Draft Mental Health Bill

– in the House of Commons at 3:34 pm on 27th June 2022.

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Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care 3:34 pm, 27th June 2022

With permission, Mr Speaker, I would like to make a statement on our plans to bring the Mental Health Act 1983 into the 21st century. Today, just as we pledged in the Queen’s Speech, we have published a draft Mental Health Bill to modernise legislation that was passed by the House almost 40 years ago and make sure that it is fit for the future.

Last year, we invested £500 million to support those with mental health needs who were most affected by the pandemic and, as we set out in the NHS long-term plan, we are investing record amounts into expanding and transforming mental health services. That will reach an extra £2.3 billion each year by 2023-24. Later this year, we will also publish a new 10-year mental health plan followed by a 10-year suicide prevention plan, which, as I set out in a speech on Friday, will place a determined focus on this major source of grief and heartbreak so that fewer people will one day get the news that turns their lives upside down. But we cannot make the critical reforms that we need and that are so essential to the country’s mental health system without making sure that the law that underpins our country’s mental health system is up to date, too.

Since the 1983 Act, our understanding of and attitude towards mental health has transformed beyond recognition, and it is right that we act now to bring the Act up to date. The Mental Health Act was created so that people who have severe mental illnesses and present a risk to themselves or others can be safely detained and treated for their own protection and that of those around them, but there are a number of alarming issues with how the Act is currently used. Too many people are being detained. They are also being detained for too long, and there are inequalities among those who are detained. The previous Prime Minister, my right hon. Friend Mrs May, asked Professor Sir Simon Wessely to lead a review into the Act. I pay tribute to my right hon. Friend for her tireless commitment to this most important of issues and to Sir Simon for his illuminating report, which made a powerful case for reform and was rightly welcomed on both sides of the House. It made for uncomfortable but essential reading, vividly showing how currently the Act fails patients and their loved ones and deprives people of autonomy and control over their care.

The draft legislation that we have published today builds on Sir Simon’s recommendations as well as those in our White Paper, which was published in partnership with the Ministry of Justice last year. Just like Sir Simon’s report, the White Paper was welcomed by both sides of the House. It was also welcomed by leading charities including Mind, the National Autistic Society and Rethink, countless mental health professionals and, critically, the people who use mental health services and their loved ones. Today, we are showing how we will put the vision into action. The Bill is a once-in-a-generation reform, and I would like to set out briefly to the House the important themes that sit behind it.

First, the Bill rebalances the criteria for detention so that it will take place only as a last resort when all other options have been explored and considered. Under the new criteria, people will be detained only when they pose a significant risk of harm to themselves and others, and patients should be detained only if they will benefit from the treatment that is made possible by their detention.

Secondly, the Bill shows how we will give patients more control over their care and treatment. It will ensure that, in most cases, clinicians can administer compulsory treatment only if there is a strong reason to do so. In future, all patients formally detained under the Act will have a statutory right to a care and treatment plan, drawn up between the patient and their clinician, and personalised based on the patient’s needs. It will give them a clear road map to their discharge from hospital.

There are some cases when patients are not able to make decisions about their own care or feel that they could benefit from greater support. Currently, patients are not always able to choose who can represent them, as their nearest relative automatically qualifies to act on their behalf. The Bill will change that, allowing patients to choose a nominated person who they believe is best placed to look after their interests. The Bill will also increase the powers of that nominated person, so that they can be consulted about the patient’s future care.

Thirdly, the Bill will tackle the disparities in how the 1983 Act is used. Black people are four times more likely to be detained under the Act than white people, and 10 times more likely to be placed on a community treatment order. The Bill provides for greater scrutiny of decision making, including through greater use of second opinions on important decisions, and through expanded access to independent tribunals; that will help us to address the disparities in the use of the Act.

