Mental Health Act Reform

– in the House of Commons at 2:24 pm on 13th January 2021.

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Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care 2:24 pm, 13th January 2021

With permission, I would like to make a statement on reforming the Mental Health Act. Even amidst the pandemic, I am enormously grateful for the work that my team and the NHS have done, led by Sir Simon Wessely and Claire Murdoch and my hon. Friend the Minister for mental health, to deliver this White Paper, which we published today, to bring mental health legislation into the 21st century.

We are committed as a Government, and as a nation, to see mental health treated on a par with physical health. We are increasing funding for mental health services to record levels, with £2.3 billion extra each year being invested through the NHS long-term plan, and an immediate £0.5 billion in place to support mental health services with the very significant pressures they are under. Our mental health services are now helping more people than ever before. Services are there for the most serious mental illnesses, although those, of course, are under significant pressure. Services are there for better community support through 24/7 crisis services and establishing liaison in A&E, and supporting people to manage their own mental health.

This programme of transformation is ambitious, and as we support mental health services now, so we must bring up to date the legislative framework for the long term. The Mental Health Act 1983 was created so that people who have severe mental illness and present a risk to themselves or others can be detained and treated for their protection and the protection of those around them, but so much has changed since the Act was put into place, nearly 40 years ago. We now understand a lot more about mental health. Public attitudes around mental health have changed significantly for the better. We now have a better understanding and practice of how we can best support people with learning disabilities and/or autism. We are also concerned by the growing number of people being detained, inequalities among those who are detained, and the length of time that people are spending detained under the Act.

So, after a generation, we must bring the Mental Health Act into the 21st century. The previous Prime Minister, my right hon. Friend Mrs May, asked Professor Sir Simon Wessely to lead a review into what a modern mental health Act should look like. I thank her for her work, and I am so grateful to Sir Simon and his vice-chairs for their dedication. As I said to the House last year on its publication, the Wessely review is one of the finest pieces of work on the treatment of mental health that has been done anywhere in the world. I know that the review was welcomed across the House. We committed in our manifesto to deliver the required changes, and I am grateful to the Prime Minister for his emphatic support.

Sir Simon’s review compellingly shows that the Mental Health Act does not work as well as it should for patients or their loved ones—that the Act goes too far in removing people’s autonomy and does not give people enough control over their care. I am delighted to set out our full response to that review in our White Paper, which, together with my right hon. and learned Friend the Lord Chancellor, we have laid before the House.

The White Paper sets out plans for a landmark new mental health Act. The new Act will ensure that patients are put at the centre of decisions about their own care; that everyone is treated with respect; and that the law is only used to compel treatment where absolutely necessary. The White Paper has been developed in close consultation with those with the greatest expertise—the Royal College of Psychiatrists, Rethink Mental Illness, Mind, the Centre for Mental Health and countless practitioners on the frontline—and I thank them all.

There are four pillars to this work; I should like to take a moment to update the House on all of them. First, we will give patients a voice in their own care, which we know leads to better engagement in treatment. We will put care and treatment plans and advance choice documents in statute for the first time, so that patients are more closely involved in the development of their care, and so that they can have confidence that if they lose capacity because of illness, their preferences will be properly considered. We are making it easier for patients to challenge decisions about their care, creating a new right to choose a nominated person who is best placed to look after their interests, and increasing patients’ access to the independent tribunal to provide vital independent scrutiny of detention. In his report, Sir Simon recommended that one of the best ways to ensure dignified care is to ensure that patients can expect the privacy of their own en-suite room. We have already committed £400 million of funding to deliver that, and we are building new mental health hospitals, with two schemes already approved and with more to come.

Secondly, we will address the disparities that currently exist within the application of the Mental Health Act. Black people are currently four times more likely to be detained under the Mental Health Act than white people, and black people are 10 times more likely to be placed on a community treatment order. We also know that people from black and minority ethnic backgrounds can often engage with services later, and our plans to enhance patient choice, increase scrutiny of decisions and improve a patient’s right to challenge will help us to improve service provision for all. On top of that, we have already announced our new patient and carer race equality framework, as recommended by the review, and we are developing the use of culturally appropriate advocates, so that patients from all backgrounds can be supported in making their voice heard.

