Gregory Stafford MP: speeches

Speeches

• 1 Jul 2025 · Hospitality Sector · Hansard source

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  I held a pub and hospitality roundtable in my constituency, where publicans stated that the changes in the Budget had been worse than covid for their balance books and the viability of their businesses, because at least during covid the then Conservative Government gave relief and help to them; this time, they have received nothing.

• 1 Jul 2025 · Hospitality Sector · Hansard source

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  In Farnham, the Nelson Arms pub uses zero-hours contracts, and it needs them. I spoke to a staff member who said that the reason he was so keen on them is that he is actually a paramedic, and between his shifts he worked at the pub. That worked for him and the pub, because it gave them both flexibility.

• 26 Jun 2025 · Topical Questions · Hansard source

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  The Minister may be aware that the outline business case for improvements to the A31 at Hickley’s Corner in Farnham will come before her in a couple of months’ time. While I understand that she cannot make any promises now, will she at least agree to look kindly on that application and meet me to discuss it?

• 24 Jun 2025 · Department of Health and Social Care · Hansard source

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  I congratulate the hon. Member for Birmingham Erdington (Paulette Hamilton) on securing the debate. We have learned this week that rather than the Government ensuring that funding reaches the frontline, spending on staff at the Department of Health and Social Care and seven other arm’s length bodies has increased by more than 10% since Labour came to power, while GPs, social care providers and hospices are forced to do more with less. The situation is further compounded by rising financial pressures. Despite repeated promises that additional funding would improve patient care, the chief financial officer of NHS England has confirmed to the Select Committee that all the extra money allocated to the NHS will be swallowed up by national insurance increases, inflation and pay settlements, which means that none of it will go towards real improvements in frontline care. The rise in national insurance contributions was supposed to bolster the NHS and social care. In reality, it has landed like an extra tax on providers themselves. GP surgeries, care homes, hospices and community services are all grappling with the additional payroll costs, just as they struggle with surging demand and chronic workforce shortages. The Institute of General Practice Management estimates that the average GP practice now pays an extra £20,000 a year in national insurance alone. Across the nearly 6,500 practices, that adds up to around £125 million a year—money that could otherwise pay for more than 2 million GP appointments, at a time when patients are struggling to be seen. Adult social care providers face an equally stark reality. The Nuffield Trust projects that employers will shoulder nearly £940 million in extra national insurance costs in this financial year, on top of the £1.85 billion required to cover the rise in the national living wage. Local councils already face a £665 million shortfall in delivering their legal social care duties. The Government have promised a 3% real-terms rise in NHS revenue spending each year to 2028-29, reaching £232 billion by the end of that financial year, yet despite the headline increases, capital investment is being held flat in real terms. NHS leaders have made it clear that it will not be enough to rebuild or modernise our hospitals, or to fund the facilities required to support more care in the community. The Health and Social Care Committee’s recent inquiry, “Adult Social Care: the Cost of Inaction”, has drawn attention to the enormous human and economic toll of the Government’s failure to reform the care sector. From the burden of unpaid carers to the economic impact of people leaving the workforce due to unmet care needs, the system is under severe and unsustainable strain, but rather than tackling this issue, the Government have once again kicked social care into the long grass and are waiting for a report from Baroness Casey that will probably not emerge until the very end of the Session. The cross-party talks that this Government promised have been scrapped again. Although the spending review includes £4 billion in additional adult social care funding and an increase in the NHS minimum contribution to the better care fund, there remains little clarity on how the Government will fund their commitment to deliver a fair pay agreement for care workers. It is also far from clear that the better care fund is currently structured to meet the real needs of the care sector, rather than simply alleviating pressures in primary care. These estimates are not abstract figures; they translate directly into longer waits for elderly patients, overstretched family carers and staff driven to exhaustion. Can the Minister confirm exactly how much funding the Government will allocate next year to tackle the social care workforce emergency, reduce waiting lists for assessments and services, and ensure that councils can meet their statutory obligations? What concrete recruitment and retention measures will be put in place to attract and retain carers, nurses and support workers in this vital sector, and how much new capital investment will be committed to help providers to modernise facilities and expand capacity to meet the needs of our growing and ageing population? When will the cross-party talks that the Government promised on social care happen? They must happen; otherwise, all the good effort—from Members on both sides of the House—on this issue will be lost. Finally, with social care vacancies entrenched and NHS productivity still trailing pre-pandemic levels, will the Minister set out what credible workforce and capital investment plans will be included in the forthcoming NHS 10-year plan to address these challenges once and for all? I pay tribute to all the health and social care workers—employed or voluntary—across this country. This Government, with their massive majority, have a real opportunity to make real changes. They must start doing so now, and quickly.