Fourthly, the Bill will enhance support for patients with severe mental health needs who come into contact with the criminal justice system. Under the 1983 Act, too often, people in prison experience delays in getting treatment in hospital. Courts are sometimes forced to divert defendants who require care and treatment, some of whom have not been convicted, to prison as a so-called place of safety. The Bill will make crucial improvements so that vulnerable offenders and those awaiting trial can access the treatment that they need. It will tackle delays and speed up access to specialist care by introducing a new statutory 28-day time limit for transfers from prison to hospital, and it will end the use of prison as a so-called place of safety, so that patients can get the care that they need in the appropriate hospital setting.

The Bill will also amend the Bail Act 1976 so that courts are no longer forced to deny a defendant bail if the judge’s sole concern about granting bail has to do with the defendant’s mental health. The Bill will allow the judge to send them to hospital instead, so that they can be in the best environment for their mental health and can receive any treatment that they need.

Finally, the Bill will improve the way that people with a learning disability and autistic people are treated under the 1983 Act. One of my priorities in my role is personalised care. The current blanket approach cannot be allowed to continue; it means that too many autistic people and people with a learning disability are admitted into institutional settings when they would be better served by being in the community. The Bill will change this. It limits the scope for detaining people with learning disabilities and autistic people for treatment unless they have a mental illness that justifies a longer stay or they are admitted through the criminal justice system. It also gives commissioners of local authorities and integrated care boards new duties to make sure that the right community support is available instead.

I look forward to working with hon. Members in all parts of the House as we take these plans forward. This momentous Bill deals with one of the most serious and sombre responsibilities of any Government: their responsibility for the power to deprive people of their liberty. Mental ill health can impact any of us at any time. It is essential that we all have confidence that the system will treat us and our loved ones with dignity and compassion. That is what the Bill will deliver. I commend the statement to the House.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health) 3:43 pm, 27th June 2022

I thank the Secretary of State for an advance copy of the statement, and for sharing his family’s experiences over the weekend. I am so sorry to hear about the circumstances surrounding his brother’s tragic death.

This overhaul of the Mental Health Act 1983 is long awaited. We welcome the draft Bill, and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Act. It was interesting to hear, in the statement, of the Government’s focus on keeping people in crisis out of A&E, and of their plans to reduce the use of general ambulance call-outs for those experiencing a mental health crisis. In 2020, there were over 470,000 calls to 999 because someone was in a mental health crisis, which took up an estimated 66,000 hours of call time. In my email inbox, I have numerous examples from across the country of children being stuck in A&E for over 24 hours waiting for a mental health bed. One child waited over three days. When I work shifts in A&E, I see more and more people coming into hospital in crisis. The increased frequency is deeply concerning. Conditions are getting worse and illnesses are going untreated. We would not allow that in cancer treatment, so why is it allowed in mental health treatment?

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 situations and whose voices are often not heard when decisions are made. We are pleased that patients will have greater autonomy over their treatment in a mental health crisis, and we are glad that the Government have been working with organisations to listen to the experiences of those with learning disabilities or autism, but will the Secretary of State explain what safeguards will be put in place for people with learning disabilities or autism should the worst happen and they find themselves in prison? This is not a straightforward issue. Many people with learning disabilities or autism also live with serious mental illnesses, and we have to make sure that they have their rights protected and have dignity in their treatment.

In our communities, we witness the harsh reality of the health inequalities that so desperately need to be addressed. As the Secretary of State said, black people are over four times more likely to be detained under the Mental Health Act.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health)

We need to advance the mental health equality framework and there must be culturally appropriate services and the freedom for local areas to look at their specific populations in order to have the most suitable approaches. Culturally appropriate community provision is vital for mental health services that are truly joined-up and effective and that, crucially, work well for patients. Will the Secretary of State also provide reassurances on the future of community care and on how they will work with local authorities across the country to deliver community provision that works?

Mental health staffing levels are absolutely crucial to ensuring that mental health services are fit for purpose. More than a year and a half ago, I asked the Secretary of State’s predecessor about the future of mental health staffing. The proposals that have been set out today go well beyond what has been committed to in the long-term plan. Labour has a plan: to recruit an extra 8,500 mental health staff to treat 1 million additional patients a year by the end of our first term in office. Will the Secretary of State outline when we will get the workforce settlement? What reassurance can he give on filling training places?