Thirdly, it is important that the Act supports patients within the criminal justice system. We will make sure that, where people in prison require treatment in a mental health hospital, they are transferred in a timely way, and we will support rapid diversion from custody to care where appropriate so that people in our criminal justice system can get the right care in the right place at the right time, while we fulfil our fundamental duty to keep the public safe.

Finally, in our manifesto, we committed to improving how people with learning disabilities and autistic people are treated under the Act. Until now, the use of powers in the Act did not distinguish between people with mental illness on the one hand, and people with learning disabilities and/or autism on the other. That is wrong. Needs are different and the law should be different, too. That is all part of treating everyone with respect. We therefore propose reforms to limit the scope to detain people under the Act where their needs are due to their learning disability or autism alone. In future, there will be a limit of 28 days for these detentions, which would be used to assess clinical need, and, wherever possible, we will work to ensure that appropriate support is available in the community rather than in institutional settings. I thank Baroness Hollins, Ian Birrell, Mencap and the National Autistic Society for their advocacy and for their support for these reforms.

This Act is there for us all and we want to hear as many views as possible on these plans, so we will consult widely on this White Paper and will respond later this year before we bring forward a new mental health Bill. I believe that everyone in our society has a contribution to make and that everyone should be respected for the value that they bring. It is the role of Government to support people to reach their potential, even at the most difficult of times, and to protect people when they are at their most vulnerable. That is what I believe, and I believe these reforms will help put those values into action and help give patients the dignified treatment that they deserve. I commend this statement and the White Paper to the House.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health) 2:33 pm, 13th January 2021

I thank the Secretary of State for an advance copy of the statement. This overhaul of the Mental Health Act has been long-awaited, and we welcome the White Paper and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Mental Health Act.

Without a doubt, people need to be at the heart of this legislation. Service users must be involved in framing the legislation going forward, and when we talk of numbers and statistics, we must remember that these are real people with real lives and real families. There is a web of individuals who are affected when things go wrong. Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult of situations, whose voices often are not heard when decisions are being made. It is an important step that learning disabilities and autism will no longer be grounds for detention under the Act, and I am sure that we all welcome that. It is also very welcome that the recommendation on nominated persons has been included.

The best way to reduce coercion and detention is to have alternatives to admission. Will the Secretary of State please outline how that will be achieved? Community provision is vital for mental health services that are truly joined-up and, crucially, work well for patients, so will he also give reassurances on community care?

It is in our communities where we witness the harsh reality of health inequalities, which so desperately must be addressed. Social inequalities and adverse childhood experience are the drivers of mental ill health, and they cannot be ignored. Children from the poorest 20% of households are four times more likely than those from the wealthiest 20% to have serious mental health difficulties by the age of 11. That will not be solved simply by mental health legislative changes; there must be a commitment to addressing the vast chasm of health inequalities across the country.

At present, black people are over four times more likely to be detained. We need to advance the mental health equality framework, and there must be culturally appropriate services and freedom for local areas to look at their specific population in order to have the most suitable approaches.

Mental health staffing levels are crucial to ensuring that mental health services are fit for purpose. The proposals set out by the Secretary of State go well beyond what has been committed in the long-term plan. We need to see true understanding from the Government that mental health is not about promising fancy equipment; it is about people. The promises in the White Paper rely on the workforce—our fantastic frontline mental health staff, of whom there are simply too few at present. Will the Secretary of State please outline when we will get the workforce settlement? What reassurance can he give on filling training places?

It has already taken so long to get to this point—it was the former Prime Minister who started this process, back in 2016—so will the Secretary of State provide some clarity on the timeframe going forward? Given the complexities of the legislation and the need for it to be robust, what are the plans for a joint prelegislative Committee? It is vital that the blueprint that Sir Simon Wessely’s report sets out is implemented in full. I would like to take this opportunity to thank him and everyone involved for all the work they have done on this review.

We must act, and quickly. Covid has shown us how all the pressures on mental health are building. We need action now. We all know how rare these pieces of legislation are; this is a once-in-a-generation opportunity to get it right for some of the most vulnerable in our society. We simply must get this right for everyone who depends on these services.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I thank the shadow Minister for her thoughtful approach. I agree with the way that she described the challenge, and with her insistence that we must not just improve the legislation—and we will—but improve and continue to strengthen service provision, in particular community service provision, as an alternative to admission. That is how we turn legislation from dry words on a page into real action on the ground.

