Mental Health Bill [Lords]

Nusrat Ghani Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I 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.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Chris Coghlan (Dorking and Horley) (LD)]

Eight months ago, in my maiden speech to Parliament, I said that Fiona Laskaris would succeed in changing the law that prevented her from saving her autistic son, Christopher, from murder. I am here today to honour that commitment. We are on the cusp of changing the law. We have got this far thanks to the National Autistic Society; MPs from across the Chamber working together to overcome injustice, including the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), the hon. Member for Rotherham (Sarah Champion), the right hon. Member for Leeds South (Hilary Benn) and my right hon. Friend the Member for Kingston and Surbiton (Ed Davey); steadfast support from my party, the Liberal Democrats, and support from the Prime Minister and the Government, in a way that represents Parliament at its best; and Elisa Menendez and Romilly Weeks from ITV, who ran the story. Above all, we got this far because of the courage and determination of Fiona Laskaris to save others from the fate that befell her son, Christopher. Fiona and Cara, Christopher’s sister, are in the Gallery.

Christopher was not unlike many autistic children. He was a sensitive, intelligent, loving and compassionate boy, who once asked his mum to stop on the way to school to rescue a lamb that was stuck in a fence. I first met Fiona when I was eight. I stayed in my bedroom and ignored her, perhaps because I was angry that she was buying my home off my dad; my mum had died when I was a few months old, and I was a sensitive boy. Well, they moved in; Christopher grew up in my old bedroom, and he loved the house as much as I did, but as a young man living alone in Leeds, he struggled. Despite Fiona pleading for help for years, she was never able to attain for him the mental capacity assessment that he needed to determine his support requirements. Horrifically, he was exploited and murdered by a man who had just been released from jail. Christopher was 24. We are working with the Government on an amendment to the Bill to ensure that the views of family members are considered when determining an adult’s requirements for a mental capacity assessment.

Christopher’s story is not unique. King’s College London found that in 2022 alone, there were 95 preventable deaths of people with autism and learning disabilities in cases in which the Mental Capacity Act 2005 had not been correctly followed. It can be hard to grasp the scale of the special educational needs and disabilities crisis in this country, but tens of thousands of SEND children are out of school, including 1,800 in Surrey alone. We are losing autistic children, including my constituent Jennifer Chalkley, to avoidable suicide, and, at worst, we are abandoning autistic people in their 20s to murderers; we are failing a generation. How we answer their call for justice will serve as a measure of who we are, and I believe the answer is less a matter of money than of leadership. We know from Nobel laureate James Heckman that early intervention is exponentially more effective and economical in today’s brutalised system, which has cost the lives of Christopher, Jennifer and too many others.

Although this amendment is only a small part of the answer, it can save lives. If one grieving mother can change the law, perhaps we can change the other things, too. If we succeed, it will be above all because of the voices of broken but unbeaten parents, like Fiona, demanding change. Although Christopher had a difficult life, he had the most precious thing that any man can have: a loving and devoted mum. It is up to us to ensure that Fiona is a witness that in our country, it is possible for the vulnerable to be heard, for injustice to be overcome, and to find, beyond grief, hope.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was a very moving speech.

--- Later in debate ---

[Jen Craft]

I will come to that point a little later, but that confinement is detrimental to their mental health. It can sometimes be hard to pick apart a co-existing or co-occurring mental health condition from the behaviour exhibited within that environment. This is part of the reason that it is all but impossible for some detained individuals, in the circumstances they are in, to demonstrate the behaviour change they need to prove they have become sufficiently well to be released.

My attention was drawn last year to the case of a young woman called Bethany, who was detained for the best part of half a decade under the Mental Health Act. She is an autistic young woman whose parents believed that her entering a secure unit was the best choice. However, she ended up being locked up for days, weeks and then months on end in a room with only a mattress on the floor. She was unable to see her family or her support network, and her parents were absolutely devastated at being unable to get her out of that environment and seeing her continually deteriorate. It is hard to imagine the anguish of people seeing someone that they love go through this. When this happens to someone or their family, how on earth can they ever again trust the system that put them there? Learning disabled people and autistic people who have been through that have their confidence in accessing support taken away. In turn, that can create a vicious cycle.