• 24 Jun 2025 · China Audit · Hansard source

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  Will the Government publish a list of sectors considered overly dependent on Chinese input, starting with critical minerals and clean energy components, to promote transparency? Will the Foreign Secretary outline any clear Government targets for reducing those dependencies?

• 24 Jun 2025 · Mental Health Bill [ Lords ] (Ninth sitting) · Hansard source

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  My hon. Friend is being slightly charitable to the CQC. Given Penny Dash’s review, we all know that the CQC has significant problems, otherwise we would not be reviewing it. Does my hon. Friend agree that the new clause is absolutely vital because of the failures of the CQC up to this point, and our lack of faith in it being able to meet the challenges that this legislation will bring to the mental health sector? Does she also share our concern about the CQC’s ability to regulate and scrutinise properly?

• 24 Jun 2025 · Mental Health Bill [ Lords ] (Ninth sitting) · Hansard source

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  I am very sympathetic to the hon. Member’s concerns, but how does she see the new clause fitting in with the already established armed forces covenant, which protects and promotes healthcare for veterans across the country?

• 23 Jun 2025 · Child Poverty · Hansard source

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  When the Government’s own impact assessment for the “Pathways to Work” Green Paper suggests that 50,000 children will be plunged into poverty and businesses are already slashing vacancies in the light of the Employment Rights Bill, does the Secretary of State really believe that the Government’s child poverty taskforce is pushing in the same direction as the rest of the Government?

• 19 Jun 2025 · Incontinence · Hansard source

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  Thank you very much, Mr Deputy Speaker. I welcome you to your place today. It is an honour to speak in this debate on behalf of His Majesty’s Opposition, and I pay tribute to the hon. Member for Dudley (Sonia Kumar) for securing it. Her speech included the wealth of experience that she brings to the topic, and I especially congratulate her on putting this issue so clearly on the agenda today in the House. It was a powerful and wide-ranging speech that demonstrated the wide range of issues and conditions that can lead to incontinence. As the hon. Member for Nuneaton (Jodie Gosling) told us earlier, incontinence is a condition that affects around 14 million people across the UK, yet too often it remains misunderstood, under-discussed and—worse still—dismissed. One in three women experience urinary incontinence, and half a million adults live with bowel incontinence. Incontinence does not discriminate; whether bladder or bowel, temporary or chronic, or mild or severe, it touches people of all ages, backgrounds and walks of life. It affects new mothers, people recovering from surgery, those with neurological conditions, the elderly, and even children. However, too many suffer in silence, held back by stigma, isolation, or the belief that nothing can be done. Like other Members, I received some heartbreaking stories from my constituents in Farnham, Bordon, Haslemere, Liphook and the surrounding villages. Incontinence is a medical issue, not a personal failing. It is not something to be ashamed of; it is something to be addressed through compassion, awareness and proper care. The impact of incontinence can be profound. It affects people’s confidence, their work, their relationships and their mental health. That is why Continence Week, which we are currently marking, matters. We cannot expect people to reach out for help unless we first create a culture where they feel safe and supported in doing so. We also need to ensure that services are in place to respond when they do seek help. That means better access to continence nurses, urologists, and physiotherapists, such as the hon. Member for Dudley. It means investing in community support, and in research and innovation, and recognising that continence care is a core part of our health system, not an afterthought. I therefore welcome the Government’s stated ambition to tackle inequalities in women’s health and to address conditions such as incontinence more seriously, but warm words and long-term ambitions are not enough when so many continue to struggle. For example, the “Excellence in Continence Care” guidance, first published in 2018, was a groundbreaking piece of work, but we now need clear next steps, funding and measurable outcomes. We must not allow this to drift for another seven years while millions suffer in silence. Under the previous Conservative Government, we delivered real and lasting progress in this area. In 2022, we published England’s first ever women’s health strategy, a genuine turning point shaped by listening to more than 100,000 women’s voices. That strategy committed to trauma-informed care, expanded research and, crucially, improved the quality and accessibility of information on the NHS website so that women could make informed choices about their own health. Under our leadership, women’s health hubs were launched with a clear mandate to exist in every integrated care system, bringing services closer to communities and breaking down barriers to care. We also ensured the creation of specialist mesh centres across England, delivering multidisciplinary, regionally-based care for women facing the severe consequences of surgical complications. At a recent roundtable I attended with lecturers from Bath University on mesh, Primodos and valproate, it was clear that there is still more work to do to support these women and to learn from the past. I thank the hon. Members for Wolverhampton West (Warinder Juss) and for Harlow (Chris Vince) for raising the mesh scandal so passionately earlier. On incontinence, the Conservative Government backed National Institute for Health and Care Research funding for vital research into patient-reported outcome measures, empowering patients, improving clinical care and ensuring that the lived experience is properly reflected in decision making. As my hon. Friend the Member for Dumfries and Galloway (John Cooper) so powerfully elucidated earlier, men are often forgotten in this area. On the Opposition Benches, we support any culture and any steps that will help men with incontinence. As the hon. Member for Strangford (Jim Shannon) mentioned, we men are pretty poor at going for diagnosis and treatment, and that needs to change. The scale of the issue remains significant. Nearly half of women experience incontinence after childbirth and one in 10 experience faecal incontinence, yet only 17% seek help. That is often because they are told subtly or directly that it is simply part of ageing or the price of motherhood. That attitude was unacceptable then and must not be tolerated now. When a third of women suffer pelvic floor disorders after giving birth and still face barriers to care, when men living with incontinence are afraid to leave their homes, and when people are forced to depend on charities for access to basic hygiene products, it is clear that we have a public health problem that transcends mere inconvenience. Will the Department commit to publishing an updated “Excellence in Continence Care” strategy this year, with clear timelines and accountability? Will we see dedicated funding to expand women’s health hubs further, so that continence care is a core service, not a bolt-on? Will the Minister also bring forward a plan for better health services for male incontinence? Will NHS England guarantee national consistency of access to continence services and products, ending the unacceptable postcode lottery? Will the Government protect and grow funding for continence research to improve treatments for men and women? Finally, I pay tribute to the organisations, including Bladder and Bowel UK, Prostate Cancer UK and the Urology Foundation, that are breaking taboos and supporting patients so tirelessly, but it is not their responsibility alone; the Government must lead. We Conservatives made a start, and we now need the current Government to have the same urgency, ambition and delivery to ensure that these hard-won improvements are built upon so that no one is left to struggle in silence.

