Ben Spencer MP: speeches

Speeches

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  I rise to speak in support of the Bill. To begin with, I need to make a couple of declarations. I have a family member who is a consultant psychiatrist. I am now a non-practising general adult psychiatrist with an endorsement and years in psychiatry, and I previously worked as a consultant psychiatrist. I took part in the 2018 Wessely review as a panel member on the tribunal working group, and I was on the pre-legislative scrutiny Committee in the last Parliament. In a declaration of a more personal nature, this is an area that I feel passionately about. It is a great privilege to speak to this important piece of legislation and reforms going forward. The United Kingdom reforms its mental health legislation every 20 years or so. I did not want to correct the Secretary of State, but the first Mental Health Act was in 1959—I hope that was substantially before he was born, with reference to his earlier comments. The legislation has gone through various iterations from the original Lunacy Act and similar legislation in the 19th century. In the UK, we have always been at the forefront of reform to the law and to provisions and powers in this area. It is important in this Second Reading debate to focus on what the Mental Health Act is and what it does. Members have talked more broadly about the challenges of delivering mental health care currently, but it is important to reflect that the Mental Health Act is very specific and precise. It is about the regulation of detention—sometimes for assessment, sometimes for treatment—of people with mental disorder, and has a range of powers on aftercare and guardianship. It is focused on detention and assessment, or treatment, of people with mental disorder. We need that because there are times when people with severe mental illness become so unwell that they are unable to recognise their illness. Their illness puts their health at risk—predominantly through self-neglect or non-treatment. It puts their safety at risk, again through self-neglect, as well as through suicide. And, less commonly but critically, it puts them at risk of causing harm to others. The legal framework allows us to regulate compulsory treatment in that regard. It is absolutely critical that we have those powers so that, when people are so unwell that they do not recognise it and they lose agency, we can, as a compassionate society, take them into hospital and treat them, with a view to getting them back to themselves. I have used the 1983 Act countless times, applying it both to assessments and, as a section 12-approved doctor, to treatments, and I have used it as a responsible clinician. I suspect that I am one of the few Members of this House—certainly in this debate—who has had those roles and responsibilities. In terms of framing, it is important to reflect that one of the key changes in the 1983 Act, which is such an important piece of legislation, was that it was about restricting powers and ensuring that there were strong procedures for reviewing detentions. As a former health professional in this area, I am certain that all professionals working in it are mindful of the scope of powers that the Act provides. When applying restrictions, people do not use these powers in anger or without a great degree of thought and contemplation. The most intrusive intervention available to us in the health service is to detain and treat people in hospital or in secure hospital settings. Those powers are not taken lightly. A lot of concern was expressed at the start of the debate—and I am sure it will continue—about the way in which people have been treated in hospital. There have been some very high-profile scandals in which things have not worked well, to say the least, and care and treatment have been atrocious and abusive. However, people working in health and care in the UK are doing so because they want to see the best outcomes for their patients. Sometimes, they are limited in that because of the resources available. They do not use the Mental Health Act with a view to harming people, but with a view to helping them. Being detained under the Mental Health Act is not a prime facie harm; it is a treatment and a good thing. If someone needs to be detained and treated in hospital, they need to be detained and treated in hospital. If I became so unwell that I needed to be detained under the Act, I would want to be detained. Thankfully, I am not in that position today— [ Interruption. ] At least I believe that I am not, although the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), might have a different view on that. [ Laughter. ] Should I get to the point where I am so unwell that I cannot consider my own care, I would want the powers of the Mental Health Act to be used quickly, particularly if I were posing a risk to myself, my family and others, so that I can get better and back to living my life. I pay tribute to Baroness May of Maidenhead, who kicked this off, and to Professor Sir Simon Wessely—a good friend—Stephen Gilbert, Sir Mark Hedley and Rabbi Baroness Neuberger for their work in the 2018 review. There is a lot of good work in the Bill, from the greater focus on advance care planning and the more frequent detention reviews, which I recognise may bring a workforce burden, to the provisions on nominated persons. I will not go into the detail in this Second Reading speech, but I will focus on a few general points on which I think a bit more work needs to be undertaken. In some ways—I will have to message Sir Simon after this to ask his forgiveness—the Bill is a missed opportunity in that we have are not moving towards fusion law. For the benefit of those who are not all over the detail, at the moment the UK has two pieces of legislation regulating how to treat people in the absence of consent. The Mental Capacity Act 2005 came about from case law in the ’80s and ’90s and was codified in 2005. That Act broadly regulates physical health treatments for people who lack the capacity to consent—we have focused quite a lot on capacity in the recent debates on the Terminally Ill Adults (End of Life) Bill. The principles of the 2005 Act are autonomy and the functional capacity and best interests tests for people who lack capacity, meaning that we test someone’s capacity, and only if they lack capacity can we intervene in their best interests, sometimes by using deprivations of liberty. The Mental Health Act arose from a very different pathway. In its first days, it was more about the regulation of asylums. The Act is about status and risk. The gatekeeper conditions for the current Mental Health Act are that a patient has a mental disorder of a nature and a degree that requires assessment in hospital because of the risk to their health and to the safety of others. Capacity does not feature whatsoever. We have two pieces of legislation. One applies to the most severe mental disorders and deals with status and risk, and the other deals with autonomy and best interests. I strongly believe that the two need to be merged. We should use capacity and best interest frameworks to regulate treatment of mental disorder in the absence of consent—there are ways of doing that. I like the fact that we are starting to incorporate a bit more in the Bill.

