Mental Health Bill [ Lords ] (Fourth sitting)

Natasha Irons Excerpts

Committee stage
Thursday 12th June 2025 Public Bill Committees

I welcome the thinking behind the new clause, and I share the concern that young people need strong and clear safeguards, but I gently suggest that the best way forward would be to enhance guidance, clinical standards and meaningful consultation, rather than to introduce a new statutory requirement. I hope that my comments to the Liberal Democrats are clear, and that I have adequately set out my concerns about clause 20 to the Government. We will not divide the Committee.

[Natasha Irons (Croydon East) (Lab)]

It is an honour to serve under your chairmanship, Mr Vickers. I will speak briefly in support of clause 20 and comment on some of the issues surrounding new clause 5. Clause 20 aims to update wording in the Mental Health Act 1983 in regard to a patient’s capacity and competence to consent to treatment. That is in line with terms that clinicians use in practice across the piece. It provides consistency with the Mental Capacity Act 2005.

Although the clause is not expected to create practical change in clinical care, it does something vital that I would like to draw out. These changes bring forward the recognised and well-established ways that we give people the power to inform their future care and treatment if they get ill in the future. As my hon. Friend the Member for Thurrock so eloquently put it earlier, the ability to plan ahead for one’s care speaks to the heart of what we are trying to do with the Bill, namely to put people at the centre of it, but allow dignity in treatment and authority over one’s own healthcare. That is an important point to draw out in this clause.

Let me turn to new clause 5. The shadow Minister teased out a lot of detail around the Gillick competence test, which is used not just in one setting, but across multiple settings. I completely understand the need to ensure that our young people are empowered to make decisions, but the new clause may have the unintended consequence of making it harder for young people to be involved in their own treatment and have control over what they want to do with their health. We are not quite in the place where we need that statutory test.

It would be helpful to tease out from the Minister a little more about the plans to review the code of practice, which he mentioned in his opening remarks. What does he hope to see when we consult with clinicians on this? How can we be confident that clinicians will feel empowered to allow young people to take some control in their healthcare?

[Zöe Franklin]

I rise to speak in favour of new clause 5, which would require the Secretary of State to undertake a review into whether the statutory competency test for under-16s would be expedited under the Mental Health Act. It has been great to hear so many contributions from colleagues on the Committee about the challenges that young people face when discussing their mental health and wellbeing and being involved in decision making around their health.

As my colleague Baroness Tyler noted in the Lords, and as the hon. Member for Hinckley and Bosworth noted in his early comments, the consistency with which Gillick competency is interpreted in the case of young people is a bit of a grey area. That is the key reason why we have tabled this new clause. We want young people to be empowered to be involved with decisions around their mental health. It is not hard to imagine how traumatic it must be for an under-16 to refuse treatment when they fully understand and object to it, yet be overridden because no one is quite sure how to assess their competency robustly. We believe that, at the very least, we owe it to young people to ensure that our legal framework is coherent, fair and protective of their rights.

The new clause would allow the Government to lead that conversation in a measured and consultative way. A statutory review would bring much-needed evidence and direction to a complex but critical issue. I am disappointed that the Minister will not consider the new clause, but I will withdraw it for expediency. However, it has been good to hear the commitment from the Minister to consulting on and reviewing this issue. The Liberal Democrats look forward to hearing more detail on it in the future and to being part of that conversation.