• 19 Jun 2025 · Mental Health Bill [ Lords ] (Seventh sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Sir Desmond. You and the Committee will be pleased to know that my hon. Friends have made most of the points I wanted to flag. In poll after poll and survey after survey, patients feel they do not get information in a timely and constructive way. Our amendment 46 would give patients a stronger say in their future care if they lose capacity. It clarifies that patients must be given clear, proactive support to understand, prepare and use the documents. It is about ensuring that advance choice documents are not just theoretical paperwork, but living, respected statements of a patient’s wishes. I therefore support the clause and the amendment, and I ask the Minister three questions. How will NHS England and local integrated care boards ensure that commissioners are trained to respect and use ACDs in practice, especially in emergencies? Secondly, what oversight will ensure that ACDs are not simply ignored at the bedside, when a patient is most vulnerable? Will the Government consider a review mechanism so that we can assess how well ACDs are working in a few years’ time, after the Bill is passed? I turn briefly to Liberal Democrat amendment 18. Like other hon. Members, I feel that the inclusion of financial information in an ACD is not appropriate, both from a practical and a personal security, safety and information point of view. I do, however, completely support the hon. Member for Winchester’s overall view that there is a significant problem with how financial stress can affect a person’s mental health. Like him, I call on the Minister to think about how we as a country, whether in this Bill or somewhere else, can address the impact of financial stress on mental health.