The shadow Minister is absolutely right, too, that service users must be at the heart of framing the legislation. If I may link that point to her question about the timeframe, the challenge of the timeframe is to ensure that we move fast enough to help people and get the new legislation on the statute book as quickly as reasonably possible, but at the same time continue with the consensus-based approach that we have taken.

I am very grateful, as I said, for the work of Sir Simon and the NHS team, and I am grateful that we have managed to develop this White Paper with broad consensus among those who provide mental health services and service users, and politically across the House. I think that is an important consensus to keep, and I want to try to keep it by ensuring that we take as open an approach as possible to the legislation. I am absolutely open to joint prelegislative scrutiny, and I am absolutely open to the publication of a draft Bill. Let us get the details right, and let us work together on this and keep it as consensual as possible.

I also agree with the hon. Member’s point about the need to tackle broader health inequalities, and covid has laid bare some of those. That is a core part of our levelling-up agenda, and it is an important consideration for both physical and mental health. I am glad to say that this landmark White Paper, which will lead to a once-in-a-generation Bill, is proceeding with the support of the Opposition. I am really pleased about that, because this is for everyone. It is to make sure that some of the most vulnerable people in our country get the support they need and deserve.

Photo of Theresa May Theresa May Conservative, Maidenhead

May I congratulate my right hon. Friend on this White Paper and also on his continued commitment to this issue during what have been really challenging times for him and his Department in dealing with the pandemic? I fear, though, that the legislation might not be on the statute book until 2023. Meanwhile, GPs and hospitals caring for my constituents tell me that there is an increasing problem of mental health and increasing numbers of people with mental health problems, particularly young people. So what steps can my right hon. Friend take to put in place the principles that underpinned the Wessely review—I thank Sir Simon Wessely once again and his team for their work—of less coercion, better choice and control for service users, better care, and a reduction in inequality and discrimination, while dealing with the growing number of people who have mental health problems, some as a result of the pandemic?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I put on record my gratitude to my right hon. Friend. Without her, I am not sure we would have reached this point. Her dedication to this topic, both as Home Secretary and then as Prime Minister and since, has been vital, and I am grateful for the advice that she has given me in the last few months as we prepared this White Paper. I am grateful to her for appointing Sir Simon Wessely, and I am grateful to her for appointing me as Health Secretary, too. [Laughter.]

My right hon. Friend is absolutely right about the urgent pressures right now in mental health services right across the country, so I am really pleased that during the pandemic we have been able to keep work going on the policy and the new legislation that we are proposing. At the same time, however, in hospitals and in GP surgeries right across this country, there is urgent pressure on mental health services, and we know that there are mental health impacts of the actions that we have to take to control covid.

As I said in my statement, we have put in more money in the short term, on top of the long-term plan that was agreed when my right hon. Friend was Prime Minister. We are committed to doing everything we can to support people with mental ill health and, crucially, to support people to keep their mental health strong, even if they do not have a mental illness, because these are difficult times. The good public health approach means that, just as looking out for our physical health and our mental health is important for all of us, so too is the provision of acute services for people with serious mental health conditions, which is under strain right now. We are willing to—and have—put the money in at the spending review, but we must also support the clinicians on the frontline who are working so hard right now.

Photo of Lisa Cameron Lisa Cameron Shadow SNP Spokesperson (Mental Health)

This long overdue reform of the Mental Health Act rightly seeks to ensure parity of mental health, improve access to advocacy and individualised decision making, and enable treatment within the least restrictive environment. It also attempts to address the systematic inequalities we have heard about that have existed for those with autism and learning disability. Too often their rights have been quashed within the system, and it is absolutely correct that that is addressed. The Scottish Government recognise the importance of individual rights within treatment and are currently reviewing mental health and incapacity legislation in Scotland within the mental health strategy, following on from the learning disability and autism review.

As chair of the all-party parliamentary group on psychology, I hear about difficulties in the current mental health system across the UK from patients themselves, including for those who self-harm but who may not meet a diagnosis of mental disorder. There exists a cycle of assessment and discharge for patients. Will the progress announced meet their treatment needs?