I strongly welcome the moves that this Bill makes towards removing learning disability and autism as a reason alone for detention. However, similar to my hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), I note that the Government have said that these changes to detention criteria will only be switched on when systems can demonstrate a sufficient level of community support. That is a source of real concern. As the NHS Confederation has warned, the

“success of the reforms will be dependent on the wider infrastructure to support”

the Bill. As others have said, there is no clarity on what a sufficient level of support means in practice. We do not know where we are heading or when we will have got there.

The most successful support for learning disabled and autistic people to live independently in their communities is integrated care that encompasses health, housing, occupation and much more besides. I would welcome the Minister’s assurances on how that will be delivered in the timescales set out and how we get from where we are now to where good is. The continual detention of people in this way should shame us all, and an end to that cannot come fast enough.

I sound a note of caution—I think this is fairly similar to that of the hon. Member for Runnymede and Weybridge—that the legislation continues to allow for the co-occurrence of mental health conditions to be a reason to detain someone with a learning disability and autism. That in and of itself could lead to this continual cycle where people are detained for longer than is necessary for their treatment while in an environment that is entirely counterproductive to them becoming well. We also need those with a specialism in learning disability and autism to be present in assessing whether an individual also has a co-occurring mental health condition.

Finally, I put a plea in to the Minister that there is a real need for those who live with a learning disability or autism to be properly consulted. A number of disabled people’s charities that are run by people with a learning disability, such as the “Bring People Home from Hospital” campaign, which is operating under the auspices of Inclusion London, do not feel that they have had sufficient opportunity to input. A very minor point is that some relevant documents related to this legislation have not been printed in easy read. If they have, it has taken a while for them to arrive. People who have a lived experience of these conditions are unable to contribute in a meaningful way.

More broadly, I welcome the legislation’s attempt to make progress in putting patient voice at the heart of care, particularly through advance choice documents, but there is scope to go further. The Royal College of Psychiatrists is advocating for a statutory right to an advance choice document, which the pre-legislative scrutiny Committee also recommended. That would ensure that all patients who would benefit from one would get one, with the aim of reducing detentions and involuntary treatment. While I recognise the importance of this step and this legislation alongside the Government’s investment in mental health crisis centres, a pledge to recruit 8,500 mental health staff and the Secretary of State’s commitment to the mental health investment standard, there is a desperate need to transform community mental health services to put patient voice and experience at its heart and avoid the need for detention orders in the first place.

As a member of the Health and Social Care Committee, I have had the privilege of hearing from some extraordinarily courageous individuals who shared their experience of living with a serious mental illness. It is in that same spirit that I will share my own experience now. I hope that it offers an insight into the limitations of our current system.

I was diagnosed with obsessive compulsive disorder as a teenager, and with bipolar disorder in my 20s. In two and half decades with these conditions I have received good care, but sadly that is the exception and not the rule. I have never been asked what it is that I want from treatment, what it is that I want for my life, and how I can be helped to get there. I have received care that is patronising, reductive, inconsistent and non-existent. During mental health crises I have had to tread a fine line between proving that I am ill, and sometimes extremely ill, and proving that I am not so ill that I need to lose my liberty, because I know that more often than not, treatment is based not on therapeutic care but on risk management. Like thousands of others, I have had to create my own care package and my own route to treatment, because I made the decision that I deserved to live, and I deserved to live well—and also that my children deserved their mum. However, I am very aware that my ability to do this is based on a number of privileges, in no small part a very supportive family, which so many do not have.

While I welcome the Bill for its advances in reducing the amount of detention and increasing the agency of those who are detained, I must call for a significant overhaul of community mental health services to prevent crises from occurring in the first place. We know that we can and must do better. I ask all Members to note that when we discuss people’s serious mental illnesses, we often talk as though they were “others”, which they are not. Let me say this: “There is someone standing here among you, a Member of Parliament, who has a serious mental illness. It does not prevent me from doing my job or from living my life; in some ways, it makes me better at it.” While the Bill continues its passage through Parliament, can we please bear in mind that we are talking about individuals, and individuals who will be affected by it, and that what we seek to do—and what I hope we will accomplish—is give people who live with serious mental illnesses the ability and the right to live the best lives that they possibly can, with all the support that we can make available?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The hon. Lady’s family must be very proud.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I want to retain the tone of this debate, but to get everybody in, we will have a speaking limit of seven minutes, which is still quite a long time.