• 19 Jun 2025 · Mental Health Bill [ Lords ] (Eighth sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Mrs Harris. I rise to speak in support of clause 54, but with the caveat that it would be much more effective if new clause 12, in the name of my hon. Friend the Member for Hinckley and Bosworth, were added to the Bill. Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 requires healthcare providers to notify the Care Quality Commission of certain serious incidents. However, it may not comprehensively cover all mental health-related admissions of minors. Clause 54 responds to concerns about transparency and safeguarding in child and adolescent mental health services, and aims to ensure that all relevant incidents are properly monitored and reported. Like other hon. Members who have spoken, we welcome the Government’s shift to improve these standards; there is support for that across the Committee. The clauses about children and young people are some of the most vital parts of the Bill. They are vital not only to get the Bill right but, more importantly, to ensure that children are protected. That is why new clause 12, in the name of my hon. Friend the Member for Hinckley and Bosworth, is so essential to strengthen the Bill. The new clause would amend section 131A of the Mental Health Act 1983, which governs the accommodation of children in mental health settings. It responds to ongoing concerns about the inappropriate placement of children on adult wards, which can be distressing and unsafe, and which is clearly contrary to best clinical practice. The new clause would introduce a requirement that hospital managers must justify such placements in writing, including an explanation of why no alternative was available, and the steps being taken to ensure the child’s safety and transfer to more suitable accommodation. The new clause would also introduce mandatory reporting to regulatory authorities when a child was placed on an adult ward for more than 24 hours, and to local authorities when the placement exceeds 28 days, or involves an out-of-area admission. The new clause would ensure that children are placed on adult wards only when absolutely necessary. It requires the written justification and formal notification of placements. It involves local authorities and regulators in monitoring prolonged or out-of-area placements, and strengthens and clarifies existing provisions of the Mental Health Act. Most importantly, it aligns with clinical guidance on age-appropriate mental health care. I turn to new clauses 17 and 20, tabled by the Liberal Democrats. I think that their purpose is in some ways similar to that of our new clause 12. However, they put the cart before the horse, or the horse before the cart —it depends on which way round we are. We are trying to fix the system by ensuring that nobody enters an inappropriate place unless there are exceptional circumstances; new clauses 17 and 20 try to exclude those circumstances, but without necessarily fixing the problem in the first place. Although I understand, as ever, the motivations and sentiments of the new clauses tabled by the Liberal Democrats, I do not think they will have the intended consequences; at least, I do not think they will be effective. I have two questions for the Minister about clause 54. First, will the Department publish regular summaries of the notifications mentioned in the clause showing trends and disparities across the services or regions? Secondly, will the Care Quality Commission be resourced and empowered to act swiftly where patterns of overuse or misuse emerge?

• 18 Jun 2025 · Endometriosis · Hansard source

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  What commitment can the Minister give that the community diagnostic centres programme, which was started under the Conservative Government—[Hon. Members: “Hear, hear!”] I’ll start again. What commitment can the Minister give that the community diagnostic centres programme, which was started under the last Government, will be used effectively to treat and diagnose not just endometriosis, but all the conditions listed in the women’s health strategy?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Fifth sitting) · Hansard source

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  I appreciate that the hon. Gentleman sees the potential benefit in the amendments standing in the name of my hon. Friend the Member for Runnymede and Weybridge. However, my hon. Friend the Member for Hinckley and Bosworth gave an example, which I do not think is entirely distanced from reality or possibility, in which a person could well choose someone who is deeply inappropriate. In that situation, the person or people—that is, the parents—who had in every other part of life had responsibility for that child would now potentially not have responsibility for the child, in what is probably the most important part of that responsibility. Does the hon. Member for Southend West and Leigh really not have any concerns about that? If he does, does he not support at least the intentions behind those two amendments, if not the exact wording or drafting? If he does accept those intentions, would he like to see the Government table similar amendments, drafted in a way that he would find more appropriate?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Fifth sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Sir Desmond. Taking a step back to my hon. Friend’s point about “necessary”, is he concerned, as I am, that it is not clear to those responsible what “necessary” means? We could open ourselves up to potential legal challenges and disputes, which would give lawyers lots of money but would have no benefit for the patients.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Fifth sitting) · Hansard source

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  I thank my hon. Friend for his comprehensive analysis of the provisions under discussion. Does he understand amendments 54 and 55 to mean that, although there would be a narrowing of who can be chosen as the nominated person, there would still be some flexibility for the child to choose? Does he have any concerns about a situation in which a minor—someone under the age of 16—may, for whatever reason, choose somebody who the health professionals believe is not the most appropriate person, and does he have any sympathy with the idea that, given a parent has responsibility for the child in every other aspect of their life, the parent should have that same responsibility in this context?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Fifth sitting) · Hansard source

