible person tasked with addressing racial disparities related to functions discharged under the Mental Health Act 1983.

New clause 14—General duty to secure sufficient resources for services in the community—

“(1) It is the general duty of integrated care boards to ensure, insofar as is reasonably practical, that services in the community responsible for delivering care, treatment, or detention provisions under the Mental Health Act 1983 and this Act have the necessary resources, including financial support, to meet service demands.

(2) Additional forms of resource may be determined by integrated care boards in consultation with relevant local authorities or health care service providers and may include—

(a) sufficient numbers of trained medical professionals;

(b) purpose-built facilities for patient care;

(c) community services responsible for out-patient care.

(3) Each Integrated Care Board must conduct an assessment of its resources every two years to evaluate its ability to deliver services in the community effectively.

(4) Each Integrated Care Board must publish a report outlining its findings upon completing the assessment in subsection (3). The first reports must be published within one year of the passage of this Act.”

This new clause places a general duty on integrated care boards to ensure that services in the community have the necessary level of resource to meet demand on services to ensure that the provisions of the Bill function as intended and to assess and report on this every 2 years.

New clause 15—Report: statutory competency test for under-16s—

“Within 12 months of day on which this Act is passed, the Secretary of State must undertake a review of whether a statutory competency test for under-16s in determining their ability to make a relevant decision would be expedient for the purposes of this Act or the Mental Health Act 1983.”

This new clause requires the Secretary of State to undertake a review of whether a statutory competency test for under-16s would be expedient for the purposes of this Bill and the Mental Health Act 1983.

New clause 16—Duty to promote mental health wellbeing—

“After section 142B of the Mental Health Act 1983, insert—

‘Duty to promote mental health wellbeing

(1) It is a general duty of local authorities and anybody in carrying out functions under this Act or the Mental Health Act 2025 to promote mental health wellbeing.

(2) In carrying out the duty under subsection (1), local authorities and commissioning bodies must have regard to—

(a) the prevention of mental illness,

(b) the promotion of positive mental health,

(c) the reduction of stigma and discrimination associated with mental health conditions, and

(d) the provision of accessible and appropriate support services to individuals experiencing mental health challenges.

(3) Local authorities and commissioning bodies must publish an annual report outlining the steps taken to discharge their duty under subsection (1), including an assessment of—

(a) progress in improving mental health wellbeing in their area for persons affected by the provisions of this Act, and

(b) any barriers to promoting mental health wellbeing for such persons and proposed actions to address them.

(4) The Secretary of State may issue guidance on the discharge of the duty under subsection (1), and local authorities and commissioning bodies must have regard to such guidance.’”

This new clause would require local authorities and commissioning bodies to promote and report annually on mental health wellbeing, with regard to any guidance published by the Secretary of State.

New clause 17—Funding and reporting—

“(1) For each financial year until all sections of this Act have come into force, of the total health service expenditure by the bodies (taken together) in subsection (2), the proportion which relates to mental health spending—

(a) under the Mental Health Act 1983, and

(b) under this Act or which, in future, would be made under provision inserted into the Mental Health Act 1983 by this Act,

(taken together) must not decrease.

(2) The bodies are the Department of Health and Social Care, NHS England and integrated care boards.”

This new clause would require that mental health spending as a proportion of health service expenditure must not decrease in the implementation period of the Act.

New clause 18—Mental Health Commissioner—

“After section 142B of the Mental Health Act 1983, insert—

‘Mental Health Commissioner

142C Independent Mental Health Commissioner: establishment

(1) There is to be an office known as the Office of the Mental Health Commissioner.

(2) The Office in subsection (1) must be established by the Secretary of State three months after the day on which the Mental Health Act 2025 is passed.

(3) The Office of the Mental Health Commissioner will be led by an individual appointed by the Secretary of State titled the “Independent Mental Health Commissioner”.

(4) The role in subsection (3) is referred to as the “Mental Health Commissioner”.

(5) The Mental Health Commissioner may appoint staff to the Office of the Mental Health Commissioner they consider necessary for assisting in the exercise of their functions in section 142D.

142D Functions of the Commissioner

(1) The Mental Health Commissioner is responsible for overseeing the implementation and operability of functions discharged by relevant bodies and persons under the provisions of this Act, the Mental Health Act 1983, and the Mental Capacity Act 2025 particularly regarding the provision of treatment, care, and detention of people with a mental disorder.

(2) The Mental Health Commissioner must publish an annual report on the use of functions discharged under this Act, which must assess—

(a) the quality of mental health care treatment provided by relevant services;

(b) the accessibility of mental health care treatment services;

(c) the relationship between mental health and the criminal justice system;

(d) inequalities of mental health care provision regarding protected characteristics under the Equality Act 2010;

(e) the use and effectiveness of detention measures under this Act, including but not limited to Community Treatment Orders, for the purposes of therapeutic benefit outlined in section 1(2B);

(f) challenges surrounding stigma of mental health conditions;

(g) the accessibility of advice and support to mental health service users, their families and carers on their legal rights;

(h) other issues deemed appropriate by the Mental Health Commissioner.

(3) In fulfilling their duties under subsection (1), the Mental Health Commissioner may review, and monitor the operation of, arrangements falling within subsection (1), (2) and (3) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in promoting the principles in section 118(2B) of this Act.

(4) Subject to any directions from the Secretary of State, the Commissioner may take action necessary or expedient in connection for the purposes of their functions.

(5) This may include—

(a) collaborating with health services, public authorities, charitable organisations, and other relevant entities, including NHS bodies, the Care Quality Commission, and the Parliamentary and Health Service Ombudsman;

(b) ensuring enforcement authorities and public bodies under the Mental Health Act 1983 have the necessary capacity and resources to adequately discharge duties under the Mental Health Act 1983 and this Act.

142E Appointment, Tenure, and Remuneration of the Mental Health Commissioner

(1) The Secretary of State may by regulation make provision for the appointment, tenure, removal, and general terms of appointment of the Mental Health Commissioner.

(2) The Secretary of State may also by regulation determine the Commissioner’s remuneration, allowances, and pension entitlements.

142F Examination of cases

(1) The Secretary of State may, by regulations, make provision for the examination by the Mental Health Commissioner of the cases of those who are detained under this Act receiving treatment by authorised mental health care providers.

(2) The Secretary of State may, by regulations, provide for the Office of the Mental Health Commissioner to access and examine relevant data on mental health treatment provision held by NHS England and any other authorities the Secretary of State considers appropriate.

142G Regulations

A statutory instrument containing regulations under sections 142E and 142F may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.’”

This new clause establishes the office of the Mental Health Commissioner and makes provisions for relevant duties and responsibilities.

New clause 19—Duty to provide advice and support to families and carers—

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

(2) After section 117B insert—

‘117C After-care: provision of support and advice to families and carers

(1) The responsible integrated care board must ensure that, as part of the provision of after-care services under section 117 of this Act, advice and support is offered to the family or carers of the person discharged where the person consents.

(2) This support must include—

(a) information about the person’s condition and recovery;

(b) guidance on how to support their recovery at home and avoid relapse;

(c) access to financial, housing, and social care advice services relevant to the situation of the person’s family; and

(d) procedures for family members or nominated persons to notify the integrated care board of concerns that the person is at future risk of detention under Part 2 of this Act.

(3) Where a concern is raised under subsection (2)(d), the integrated care board must—

(a) consider whether the individual meets criteria to be included on the register of persons at risk under section 125D of this Act; and

(b) take reasonable steps to involve the family or nominated person in planning of subsequent support, subject to—

(i) the person’s consent; or

(ii) if they lack capacity, the person’s best interests.