For too long, the Government have had their head in the sand when it comes to mental health. They have failed on eradicating dormitories from mental health facilities, failed on cracking down on the use of restraint, and failed on getting on top of waiting times. We cannot have this kicked into the long grass and, if it gets lost in the political quagmire of Conservative in-fighting, should the Government call an early general election, people will suffer. We cannot have the Government fail on mental health legislation any longer. This is a once-in-a-generation opportunity; we simply must get this right for everyone who depends on these vital services.

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I thank the hon. Lady, particularly for her remarks at the start of her response about my personal experience.

I think the hon. Lady agrees with me, as does everyone in this House, that the 1983 Act is outdated. Society has learned since then, rightly, that people’s mental and emotional wellbeing is as important as their physical wellbeing. That was recognised in the Health and Care Act 2022, which came before Parliament recently, and this draft Bill does a lot to change the situation as well.

The hon. Lady talked, rightly, about the importance of mental health services. The NHS is putting record funding into NHS services. Some 1.25 million people were seen through the NHS talking therapies service, despite the pressures of the pandemic, and an additional £500 million of resources was put into mental health services because of the pandemic.

On the workforce, today in the NHS, we have around 129,000 health professionals focused on mental health. That is the highest number ever, and the number has gone up by some 20,000 since March 2016. As for the NHS’s strategic workforce plan—the 15-year plan on which it is currently working—having the correct provision for mental health will, of course, be a very important part of that.

Photo of Theresa May Theresa May Conservative, Maidenhead

I commend my right hon. Friend for his statement and thank him for his kind comments. I also join the Opposition Front Bencher, Dr Allin-Khan, in commending him for sharing his family’s experience. It shows that this is not just a piece of legislation from a Secretary of State; it comes from somebody who understands the issue.

I welcome the publication of the draft Mental Health Bill. While it is necessary for it to be given proper scrutiny, does my right hon. Friend join me in believing that we need to get these new provisions on the statute book as quickly as possible, to ensure that all those who are going through a mental health crisis can indeed be treated with the dignity and compassion that they deserve?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

Let me thank my right hon. Friend again for the crucial role that she has played in getting the House to this point today with the publication of the draft Bill. It was her commitment to giving mental health parity with physical health that has led us to this important point. I agree absolutely with her. The draft Bill is before the House today. No doubt there will be prelegislative scrutiny, which I strongly welcome, to have the Bill ready as quickly as possible for First Reading in this House and to make sure that it becomes legislation as quickly as possible.

Photo of Janet Daby Janet Daby Labour, Lewisham East

I welcome this statement from the Government, but I am concerned about constituents who have a mental health crisis and present at A&E departments. Because of long waiting times, they are usually unable to wait to be seen by a psychiatrist. Can the Secretary of State say how that will be addressed in the Mental Health Bill to make sure that people get the urgent treatment they need when they present at A&E departments?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

The hon. Lady is right to raise the matter. I can tell her— helpfully, I hope—that the Bill is not that important in terms of getting what she wants to see, which is more care for people when they present themselves at A&E with mental health challenges. That is work that is already prioritised with the NHS. During the pandemic, as she and other hon. Members will understand, there were increased issues around mental health and people not getting care in the normal way; that is why we have put record resources into the NHS, including into A&E provision of mental health services.

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

I commend my right hon. Friend’s courage in talking about his family’s tragedy, which is one of the most difficult things to do in politics. I also thank my right hon. Friend Mrs May for her commitment to mental health, which is unparalleled among any Prime Minister I have known in this place; it made an enormous difference to me when I was Health Secretary.