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  I rise to speak to clauses 22 and 23 and to Liberal Democrat new clause 4. As my hon. Friend the Member for Hinckley and Bosworth said, the Opposition support clauses 22 and 23 generally. Clause 22 addresses the concern that community clinicians—essentially, those responsible for overseeing a patient’s care outside hospital—have historically had limited formal input into decisions about community treatment orders, even though they are central to the patient’s ongoing care. It ensures that community clinicians not only are consulted but, in some cases, must provide written agreement before key decisions are made. It aims to improve continuity of care, ensure decisions reflect the realities of community-based treatment, and reduce inappropriate and poorly co-ordinated use of CTOs. The benefits of the clause are obvious, but they are worth restating. Clearly, it improves the continuity of care and ensures that clinicians with direct knowledge of the patient’s community care are involved in those key decisions. It enhances safeguards, adding an additional layer of professional oversight before coercive measures are imposed or suggested. It promotes collaboration by encouraging joint decision making between the hospital-based and community-based clinicians, and it reduces the risk of inappropriate CTOs by ensuring they are used only when genuinely appropriate and supported by those delivering care. However, I ask the Minister to touch on three points. First, requiring a written agreement or consultation could delay urgent decisions if not managed efficiently, so will he explain how, under the clause, any potential delay—a disagreement or just administrative inertia—can be removed to ensure treatment is not delayed? That moves me on to the administrative burden. Clearly, the clause adds a level of complexity and requires more documentation and co-ordination. Although I understand that that is a necessary outcome, I would again be grateful for the Minister’s thoughts on how to ensure effective and speedy implementation. As my hon. Friend the Member for Hinckley and Bosworth said, the ambiguity in the roles of the two clinicians may create confusion or disputes over responsibilities if they are not clearly defined or agreed. My reading of the clause is that there is no such clear definition; will the Minister look to provide one through other agencies, or will he put something into the clause in Committee or later in the Bill’s proceedings? Clause 23, on the conditions of community treatment orders, addresses the concerns that the threshold for imposing conditions on community treatment orders has been too low, allowing conditions that may be clinically unnecessary or overly restrictive. By removing the “appropriate” test, the clause will tighten the legal standard to ensure that only necessary conditions are imposed. Additionally, the clause will empower tribunals to play a more active role in scrutinising CTO conditions by allowing them to recommend that clinicians review specific conditions, even if the patient is not discharged. This reflects the Bill’s broader aim of enhancing patient rights and removing unnecessary restrictions. The clause is a welcome addition. It will ensure that CTO conditions are imposed only when strictly necessary, meaning that there are stronger safeguards, and it will enhance the role of tribunals in protecting patient rights without requiring full discharge. It will reduce clinical overreach by preventing the use of overly broad or vague conditions that may not be clinically justified. However, as with the previous clause, I have some questions. First, the tribunal power is limited in that it can only recommend, not require, the reconsideration of conditions. Is that the intention, or will the Minister strengthen the clause at some point to ensure that the tribunal can require a reconsideration of conditions? If he will not, what issues does he see arising from there not being a reconsideration? Secondly, as I mentioned in my intervention on my hon. Friend the Member for Hinckley and Bosworth, I have a concern about the potential ambiguity in the shift from “appropriate” to “necessary” leading to uncertainty or dispute over interpretation. As we touched on in relation to other clauses, clinicians will need additional guidance or training to apply the revised standard consistently. Where will that revised training and guidance be located, and what is the timeframe for its implementation? We need to ensure that all clinicians are fully trained and ready to use this new power. I will briefly touch on new clause 4, tabled by the Liberal Democrats, because although I understand that the hon. Member for Winchester may not press it, somebody else might. It would place a general duty on integrated care boards to ensure that services in the community have the necessary level of resource to meet demand such that the provisions of the Bill function as intended, and to assess and report on this every two years. As my hon. Friend the Member for Hinckley and Bosworth mentioned, the Opposition generally support the overall aims of the new clause, but as ever, there are some issues with the detail, so I have five questions for the hon. Member for Winchester if he responds, or for the Minister to answer in his summing up. First, if we imposed a statutory duty on ICBs to ensure sufficient resources for the CTOs, what mechanisms would there be to monitor and enforce compliance? Secondly, what would be the consequences if an ICB failed to meet this duty? Would there be formal accountability or a sanction process? Thirdly, how would the duty interact with existing NHS budgetary constraints and competing priorities? Would it become a statutory obligation with no clear means of redress if unmet? Fourthly, could the duty set a precedent whereby Parliament mandates resource guarantees without providing additional central funding? Finally, what constitutes “sufficient” resources in the context of the CTOs? Who defines that standard, and it is defined locally or nationally?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Fifth sitting) · Hansard source