(4) The Secretary of State must publish guidance under section 125B of this Act on the format and provision of support under subsection (3)(b).’”

This new clause would require the integrated care board, as part of the aftercare services offered under the Mental Health Act 1982, to offer support and advice to the family or carers of the person being discharged from treatment.

New clause 21—Assessment for admission: clinicians with outstanding complaints—

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

(2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 6 insert—

‘6a Assessment for admission: clinicians under investigation

(1) For the purposes of the written recommendations required under sections 2(3) or and 3(3) of this Act, a recommendation may not be made by a medical practitioner who is, at the time of the assessment or written statement—

(a) under investigation by the General Medical Council or the hospital due to concerns relating to the medical practitioner’s care of the patient being assessed; or

(b) subject to a complaint to the General Medical Council or the hospital by the patient or the patient’s close associates.

(2) The Secretary of State may by regulations make further provision under this section.’”

This new clause would prevent a patient from being assessed to be detained by a doctor under investigation by the GMC or hospital trust, or subject to a complaint, in relation to their care of that patient.

New clause 22—Veterans’ Mental Health Oversight Officer—

“After section 142B of the Mental Health Act 1983 insert—

‘Veterans’ Mental Health Oversight Officer

142C Veterans’ Mental Health Oversight Officer: establishment

(1) The Secretary of State shall appoint a Veterans’ Mental Health Oversight Officer ("the Officer") to oversee the treatment and care of veterans under this Act.

(2) The Officer shall—

(a) oversee the cases of veterans who are—

(i) at risk of detention under this Act;

(ii) currently detained under this Act; or

(iii) following detention under this Act, subject to community or outpatient treatment or other post-discharge mental health provisions;

(b) advocate for mental health assessments and care tailored to veterans' service-related experiences;

(c) collaborate with mental health professionals, veterans' services, legal representatives, and third-sector organisations to safeguard veterans' rights and well-being within relevant treatment settings;

(d) promote diversion from detention where clinically appropriate, including the use of veteran-specific support services; and

(e) submit an annual report to Parliament detailing—

(i) detention rates of veterans under this Act;

(ii) outcomes and recidivism rates for veterans detained under this Act;

(iii) recommendations for service improvement.

(3) In this section—

“veteran” refers to a person who has served or currently serves in the armed forces of the United Kingdom or a Commonwealth nation;

“relevant health authority” includes NHS England, regional NHS boards, or their successors.’”

This new clause introduces a dedicated oversight role for veterans within the framework of the Mental Health Bill, recognising that service personnel have unique needs and experiences that need to be considered in mental health care and detention decisions.

New clause 23—Mental Health Act: interim support for a child or adolescent at risk of detention—

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

(2) After section 33, insert—

‘33A Interim support for child and adolescent patients

(1) Where a child or young person (“P”) is referred to Child and Adolescent Mental Health Services and—

(a) P has not yet attended their first appointment, and

(b) P is at risk of detention under this Part, in the opinion of a family member or close associate,

the responsible authority must ensure that interim support is available.

(2) Interim support under this section must include at least one of—

(a) regular contact with a family support worker;

(b) access to GP appointments;

(c) regular contact with a school nurse or equivalent healthcare professional; or

(d) access to a peer support group, youth group, or youth club offering appropriate emotional support.’”

This new clause would ensure adequate interim support for children at risk of detention under Part II the Mental Health Act while awaiting an appointment with Child and Adolescent Mental Health Services (CAMHS).

New clause 24—Report: Mental health services for children and young people—

“(1) The Secretary of State must, within 18 months of passing this Act, prepare and lay before Parliament a report on the provision of specialist mental health services for patients aged under 18.

(2) The report under subsection (1) must include an assessment of—

(a) the number of patients aged under 18 receiving specialist mental health services;

(b) the availability of specialist mental health services based outside of hospital settings;

(c) any gaps in care and support experienced by patients aged under 18;

(d) the Secretary of State’s conclusions as to whether there are sufficient resources to deliver mental health services for patients aged under 18;

(e) the views of children, young people and families with experience of receiving specialist mental health services.

(3) For the purpose of this section—

(a) “specialist mental health services for patients aged under 18” means—

(i) inpatient mental health services specifically designed for individuals aged under 18 years, including specialist eating disorder services;

(ii) community-based mental health services specifically designed for individuals aged under 18 years as an alternative to inpatient care.

(b) “resources to deliver mental health services” include—

(i) finances;

(ii) appropriate trained medical professionals;

(iii) appropriate facilities for patient care.”

This new clause would require the Secretary of State to review and report on the availability of specialist mental health services for patients under 18.

New clause 25—Determination of competency for persons under 16—

“(1) For the purposes of this Act, a person aged under 16 (referred to in this section as a child) is able to make a relevant decision if they can—

(a) understand the information relevant to the decision;

(b) retain that information;

(c) use or weigh that information as part of the process of making a decision; and

(d) communicate their decisions (whether by talking, using sign language or any other means).

(2) Where a child is able to make a relevant decision in accordance with paragraph (1) above, that child will be competent for the purposes of this Act.

(3) A child is not to be regarded as unable to understand the information relevant to a decision if he is able to understand an explanation of it given to him in a way that is appropriate to his circumstances (using simple language, visual aids or any other means).

(4) A person determining a child’s ability to make a relevant decision under this section must—

(a) have due regard to Article 12 of the United Nations Convention on the Rights of the Child, and

(b) be able to show reasonable grounds for their belief that the child is or is not able to make a relevant decision.”

This new clause inserts a competency test for determining a child’s ability to make a relevant decision.

New clause 26—Duty to establish carer liaison service—

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

(2) In Part X (Miscellaneous and Supplementary), after section 133 insert—

‘133A Duty to establish carer liaison service

(1) The managers of every hospital providing services under this Act must establish and maintain a dedicated carer liaison service.

(2) A service established under this section must provide—

(a) support to unpaid carers when a patient for whom they provide care is—

(i) awaiting admission to hospital for treatment under the Act;

(ii) receiving treatment in hospital under the Act;

(iii) set to be discharged from a hospital where they had been receiving treatment under this Act;

(b) timely and accessible information regarding the discharge of the patient they care for, including details of—

(i) the patient's discharge plan; and

(ii) aftercare arrangements under section 117 of this Act;

(c) support for unpaid carers to identify their own needs and connect to relevant local services for post-discharge support, including local authority adult social care services, general practitioners, and local carers' centres;

(d) facilitation of effective communication and collaboration between unpaid carers and the patient's multi-disciplinary clinical team regarding the discharge process;

(e) assistance to unpaid carers in developing or updating a carer's support plan in the context of the patient's discharge, including guidance on—

(i) their rights to assessment and support as carers

(ii) their participation in education or employment;

(iii) available counselling services;

(iv) support in planning for emergencies in relation to the patient;

(v) benefits for the carer and patient; and

(vi) other forms of local support; and

(f) services to ensure that the perspective of the unpaid carer, as a key provider of support, is considered during discharge planning, where appropriate and with due regard to patient confidentiality and consent.’”

This new clause would require hospitals to establish a dedicated liaison service for the carers of patients detained under the Mental Health Act.

New clause 27—Duty to identify children of patients receiving treatment—

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

(2) In Part X (Miscellaneous and Supplementary), after section 133 insert—

‘133B Duty of managers of hospitals to identify children of patients

(1) Where a patient liable to be detained under this Act is in a hospital or registered establishment, the managers of the hospital or registered establishment shall take such steps as are practicable to identify children of the patient.

(2) The managers must ensure, where children of patients are identified, that—

(a) information is provided to the family about support available for the child;

(b) the appropriate practitioner consider whether the child might be a young carer and whether they might benefit from additional support including—

(i) a Young Carers’ Needs Assessment under section 17ZA of the Children Act 1989, or

(ii) additional support from their local authority or local young carers service.’”

