Mental Health Bill [Lords]

Stephen Kinnock Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I thank everyone in the Chamber for their contributions to today’s debate. I will start by talking about the deeply moving contributions regarding the tragic death of Ruth Szymankiewicz. I extend my heartfelt condolences to Ruth’s family, and I pay tribute to my hon. Friend the Member for Isle of Wight West (Mr Quigley) and the right hon. Member for Salisbury (John Glen) for so powerfully advocating on behalf of Ruth and her family. The circumstances around Ruth’s death were unacceptable and should never have happened. We acknowledge multiple failings in her care.

Turning to the amendments, while we are not accepting any changes to the Bill, I hope that I can assure the House, in the short time remaining, that we are taking action to address the concerns that have rightly been raised. In relation to new clauses 6, 7, 29 and 36, we absolutely do not want young people placed in adult wards, and we are clear that patients should get treatment close to home. However, further legislative restrictions on placements risks leaving clinicians without options in emergencies or preventing treatment that is in the patient’s best interests. NHS England has worked with hundreds of children and families to develop a new service specification for children and young people’s mental health services. The specification is for commissioners and providers to follow, defining the care expected from organisations funded by NHS England to provide specialised care.

[Mr Bayo Alaba (Southend East and Rochford) (Lab)]

Will the Minister give way?

[Stephen Kinnock]

I will, but I have got little time and a lot of amendments to address, so I will not take any further interventions.

[Mr Alaba]

I had the privilege of meeting Helena and Christina, who shared with me the challenges they faced when their mother was sectioned when they were young girls. For two weeks, the responsibility for care was left entirely in their hands while local services struggled to find a suitable bed. Can the Minister confirm that through the Mental Health Bill, in conjunction with the Children’s Wellbeing and Schools Bill, young carers will be properly identified and that the additional boost in Government investment directly into mental health services will ensure that young carers receive the support they need?

[Stephen Kinnock]

I can give my hon. Friend that assurance. One of the core purposes of this Bill is to ensure that we catch such issues, particularly around the identification of children in cases where parents are required to be detained. We will reaffirm that children should be treated in the least restrictive, most age-appropriate environment and close to home and family, and that all services would work towards alternatives to admission, such as day care and intensive home treatment, with better support for visits, including with dedicated family areas and overnight stays. We have committed £75 million for systems to invest in reducing out-of-area placements, and I am pleased to report that the number of children placed on adult wards is now decreasing, and that trend must continue.

We have also committed in the Bill to reviewing the existing CQC notification requirements, including whether notification should be extended to other incidents and whether the time period remains appropriate. We will work with families, clinicians and MPs as part of that review. Indeed, following recent conversations with my hon. Friends the Member for Isle of Wight West and for Lowestoft (Jess Asato), I have asked officials to host a roundtable next month with Members and experts on how we can provide greater clarity in the code. The focus will also be on NHS England’s service specifications and regulations on the placement of children and young people in adult wards, including determining if a placement is suitable.

The revised code, on which we will engage extensively with—among others—children and their families and carers, will provide further opportunities to address concerns raised in amendments 33 and 39 and new clause 28. The code will also address the issue of competency. We believe that that is more appropriate than a test for competency in the Act, as proposed in new clauses 15 and 25.

[John Glen]

Will the Minister give way?

[Stephen Kinnock]

I will, but can the right hon. Gentleman please make his intervention very short?

[John Glen]

I am grateful to the Minister, and I am also grateful to him for what he said about my constituent. There are so many codes of best practice, and so many guidelines. Can he say a little more about what force the code would have, so that we can have some reassurance that the risks that were so tragic in the case of my constituent will be eliminated?

[Stephen Kinnock]

The code of practice will be statutory. It is better to have these provisions in the code, because clinical practice evolves, and it is much easier to revise a code of practice than to go through primary legislation.

We understand the concerns expressed about young carers in new clauses 26 and 27, and recognise that despite existing duties, the right questions are not always being asked to identify children when someone is detained. While we do not agree that additional legal duties are needed, especially as multi-agency working is already being strengthened through the Children’s Wellbeing and Schools Bill, we do agree that we need to make the requirements more explicit. The revised code of practice will therefore specify that when someone is detained, steps must be taken to identify the children of the patient. Information about support that is available must be shared, and if a young carer’s needs assessment is required, the appropriate referral must be made.

[Alison Bennett (Mid Sussex) (LD)]

Will the Minister give way?

[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?

--- 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.