Mental Health Bill [Lords] Debate
Full Debate: Read Full DebateNeil Coyle
Main Page: Neil Coyle (Labour - Bermondsey and Old Southwark)Department Debates - View all Neil Coyle's debates with the Department of Health and Social Care
(1 day, 21 hours ago)
Commons ChamberI add my thanks to the Secretary of State and his whole ministerial team for bringing forward this crucial legislation so early in this Government, alongside other positive measures to fix our NHS. It was Labour that built the NHS and saved it in 1997, and here he is with his team, fixing our crucial NHS.
I serve a community, in Bermondsey and Old Southwark, with a higher prevalence of mental health conditions and psychoses. We are fortunate to have South London and Maudsley NHS foundation trust on our doorstep. This legislation will be crucial for the service professionals working on the frontline, as well as all those who need support. My borough of Southwark has additional help, funded by Southwark’s Labour council and our integrated care board, including direct access to help through online systems, and a drop-in hub for young people—a means of support that allows them to avoid GP wait times and delays in accessing help. I am glad that this legislation adopts a similar principle of ensuring early access to help, but despite the additional support in Southwark, as the local MP, I see the impact that poor mental health has on people’s lives, which are blighted by ill health and discrimination. I am acutely aware that just 5% of people with schizophrenia are in employment, for example. This Bill offers a chance to tackle some of the issues, but it is overdue.
I look forward to working with local organisations and people with direct experience, including trade unions in mental health services, carers, Blackfriars Settlement, food banks, and the drop-in clubs that support people with mental health conditions throughout Southwark, which are doing fantastic work, often on a shoe-string budget. As the constituency MP, I also see the impact on whole neighbourhoods if someone’s ill health causes them to behave erratically, and sometimes antisocially—noise and drugs are often interrelated issues. There can also be police involvement, following cuckooing by criminals who take advantage of vulnerable people. I hope that the Bill will challenge that growing phenomenon. It would be good to hear from the Minister whether communities—including landlords and neighbours, where appropriate—can trigger interventions to support people in crisis.
Just two weeks ago, I joined a ride-along with the police 999 response team. Some might say that it was not the first time I had helped the police with their inquiries. On that ride-along, which was my third with the local police, I saw again the consistent and sad overlap between what they were dealing with and mental health crises. I ended my shift with those police officers at King’s College hospital, trying to seek support for one ill man. I hope that the Government will retain the extension of section 135 and 136 powers, delivered in a Lords amendment. That would ensure that there was trained and qualified support, which would reduce the time that police lose. The amendment would save thousands of hours a week of officers’ time in London alone, and police could be redirected to areas where they are more needed.
Going back further, in the run-up to the introduction of the Mental Capacity Act 2005, I was working at the Disability Rights Commission, and I recall that mental health organisations were almost envious of that legislation, given the need to reform the Mental Health Act. They wondered when access to advocacy and patient-centred treatment would be delivered for people with mental health conditions. It is sad that there have been missed decades in between, but I am glad that this Bill is before us today.
The advance choice documents are a step towards a return to the greater choice and control lost in recent years, as services declined under the last Government. The use of nominated persons, as outlined by the Secretary of State, also offers a great step forward, as does access to extended use of independent mental health advocates for those in hospital. That should be automatic, as Mind has advocated. It is great that the legislation is based on the Wessely independent review and the principles underpinning it.
On a more personal level, and going back even further, the reason I became more aware of politics was my mum’s diagnosis of schizophrenia in the early ’80s—at roughly the time when the Secretary of State was born. Then, Rethink was still called the National Schizophrenia Fellowship. Mum has been through the mill in the decades in between. I will not suggest that she has been detained more times than I have had hot dinners—hon. Members can see by my waistline that that is not true—but the fact that the Mental Health Act has not been updated since then is appalling. When I joined the Labour party in the early ’90s, I never dreamed that I could play a part in improving legislation as an MP. I want to flag a couple of concerns, based on family experiences.
Recently, Mum told us that she believed she worked at a bank. That was news to us in the family—no doubt, it was news to the bank—as she is 75 and has not had to work for some time. I can laugh about it, but it is upsetting that she is unwell; it is frustrating that the system is mad; and trying to access support for her is maddening for us as a family. Her GP denies that she is unwell and refuses to see her. The last time this happened, she was sectioned for six weeks until she was back in rude health—and believe me, she was very rude when she came out.
South London and Maudsley NHS foundation trust estimates that it costs £3,000 a week to keep someone in hospital until they recover. NHS England has put a figure of £20,000 on detaining someone with schizophrenia until they are well. Those costs are avoidable if GPs act faster. Will the Bill result in better trigger points? This is not about artificial intelligence; it is about using known data in the system, so that there is access to supportive interventions that help individuals who have a mental health condition; help their family avoid the pain and suffering that they share when an individual is unwell; save a community the misery of associated antisocial behaviour or other problems; potentially save the police a fortune, as a result of their no longer having to accompany people to hospital for treatment, where that can be avoided; and, of course, save the NHS thousands in avoidable hospitalisation and in-patient treatment.
GPs can be part of the solution, but too often, they pass the buck and avoid the issue, as the Gardenia surgery in Luton does, pretending that everything is okay, despite prescriptions being uncollected, which leads to the inevitability of mental ill health rising fast. I hope that the Bill will lead to better community care, as the Secretary of State has outlined, but I also hope that GPs and pharmacists will be supported in triggering outreach work from mental health trusts when someone does not collect their repeat prescription, for example. I hope that it will be confirmed clearly that this will be in the legislation, or that the Government will indicate a willingness to accept an amendment along those lines.
My final, linked point is that the Bill should come with Government targets for reduced readmissions and sectioning. If the Bill is successful, people will not be discharged and readmitted in quick succession, and patients known to the system will not require routine, cyclical readmission. With the right support, the dysfunctional system can be replaced. That will have huge benefits for people’s mental health, and will mean huge savings for the NHS. There were, I think, 52,000 detentions last year. I hope that the Government will set out how that figure will fall.
I really look forward to supporting the Bill’s progression. The Bill will be transformative for the people I serve in my community, and the people I love in my family. It will be transformative for millions of people across the country—people with mental health conditions, their families, carers and service professionals—and, if it is done right, it will save the NHS a fortune, too.
I call the Liberal Democrat spokesperson.