This new clause would require hospitals to identify children of patients and provide support or provide guidance on available support to them, particularly if they are a young carer.

New clause 28—Duty to mitigate adverse effect of compulsory measures on parental relations—

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

(2) After section 131A, insert—

‘131B Duty to mitigate adverse effect of compulsory measures on parental relations

(1) Subsection (2) below applies—

(a) where—

(i) a child is subject to any measures authorised by virtue of this Act; and

(ii) the measures will or will be likely to impair the personal relations or diminish direct contact between the child and any person with parental responsibilities in relation to the child; or

(b) where—

(i) a person with parental responsibilities in relation to a child is subject to any measures authorised by virtue of this Act; and

(ii) the measures will or will be likely to impair the personal relations or diminish direct contact between that person and the child.

(2) Every person having functions by virtue of this Act shall take such steps as are practicable and appropriate to mitigate the impairment or diminution referred to in this section or, as the case may be, the likelihood of that impairment or diminution.

(3) In this section—

“child” has the meaning given by section 105 of the Children Act 1989; and

“parental responsibilities” has the meaning given by section 3 of the Children Act 1989.’”

This new clause would create a duty to mitigate the adverse effect of compulsory treatment under the Mental Health Act 1983 on relations between parents and their children, mirroring provisions in the Mental Health (Care and Treatment) (Scotland) Act 2003.

New clause 29—Age-appropriate treatment for children—

“(1) Section 131A of the Mental Health Act 1983 is amended as follows.

(2) After subsection (1), insert—

‘(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—

(a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward; and

(b) the decision is in accordance with the best interests of the child.’

(3) After subsection (3), insert—

‘(3A) Where a patient to whom this section applies has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—

(a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient;

(b) details of the measures to be taken by the hospital to ensure that, while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment; and

(c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.

(3B) Where a patient to whom this section applies is—

(a) detained in, or admitted to, an adult ward or in a local authority other than the local authority in which the patient was ordinarily resident; and

(b) the detention or admission is of more than 24 consecutive hours' duration, the managers of the hospital must notify the regulatory authority immediately, setting out why they consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).

(3C) Subsection (3D) applies when—

(a) the managers of a hospital accommodate a patient to whom this section applies in an adult ward for a consecutive period of at least 28 days; or

(b) detain or admit a patient to whom this section applies who—

(i) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, or

(ii) was not ordinarily resident within the area of any local authority.

(3D) Where this subsection applies, the managers of the hospital must immediately inform the appropriate officer of the responsible local authority—

(a) of the patient's detention or admission, and

(b) when the patient's detention or admission ceases.’

(4) Leave out subsection (4) and insert—

‘(4) In this section—

(a) “adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to;

(b) “the appropriate officer” means—

(i) in relation to a local authority in England, their director of children's services, and

(ii) in relation to a local authority in Wales, their director of social services;

(c) “hospital” includes a registered establishment; and

(d) “the responsible authority” means—

(i) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or

(ii) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.’”

This new clause seeks to ensure that children are only placed on adult wards where there are exceptional circumstances, and it is in their best interests. It includes procedural safeguards for determining the reasons behind (and suitability of) admitting a child to a hospital environment in which adults are simultaneously accommodated or in an out of area placement, along with notification requirements.

New clause 30—Application in respect of patient already on hospital grounds—

“(1) Section 5 of the Mental Health Act 1983 (Application in respect of patient already in hospital) is amended as follows.

(2) In subsection (1), after ‘or,’ insert ‘that the patient has attended a hospital or been brought to a hospital to seek help or admission as a patient or,’.

(3) After subsection (2), insert—

‘(2A) If, in the case of a patient who—

(a) is an outpatient in hospital; or

(b) has attended hospital to seek treatment as an outpatient; or

(c) has attended hospital to seek admission as an inpatient,

it appears to the registered medical practitioner assessing the patient that an application ought to be made under this Part of this Act for the admission of the patient to hospital, the registered medical practitioner may furnish to the managers a report in writing to that effect; and in any such case the patient may be detained in the hospital for a period of 72 hours from the time when the report is so furnished.’

(4) In subsection (3), after ‘(2)’ insert ‘or (2A)’.”

This new clause would allow people who have attended or been brought to a hospital to seek help or admission as a patient to be detained for assessment under the Mental Health Act.

New clause 31—Costed plan to ensure community provision for individuals with learning disabilities and autism who are at risk of detention—

“(1) Within 18 months of the day on which this Act is passed, the Secretary of State must publish a fully costed plan for how Integrated Care Boards and local authorities will ensure provision of adequate community services for individuals with learning disabilities and autistic people who are at risk of detention under Part 2 of the Mental Health Act 1983.

(2) As part of the development of that plan, a formal consultation process must take place to determine how the decision to enact the relevant parts of this Act will be made.

(3) The consultation must include input from relevant stakeholders, including—

(a) individuals with learning disabilities and autistic people;

(b) carers for people with learning disabilities and autistic people;

(c) healthcare professionals; and

(d) advocacy groups.”

This new clause would require a costed plan to ensure that ICBs and local authorities are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under Part 2 of the 1983 Act, informed by a consultation with a range of stakeholders.

New clause 32—Mandatory Independent Care (Education) and Treatment Reviews for patients detained in long-term segregation—

“In the Mental Health Act 1983, after section 142D (inserted by section 52 of this Act) insert—

‘142E Mandatory Independent Care (Education) and Treatment Reviews for patients detained in long-term segregation

(1) A notification of any use of long-term segregation for a patient detained under this Act must be issued to the Care Quality Commission, the hospital’s Board of Directors and the relevant NHS Commissioner within 72 hours of the person being placed in long-term segregation.

(2) Upon receipt of a notification under subsection (1), the Care Quality Commission must appoint a qualified professional to conduct an Independent Care (Education) and Treatment Review.

(3) The independent reviewer must—

(a) conduct a face-to-face assessment of the patient,

(b) consult with the patient’s family or carers, where appropriate,

(c) review the patient’s care and treatment plan, including the rationale for continued segregation, and

(d) assess whether alternatives, including ward or community-based alternatives, were considered prior to the implementation of long-term segregation.

(3) Where the assessment under subsection (3)(d) reveals that alternatives were not adequately considered, the independent reviewer may require the detaining organisation to—

(a) provide justification for this omission, and

(b) outline steps to ensure that alternative options are considered in future cases.

(4) The independent reviewer has authority equivalent to a second opinion appointed doctor to—

(a) confirm the appropriateness of the long-term segregation,

(b) recommend amendments to the treatment plan, and

(c) require alternative interventions if long-term segregation is deemed inappropriate.’”

This new clause requires independently chaired reviews for any person detained in long-term segregation, in line with the recommendations of Baroness Hollins’ report on solitary confinement for people with autism and learning disabilities.

New clause 33—Mandatory Independent Care (Education) and Treatment Reviews for patients with autism or learning disability detained for more than 5 years—

“In the Mental Health Act 1983, after section 142D (inserted by section 52 of this Act) insert—

‘142E Mandatory Independent Care (Education) and Treatment Reviews for patients with autism or learning disability detained for more than 5 years

(1) Where a person with autism or a learning disability has been subject to compulsory detention under this Act, including by virtue of a community treatment order, for a continuous period of 5 years or more, the Care Quality Commission must appoint a qualified professional to conduct an Independent Care (Education) and Treatment Review (ICETR) of that person’s care and treatment.

