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Mental Health Act Reform
13 January 2021
Lead MP
Matthew Hancock
Debate Type
Ministerial Statement
Tags
Justice & CourtsNHSEmploymentMental Health
Other Contributors: 21
At a Glance
Matthew Hancock raised concerns about mental health act reform in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Secretary of State for Health and Social Care, Matthew Hancock, made a statement on reforming the Mental Health Act. The current legislation was enacted in 1983 but does not adequately reflect modern understanding of mental health and public attitudes towards it. The proposed reforms aim to put patients at the centre of care decisions, ensuring they have greater autonomy and control over their treatment. Funding for mental health services has increased significantly, with £2.3 billion extra annually through the NHS long-term plan and an additional £0.5 billion to address immediate pressures.
The White Paper introduces a new Mental Health Act designed to enhance patient rights and reduce unnecessary detention. Key reforms include making care plans statutory, introducing advance choice documents for future scenarios, providing patients with a nominated person to support their interests, and increasing access to independent tribunals. The minister also highlighted efforts to address disparities in the application of the Act, particularly concerning black people who are disproportionately detained.
The proposed legislation will focus on improving mental health care within the criminal justice system and for those with learning disabilities or autism. Funding has been allocated to ensure better housing conditions and timely transfers for patients requiring treatment in hospitals. The minister committed to consulting widely before introducing a new Bill later this year.
Tooting
Question
How will the Government ensure that there are alternatives to admission for patients, thereby reducing coercion and detention? What assurances can be given about community care provisions?
Minister reply
The minister responded by highlighting the importance of enhancing community provision as a key component of mental health services. He emphasised the need for joined-up care that works effectively for patients but did not provide specific details on how this would be achieved.
Tooting
Question
What are the plans to address mental health staffing shortages and ensure that the promises in the White Paper can be fulfilled? When will a workforce settlement be announced?
Minister reply
The minister did not provide concrete assurances regarding the timing of the workforce settlement or details about filling training places. However, he acknowledged the importance of having a sufficient mental health workforce to support the reforms outlined in the White Paper.
Tooting
Question
Congratulates the Secretary of State for the White Paper, emphasising the need to involve service users in legislation and reduce coercion through community alternatives. Highlights health inequalities and disparities affecting mental health services among different socioeconomic groups and ethnicities, particularly black people overrepresented in detention. Stresses workforce commitment and requests clarification on timeframe and joint prelegislative scrutiny.
Minister reply
Acknowledges the importance of service user involvement and consensus-based approach. Confirms willingness to engage in joint prelegislative scrutiny and publication of a draft Bill. Emphasises the need for community alternatives and addresses broader health inequalities as part of the levelling-up agenda.
Question
Congratulates the Secretary of State on progress but expresses concern about delayed implementation amidst increasing mental health pressures, particularly affecting young people. Asks how to address principles from the Wessely review—reducing coercion, improving choice and care, reducing inequality and discrimination—and dealing with growing number of people with mental health issues due to pandemic.
Minister reply
Grateful for Theresa May's dedication; acknowledges urgent pressures in mental health services. Confirms additional funding beyond long-term plan during the pandemic to support acute mental health services and keep mental health strong amid difficult times.
Question
Welcomes reform addressing parity of mental health, advocacy, individual decision-making, and reducing systematic inequalities for those with autism and learning disability. Questions about treatment needs for self-harming patients not meeting a diagnosis of mental disorder and accessibility issues for comorbid mental health and addiction services, including diversion services for people with autism overrepresented in criminal justice systems.
Minister reply
Welcomes support; acknowledges challenges faced by individuals with autism disproportionately present in the criminal justice system. Emphasises importance of proper treatment within the criminal justice context and aims to improve law to ensure better support on the frontline.
Jeremy Hunt
Con
Godalming and Waverley
Question
I thank my right hon. Friend for a comprehensive response to Sir Simon Wessely’s review, which I was proud to commission at the request of the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May). However, he knows that changes in the law only matter insofar as they affect the lives of real people and his Department’s data says that we still have more than 2,000 people with autism and learning disabilities locked up in mental health units. Will my right hon. Friend use this moment to follow Italy's example and close down all such units so that these highly vulnerable people can be looked after humanely in the community?