Mental Health Bill [Lords]

Nusrat Ghani Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

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

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

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

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

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

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

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

[Madam Deputy Speaker (Ms Nusrat Ghani)]

To squeeze in a few more Back Benchers, the speaking limit is now three minutes.

[Layla Moran]

This is a long-overdue and very welcome Bill, but frankly it will not even touch the sides of what most of our constituents and communities need when it comes to the wider mental health landscape. I support many of the amendments to improve it, not least those laid by my hon. Friends on the Liberal Democrat Benches. I need to make a couple of quick points, because we want the Bill to succeed.

The Minister will know that since December the Health and Social Care Committee has been conducting an inquiry into community mental health services, because we recognise that unless we start tackling these matters upstream, we will not achieve the Bill’s aims. For so many, it feels like they are walking through an NHS desert: they simply cannot get the appointments they need; they do not feel supported; and no one can navigate this complex system.

Just a few weeks ago, while still on maternity leave, I decided to have a keeping-in-touch day and the Committee decided to visit an oasis in this desert—the incredible Barnsley Street neighbourhood mental health centre in Tower Hamlets. Unfortunately, the centre is one of only six pilots set up to this level across the country, but we heard some amazing stories of how people had been diverted away from in-patient mental health units by an approach that truly puts the patient at its centre. It was inspiring. However, we heard from the centre that its funding will not continue beyond April. It is only just starting to gather the data it needs; system change is desperately needed in this space, but the concern is that the system will change without robust data behind it. My question to the Minister is, will the centres be funded beyond April? If not, how can the Department make decisions about the system based on data that does not represent a full calendar year?

I also want to speak in support of amendment 9. I pay tribute to Cyril and Dianne whose son Leon suffered from schizophrenia for many years and sadly completed suicide in January 2019. He was let down by community mental health services. Leon’s mother, Dianne, saw the illness get worse and worse, and when she tried to re-refer him into the system after he had been detained, she was told, “Computer says no.” This Bill will improve the lives of families like Dianne and Leon’s, because Dianne’s pleas would have been heard under the new nominated persons provisions. Amendment 9 would be an extra step, ensuring that the plan is shared with parents and carers—with the nominated person. I pay tribute to those who have campaigned so doggedly for the inclusion of nominated persons in the Bill.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Jen Craft to make the final contribution. All those who have contributed to the debate should make their way back to the Chamber.

[Jen Craft (Thurrock) (Lab)]

Thank you very much, Madam Deputy Speaker—I will be as brief as possible. I will speak to new clause 37, which stands in my name and which seeks to support the Government in ending the scandal of the inappropriate detention of people with a learning disability and/or autism. I declare an interest as the chair of the all-party parliamentary group on learning disability.

Currently, a learning disability or autism, in and of itself, can be grounds for detention under the Mental Health Act. As we all know, this is an absolute scandal—something from a previous age that should be a source of moral shame to everyone in our community. The Bill seeks to address this by removing autism or a learning disability, in and of themselves, as criteria for detention under the Mental Health Act. That offers a lifeline—a light in the tunnel of darkness that a number of people who are detained under the current Act face.

However, the impact assessment for the Bill states that the proposed changes to the detention criteria in clauses 3 and 4

“will only be switched on when systems are able to demonstrate sufficient level of community support”.

The families and carers of those have a learning disability or autism and who are detained under the Mental Health Act, and the organisations that support them and people who advocate for them, know that too often this vulnerable group of people are pushed to the bottom of a list of competing priorities, and very often slide off it.

We know that this Government and the Department of Health and Social Care have a number of competing priorities to deliver on, and the concern for people who fall into this bracket under the legislation is that their concerns just will not be addressed and that this absolute scandal will continue in perpetuity. People who have a learning disability or autism will be detained because our community services just are not up to snuff; we have so categorically failed them that the only thing we can think to do is to lock them away from society.