(2) The independent reviewer must—

(a) conduct a face-to-face assessment of the patient,

(b) consult with the patient’s family or carers, where appropriate,

(c) review the patient’s care, education (where applicable), and treatment plan, including the rationale for continued detention or the continuation of a community treatment order, and

(d) assess whether alternatives to continued compulsory detention, including community-based or less restrictive options, have been adequately considered.

(3) The Care Quality Commission must ensure that a further ICETR is conducted at intervals of not more than 12 months for so long as the person remains subject to compulsory detention under this Act or to a community treatment order.

(4) Where the assessment under subsection (2)(d) reveals that alternatives to continued detention or community treatment were not adequately considered, the independent reviewer may require the detaining organisation or responsible commissioner to—

(a) provide justification for this omission, and

(b) outline steps to ensure that alternative options are fully considered in future reviews.’”

This new clause provides for a new process with independently chaired reviews for any patient with autism or a learning disability subject to detention or community treatment orders for long periods of time.

New clause 34—Grounds for detention—

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

(2) In section 2 (admission for assessment), in subsection (2)—

(a) omit the ‘and’ at the end of paragraph (a);

(b) for paragraph (b) substitute—

‘(b) there is a risk of serious harm to the health or safety of the patient or of another person; and

(c) given the nature or degree of the harm, the patient ought to be so detained.’

(3) In section 3 (admission for treatment)—

(a) in subsection (2), for paragraphs (c) and (d) substitute—

‘(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient is so detained,

(c) it is necessary, given the nature or degree of the harm, for the patient to receive medical treatment,

(d) the necessary treatment cannot be provided unless the patient is detained under this Act, and

(e) appropriate medical treatment is available for the patient.’

(b) in subsection (3)—

(i) in paragraph (a), for ‘(d)’ substitute ‘(e)’;

(ii) in paragraph (b), for ‘(c)’ substitute ‘(b) to (d)’

(4) In section 5(4) (detention for six hours pending application for admission), for paragraph (a) (but not the ‘and’ at the end) substitute—

‘(a) that there is a risk of serious harm to the health or safety of the patient or of another person unless the patient is immediately restrained from leaving the hospital;’

(5) In section 20 (renewal of authority for detention of patient detained in pursuance of application for admission for treatment etc), in subsection (4), for paragraphs (c) and (d) substitute—

‘(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient receives medical treatment,

(c) it is necessary, given the nature or degree of the harm, for the patient to receive medical treatment,

(d) the necessary treatment cannot be provided unless the patient continues to be liable to be detained, and

(e) appropriate medical treatment is available for the patient.’

(6) The amendment made by subsection (5), so far as relating to persons who are liable to be detained by virtue of Part 3 of the Mental Health Act 1983, applies in relation to such a person whether the person became so liable before or after the coming into force of this section.”

This new clause is intended to replace Clause 5 (see Amendment 43). It would remove from the criteria for detention any reference to ‘likelihood’ or ‘may be caused’, replacing those words with language related to an individual’s risk, in order to simplify a psychiatrist’s assessment of a patient’s levels of risk.

New clause 35—Community treatment order: conditions—

“(1) Section 17B of the Mental Health Act 1983 (Conditions) is amended as follows.

(2) After subsection (7) insert—

‘(8) The responsible clinician must ensure that a community treatment order complies with the code of practice as set out in section 118(2B) of this Act.

(9) A community treatment order has a maximum duration of 12 months, unless the conditions set out in subsection (10) apply.

(10) The responsible clinician may extend the duration of a community treatment order beyond 12 months only after the responsible clinician has—

(a) consulted the patient, the patient’s nominated persons, and any relevant mental healthcare professional involved in the patient’s treatment or care planning;

(b) undertaken a review to evaluate the ongoing necessity and therapeutic benefit of the community treatment order; and

(c) consulted a General Medical Council registered psychiatrist regarding the conditions of the community treatment order and obtaining their written agreement that an extension is necessary and in accordance with the principles set out in section118(2B).

(11) A tribunal may recommend that the responsible clinician consider whether to extend, vary, or terminate the duration and conditions of a community treatment order.

(12) A community treatment order with a duration of less than 12 months is not subject to the conditions set out in subsection (10).

(13) Where a community treatment order is extended beyond a period of 12 months, the order must be reviewed at intervals not exceeding six months from the date of the extension, in accordance with the requirements set out in subsection (10).

(14) At the conclusion of the initial 12 month period or of any extended period, the responsible clinician must undertake a review to assess the effectiveness of the community treatment order at complying with the code of practice set out in section 118(2B) of this Act.’”

This new clause would set out conditions for the extension of a community treatment order beyond 12 months, and would require such an order to comply with the Mental Health Act’s code of practice.

New clause 36—Age appropriate treatment for children—

“(1) Section 131A of the Mental Health Act 1983 is amended as follows.

(2) After subsection (1), insert—

‘(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—

(a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward, and

(b) the decision is in accordance with the best interests of the child.’

(3) For subsection (3), substitute—

‘(3) For the purpose of deciding how to fulfil the duty under subsection (2) above, the managers must consult—

(a) someone with parental responsibility for the child, unless it is not deemed in the best interests of the patient for someone with parental responsibility to be consulted; and

(b) a person who appears to them to have knowledge or experience of cases involving patients who have not attained the age of 18 years which makes the person suitable to be consulted.’

(4) After subsection (3), insert—

‘(3A) Where a patient to whom this section applies has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—

(a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient;

(b) details of the measures to be taken by the hospital to ensure that, while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment; and

(c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.

(3B) Where a patient to whom this section applies is detained in, or admitted to, an adult ward, and the detention or admission is of more than 24 consecutive hours’ duration, the managers of the hospital must notify the regulatory authority and the responsible authority within 48 hours of the patient’s admission, setting out why the managers of the hospital consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).

(3C) Subsection (3E) applies when the managers of a hospital accommodate a patient to whom this section applies on an adult ward for a consecutive period of at least 28 days.

(3D) Subsection (3E) also applies where the managers of a hospital detain or admit a patient to whom this section applies who—

(a) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, unless the hospital is less than 20 kilometres from the patient’s ordinary residence; or

(b) was not ordinarily resident within the area of any local authority.

(3E) Where this subsection applies, the managers of the hospital must inform the appropriate officer of the responsible local authority without delay—

(a) of the patient's detention or admission, and

(b) when the patient's detention or admission ceases.’

(5) Leave out subsection (4) and insert—

‘(4) In this section—

“adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to

“the appropriate officer” means—

(a) in relation to a local authority in England, their director of children’s services, and

(b) in relation to a local authority in Wales, their director of social services;

“hospital” includes a registered establishment; and

“the responsible authority” means—

(a) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or

(b) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.’”

This amendment would restrict the circumstances in which a child can be admitted to or detained on an adult ward for treatment under the Mental Health Act 1983, require the hospital to notify the local authority when they have done so, or when they have placed a child in a ward outside their local authority, and require that the parents or legal guardians of the child have access to their child and are consulted about their admission to an adult ward.

New clause 37—Roadmap for the provision of sufficient services for autistic people and people with a learning disability—

“(1) Within six months of the passing of this Act, the Secretary of State must prepare and lay before Parliament a roadmap to outline the Government’s plans for ensuring sufficient community services for autistic people and people with a learning disability to facilitate the operability of section 3 of this Act.

(2) When developing the roadmap under subsection (1), the Secretary of State must engage with relevant stakeholders, including—

(a) autistic people and people with a learning disability;

(b) carers for autistic people and people with a learning disability;

(c) health and care professionals; and

(d) advocacy groups.

(3) Within twelve months of the publication of a roadmap under subsection (1) above and annually thereafter, the Secretary of State must publish a monitoring statement on progress made towards implementing the roadmap, including its targets and milestones.”