I support wholeheartedly what the Health Secretary has said today. I hope that he does not mind my saying that in one instance it does not go far enough: there are still 2,000 people with autism and learning disabilities in secure institutions, effectively incarcerated, even though they would be better off in the community. It is a human rights scandal. As part of the remedy, would he consider changing the rules on sectioning so that, after a short period, anyone who wanted to keep someone in a secure unit would have to reapply for sectioning every week or two, so pressure is put on the system to find a better solution?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

We are determined to reduce the number of people with learning disabilities and autism who are in mental health hospitals. As part of those plans, we will shortly publish the cross-Government “Building the right support” plan to drive progress; I will have more to say about that shortly. I listened carefully to my right hon. Friend’s suggestion and would be happy to meet him to discuss it further.

Photo of Daisy Cooper Daisy Cooper Liberal Democrat Spokesperson (Health and Social Care)

I was incredibly moved to learn of the Secretary of State’s personal experience with this issue. I commend his courage in talking about a deeply personal issue.

In his statement, the Secretary of State outlined that patients will be able

“to choose a nominated person who they believe is best placed to look after their interests.”

Could he outline what rights that nominated person might have? I have a particular issue in my constituency: somebody has been moved from one part of the country to another, but their next of kin was not asked for permission and only found out after the event. I think that it is incredibly important not only that there is a nominated person, but that that person has outlined rights that can be enforced in these situations.

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I am pleased that the hon. Lady welcomes the change that will come about through the Bill. The draft version has only just been published, and I appreciate that she will need time to digest it, but it does explain how the nominated person—who does not have to be a family member, but can be anyone whom the individual chooses and trusts—will be able to co-produce the treatment plan for that individual and work with him or her very closely.

Photo of Robert Halfon Robert Halfon Chair, Education Committee, Chair, Education Committee

Will my right hon. Friend look at a book published this week by Liz Cole and Molly Kingsley of the UsForThem parents group, which discusses the damage to children’s mental health during lockdown? We know that the number of referrals has increased by 60%, and that eating disorders among young girls rose by 400% during lockdown. Will my right hon. Friend set out measures to help children with their mental health? Given the damage that social media companies do to children’s mental health, will he consider a social media levy to raise money to fund mental health resilience, and will he also consider introducing a longer school day with extra sporting and wellbeing activities to help those children further?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

My right hon. Friend has made the important point that children need full mental health support in normal times, but need it particularly when experiencing the impact of a pandemic. I will take a look at the book that he mentioned. Levies, as he will know, are a matter for the Treasury, but I am sure that he welcomes some of the measures in the Online Safety Bill. I should be happy to meet him and discuss some of his other proposals further.

Photo of Clive Lewis Clive Lewis Labour, Norwich South

I think the whole House will welcome many of the changes that the Bill represents. I especially welcome the section on black mental health and on the situation of people who are being incarcerated in the mental health system, but many of my constituents have suffered the effects of eight years of systemic and catastrophic failure on the part of their mental health trusts. What provisions in the Bill will make a difference to them following nearly 1,000 excess deaths in our mental health trusts? I know that he has committed himself to meeting me to talk about this, but will he also commit himself to meeting many of the victims of those eight years of failure who will be coming to Parliament next Tuesday to discuss what has happened to them? Perhaps he will be able to tell them how the Bill will turn their lives around and make a difference to them and their families.

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I hope the hon. Gentleman agrees with me—as I think he does, given the way in which he framed his question—that the Bill is a huge step forward, especially in respect of the important issue of dealing with some of the inequalities in provision which we all know have existed, and which he mentioned at the beginning of his question. The way in which we change things will be not just through the Bill but through continued investment, and by ensuring that, when trusts are failing, those failures are addressed. As the hon. Gentleman said, I will be meeting him, but the Minister for Care and Mental Health will be happy to meet the constituents he mentioned.

Photo of Jonathan Gullis Jonathan Gullis Conservative, Stoke-on-Trent North

I commend the statement, and I commend my right hon. Friend’s bravery in sharing that story. After speaking to friends, I decided to share my own story: twice I attempted to take my own life. Thankfully I did not succeed, but when I needed help, I was lucky enough to be able to get that help. Sadly, that is not the case for too many people throughout our United Kingdom, at a time when 40% of GP appointments are related specifically to mental health.

