Mental Health Bill [Lords] Debate
Full Debate: Read Full DebateSojan Joseph
Main Page: Sojan Joseph (Labour - Ashford)Department Debates - View all Sojan Joseph's debates with the Department of Health and Social Care
(1 day, 19 hours ago)
Commons ChamberSimilarly, a community service called Mental Health Together has been introduced in my area. Does my hon. Friend agree that the whole mental health system is so complex, with different practices in different parts of the country, and that not having continuity and a standard across the country is a big issue for mental health?
My hon. Friend is absolutely right and I thank him for his intervention. Part of the issue around poorly reported waiting times is that it is less easy to see that differential access than it would perhaps be in physical health services. Indeed, over the years when specialist teams have been set up—for example the early intervention and psychosis teams and assertive outreach teams, which I know my hon. Friend knows well given his professional background—they have been introduced with very good intentions and to target specific needs, but they sometimes make it more difficult for patients to get overall care rather than very specialist care for individual conditions.
I will not take any more time, Madam Deputy Speaker, but I will just say that the mantra of investment and reform applies to mental health services, as it should apply to all our health services. For us to make further progress in pursuing parity of esteem between mental health and physical health, we not only need to consider these amendments today and pass the Bill to modernise the legislation, but ensure the Government have sufficient political priority on producing and improving mental health services.
My hon. Friend is absolutely right. Both he and I made those points in Committee. I am surprised that the Minister does not see the risks here. The safeguard that my hon. Friend talks about must be beyond any doubt. The amendment in his name provides exactly that clarity. It would prevent unrelated or loosely connected individuals from stepping into a role that rightfully belongs to those with both a legal duty and an emotional bond—the parents or guardians—and it would preserve the fundamental principle that parents should not find their role diminished by accident or administrative oversight.
As I was saying, this is not an abstract risk; it is a very real and foreseeable consequence of the unclear drafting. These amendments do not weaken the rights of patients. They strengthen the protections around them. They ensure that in modernising this law, quite rightly, we do not inadvertently undermine the oldest and most important protection of all: a parent’s duty to safeguard their child. We must ensure that the state can only curtail that right under the strictest judicial scrutiny, with evidence tested and the child’s welfare paramount. In doing so, we will make this legislation not only legally sound but, in my view, morally right.
New clause 31, tabled by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), would require local authorities and ICBs to supply a fully costed plan to ensure they are able to provide adequate community services for people with learning disabilities and autistic people. I support that entirely. As vice-chairman of the all-party parliamentary group for special educational needs and disabilities, and from speaking to groups in my constituency such as Last Wednesday and Growing Hope, I know that the process around SEND is complicated and not fit for purpose. Fortunately, we have a chance to help it slightly with this Bill, so I ask the Minister to support new clause 31.
I would like to speak in support of new clause 37, tabled by my hon. Friend the Member for Thurrock (Jen Craft). On Second Reading, I warmly welcomed the changes that this legislation will introduce regarding autistic people or those who have a learning disability. As a result, it will no longer be possible for someone to be detained in a mental health hospital indefinitely simply because they have autism or a learning disability. In the current system, autistic people and those with a learning disability have experienced inappropriate care, over-medication and extended periods of detention because of a lack of facilities in the NHS and social care, so this change is welcome and long overdue.
The Government have confirmed that the changes will be implemented once the necessary community provision is in place. Establishing strong support in the community is essential for not only enabling safe discharge from hospital settings but preventing unnecessary admissions in the first place. I recognise that the Government are working on setting out what strong community services look like and what resources they require to implement them. From serving with the Minister in Committee, I have no doubt about his commitment to ensuring that this community provision is introduced in a timely manner, but I support the proposal of my hon. Friend the Member for Thurrock that there should be a road map in the legislation that will provide a clear framework outlining how those services will be introduced. After all, ending inappropriate detention requires robust community-based alternatives to ensure that people with autism or a learning disability who would have previously been detained do not fall through gaps in the system.
Having a road map developed in conjunction with autistic people, people with learning disabilities, their carers and healthcare professionals will help to identify and address any gaps in service provision and workforce capacity. I also believe that it will help to reduce the risk of people with autism or a learning disability needing police intervention or emergency hospital care because the support is inadequate. By putting in place a road map, new clause 37 would help to ensure that we end all the sooner the injustice of people with autism or a learning disability being detained.
I will speak to amendments 24 to 28 and 36 to 38 in my name, which address gaps in crisis provision and accountability for autistic people and people with learning disabilities.
On Second Reading, I told this House about Declan Morrison, my constituent who died aged just 26 after spending 10 days in a section 136 suite that was wholly inappropriate for his complex needs. I remind the House that section 136 suites are designed for 24-hour stays, or a maximum of 36 hours in extreme cases. The coroner who investigated Declan’s death found that
“there is a risk that future deaths could occur unless action is taken.”
The timeline of what happened in the run-up to Declan’s death shows a cascade of systemic failures. Declan’s family, Graeme, Sam and Kaitlyn, have asked me to ensure that Parliament learns from what happened. These amendments in my name reflect those lessons and the coroner’s recommendations.
In Committee, the Minister made several points about earlier versions of these amendments, which I have tried to address in these revised versions. In particular, on crisis accommodation, the Minister argued that existing duties on ICBs already cover crisis provision and that the amendment was too prescriptive, potentially restricting ICBs in designing provision, emphasising the importance of flexibility for ICBs to meet local needs. I understand the desire not to be overly prescriptive, but in Declan’s case, over 100 places were contacted and no suitable accommodation could be found anywhere in the country. Flexibility failed Declan.
The revised version of the amendment allows for regional solutions beyond the ICB, but I suspect that the Minister will still find it too prescriptive. However, the fundamental question remains: should there not be a duty to ensure that provision exists somewhere? The Cambridgeshire and Peterborough ICB established a crisis service after Declan’s death that operated at 98% capacity, demonstrating both need and viability, but it closed when funding was withdrawn, highlighting the challenge with voluntary provision.