--- Later in debate ---

[Stephen Kinnock]

I am really struggling for time. I am sorry, but I cannot take any more interventions, because it is not fair to Members who have tabled amendments.

Amendments 41 and 42 would prevent children with competence from choosing a step-parent or kinship carer as their nominated person if that is the most appropriate person for them. A nominated person can be overruled or displaced if acting against the child’s best interests. Parents will always maintain their rights under the parental responsibility.

Many amendments concern statutory care and treatment reviews designed to help to ensure that people with a learning disability and autistic people receive the right care and treatment while detained and barriers to discharge are overcome. Reviews will happen within 28 days of detention, and at least once a year during detention. This can be more frequent, depending on needs. Patients’ families and advocates can request a review meeting at any point. In respect of new clause 32, we have consulted on making some restrictive practices, including long-term segregation, notifiable to the Care Quality Commission within 72 hours.

Let me now deal with amendments 14 and 26 and new clauses 31 and 37. I acknowledge the importance of having a clear plan to resource community provision for people with a learning disability and autistic people to implement these reforms. We have committed ourselves to an annual written ministerial statement on implementation of the Bill post Royal Assent. Following conversations with my hon. Friend the Member for Thurrock (Jen Craft), we will work with stakeholders, including people with lived experience, to shape our road map for commencing changes to clause 3. The written ministerial statements will give updates on progress, as well as setting out future plans. It is not possible at this stage for us to commit ourselves to the specifics of implementation and community support, which depend on the final legislation passed, future spending reviews, and engagement with stakeholders to get implementation planning right.

As for the concerns raised by my hon. Friend the Member for Shipley (Anna Dixon) about the detention criteria in the Bill, it is vital that the work “likelihood” is included in those criteria to set clear expectations of what clinicians need to consider. However, we are clear about the fact that our intention is not to set a threshold for detention. Under the new criteria, a harm does not have to be likely to justify detention. The criteria require likelihood to be considered holistically, alongside the change, nature and degree of the harm.

I know that the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) is keen for me to deal with the question of public safety. The key point is that there are detention criteria in clause 5, which makes a clear reference to harm either to the patient or to other persons. That is clearly a consideration of public safety, and we therefore believe that amendment 40 is surplus to requirements.

I trust that, on the basis of the assurances I have given, Members will be content not to press their amendments and new clauses.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Zöe Franklin, is it your pleasure that new clause 2 be withdrawn?

[Zöe Franklin]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

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 multidisciplinary 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.””—(Dr Chambers.)

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

Brought up, and read the First time.

Question put, That the clause be read a Second time.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Before I ask for the next decision, I remind colleagues in the Chamber that once the doors are locked, Members should not be forcing themselves through the doors to either Lobby.

--- Later in debate ---

[Stephen Kinnock]

I beg to move, That the Bill be now read the Third time.

Since the Mental Health Act 1983 was passed, and since it was updated in 2007, attitudes towards mental health have shifted dramatically, and our understanding has grown, but the law has been neglected. That is why this Government were proud to announce this Bill in our first King’s Speech, fulfilling our manifesto commitment and taking the first steps towards ensuring patients are consistently treated with dignity and respect—promise made, and promise delivered.

It is clear that adults and young people with mental health issues have been let down for years, which is why we are transforming the current mental health system through our 10-year health plan, including through recruiting more than 8,500 additional mental health workers, delivering more NHS talking therapy appointments than ever before, increasing the number of mental health crisis centres, and providing access to a specialist mental health professional for every school in England.

Today, we are another step closer to delivering the reforms to dealing with people with severe and acute mental health disorders, a step closer to strengthening and clarifying the criteria for detention, and a step closer to better supporting clinicians to make the right decisions around appropriate care and treatment, including community treatment orders. We want to make sure that patient choice and patient needs are at the heart of decision making. That is why we are introducing these reforms to enshrine in law measures such as the clinical checklist, the use of advance choice documents, the role of nominated persons and the expansion of advocacy services.