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  My hon. Friend makes a powerful point. I remember the comments made by the hon. Member for Southend West and Leigh, who is chuntering from a sedentary position—I think he disagrees with my hon. Friend’s point. In his reply to my intervention, he made the point that there are situations in which things are the other way round, where those who have parental responsibility are not necessarily the appropriate persons. Does my hon. Friend agree that, on first principles, the parent should have parental responsibility in all areas of life, including the ones that she is talking about, unless there are specific reasons, such as the court decision to which she referred, that suggest that the parent is not the correct person to have responsibility? Surely, in the balance of danger or risk, there is a far greater risk if the nominated person is not a parent than if the nominated person is a parent.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  Does my hon. Friend think that if there is a backlog, that could undermine patient rights or clinical progress in some way? How will the tribunal system be able to cope with that increased workload and meet its legal obligations to provide timely tribunals so that patients get the best care?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  I apologise—this may be due to the terminology of “amendment” versus “clause”—but is the Minister saying that the Government are likely to vote against clause 35 as it currently stands? He is talking about amendments and clauses, and that is slightly confusing me. [Interruption.] His officials are nodding.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  Surely the fundamental part of the Bill is self-assessment and self-reflection. That does happen in some cases, and certainly in other parts of the healthcare system, but in this area generally does not; when it does happen, it is done in an inconsistent manner. The clause seeks to formalise things and to ensure that there is a benchmark by which service users and patients can feed back to the service they have just come from, to improve services. Does my hon. Friend share my confusion about why the Government would want to take that out?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Mrs Harris. I rise to speak in support of clauses 24 to 28, schedule 2, and the vital amendments 54 and 55 in the name of my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). Together, those provisions form a crucial pillar of the Bill, which must modernise our framework for the 21st century while not forgetting one of the oldest truths in our social contract: that parents, not the state, bear the first and deepest duty to protect their children. The Bill will reform an Act that has stood in various forms since 1983, and which was itself built on a much older legacy of how this country balances individual liberty with the need, in rare cases, to deprive someone of that liberty for the sake of that person’s safety, or the safety of others. For decades, that balancing act has been shaped by the so-called “nearest relative” rule. However well intentioned that rule was, it has often failed to serve the people it is meant to protect. Patients have found themselves legally represented by estranged parents, distant cousins or an ex-spouse with whom they have had no contact for years. In the worst cases, that has compounded trauma and undermined recovery. Clause 24 will address that problem by giving patients the power to appoint a “nominated person” of their choosing: someone whom they trust, who understands their needs, and who can speak up when they themselves cannot. That is, quite simply, the right approach for modern mental health care. It is grounded in autonomy, and respect for the individual’s right to shape their own care and safeguard their own dignity. Good principles must be matched by good machinery. That is why schedule 2 is not a mere administrative detail, but the backbone of this reform. It sets out, step by step, how a nomination is made, who may be nominated, how conflicts are avoided, and how mistakes are corrected. Under part 1 of schedule 2, a patient must make the appointment in writing. It must be signed and witnessed by “a health or care professional or independent mental health advocate”. That is a safeguard against casual or coerced choices. The nominated person must themselves consent: they are not a passive bystander but an active participant. If the relationship breaks down, the patient may revoke the nomination, or the nominated person may resign. Crucially, the county court may step in to remove or bar a nominated person if that person acts unreasonably, abuses their power, or is clearly unsuitable. Part 2 of proposed new schedule A1 to the Mental Health Act 1983, inserted by schedule 2 to the Bill, addresses an issue that we must take seriously: capacity. Not every patient will have the capacity to make the appointment at the moment it matters most. The proposed new schedule therefore provides a fall-back system. A court may appoint a nominated person on the patient’s behalf, or a default can be determined under criteria set by regulation. The court again retains ultimate oversight to resolve disputes or replace a default, if the circumstances require it. It is thoughtful, practical and rights-based lawmaking, and I commend the drafters for getting the balance broadly right. Clauses 25 to 28 will give the nominated person real power. They are not a figurehead. Clause 25 demands that professionals consult the nominated person before applying for detention or guardianship. If the nominated person objects, the professional must provide a report showing why detention is none the less necessary, with a clear risk-based justification. The nominated person can then challenge that decision. Clause 26 shortens the duration of the bar on discharge requests from six months to three. If a nominated person believes that the person no longer needs to be detained, they can press for release sooner and more effectively than before.