This new clause would require the Government to publish a roadmap outlining its plans for ensuring sufficient community services to enable the implementation of the Act’s provisions on ending the detention of autistic people and people with a learning disability.

Amendment 33, clause 1, page 1, line 19, at end insert—

“(2BA) The Secretary of State shall ensure that each of the following matters is addressed—

(a) the provision of access to advocacy services for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1);

(b) the assessment of ‘competence’ in relation to patients who have not attained the age of 16;

(c) the preparation of care and treatment plans for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1);

(d) matters to be taken into account by an approved mental health professional when deciding who to appoint as a nominated person in circumstances in which the patient has not attained the age of 18 and paragraph 7 of Schedule 2 of this Act applies;

(e) steps to be taken by managers of the hospital when section 131A of this Act applies including—

(i) matters to be taken into account when determining whether the patient’s environment in hospital is suitable having regard to the patient’s age (including article 3(1) of the UN Convention on the Rights of the Child (‘the best interests of the child’));

(ii) measures to be taken in cases where a patient who has not attained the age of 18 has been admitted to an environment that provides care and treatment to patients who have attained the age of 18, including—

(A) safeguards to ensure that the patient is provided with care in a safe environment; and

(B) action to be taken to ensure that the patient is transferred to a more age-appropriate environment as soon as reasonably practicable;

(f) matters to be taken into account when determining whether a patient who has not attained the age of 18 should be admitted to a hospital for the purpose of treatment (or assessment, or assessment followed by treatment) of mental disorder which is located in an area falling outside the local authority in which the patient was ordinarily resident, or otherwise living in, prior to such detention or admission and the safeguards to be followed if the patient is so admitted;

(g) an explanation of the arrangements for the commissioning and provision of community and inpatient mental health services for those who have not attained the age of 18.”

This amendment inserts commitments related to children and young people which the Government made in the House of Lords into the section on principles to inform decisions on the Code of Practice.

Amendment 2, clause 4, page 4, line 41, at end insert—

“(iv) accommodation and relocation, and”.

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

Amendment 6, 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 7, 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 8, 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 9, 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 10, 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 11, 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.

Amendment 12, 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.

Amendment 3, 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 36, page 9, line 20, at end insert—

“125DA Registers: reviews

(1) Each integrated care board must make arrangements for ensuring that care and treatment review meetings take place in relation to a person included in that board’s register under section 125D if either—

(a) the person consents to meetings taking place and to the disclosure of information in accordance with the arrangements, and to the use of the information in accordance with this Act, or

(b) the person lacks capacity to give that consent but the board considers that it is nonetheless in the person’s best interests for the meetings to take place, and information to be disclosed and used, as mentioned in subsection (a).

(2) In this section ‘care and treatment review meeting’ means a meeting, convened by the integrated care board, for the purpose of reviewing a person’s case in order to—

(a) identify any needs of the person for—

(i) social care provision,

(ii) medical treatment, or

(iii) financial support, and

(b) make recommendations about—

(i) whether and how any such needs can be met,

(ii) how the person’s safety can be ensured while they are at risk of detention, and

(iii) how to reduce any risk of the person being detained in a hospital or registered establishment.

(3) The arrangements under subsection (1) must include arrangements for—

(a) the preparation of a report (whether by the board or another person) setting out the needs identified, and recommendations made, at each meeting, and

(b) the provision of a copy of the report, within the period of 14 days beginning with the day on which a meeting takes place, to each of the following persons (other than any who prepared the report)—

(i) the responsible commissioner,

(ii) the person’s responsible clinician,

(iii) the integrated care board, and

(iv) the local authority in whose area the person is ordinarily resident.

(The arrangements may also include provision authorising or requiring a copy of the report to be given to other persons.)

(4) The integrated care board shall arrange appropriate provision within 28 days of receipt of a report under subsection (3) to address any needs identified and recommendations made.

(5) The arrangements under subsection (1) must include arrangements for ensuring that—

(a) the first meeting in relation to the person takes place within the period of 28 days from their inclusion in the register under section 125D, and

(b) a further meeting takes place at least once in each successive period of 24 months for which the person remains on the register, beginning with the day on which the first meeting takes place.

(6) A person may withdraw consent to the taking place of meetings and to the disclosure of information in accordance with arrangements under subsection (1).

(7) The arrangements under subsection (1) must include provision about—

(a) how consent to the taking place of meetings or the disclosure of information may be withdrawn;

(b) what is to happen when consent is withdrawn (which may include provision about who is to be informed).”

This amendment replicates the provisions for care and treatment reviews for patients under sections 125A and 125B but for people with autism and learning disabilities who are at risk of detention, in order to identify needs and ensure that those needs can be met without detaining them.

Amendment 37, page 9, line 26, after “125D(3)(c)” insert “and 125DA(3)”.

Amendment 13, 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.

Amendment 38, page 9, line 32, after “125D(3)(d)” insert “and 125DA(3)”.

Amendments 37 and 38 are consequential on amendment 36 and would ensure that integrated care boards and local authorities have regard to reports from care and treatment review meetings with people on their registers when commissioning services.

Amendment 24, page 9, line 38, at end insert—

“125ZF Crisis accommodation: duty to assess and provide

(1) In exercising its functions under section 125E, an integrated care board must assess the need for appropriate crisis accommodation for autistic people and people with a learning disability within its area.

(2) Where such need is identified under subsection (1), the integrated care board must ensure appropriate crisis accommodation is available, either—

(a) within its area, or

(b) through arrangements with other integrated care boards for regional provision.

(3) For the purposes of this section, ‘appropriate crisis accommodation’ means accommodation which—

(a) is designed to meet the specific needs of autistic people and people with learning disability during periods of acute mental health crisis;

(b) is staffed by persons with specialist training in supporting autistic people and people with learning disability;

(c) provides a safe alternative to detention under section 136 of this Act;

(d) is developed through co-production with autistic people and people with learning disability.

(4) The Secretary of State must issue guidance about the assessment of need and provision of crisis accommodation under this section.”

This amendment requires ICBs to assess need and ensure provision of appropriate crisis accommodation, either locally or regionally, designed specifically for autistic people and people with learning disability in crisis.

Amendment 14, page 10, line 5, at end insert—

“125FA Report: sufficient commissioning services for people with autism or learning disability

(1) Within four months of the day on which the Mental Health Act 2025 is passed, the Secretary of State must lay before Parliament a plan to allocate sufficient resources for commissioning services regarding the treatment and detention of autistic people and people with learning disabilities to ensure operability of provisions in this Act.

(2) The plan must include—

(a) revised assumptions of the number of autistic people and people with learning disabilities who may require detention under this Act;

(b) the actions that the Secretary of State will take to ensure community services are available to meet demand after the 28-day detention period;

(c) plans for data collection to support commissioning sufficient services;

(d) plans to allocate appropriate resource to ensure operability of services, including, but not limited to, financial resource;

(e) plans to ensure that responsible bodies and individuals receive the necessary training to carry out support, diagnostic, and treatment plans.”

This amendment requires the Secretary of State to present a plan within four months to ensure sufficient services, resources, data, and training are in place to support autistic people and those with learning disabilities under the Act.

Amendment 25, page 10, line 5, at end insert—

“125FA Assessment: provision of services for autistic people and people with a learning disability

(1) Each financial year, an integrated care board must—

(a) conduct an assessment of the availability and adequacy of services within its area for autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act;

(b) publish the results of the assessment; and

(c) publish an action plan to address any gaps in provision identified.

(2) The assessment under subsection (1) must include consideration of—

(a) the availability of appropriate crisis accommodation;

(b) the availability of appropriate community support services;

(c) the adequacy of training for responsible bodies and individuals to carry out support, diagnostic and treatment plans; and

(d) the experiences of autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers.