Minister reply
Absolutely. I want to see more people cared for in appropriate settings, which will often be in the community. The number of individuals with autism or learning disabilities in secure in-patient care has significantly reduced by almost half since the target was set. However, where there is a criminal justice element, this can be more challenging. We must ensure that treatment and setting are suitable for each person. During the pandemic, some settings were closed down and we have budget allocations to build capacity through staff training and physical estate improvements.
Munira Wilson
Lib Dem
Twickenham
Question
I welcome the Secretary of State’s statement and the publication of the White Paper. Recent forecasts suggest only 71 additional consultant psychiatrists will be added to the NHS workforce by 2023-24 against a requirement of more than 1,000 to deliver the long-term plan. What measures will he take to address the additional workforce requirements of reforming the Mental Health Act?
Minister reply
That is an important question. I do not recognise the figure of 71 and will write to the hon. Lady with my full understanding, having consulted with Health Education England. We are hiring psychiatrists and mental health nurses who play a critical role in these services.
Question
Mental health is crucial for our veterans. Can he look at child and adolescent mental health services (CAMHS) as a matter of urgency? Families are waiting long periods for appointments and living through desperate times.
Minister reply
Yes, absolutely. The waiting time for IAPT services has come down considerably to 15 days in the latest data. Services for more serious conditions are under pressure, but putting more resources into them is critical.
Jim Shannon
DUP
Strangford
Question
May I thank the Secretary of State for his statement? What support has been given to GP practices in terms of mental health diagnosis and referral processes?
Minister reply
GPs are on the frontline in treating mental ill-health. Funding is increasing, and as GPs form larger groups through primary care networks, they can have more specialist help. We want closer integration between primary care, mental health trusts, and acute trusts within the NHS.
Question
I warmly congratulate my right hon. Friend on the statement. The abolition of using prisons as places of safety for those who are mentally unwell is welcome. What practical steps will be put in place to ensure that a hospital place is identified before someone appears in court?
Minister reply
Ensuring link-up across the criminal justice system is critical, and it consists of two pieces of work: building more mental health hospitals and ensuring people leave these when they can better be cared for in the community.
Question
May I thank the Secretary of State for his statement? The provision in the review to have mental health advocates is welcome. Will he work closely with the community and voluntary sectors, considering funding for those sectors so that they can provide necessary advocates?
Minister reply
I am very happy to do that. One outdated aspect of current legislation is that if someone unmarried is incapacitated through illness, decisions are automatically taken by their father. This needs changing along with support for community and voluntary services.
Question
I wish to add my voice to the tributes paid to Sir Simon Wessely who drew extensively from lived experiences of those detained under the Mental Health Act. Will he join me in paying tribute to these individuals for their contribution towards improving services through legislation?
Minister reply
Absolutely, I would like to pay tribute to those brave enough to share their testimony and also thank my hon. Friend for her sensitive handling of mental health issues during her time as Minister.
Kim Johnson
Lab
Liverpool Riverside
Question
I welcome the changes being proposed today because black people are four times more likely to be detained under the Mental Health Act and over ten times more likely to be subject to a community treatment order. Will the Minister confirm that steps will ensure care is accessible, culturally appropriate, and free from discrimination?
Minister reply
Yes, absolutely right. The figures she sets out demonstrate why it is so important we make these changes as fast as reasonably possible.
Question
I very much welcome the statement and support work this Government has done to improve mental health provision through our schools. Children and young people are a critical part of getting mental health right. Can I have an assurance that educational settings will be at the heart of these reforms?
Minister reply
Yes, absolutely. We put more support directly into schools and are rolling out mental health link workers to ensure young people get support when they need it.
Steve McCabe
Lab
Birmingham Selly Oak
Question
I welcome the Secretary of State’s approach to this issue. Can he give an assurance that independent mental health advocates will have the power to challenge treatment decisions and to make applications for discharge?
Minister reply
That is one of the purposes of having advocates in this way. Exactly how we frame that in law will no doubt be a subject for nuance and debate to get it right, and I am very grateful for the hon. Gentleman’s support.