There is also an issue about accessibility of services for those with comorbid mental health and addiction issues, including access to rehabilitation units. How will comorbidity be addressed within the reforms? We know that those with autism are currently overrepresented in our criminal justice systems. Will diversion services make sure that this great disparity in access to care in a crisis for the most vulnerable people with autism is finally addressed?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I welcome the comments of the SNP spokesman, and I appreciate her support and thoughtful questions. She is quite right about ensuring that we address the challenges that present themselves for people with autism who are, as she says, disproportionately likely to end up in the criminal justice system. This is an issue on which I have worked very closely with my right hon Friend the Lord Chancellor; I am delighted that he has been able to join us for this discussion.

Part of the point of separating the attitude in law towards those with mental ill health and those with learning disabilities and autism also relates to treatment when there is an interaction with the criminal justice system. It is absolutely critical to get this right. It is difficult, and a huge number of people are working very hard to get this right on the frontline, but at the moment they are hampered by the law when it comes to how that can happen. I hope that in the future they will be supported by the law such that they can make sure people get the right support and the right treatment, whether those people are in the criminal justice system or—as with the vast majority—they are law-abiding and need support from the state because they are in a vulnerable condition.

Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee

I thank my right hon. Friend for a comprehensive response to Sir Simon Wessely’s superb review, which I was proud to commission at the request of the former Prime Minister, my right hon. Friend Mrs May, whose commitment to mental health issues has been unparalleled. However, he knows that changes in the law only matter insofar as they affect the lives of real people, and his Department’s own data says that we still have more than 2,000 people with autism and learning disabilities locked up in mental health units, often supposedly temporarily, and sadly sometimes experiencing terrible breaches of human rights, such as the frequent use of restraint.

Will my right hon. Friend use this landmark moment to follow what Italy has done and close down all such units, so that these highly vulnerable people can be looked after more humanely in the community?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Absolutely. I want to see more people cared for in appropriate settings, which will often be in the community. My right hon. Friend set the target, as Health Secretary, to reduce the number of people with autism and/or learning disabilities in secure in-patient care. The 2,000 figure that he cites is a significant reduction, I am glad to say, from when he set that target and set that work in train—almost half. I want that number to continue to fall.

Of course, where there is a criminal justice element or restriction, that can be more difficult. However, we must make sure that the treatment and setting are appropriate for each and every person. Very often, a mental health setting is not appropriate for somebody with learning disabilities or somebody with autism, for whom it can in fact be the opposite of appropriate; it could be the worst place.

My right hon. Friend will know, as the Chair of the Select Committee, that the Care Quality Commission has in fact closed a number of settings during the pandemic, and we must make sure that we build more capacity. We have the budget in the spending review to do that and some of that building work is under way. There is a huge programme of work on the physical estate side and on training staff, as Dr Allin-Khan mentioned, as part of the legislative change. No one element of that transformation works without all the others.

Photo of Munira Wilson Munira Wilson Liberal Democrat Spokesperson (Health and Social Care)

I welcome the Secretary of State’s statement and the publication of the long-overdue White Paper. As has already been alluded to, the increased level of safeguards and a commitment to improving the quality of in-patient care will require a significant recruitment drive for mental health services. Recent forecasts suggest, for instance, that 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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is a very important question. I do not recognise that 71 figure; I will look into it and write to the hon. Lady with my full understanding of the situation, having consulted with Health Education England. The short answer to her question is that we are hiring psychiatrists and mental health nurses, who play such a critical role.

Photo of James Sunderland James Sunderland Conservative, Bracknell

Mental health is so important, not least for our veterans, so I commend the Secretary of State for his hard work and for this excellent initiative at a busy time for the country. One area was not covered in the statement, however: child and adolescent mental health services. Will he look at that as a matter of urgency? Families are waiting a long time for appointments at CAMHS and are living in desperate times, so I ask for his reassurance on that issue.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, absolutely. I can give the reassurance that for those who need to access IAPT—improving access to psychological therapies—services and talking therapies for lower-level mental health conditions, the waiting time has come down quite considerably. In the latest data I saw, it was 15 days, which is a considerable improvement. The services for more serious mental health conditions are under pressure at the moment and putting more resources into them will be critical.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

May I thank the Secretary of State for the statement today? I also thank him for the clear way that he has put forward to help those who are vulnerable and have problems, because that is important. I ask him for clarity on what support has been given to the frontline of mental health diagnosis in the form of GP practices, which refer patients on only to see them worsen in the months it takes for them to be formally assessed and get the help they need. That is leading to a high rate of strong medicine being used, instead of counselling. The issue is important.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The hon. Gentleman is right that GPs are the absolute frontline in treating mental ill health, not least because the first presentation of mental illness is often at GP practices. Funding for those services is increasing and it is important that that continues.