As my right hon. Friend will know, I am supporting the No Time to Wait campaign, led by my good friend James Starkie, who is trying to ensure that there is a mental health nurse in every GP surgery in the country to help with the early intervention that we know is so critical. There is a great example in Norfolk and Suffolk NHS Foundation Trust, led by Lisa Dymond. Will my right hon. Friend, in the course of his work on this draft legislation, engage with that trust to see the work that it is doing to ensure that we can provide the access that people so desperately need?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

May I first commend my hon. Friend for sharing his story and for being so open about it? There is no doubt that that will help a great many other people. I am sure he will welcome the Government’s plans for a new 10-year suicide prevention plan. I agree with him about the need to continue to work on improving provision, and I believe I will be having a meeting with him and Mr Starkie to discuss his campaign further.

Photo of Chris Bryant Chris Bryant Chair, Committee on Standards, Chair, Committee on Standards

I warmly commend what the Secretary of State said over the weekend. Many of us have experienced suicide in our own families, and it is good when people like him can share their experience; I think it helps an awful lot of people around the country.

Can I ask the Secretary of State about brain injury, which he knows I am a bit obsessed with? I visited three units—in Newcastle, Birmingham and Sheffield—the week before last. The big problem is that people are being given what is called a neurorehabilitation prescription, which is very similar to what he has described, but unfortunately, the moment they leave the trauma unit, the services that they require simply are not available in vast parts of the country. There are not enough occupational therapists, speech and language therapists, physiotherapists or psychiatrists to do that work.

The most distressing thing I heard was at the Birmingham Children’s Hospital—it does not have a hydrotherapy pool, which would be useful; nor does any other children’s hospital in the UK—which saw a 70% increase in brain injuries in children during covid from parents attacking their children. How are we going to get the workforce we need in order to make a difference to those people’s lives?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

The hon. Gentleman will know that the investment already going into the workforce is at record levels. As the NHS sets out its 15-year workforce strategy, it will look into acquired brain injury, and rightly so. I thank him for the work he is doing with the Minister for Care and Mental Health, my hon. Friend Gillian Keegan, on the ABI strategy. I understand that the call for evidence has just closed. That process will also help to bring about the change that he seeks.

Photo of Sally-Ann Hart Sally-Ann Hart Conservative, Hastings and Rye

I met some amazing young people from my constituency last week during the “It’s our Care” lobby of Parliament, and one issue they raised was mental health among looked-after children. What steps is my right hon. Friend taking to ensure that the mental health needs of looked-after children are taken into account, so that they, too, can thrive?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

My hon. Friend raises an important issue. We have increased to a record level resources for mental health services for children, including looked-after children, but we need to ensure that the strategy is fit for the future. This will be a key part of our 10-year mental health strategy.

Photo of Charlotte Nichols Charlotte Nichols Labour, Warrington North

Global research into psilocybin has shown that it has significant potential for the treatment of mental health conditions, including depression, post-traumatic stress disorder, anorexia and alcohol addiction. However, its schedule 1 status under the Misuse of Drugs Regulations 2001 is hindering research in the UK and condemning thousands of people to unnecessary suffering. The organisation Heroic Hearts, which supports military and emergency services veterans with PTSD, has to facilitate patients’ travel abroad to access treatment that they should be able to receive here, where appropriate. Can the Secretary of State please tell the House what conversations he has had, or intends to have, with the Home Office about the rescheduling of psilocybin to ensure that this vital area of mental health research can be progressed and treatment can be brought into the 21st century with this Bill?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

The hon. Lady has raised an important issue. As she has said, rescheduling is an issue for the Home Office, and I will make sure that I take this up with the Home Secretary.

Photo of Huw Merriman Huw Merriman Chair, Transport Committee, Chair, Transport Committee

I chair the all-party parliamentary group on autism, a role I took on after we lost Dame Cheryl Gillan. From her position in this place, she was tireless in highlighting the fact that there is a difference between those who suffer lifelong development disabilities such as autism and those who have mental health conditions, although it is fair to say that those with autism suffer with a higher proportion of mental health conditions. As things stand, 61% of those in mental health hospitals have autism as a condition—that is 1,200 people—and the figure used to be 38%.