Lee Anderson
Reform
Ashfield
Question
In December 2016, with just a few months to live, my wife received the gift of a double lung transplant courtesy of a donor, a young lady called Holly. My wife coped with the physical recovery very well, thanks to our brilliant NHS and a loving family. However, her mental recovery is ongoing. My wife fell into a depression, believing that her lungs would reject and she would die. With our new opt-out organ donor scheme, thousands more will receive the gift of life. Will my right hon. Friend please advise me on what more can be done to ensure that the mental health of donor recipients is treated on an equal footing with their physical health?
Minister reply
It is very moving to hear the personal testimony of so many people, and I am grateful to my hon. Friend for his personal testimony today of how important this is. He is right that it is not just about physical recovery; it is about physical and mental recovery.
Barbara Keeley
Lab
Worsley and Eccles South
Question
With the detention of 2,000 autistic people and people with learning disabilities who are currently trapped in inappropriate mental health units, the news that autism and learning disabilities will no longer be grounds for detention under the Mental Health Act is welcome. As well as changes to the legal framework, ending this in-patient detention means putting in place funding for community support, which has often not been available due to cuts to council budgets. Can the Secretary of State set out what additional funding the Government will be putting into those community services so that we can follow through on this much-needed reform?
Minister reply
We have put extra funding into those services. I absolutely appreciate, of course, that they are under pressure, especially with the pandemic.
Rehman Chishti
Con
Gillingham and Rainham
Question
I thank the Secretary of State for his statement and Sir Simon Wessely for the fantastic work that he and the team have done on the review. Personally, I would like to give a big thank you to Sir Simon Wessely, who helped me with two private Members’ Bills on improving mental health care. May I ask the Secretary of State this specific question: will there be proposals to have a review timeline in these measures—say, two years? As we often find in Parliament, putting forward legislation and how it works in practice are two separate things. Linked to that, will he clarify, with regard to parity of esteem between physical health and mental health, what proportion of NHS frontline staff dealing with individuals suffering from mental ill health have had the covid-19 vaccination, as well as patients suffering from mental ill health themselves?
Minister reply
I do not have the exact figure on the last question, but the total number of NHS staff who have had the vaccination is now in the hundreds of thousands. Making sure that we support the mental health of those working on the frontline in emergency departments and in intensive care units is incredibly important.
Tan Dhesi
Lab
Slough
Question
Sadly, one in eight LGBT+ young people aged 18 to 24 have said that they were tempted to take their own lives within the past year. Will the Secretary of State highlight how the Government intend to address this shocking statistic and ensure that every young person within the LGBT+ community has access to mental health crisis support?
Minister reply
One of the things that we have tried to do, which has been made more important because of the pandemic, is to ensure that access to IAPT therapies is available and that mental health support is as widely available as possible. We have managed to bring down some of the waiting times even while the pandemic is on.
Dean Russell
Con
Watford
Question
I thank my right hon. Friend and the Lord Chancellor for this landmark announcement. I am a member of both the Joint Committee on Human Rights and the Health and Social Care Committee, and we have covered the serious impact of the Mental Health Act in detail, particularly on people with learning disabilities and autism, and especially over the past year. Can my right hon. Friend set out what steps he is taking to change the way that people with learning disabilities and autism are treated within law?
Minister reply
My hon. Friend has done so much, alongside other members of the Select Committee and more broadly, on this piece of work to ensure that the law treats people with learning disabilities and autism separately from how it treats people with mental ill health.
Shadow Comment
Rosena Allin-Khan
Shadow Comment
The shadow Minister for Mental Health, Rosena Allin-Khan, welcomed the White Paper but raised concerns about its implementation. She emphasised the importance of involving service users in the legislative process and highlighted the need to address health inequalities and social disparities that contribute to mental ill-health. The Labour party advocated for more robust community care provision as an alternative to admission.
Allin-Khan also questioned the minister on the timeframe for reforms, workforce planning, and the necessity of a joint prelegislative Committee to ensure comprehensive implementation of Sir Simon Wessely’s recommendations. She stressed the urgency of addressing mental health inequalities and ensuring adequate staffing levels in the NHS.
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