We are increasing the scrutiny and oversight of compulsory detention. We are making sure that those patients who are detained have a clear path to recovery and to discharge. We are introducing statutory care and treatment plans for all patients, so that their needs are met both during and after their hospital stay. To reduce reliance on in-patient care and ensure that people with a learning disability and autistic people get the right support, we are limiting the scope for detention. We are also introducing a package of measures to improve community support, including statutory care, education and treatment reviews and dynamic support registers. We are introducing stronger safeguards for people who lack capacity or competence to consent to treatment—a potentially highly vulnerable group. Those patients will receive a second opinion-appointed doctor at an earlier stage in their treatment.

This Bill has been the product of years of work predating this Government, and it is right that we thank hon. Members and peers for their scrutiny and support over many years. We should particularly note the work of the former Prime Minister Baroness May for launching the independent review that paved the way for this legislation, along with the review chair, Sir Simon Wessely, and his vice-chairs, Steven Gilbert, Sir Mark Hedley and Baroness Neuberger.

I thank Members who served on our Public Bill Committee, including the Chairs, and the clerks and all the parliamentary staff who have worked hard to ensure that the Bill was subject to the proper scrutiny while ensuring smooth and quick passage. I also thank the Joint Committee on Human Rights and particularly Lord Alton for its report and recommendations. I am grateful to the devolved Governments for their support during the Bill’s passage and to the Welsh Senedd and Northern Ireland Assembly for granting legislative consent. I thank the Bill team, my private office and all the officials and stakeholders over numerous years who have worked hard to get this legislation to where it is today.

Above all, thanks go to those with lived experience who have bravely shared their personal experiences with us through the independent review, through our consultation with stakeholder groups and through Members across both Houses. The Bill is the product of sustained effort over a number of years. That work will continue following the Bill’s Royal Assent, but none the less it is an important moment to acknowledge and pay tribute to those who have got the Bill to where it is now.

The work continues as we look to implement the legislation. The first priority once the Bill gets Royal Assent will be to draft and consult on the code of practice. We will engage closely with people with lived experience and their families and carers and with commissioners, providers, clinicians and others to do that. Much has been done, but there is much more to do. This Government are delivering on our commitment to modernise the Mental Health Act, and the work begins now to deliver that change on the ground. The Bill will of course now go to the other place, and I thank peers for their previous extensive consideration. I hope the noble Lords will be able to agree to the changes made in this House, so that the Bill can make swift progress to Royal Assent. I commend this Bill to the House.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I want first to recognise and thank everyone for the constructive debates we have heard here and in the other place throughout the Bill’s passage. In particular, I thank the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), for everything he has done on the Bill, especially in Committee. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his expertise, whose involvement with the Bill began before he was elected to this place. I also pay tribute to my right hon. Friend the Member for Salisbury (John Glen) and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford) for their thoughtful contributions.

This is clearly an important and emotive issue, and the respect and sensitivity that have been shown by all sides is a testament to this House. Since the election, we have said that we would not oppose for the sake of opposition. While we have rightly asked tough questions of the Government, we have done so with the best interests of patients at heart, because everybody here wants to help and support vulnerable people better—those patients with the most severe and complex mental health needs. This Bill, which started under the previous Government—I pay tribute to former Prime Minister Baroness May for that—and continued under this Government, will achieve that. We welcome efforts to improve the patient’s voice and involvement in their own care, to ensure that patients receive effective and appropriate treatments, to minimise restrictions on liberty so far as is consistent with patient and public safety, and to treat patients with dignity and respect.

Although we are disappointed that opportunities to strengthen the Bill further have been missed, especially in public safety and the protection of vulnerable children, we listened closely to what the Minister said and to his assurances on action, for which we thank him. We will of course continue to push on these matters, not on party political grounds, but because doing so is the right thing for patients.

We are very disappointed that the proportion of health spending on mental health has been reduced. We welcome the Government’s continuation of our work looking again at how we treat and protect people with the most severe mental health illnesses, so that we can improve the safety, treatment and dignity of patients and the wider public, and ensure that our laws remain relevant and proportionate in the modern world. The Government must now turn their words into action and deliver on the commitments that they have made.

I thank everybody again for the constructive way in which they have dealt with the Bill. We are pleased to support its Third Reading. We hope that it will bring improvements for those we all care about: the patients.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.