As GPs form larger groups—for instance, through primary care networks—the ability to have more specialist help is strengthened. I want to see closer integration between primary care, mental health trusts and acute trusts within the NHS. Throughout its history, the NHS has held mental health trusts separately from the provision of other services. It is increasingly clear that their integration, rather than separation, is the way forward.

Photo of Bob Neill Bob Neill Chair, Justice Committee, Chair, Justice Committee

I warmly congratulate my right hon. Friend on the statement—and my right hon. Friend the Lord Chancellor, who I am delighted to see on the Treasury Bench with him.

The abolition of the appalling practice of using prison as a place of safety for those who are mentally unwell is particularly welcome. That was unfair for the individuals and for the prison staff who had to deal with them under often-unsatisfactory conditions. It frequently happened because at the end of a hearing, magistrates or judges had endeavoured to find a hospital place, but none was available at the end of the day. What practical steps and resources will be put in place to ensure that a hospital place is identified before the defendant appears in court, so that they can be taken swiftly and seamlessly to an appropriate safe place, rather than prison?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Ensuring that that sort of link-up is standard practice across the criminal justice system is critical, and that is one area that the Lord Chancellor and I are working on. Ultimately, so too is the provision of enough places, because we can only send somebody to a place if the place exists. That consists of two pieces of work. The first is building more mental health hospitals, and the second is ensuring that people leave mental health hospitals when they can be better cared for in the community. Often it is cheaper and better for a patient to be treated in the community, but provision of community services must be in place so that that discharge can take place. A significant amount of work is going on to try to improve that process.

Photo of Kevan Jones Kevan Jones Labour, North Durham

May I thank the Secretary of State for his statement, and welcome the publication of the White Paper? It is important in these reforms that the patient is at the centre of their treatment. The provision in the review to have mental health advocates for mental health patients is welcome, but may I suggest that the Secretary of State works closely with the community and voluntary sectors, and considers funding for those sectors so that they can provide the advocates that will be needed if the reforms go forward?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am very happy to do that. One of the most striking and out-of-date things about the current legislation is that if somebody who is unmarried is incapacitated through illness, decisions on their behalf are automatically, in the first instance, taken by their father, rather than by their choice of who might take those decisions. That is one of the things we want to change, along with the wider point about support for the community and voluntary services that the right hon. Gentleman rightly suggests.

Photo of Jackie Doyle-Price Jackie Doyle-Price Conservative, Thurrock

I wish to add my voice to the tributes paid to Sir Simon Wessely who, as my right hon. Friend will know, drew extensively from the lived experience of those who have been through detention under the Mental Health Act. Will he join me in paying tribute to those individuals, who often had to relive harrowing and distressing experiences so that we might improve our services through this legislation, recognising that their contribution will pay dividends to those who follow their treatment in future?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I would very much like to pay tribute to those who bravely put forward their testimony of their lived experience of what it was like to be a service user under the existing Act, which formed so much of the evidence for what we need to do to make it better.

I also pay tribute to my hon. Friend. She was the Minister responsible for mental health during much of the framing of the review, and the initial turning of that review into this White Paper. She did that with such sensitivity, thought, and—crucially—by actively listening to what people want when they are at some of the most vulnerable points of their lives. It is not easy to do that; it requires skill and compassion, and my hon. Friend has both of those in spades.

Photo of Kim Johnson Kim Johnson Labour, Liverpool, Riverside

I welcome the changes being proposed today because as the Mental Health Act currently stands, black people are four times more likely to be detained, and more than 10 times more likely to be subject to a community treatment order. Evidence from my constituency of Liverpool, Riverside echoes that, and my office deals with multiple requests for support from constituents from our diverse communities. Will the Minister confirm that the steps being proposed will ensure that care is accessible, culturally appropriate, and free from the levels of discrimination currently experienced?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes. The hon. Lady is absolutely right to draw out this point, and the figures she quotes were one of the reasons it became so urgently clear that we need to make these changes. We need to make these changes as fast as reasonably possible, but no faster. We need to bring people with us. We need to give people time to read and consider the White Paper and to look at the legislation, as drafted, as it makes its way through the House, but the figures she sets out demonstrate why it is so important that we make these changes. I am delighted that the Prime Minister has set aside the future parliamentary time to be able to make this new Mental Health Act a reality.

