Queen’s Speech - Debate (5th Day)

Part of the debate – in the House of Lords at 6:59 pm on 17 May 2022.

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Photo of Baroness Tyler of Enfield Baroness Tyler of Enfield Chair, Children and Families Act 2014 Committee, Chair, Children and Families Act 2014 Committee 6:59, 17 May 2022

My Lords, I draw attention to my interests in the register, particularly as a non-executive director at the Royal Free London NHS Foundation Trust and as a member of the Financial Inclusion Commission. I wish briefly to highlight three areas today: mental health, carers and financial inclusion. I do not think that that last subject has come up yet.

Turning first to health, as we have heard, the main legislative plans are the long- awaited reforms to the Mental Health Act. However, the wider context cannot be ignored. Tackling the backlog of NHS care is a matter of life and death for many, or having to endure chronic pain, with growing waits for treatment, major workforce shortages and an unsustainable social care system following a decade of funding settlements that have failed to keep up with demand. Yes, these challenges have been accelerated by Covid, but they were leading to rising pressures on services well before the pandemic started.

I welcome, like others, the announcement of a draft Mental Health Act reform Bill; many of the reforms are urgently needed. I look forward to scrutinising the detail of the legislation relating to detention criteria, the offer of a mental health advocate for all in- patients, changing the definition of mental disorder so someone cannot be detained solely because they have a learning disability or are autistic, and a greater voice for all in-patients in detention in their treatment and care. However, I believe there are areas where the current proposals should go further, including by abolishing community treatment orders, addressing race inequalities and equity more comprehensively in the Act, and ensuring the reforms work for children and young people too. It is vital that the reforms are fully funded and that there is sufficient investment in mental health, particularly the workforce, to ensure that everyone can access the support they need when they need it.

Therefore, will the Minister answer the following questions, or perhaps write to me if that is easier? First, what is the timeframe for pre-legislative scrutiny, introduction of a Bill and implementation of the reformed Act? Secondly, are the Government proceeding with all the reforms included in the White Paper? Thirdly, will the Minister provide assurance that children and young people will benefit from the reforms at least as much as adults?

Of course, we also need a much stronger focus on preventing people reaching the point where they risk being sectioned. This means deeper and wider preventive mental health work in our communities, but the most important thing the Government need to do, as we have heard already, is to introduce proper workforce planning across both health and social care that is designed to meet both current and future demand for care, as so many of us argued for powerfully during the recent passage of the Health and Care Bill. What a pity those clarion calls went unheeded.

Like others speaking in today’s debate, I was particularly disappointed that the gracious Speech contained no reference to carers’ leave to help carers juggling work and unpaid care at a time when they most need it—not least because it was a Conservative Party manifesto commitment back in 2019. Responses to the Government’s consultation were positive, from carers and employers alike, with 53% of working carers saying they need unpaid leave in order to juggle work and care successfully. We are talking not about giving people leave so that they can sit in the garden, but giving carers the flexibility to ask for leave to attend medical appointments, provide short-term care and step in if care arrangements break down. Can the Minister explain the Government’s current position on carers’ leave and when we can expect to see proposals bought forward? Does she agree with me that support for carers is an integral part of both tackling health inequalities and levelling up?

I turn now to financial inclusion, which I see as a critical part of the levelling-up agenda. The financial services and markets Bill is potentially an excellent opportunity to redesign financial services regulation. It is a chance for the Government to ensure that both the financial regulator and the industry better serve the needs of consumers. However, I strongly believe that this can only be achieved by giving the Financial Conduct Authority a “must have regard to financial inclusion” duty as part of its overall remit. The soaring costs of living have only increased the importance of making sure that everyone has access to financial products and services that meet their needs; but low-income and vulnerable consumers still struggle to afford, are having to pay extra for or are unable to access appropriate services.

Finally, I turn to access to cash. Three years ago, the Access to Cash review warned that Britain was sleepwalking into a cashless society. This has been exacerbated by Covid. Recent research shows that 10 million people would struggle to cope in a cashless society. That is why I was pleased to see the announcement in the gracious Speech of the Government’s intention to legislate to protect access to cash, which is important to so many people. This must be seen as part of the levelling-up agenda.