(3) The integrated care board must consult the following in conducting the assessment—

(a) autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;

(b) the relevant local authority or authorities;

(c) providers of relevant services; and

(d) such other persons as the integrated care board considers appropriate.

(4) The Secretary of State must issue guidance about the conduct of assessments under this section, and integrated care boards must have regard to this guidance.”

This amendment would require integrated care boards to conduct and publish annual assessments of the provision available for autistic people and people with learning disability at risk of detention and to prepare action plans to address any identified gaps.

Amendment 26, page 10, line 5, at end insert—

“125FA Report: services for autistic people and people with a learning disability

(1) The Secretary of State must, within 12 months of this section coming into force and annually thereafter, prepare and lay before Parliament a report on—

(a) the availability of appropriate accommodation for autistic people and people with a learning disability detained under this Act;

(b) the number of instances where appropriate accommodation could not be found within statutory timeframes;

(c) the progress towards implementation of sections 3 and 4 of the Mental Health Act 2025 and the impact of any delays to implementation on autistic people and people with a learning disability; and

(d) progress made towards meeting the needs of autistic people and people with a learning disability without detaining them under Part 2 of this Act.

(2) In preparing the report, the Secretary of State must consult—

(a) autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;

(b) integrated care boards;

(c) local authorities; and

(d) such other persons as the Secretary of State considers appropriate.”

This amendment would require the Secretary of State to report annually to Parliament on the availability of appropriate placements for autistic people and people with learning disability and on progress implementing the relevant provisions of the Act.

Amendment 28, page 10, line 5, at end insert—

“125FA Training standards

(1) The Secretary of State must by regulations make provision about training standards for responsible bodies and individuals working with autistic people and people with a learning disability in—

(a) mental health hospitals;

(b) places of safety designated under sections 135 or 136 of this Act;

(c) crisis accommodation; and

(d) such other settings as the Secretary of State considers appropriate.

(2) Regulations under subsection (1) must—

(a) specify minimum training requirements;

(b) require training to be co-produced with autistic people and people with learning disability and their families or carers;

(c) require regular refresher training; and

(d) include training on de-escalation techniques and alternatives to restraint.

(3) The Secretary of State must publish guidance about the standards set out in regulations under subsection (1).

(4) A statutory instrument containing regulations under this section is subject to annulment in pursuance of a resolution of either House of Parliament.”

This amendment would require the Secretary of State to produce guidance on minimum training standards for staff working with autistic people and people with learning disability in mental health settings and require that training be co-produced with people with lived experience and their families.

Amendment 43, page 11, line 15, leave out clause 5.

Amendment 44, clause 6, page 12, leave out lines 26 to 29 and insert—

“(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient receives medical treatment,”.

This amendment is linked to NC34

Amendment 45, page 12, line 29, for “degree and likelihood” substitute “or degree”.

This amendment is linked to NC34

Amendment 15, page 12, line 40, at end insert—

“(c) after subsection (6) insert—

‘(6A) Any person subject to a community treatment order must be informed orally and in writing at the time of the making of the order of their right to an independent mental health advocate under section 130A of this Act.’”

The amendment would ensure that people who are to be subject to a community treatment order would receive information about their right to advocacy.

Amendment 16, clause 8, page 14, line 13, after “treatment” insert

“including the setting in which treatment takes place,”.

This amendment ensures that the definition of appropriate medical treatment includes the setting in which treatment takes place.

Amendment 17, clause 18, page 26, line 22, at end insert—

“(1A) Regulations under subsection (1) may only be made to provide for circumstances where—

(a) the treatment is immediately necessary to save the patient’s life,

(b) obtaining a second opinion would cause a delay that places the patient at a significant and imminent risk of death or serious physical harm, and

(c) the treatment is reversible.”

The amendment limits the power to dispense with a second medical opinion for urgent electro-convulsive therapy to exceptional, life-threatening cases, introduces periodic reviews of its use, and ensures transparency by prohibiting retrospective application.

Amendment 4, clause 21, page 29, line 28, at end insert—

“(ab) containing steps to alleviate social and financial stressors contributing to the patient’s risk of requiring detention in future; and”.

This amendment would require social and financial stressors be addressed in care and treatment plans.

Amendment 40, page 29, line 30, at end insert—

“(c) containing an assessment of the levels of risk to public safety posed by the patient in the community.”

This amendment would require consideration to be given to public safety in care and treatment plans.

Amendment 18, page 29, line 39, at end insert—

“(iii) the discussion of the person’s finances and financial situation.”

This amendment ensures that the care and treatment plan includes matters relating to the patient’s financial circumstances.

Amendment 1, page 29, line 41, at end insert—

“(4A) For the purposes of preparing a plan under this section, a discharge planning meeting must be held.

(4B) A meeting under subsection (4A) must include—

(a) the patient;

(b) the patient’s nominated person;

(c) any independent mental health advocate acting for the patient;

(d) a representative of the integrated care board;

(e) a local housing officer;

(f) a local authority social worker;

(g) a representative from the Department for Work and Pensions; and

(h) any other person or agency involved in the patient’s care or likely to support recovery in the community.

(4C) A care and treatment plan under this section must include—

(a) actions agreed by relevant agencies to support the patient’s recovery;

(b) provisions to address clinical, financial, housing, and social needs;

(c) steps to reduce the likelihood of readmission or further detention under this Act; and

(d) a record of any points of disagreement and how they are to be resolved.

(4D) Where an agency listed under subsection (4B) fails to attend a discharge planning meeting, the responsible clinician must take reasonable steps to obtain their input in writing and record it in the plan.

(4E) For the purposes of subsections (4A) to (4D), the Secretary of State must issue guidance on best practice for discharge planning meetings and multi-agency collaboration.”

This amendment would require the clinician preparing a care and treatment plan to hold a multi-agency planning meeting to inform it, and specifies what must be included within the plan.

Amendment 19, page 29, line 41, at end insert—

“(4A) The information authorised or required to be included in, or attached to, a care and treatment plan by virtue of regulations under subsection (3) must include provision to protect the patient's housing and accommodation during and immediately after they are subject to a care and treatment plan.”

This amendment ensures that protection of housing and accommodation are considered as part of care and treatment plans.

Amendment 20, page 30, line 26, at end insert—

“(g) following the patient turning 18 years of age during the course of a care and treatment plan.”

This amendment ensures that individuals turning 18 during a care and treatment plan have their plans reviewed to maintain continuity of care while transitioning from child to adult services.

Amendment 39, page 30, line 26, at end insert—

“(vii) for a relevant patient who has not yet reached the age of 18, the parents or legal guardians of the relevant patient, unless that is not deemed in the best interests of the patient.

(5A) Any care plan prepared under this section, if prepared for a relevant patient who has not yet reached the age of 18, must include provision for the parents or legal guardians of the patient to be directly involved in the care and treatment of the relevant patient, unless such involvement is not in the best interests of the patient.

(5B) For the purposes of subsection (5A), the parents or legal guardians must be given regular access to the relevant patient through attendance on the hospital ward.”

This amendment would require a practitioner to consult the parents or legal guardians of a child patient when preparing the patient’s care and treatment plan, require parental involvement in patient care through the plan, and enable those parents (or guardians) regular access to the patient on the hospital ward.

Amendment 27, page 29, line 41, at end insert—

“(4A) Where a patient has autism or a learning disability, the care and treatment plan must—

(a) identify specific crisis prevention strategies appropriate to the patient's individual needs;

(b) identify suitable crisis accommodation options in the event that the patient's current placement becomes unable to meet their needs;

(c) specify how the patient's sensory needs will be met;

(d) specify communication approaches appropriate to the patient's needs; and

(e) record the views of the patient’s family members or carers, where appropriate and with the patient's consent.”