• 4 Mar 2025 · Data (Use and Access) Bill [ Lords ] (First sitting) · Hansard source

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  Amendments 10 and 11 seek to remove certain provisions that were introduced in Committee in the other place. I thank Sex Matters for its work, but also many people in this policy area who have tried to focus on the importance of data accuracy and validity when it is used. I hope we all agree that it is important that data, when it is collected—in fact it is a principle of data collection and maintenance—is accurate and correct and that there is no point holding or using data if it is incorrect. Biased data is worse than no data at all. Therefore, I do not understand—especially given the extra use of the data that will come as part of digital verification services—why the Minister and the Government are not keen on the provision to stipulate that public bodies that hold sensitive data should be certain of its accuracy, particularly when the data is going to be passed on and used as part of digital verification services. I am confused by the resistance to ensuring that the data is correct, particularly when we anticipate that it will be used as part of a far bigger spectrum. It will be consumed by a digital verification service in which it is not routine to go back and look at the original paper records. The only dataset to be relied on will be some Oracle Excel spreadsheet or whatever database is used by public authorities. This debate has become more acute with regard to the importance of sex data. It is critical that sex data is available to protect public spaces and to be used in scientific research to allocate someone’s sex as part of medicine and healthcare. I speak as a former doctor, and I guess I should declare an interest in that I am married to a doctor. The use of sex data is critical in medical screening programmes, such as cervical screening and prostate screening, to understand and interpret investigations. It is critical that the data is accurate; otherwise, there is a danger that research will not be appropriate or will produce bad results, and there is also a potential degree of medical harm. It is critical that we get sex data correct when it is being used. I do not agree with the argument that requiring the disclosure of sex data is either disproportionate or somehow a breach of the European convention on human rights. The whole point of digital verification services is proportionate disclosure. In fact, we have heard speeches from both sides of the Committee about proportionate disclosure, and limiting the amount of personal data that is passed on as part of a digital verification service. My challenge is, quite simply, that if somebody is collecting sex data as part of a verification system, why are they doing so? If they do not need to know what someone’s sex is, it should not be collected. Digital verification services allow people to choose their proportionate disclosure. There will be times when sex data is required for renting a property—that example has been used before—because people may want to rent properties in single-sex accommodation. I may argue that is a proportionate disclosure. If it is a standard rental property in another situation, it is probably a non-proportionate disclosure. Another argument has been made that it is needed to triangulate data to verify ID. Again, that does not seem to work, because the whole point of a digital verification service is to allow someone to have a digital ID framework and use different points to verify. The perversity of this debate is that these schemes and their proportionate disclosure protect people’s identities. They protect people from non-disproportionate disclosure. We need to make sure that the data we are using is accurate and correct, and that it says what we want it to say when someone is inquiring about somebody’s sex. If somebody is asking for sex data but they do not need it, people should be able to say no, which the existing provisions allow for.