I welcome the Secretary of State’s draft mental health Bill. Will he meet members of the all-party parliamentary group to discuss what the Bill will do for those with autism? Can I also parrot the call from the Chair of the Select Committee, my right hon. Friend Jeremy Hunt, about the need to review the sectioning of those in mental health provision? There are far too many people languishing, and they need our help.

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I agree with my hon. Friend. The reforms that we have set out today in this draft Bill mean that, in the absence of a mental health condition, learning disability and autism will no longer be a reason for people to be detained in a mental health hospital after an initial period of assessment. I would be happy to meet him and his APPG.

Photo of Marsha de Cordova Marsha de Cordova Labour, Battersea

I am disappointed that, yet again, the Department has not produced all the papers for me in large print; it has produced all the papers in standard print. I hope the Secretary of State will take that away and ensure I receive my papers as soon as possible.

I am sure the Secretary of State will share my disappointment that, in England, 24% of all children’s mental health referrals are closed before the child receives any support. In my Adjournment debate last week, I highlighted the importance of children’s mental health services and trauma support and care, so will he reassure the House and me that he will do everything in his power to make sure children receive timely mental health support?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

Of course the hon. Lady should get the Bill and any other documentation she needs in large print, and I am sorry that she has not. I will take that up. I apologise to her, and she makes a very important point.

Support for children, even before the pandemic, was rightly a priority. Funding will increase to record levels by 2023, with an additional £2.3 billion in total so that an additional 345,000 children and young people can be seen. We put in an additional £79 million during the pandemic, and we will set out in our new 10-year mental health strategy exactly how we will do more.

Photo of Robbie Moore Robbie Moore Conservative, Keighley

I commend the Secretary of State for bringing forward this draft Mental Health Bill. I have met key individuals across Keighley in recent months who provide mental health and wellbeing support and advice, including Nick Smith, Ryan Anderton, Bill Graham and one of our hard-working GPs, Caroline Rayment. They are all passionate about this subject, and I am sure they will be pleased to see greater autonomy in providing personalised care. A key issue they have raised with me is that of adults and children with learning difficulties. Can my right hon. Friend confirm that the Bill will help those with learning difficulties to engage further with mental health and wellbeing services?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

Yes, it will. I set out in my earlier answers some of the Bill’s changes for those with learning difficulties and autism. I think my hon. Friend will also welcome the publication of the new 10-year mental health plan.

Photo of Barry Sheerman Barry Sheerman Labour/Co-operative, Huddersfield

The Secretary of State may recall that I am very much involved with the Autism Commission, and I hope he has seen our recent report on autism’s lifelong impact on families. I support everything he has said this afternoon, except one thing. We need a deep cultural change in this area, whether it is GPs understanding more and having more proficiency, or teachers and schools recognising early signs of difficulty and struggle. If we believe in levelling up, why do only wealthy people get easy access to therapy? As I found when I chaired the Education Committee, we need more therapists and more therapy to be available.

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I agree with the hon. Gentleman about cultural change. Whether we are talking about teachers or healthcare professionals, we need to make sure they have a certain level of training on autism. I am sure he knows the NHS has started rolling out a type of mandatory training on autism, and I would be happy to meet him to discuss how we can go further in the light of that report.

Photo of Duncan Baker Duncan Baker Conservative, North Norfolk

This is an enormously welcome Bill, not least in my constituency, where I have campaigned endlessly for better mental health services and for a hub at our wonderful Cromer Hospital. As Norfolk has the slowest ambulance response times and the most mental health referrals in the UK, how can we access the £7 million-worth of specialist mental health ambulance services?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

First, I commend my hon. Friend on the work he has done. I remember meeting him to discuss this important issue, and I welcome his support for the Bill. He may know that the extra support of around £150 million announced today includes £7 million of support for mental health ambulances.