Photo of Henry Smith Henry Smith Conservative, Crawley

I very much welcome the statement and support the work this Government have done to improve mental health provision through our schools. Children and young people are a critical part of getting mental health right. Therefore, as we reform the Mental Health Act, can I have an assurance that educational settings will be at its heart?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, absolutely. We have put more support directly into schools, and we are rolling out the mental health link workers to make sure young people get that support when they need it.

Photo of Steve McCabe Steve McCabe Labour, Birmingham, Selly Oak

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

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. It is very heartening to see the emphatic cross-party support for the White Paper today, and the commitment I will give to him is that we should continue to discuss, and we will continue to discuss in an open-minded way, exactly how we put the details into legislation to make sure that we get them right and continue with this consensus-based approach.

Photo of Lee Anderson Lee Anderson Conservative, Ashfield

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

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. Like him, I am thrilled that we have been able to make organ donation an opt-out system, and we did that in the middle of the pandemic. He is right that it is not just about physical recovery; it is about physical and mental recovery. The point he makes so sensitively just shows how important and how broad this subject is, and I would be very happy to work with him on this specific subject to make sure that people get the best possible services.

Photo of Barbara Keeley Barbara Keeley Labour, Worsley and Eccles South

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have put extra funding into those services. I absolutely appreciate, of course, that they are under pressure, especially with the pandemic. The hon. Lady is right that we must have the community services in place. Whether those are NHS community services or community services provided by councils, it is very important that they are provided in as seamless a way as possible. In fact, the best commissioning is often joint commissioning between local authorities and the NHS. I hope that a wider set of reforms to the provision of local services that have initially been set out by the NHS, but that we will be taking forward, will help us, combined with this legislation, to ensure that the link-up that she rightly addressed is much stronger.

Photo of Rehman Chishti Rehman Chishti Conservative, Gillingham and Rainham

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I do not have the exact figure on the last question, not least because it goes up every day, I am glad to say, but the total number of NHS staff who have had the vaccination is now in the hundreds of thousands.

I am grateful for the broader point that my hon. Friend makes. There are NHS staff on the frontline who have supported people through very traumatic experiences over these past few months, during 2020 in the first peak, and then even more intensively, in some cases, over the past few weeks—and it is even harder this time round, because it has happened after a whole year of dealing with this pandemic. 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.

We have put extra resources into making sure that people get these services. Often with the NHS it is about encouraging people to come forward to access the services. Of course, Sir Simon Wessely first came to prominence working with the Army in supporting it on dealing with post-traumatic stress disorder. We have to make sure that we put in all possible support for frontline NHS staff who have suffered trauma because of what they have seen and what they have had to do in looking after us all in this covid pandemic. We have to make sure that they are looked after, and I make a personal commitment today that we will do all we can to look after them.

Photo of Tan Dhesi Tan Dhesi Shadow Minister (Transport)

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

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, although it is more difficult in lockdown. This is an area of a huge amount of focus for us, particularly for the Minister for Patient Safety, Suicide Prevention and Mental Health. It is a very important subject on which we are working very hard.

Photo of Dean Russell Dean Russell Conservative, Watford

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?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

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, and as appropriately as possible for both. This has been the big development on top of the Wessely report, which is in the White Paper, and it builds on the learnings we have had over the last couple of years, when the focus on this subject has become yet more acute, and rightly so. It is about the need to ensure that people get the appropriate provision, in the community if at all possible, and, critically, the need to ensure that the legislative underpinning supports that and does not wrongly use mental health legislation when that is not the appropriate legislation. I am really glad that we have been able to build that on top of the Wessely report and that it has had such a warm welcome. Now we have to get the details right, and I look forward to working with my hon. Friend, who has done so much work on this, and others to ensure that the details of how this is framed in legislation are got right.