This amendment would ensure that care and treatment plans for patients with autism or learning disabilities include specific components addressing their particular needs, including crisis prevention strategies and identification of suitable crisis accommodation options.

Amendment 22, clause 45, page 56, line 37, at end insert—

“(5A) An ‘advance choice document’ under subsection (5) should include consideration of the person’s financial circumstances.”

This amendment ensures that the advance choice document includes matters relating to the patient’s financial circumstances.

Amendment 32, page 58, line 2, at end insert—

“(2A) After subsection (3), insert—

‘(3ZA) After-care provision under subsection (3) above may include, for patients who have not yet reached the age of 16, appropriate Early Help services in the community.’”

This amendment would ensure that, when a tribunal is discharging a child who has experienced a mental health crisis, the tribunal may recommend that they are referred to appropriate Early Help services as part of their after-care planning.

Amendment 29, clause 46, page 59, line 10, at end insert—

“(4) After subsection (6), insert—

‘(6A) After-care services under this section may include provision for authorised community pharmacies to dispense emergency and ongoing medication in line with after-care plans.

(6B) Community pharmacies providing services under subsection (6A) must be—

(a) given access to suitable training and resources;

(b) integrated into the local primary care team, with appropriate access to prescribing professionals and multidisciplinary support; and

(c) given appropriate remuneration and reimbursement for providing after-care services.

(6C) Responsible bodies must carry out due diligence of any pharmacy operator before authorising them to provide after-care services under this section.

(6D) Due diligence checks under subsection (6C) must include ensuring that—

(a) the operator is not in significant arrears in respect of staff wages, supplier payments or other financial obligations;

(b) the operator can demonstrate the financial capacity to sustain additional locations without compromising existing services; and

(c) the operator has an established record of compliance with relevant regulatory and contractual requirements.

(6E) Where due diligence checks under subsections (6C) and (6D) determine that a pharmacy operator is failing in its existing financial obligations, the pharmacy operator must not be authorised to take on new after-care service locations.’”

This amendment would allow community pharmacies to be reimbursed for dispensing medication under the aftercare provisions of the Mental Health Act 1983, and would ensure that they have access to relevant training, that they are integrated into the primary care team, and that the responsible body carries out due diligence checks on their financial health.

Amendment 30, page 59, line 10, at end insert—

“(4) After subsection (6), insert—

‘(6A) After-care services provided under this section must include the availability of family support workers.’”

This amendment would require the provision of family support workers as part of the after-care provisions under the Mental Health Act 1983.

Amendment 31, page 59, line 10, at end insert—

“(4) After subsection (6), insert—

‘(6A) When determining the adequacy of after-care services for a specific patient, responsible bodies must take into account—

(a) whether the patient lives in a rural or urban area;

(b) associated travel times between the patient’s residence and after-care services;

(c) the patient’s levels of contact with others in their community; and

(d) the views of local transport authorities and operators and relevant community transport or volunteer groups on levels of accessibility to after-care services.

(6B) The responsible body must ensure the provision of outreach or visiting services to isolated individuals eligible for after-care under this section, including to those in remote or agricultural areas.’”

This amendment would ensure that the needs of individuals living in rural areas are accounted for when providing after-care services under the Mental Health Act 1983, and that local transport operators are consulted on how easy it is to access these services.

Government amendments 34 and 35.

Amendment 41, schedule 2, page 77, line 21, at end insert—

“(3) Where the patient has not yet reached the age of 16 (the ‘child patient’), the nominated person must be a person with parental responsibility for the child patient, unless the factors set out in sub-paragraph (4) below apply.

(4) A person who has parental responsibility for a patient under the age of 16 (‘the parent’) must not be the nominated person if—

(a) the parent is subject to a prohibited steps order under section 8 of the Children Act 1989;

(b) a local authority is taking action under section 47(8) of the Children Act 1989 to safeguard the child patient or otherwise protect the child patient’s welfare due to concerns about the parent; or

(c) the local authority has made enquiries under section 47(1) of the Children Act 1989 and concluded that the child patient is suffering, or is likely to suffer, harm at the hands of the parent (within the meaning of section 31(9) and (10) of that Act).”

This amendment would stipulate that the nominated person for a patient under the age of 16 must have parental responsibility for the patient, unless there are safeguarding concerns.

Amendment 42, page 80, line 13, after “2(2))” insert

“, has parental responsibility for the patient, subject to conditions (see paragraphs 2(3) and 2(4)),”.

This amendment is connected to Amendment 41; it would stipulate that the nominated person for a patient under 16 must have parental responsibility for the patient, unless there are safeguarding concerns about that parent.

Amendment 5, page 86, line 38, at end insert—

“18A In section 130B (arrangements in relation to independent mental advocates: England), after subsection (3)(d), insert—

‘(e) support the patient’s carer and family members to prepare for the patient’s discharge from hospital treatment, and

(f) support the patient to access help with social and financial stressors that might otherwise increase their likelihood of future detention.’”

This amendment extends the support offered by Mental Health advocates to cover social and financial stressors and support for family carers and other members of the household when the patient is discharged.

Amendment 23, schedule 3, page 90, line 32, after “patient” insert

“or English qualifying informal patient under 18”.

This amendment extends the provision of opt-out advocacy services in England to informal in-patients under 18.

[Zöe Franklin]

I am honoured to open today’s debate on Report and to have served in Committee, where it was clear that Members on both sides of the House shared a commitment to high-quality mental health care for those in crisis. I thank my colleagues who also served in Committee; it was an informative and moving discussion. It is that commitment to high-quality mental health care that underpins new clause 2. It addresses a critical issue: the inconsistency and inadequacy of care in mental health units across England.

I am sure we have all heard distressing accounts of vulnerable individuals being placed in units that are understaffed, unsafe and ill equipped for recovery. Families entrust the system with their loved ones during moments of crisis, only to find that trust undermined—not by a lack of compassion, but by a lack of national direction. New clause 2 seeks to change that by establishing a national strategy and annual reporting to ensure that every mental health unit is safe, well-staffed and fit for purpose.

In my Guildford constituency, a family recently shared with me their experience of a loved one’s stay in a mental health facility. The unit was understaffed from the outset and wards were mixed in age and illness, with little therapeutic structure. There was no clear advocate or caseworker, and the family did not know whom to contact. They described a system that, in their words,

“dishes out drugs without improving mental health or wellbeing.”

The setting was so short-staffed that their loved one was able to self-harm—an unacceptable failure in any care setting. New clause 2 aims to prevent such failures from recurring.

The Care Quality Commission has repeatedly raised concerns about the safety of mental health wards, citing staff shortages, poor infrastructure and environments that are unfit for therapeutic care. In 2023, the King’s Fund reported that 40% of NHS mental health providers were rated “requires improvement” or “inadequate” on safety—figures that would be intolerable elsewhere in the health system. The Health Services Safety Investigations Body has identified systematic risks in in-patient mental health care, including delayed responses to distress, inappropriate use of restraint and a lack of therapeutic staffing models. Perhaps most starkly, the British Medical Journal reported over 17,000 serious incidents in mental health services between April 2022 and March 2023. Each one was a moment when care went seriously wrong. These are not just statistics; they represent real people who deserve better.

New clause 2 would require the Secretary of State to publish a national strategy within 12 months to ensure that all mental health units meet or exceed “good” safety standards under the CQC framework, and to report annually to Parliament. It focuses on three key areas: recruitment, retention and training of staff; safe staffing levels and patient-to-staff ratios, especially during nights and peak times; and ongoing accountability through public reporting. The new clause would make patient safety a national obligation, not a postcode lottery. It is about responsibility and transparency.