Photo of Kerry McCarthy Kerry McCarthy Labour, Bristol East

Clause 31 states that transfers from prison to hospital should take place within 28 days of a referral notice,

“unless there are exceptional circumstances”,

and makes it very clear that those exceptional circumstances do not include a shortage of staff or beds. That is welcome, but at the moment about 50% of prisoners who are assessed as needing transfer to hospital are not transferred because the beds are not available. What can the Secretary of State do to make sure that that is not an issue by the time the Bill becomes law?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

The NHS is already preparing for this change. Of course, this is not law yet and we can make progress before it becomes law, but I believe that once it does become law, subject to the will of this House, it will galvanise more parts of the NHS to make sure that that commitment is met at all times.

Photo of Tom Hunt Tom Hunt Conservative, Ipswich

I very much welcome the Bill’s focus on autism and special educational needs. Having a learning disability often means that your brain is wired a bit differently, and often you feel like you are not understood, and that can contribute to mental ill health. On Norfolk and Suffolk mental health trust, we have been languishing for seven years and that has led to hundreds of people losing their lives. Will the Secretary of State assure me that this Bill will be part of ensuring that never again will we let failure last so long and the cost be so high?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I can give my hon. Friend that assurance. Sadly, we have instances around the country where certain trusts have failed local people when it comes to mental health. He mentions Norfolk and Suffolk. We need to do better. This Bill and the resources behind it will make the difference.

Photo of Paulette Hamilton Paulette Hamilton Labour, Birmingham, Erdington

Through my role as a lay manager for Birmingham and Solihull mental health trust, I know that a major problem in the west midlands is the availability of beds for individuals detained by the police under section 136 of the Mental Health Act 1983. This is having a huge impact on A&E services in our area, because that is where the police take patients if there are no mental health beds available. How does the Secretary of State plan to improve bed availability for mental health patients?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I know that the hon. Lady speaks with experience, and I listen carefully to her when she speaks on these important issues. She may have seen the announcement earlier today that the additional support of around £150 million will go towards addressing her exact point about more provision, including crisis houses and sanctuaries—I also mentioned mental health ambulances earlier—and I think that will help.

Photo of Richard Holden Richard Holden Conservative, North West Durham

This is an enormously welcome Bill on an issue on which I have campaigned and spoken to the Secretary of State about previously. North West Durham has an historic and ongoing issue, with suicide rates at double the national average. I commend him for speaking about his personal situation, and I look forward to the 10-year mental health plan and the 10-year suicide prevention plan. Will he outline how the Bill will reform the totally outdated Mental Health Act; how it will make a particular difference to those with serious mental health issues in my constituency, including children with anorexia issues whose parents have brought them to see me recently; and how it will deliver for people and their families as they go through really difficult treatment, making it more personalised for them?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

I commend my hon. Friend on all the campaigning he has done on mental health and suicide prevention ever since he entered the House. The meetings I have had with him have gone directly into the publication of this Bill. The Bill will make a difference. I have summarised how it will result in more personalised care. Alongside the new resources, it will really help his constituents and many others.

Photo of Rachael Maskell Rachael Maskell Shadow Minister (Digital, Culture, Media and Sport)

I welcome the Bill. The acuteness of people’s mental health challenges while in the community is escalating before appropriate intervention is taken. How will the Bill ensure that earlier interventions are made, so that people do not have to go into secure accommodation for their safety?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

Once the Bill is law, it will require the use of secure accommodation to be limited to those who absolutely need to be detained, either for their protection or for the protection of others. Alongside the Bill, we need to make sure that the right resources are there. I mentioned earlier the extra resources that are going in, to a record level, including today’s announcement of the £150 million.

Photo of Liz Twist Liz Twist Opposition Whip (Commons), Shadow Minister (Scotland)

I, too, thank the Secretary of State for sharing his personal experience, which it is so important to do. Will he tell me how he will match up the welcome provisions in the Bill with the need to ensure that action is taken? How will the resources match the responsibilities in the Bill?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

When it comes to resources for mental health, we have not been waiting for the Bill. Although the Bill is an important part of ensuring that people get the right treatment, the commitment to resources began with the NHS’s long-term plan, which means that an additional £2.3 billion a year will be going into mental health services by 2023-24. Alongside that, an additional £500 million at least has gone in to support people with mental health needs because of the pandemic.