• 6 Jan 2025 · NHS Backlog · Hansard source

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  My right hon. Friend is absolutely right; it is important that patients have information and choice, and that they have the flexibility to move between different practices to suit their needs. My view is that the GP list system does not work. It does not make sense as it currently stands, and it limits the ability of patients to seek the care that they need in a timely manner. As he just mentioned, people get stuck in practices that are not performing or are not working for them, and they have no ability to move out of them. My right hon. Friend also mentions the role of the ICB/ICS system, which brings me to my final point. As a constituency MP, I find it incredibly frustrating that I have no direct control, power or hard influence, as opposed to soft influence, over the local ICS/ICB system. I can write letters and campaign, and I have spoken in debates in Parliament. I have led a debate on the Weybridge health centre, which is finally going to planning after the drama of multiple consultations. My only ability to direct what is happening on the ICB is through directly asking Ministers questions in Parliament, or by trying to get them to intervene. When the Health and Care Act 2022 was going through in the last Parliament, I raised with the then Minister my concerns about the accountability of our ICSs and ICBs. We have a real problem with what we MPs can do to ensure that our ICBs and ICSs are performing for people locally, because there is a disconnect in the link of accountability. I believe that the Secretary of State for Health and Social Care and the Ministers on the Front Bench absolutely want to see all our local NHS services performing at their very best. I totally believe that they are in it for the right reasons and want to see better performance, and I want to help them deliver that. But with all the enthusiasm and will in the world, are they going to take the same interest in my local area as I do? We MPs need the ability to cajole and to direct what our local NHS services are doing in order to deliver the best possible care for patients. After all, we are the locally elected representatives and, as we saw in this year’s election and will see in elections going forward, there are always 24 hours to save the NHS.

• 20 Nov 2024 · Shared Rural Network · Hansard source

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  We welcome the recent update on the expansion of 4G to rural areas under the shared rural network project, particularly for businesses and farmers who are under such pressure at the moment, with the recent Treasury announcements. Which Secretary of State should we thank for the planning approval and funding of this vital infrastructure project?

• 10 Oct 2024 · Mental Health Support · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Dowd. I start by declaring that I am a former consultant psychiatrist and that a family member is a consultant psychiatrist. Listening to this debate has been a mixed experience. It has been great to hear the wealth of talent and expertise that we have in the House, but at times it has been harrowing to hear people speak about their personal experiences or those of their constituents. That is a reminder to us all of just how substantial the impact of mental illness can be on people—our families and friends. The tone in which this very sensitive debate has been conducted is fantastic. I thank the hon. Member for Ashford (Sojan Joseph) for bringing forward this debate, for the wealth of experience—22 years—that he brings to this place, and for a very balanced speech in which he acknowledged the catchment investments under the previous Government and raised the importance of waiting lists. When I was first elected, I brought up targets for mental health in a private Member’s Bill, which did not end up going anywhere, on waiting times for getting an in-patient bed when one is requested for somebody with a mental disorder. Of course, we all want improvements in mental health care and treatment, and there need to be improvements in mental health care and treatment. I am sure there will be no disagreement across the House about that. The hon. Member for Ashford was absolutely spot on to mention housing, work and benefits. It is a testament to his experiences in psychiatric nursing that he went on to mention the surrounding holistic care. One of the challenges of debates on improving mental health services is that we must acknowledge that that involves many other areas of public policy, public provision and cultural factors, and try to broaden that as much as possible.

• 19 Jul 2024 · Planning, the Green Belt and Rural Affairs · Hansard source

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  My constituency has vast swathes of high-risk flood area—zones 2 and 3—and we see flooding every year; we saw it most notably in 2014, but also in January. Will the right hon. Lady’s planning reforms protect areas at high risk of flooding, so that they are not built on, making our flooding worse?