Although the Bill modernises detention criteria and patients’ rights, it does not explicitly require the Secretary of State to guarantee basic safety and staffing standards, and new clause 2 would fill that gap. Some may worry that it would be too prescriptive or add bureaucracy, but it would not replace local management; it would support it. It would build on the CQC’s role by ensuring that action is taken when failings persist, and it would turn inspection findings into a driver of national improvement.

On cost, unsafe care is already expensive. It leads to readmissions, litigation, staff burnout and the loss of public trust. A national strategy would allow for smarter investment, preventing failures rather than paying for them later. We have had decades of guidance and reviews, but what we have not had is statutory accountability. My new clause would deliver that.

New clause 2 is focused, deliverable and urgently needed. It complements the Bill by ensuring that the rights it enshrines are backed by safe, well-staffed and properly regulated environments. Without it, we risk legislating for rights in theory while leaving patients unsafe in practice. By supporting it, we affirm that mental health care deserves the same national standards as any other branch of healthcare. I urge Members to support new clause 2 and make safety, dignity and accountability a permanent part of our mental health law, and I look forward to the debate in this House today.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Members will have noticed that many people are standing to speak and there is not a significant amount of time for the debate, so with the exception of Front-Bench contributions, there will be an immediate four-minute time limit. I call the shadow Minister.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

When we last debated the Bill on Second Reading, I said that protecting someone’s freedom for their own safety is not a licence to own their life, but a duty to help them find it again. That principle still guides us today, because good intentions alone do not mend a troubled system. Compassion without competence is not care; it is sentiment without substance.

On Second Reading, I spoke of bridges and rough roads, and of how resilience and recovery depend on the strength of the structures that carry people through their hardest times. Tonight, we return to that bridge. The question before us is not whether we believe in reform—after all, there is cross-party agreement on that—but whether the Government have built the foundations to make it stand. Warm words are plentiful, but the reality is that too many people are still falling through the gaps: detentions are still present, community services are stretched, and families are left navigating a maze of bureaucracy while waiting for help that may never come.

We all know that reform cannot be delivered on aspiration alone. It requires a delivery plan, a workforce and a system capable of learning from its own mistakes. We know the chapter on delivery is missing from the 10-year NHS plan and there is further risk tonight that we miss another opportunity. After all, the principles in the Bill are the right ones. They are even on the face of the Bill—choice and autonomy, least restriction, therapeutic benefit, and treating the person as an individual—but those principles need power behind them and that power lies in delivery.

This Report stage is our chance to turn those words into commitments. New clause 31 requires the Government to publish a fully costed delivery plan within 18 months of the Act passing into law, setting out how integrated care boards and local authorities will deliver adequate community services. Crucially, the plan must be developed through consultation with those who know best. That is vital, because although we support the many aims of the Bill, the Government already have a pretty dismal record of announcing reforms without any credible plan to deliver them.

Let us take the ongoing NHS reorganisation. In March, Ministers made a surprise announcement of the abolition of NHS England and its absorption into the Department of Health and Social Care, yet six months on they cannot say what it will cost, how many staff will be lost or how it will be paid for. The Health Service Journal reports growing confusion inside the system and warnings from NHS leaders that the lack of clarity risks paralysing decision making. Written questions to the Government simply receive the answer

“some upfront cost in the millions”

yet independent estimates say the cost is over £1 billion. Even the chief executive, Sir Jim Mackey, points out that the Treasury must agree funding for integrated care board redundancies within weeks or the NHS will have to turn to a plan B.

The same chaos is playing out across integrated care boards, with local leaders warning that there is already destabilisation due to the 50% reductions. If Ministers cannot manage their own top-down reorganisation, why should anyone believe they can deliver a more ambitious overhaul of mental health services without a clear costed plan, especially when waiting lists have risen in the last three consecutive months?

This Labour Government have already cut the proportion of spending on mental health. As Dr Lade Smith CBE, the president of the Royal College of Psychiatrists, said at the time:

“It is illogical that the share of NHS funding for mental health services is being reduced at a time of soaring need and significant staff shortages.”

Going on, she said that:

“The proportion of NHS funding allocated to mental health services will decrease”,

which will

“equate to these vital services missing out on an estimated £300 million or more that they would have received if their share…had been maintained.”

--- Later in debate ---

[Mr Richard Quigley (Isle of Wight West) (Lab)]

I will speak to new clauses 28 and 36 and amendment 39, which I tabled not just as an MP but as a father. After what my family have been through, I believe that any parent would do the same.

Yesterday, alongside the right hon. Member for Salisbury (John Glen), I had the privilege of hearing Dr Kate Szymankiewicz speak about her daughter Ruth. She shared not only the tragic circumstances of Ruth’s death but the type of person Ruth was: her dream of becoming a vet, her kindness, and how friends described her as a character straight out of an Enid Blyton novel. That is the Ruth her family remember and cherish. As parents, we became part of a world we never wanted to know. I am privileged to have met Kate, but we agreed that we wished our paths had never crossed because of what that meant.

Ruth was admitted to an in-patient facility for treatment of an eating disorder, but instead of receiving the care she needed, her family were shut out and allowed only two two-hour visits per week. They spent more time travelling than they did with their daughter. Ruth was just 14 years old when she fatally self-harmed, just five months into her stay.

Three months from that date, my family were faced with the same hospital, Huntercombe, as the only choice of a bed for our daughter. At that same hospital, when a child asked if they could have an extra type of jam for breakfast in the morning, they were told it did not have the budget, and when asked why Minstrels were no longer part of snack time, they were told that they were eating too many. That is the problem with NHS-funded private provision: even at £900 a night, the operators plead poverty.

My wife and I have two vivid memories of our youngest being prised from us without any warning. We thought that was normal. Six months of nasogastric tube feeding—we thought that was normal. Illegal restraint so bad that it caused post-traumatic stress disorder—we thought that was normal. Forgetting to feed our daughter 11 times—we started to realise that that was normal, but not acceptable. Instead of wishing to improve its practice, the hospital has accused me of making this up.

If a child is facing any other physical illness such as cancer, or even something more short-term that requires a hospital stay, parental visits and involvement are quite rightly seen as a means of enhancing care. I genuinely struggle to understand why our clinical consensus around mental health continues to support a model where already vulnerable children are isolated from their parents—the very people who know and love them most. Children on these wards are treated as wilful—they are not; they are children—and without empathy or sympathy. Many consultants we encountered opted not to apply the National Institute for Health and Care Excellence guidelines. Staff were poorly trained and in fear of psychiatrists, who ruled the roost and prevented people from speaking up. The private equity firms are focused not on long-term treatment but just on turning mental health into money.

My amendments do not seek to undermine the Bill’s strengths, nor the important work undertaken by the Department. In fact, the cross-party support I have received, including from the right hon. Member for Salisbury, reflects how uncontroversial they are.

The Minister and I have had robust and constructive discussions on the matter, but I ask him to confirm that he will do everything in his power to ensure the following. Parents must not be shut out of their child’s care, as evidence shows that regular parental contact enhances care outcomes. The placement of children on adult mental health wards under the Mental Health Act must be limited strictly to exceptional circumstances, and practitioners must be actively compelled where appropriate to involve themselves in the development and delivery of a child’s care and treatment plan.

We have a duty to ensure that the tragic circumstances surrounding Ruth’s death are never repeated. The Government were elected with a phenomenal majority, winning places we never thought possible—including my own constituency of Isle of Wight West—on a platform of meaningful change. If we do not use this moment to do the right thing and acknowledge that children in mental health services need their parents more often than not, I fear that we may never get another chance.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.