Photo of Rachel Hopkins Rachel Hopkins Shadow Minister (Cabinet Office)

I refer to my entry in the Register of Members’ Financial Interests, as a vice-president of the Local Government Association.

Far too many people are sent to mental health and learning disability placements out of their area. In April 2021, the Government committed to end the practice, but in March 2022 some 670 people were in out-of-area placements and, most concerningly, 50 of them were more than 300 km away from their homes. When will the Government meet their target and end out-of-area placements? What discussions has the Secretary of State had with the Secretary of State for Levelling Up, Housing and Communities about the issue of commissioning?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

This is a very important issue on which the Government have been working with people across the sector, including in the NHS. We will shortly publish information on how we will build in the right support in the community plan.

Photo of Olivia Blake Olivia Blake Shadow Minister (Climate Change and Net Zero)

I am afraid we are overseeing a scandal brewing in compulsory treatment as a result of covid. Because of the lack of available tier 4 beds, children up and down the country are in medical wards, and we see unsettling reports of restraint being used to feed them even though, when they get to see a mental health professional, they should not be force fed. I am conscious that the Secretary of State has answered a question about this already, but will the Government commit to starting to record restraint for feeding, no matter where patients are in the system and including in medical wards?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

We of course want to ensure that children with mental health challenges, including eating disorders, get the support that they need. That is why during the pandemic—just last year—we put in an additional £79 million specifically for children’s mental health services. That is providing many thousands more children with that support.

Photo of Florence Eshalomi Florence Eshalomi Labour/Co-operative, Vauxhall

The Bill’s focus is on individuals who are sectioned under the Mental Health Act, which is important, but I refer the Secretary of State back to the issue of waiting times raised by many Members. In December, I spoke to my constituent who was concerned about the welfare of his child who suffers from an eating disorder. At every stage, it has impacted his mental health. Despite the local services, this child is still waiting, six months on, just to see a specialist. The limited staff available cannot cope. What is the Secretary of State doing now to address the issue so that we do not see more young people suffer?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

We are putting in record amounts of new investment, with newer services. During the pandemic, we established for the first time a national 24/7 all-age mental health helpline. I would like to make that permanent, beyond the pandemic. When it comes to NHS talking therapies, I mentioned earlier that some 1.25 million people were seen last year. We aim to get that up to 1.9 million over the next couple of years. When it comes to waiting times, the hon. Lady is right that there is a waiting time for high-intensity mental health services, and the NHS is of course working to bring that down. For low-intensity mental health services we have managed to bring the median waiting time down to 14 days nationally.

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

I thank the Secretary of State for his clear commitment to make things better. We are most grateful for that. I wholeheartedly welcome the strategy in his statement on mental health, but I am of the belief that the lockdown has impacted and exacerbated mental health issues in each corner of this great United Kingdom of Great Britain and Northern Ireland.

With that being the case, can the Secretary of State tell me what discussions have taken place with the relevant Minister in the Northern Ireland Assembly? Furthermore, the Secretary of State said that £2.3 billion had previously been allocated for this. How much will come to Northern Ireland through the Barnett consequentials, taking into account the fact that Northern Ireland has the largest percentage of mental health disorders in the United Kingdom and is in need of similar radical reform and, indeed, additional funding as well?

Photo of Sajid Javid Sajid Javid Secretary of State for Health and Social Care

Much of the work that has gone into the publication of this draft Bill, such as that carried out by Sir Simon as well as the work that went into the White Paper, would apply equally to Northern Ireland. We stand ready to work with our friends in Northern Ireland to help them if they wish to go down a similar route. I can also confirm that the Barnett consequentials for the £2.3 billion would have gone to Northern Ireland.