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  I rise to support clauses 36 to 40. Clause 36 addresses a legal gap identified in case law, which held that the Mental Health Act 1983 did not permit the imposition of conditions amounting to a deprivation of liberty for conditionally discharged patients. The clause provides a clear statutory basis for such conditions, but only under strict safeguards. It aims to balance public protection with patient rights, ensuring that DoL conditions are used only when absolutely necessary and proportionate. This is a positive step, because it clarifies the legal authority, resolving any uncertainty, following court rulings, about the legality of DoL conditions in conditional discharges. It protects public safety by ensuring that high-risk patients can be managed safely in the community, under appropriate restrictions. It includes safeguards that require DoL conditions to be justified and proportionate, with a focus on patient welfare, and it aligns with notable human rights law, especially the definitions and principles from the Mental Capacity Act and the relevant case law. However, I have a couple of questions for the Minister. My view is that there is potential for overuse. Without robust oversight, there is a risk that DoL conditions could be used too readily. What safeguards is the Minister putting in place to ensure that that does not happen? There is clearly an impact on patient liberty, and we need to get the balance right. Even with the safeguards, these conditions significantly restrict individual freedom and therefore must be carefully monitored. How is the Minister ensuring that that will happen? In relation to the legal thresholds, determining whether conditions meet the legal test may require detailed clinical and legal assessment. We have talked about the practical implications of this Act on numerous occasions. I again ask the Minister whether he is certain that we have the relevant clinical and legal assessors out there to ensure that we can push that forward. Clause 37, entitled “Transfers of prisoners and others to hospital: conditions”, will update the legal framework for transferring individuals from prison or immigration detention to hospital under the Mental Health Act. The previous wording of the Act required that treatment be “available”, but did not specify that it must be appropriate for the individual’s condition. This clause will align the criteria with more modern clinical standards and broader reforms in the Bill, which emphasise person-centred care and treatment suitability. It will also ensure that immigration detainees are clearly included in the scope of these provisions. Again, it is positive, because it updates and consolidates the list of immigration-related detention powers covered by the Act. It supports human rights compliance, because it aligns with principles of lawful and proportionate deprivation of liberty under article 5 of the European convention on human rights; it brings the Act in line with the current clinical and legal terminology; and, most importantly, it ensures that transfers are made only when appropriate treatment—not just any treatment—is available. I have just a couple of questions for the Minister on this clause. I see potential for disputes. Determining what constitutes appropriate treatment may lead to disagreements between clinicians and authorities. What are the Minister’s thoughts on those potential disagreements? There are also some resource implications. It may increase demand for secure hospital beds if more transfers are approved under the revised criteria. I would welcome any thoughts from the Minister on how to ensure that we have the right number of secure hospital beds, not just as a totality, but in the specific regions and areas where people may be being detained. Clause 38 is also about the transfer of prisoners and others to hospital, but specifically about time limits. It responds to a long-standing concern about delays in transferring prisoners and immigration detainees to hospital for mental health treatment. Under the current system, there is no statutory time limit, and individuals can wait weeks or months in prison, despite being assessed as needing urgent psychiatric care. That has been criticised by mental health professionals, legal advocates and human rights bodies. The clause will introduce a legal framework for setting and enforcing time limits, aligning with the Bill’s broader goals, which I think we all agree with, of improving patient rights and dignity and timely access to care. Again, I support the clause, because it will reduce delays. It will help to ensure that mentally unwell detainees are transferred to appropriate care settings without unnecessary delay, and will introduce clear expectations and accountability for decision making. It enables some flexibility, I think, because it allows for tailored regulations, to accommodate different case types and operational realities. Again, however, I have some questions. I think there will be some implementation challenges. Services may struggle to meet the deadlines without sufficient resources —an issue that I mentioned in relation to the previous clause. Also, time limits may be difficult to apply in complex or borderline cases without clear guidance. Does the Minister see a need for explicit guidance in the code of conduct, or in some other form, to ensure that the risk of a rigid application does not make things more complicated or, more especially, mean that a potential patient is sent to the wrong care simply because we are focusing on the time rather than the appropriateness of the care? Of course, I would welcome his thoughts on how any new tracking systems and co-ordination between prisons, hospitals and the Ministry of Justice might work in this case. Finally, I will briefly touch on clause 39. This is a technical update regarding the term “remand centre”, because that is no longer used in law or in practice; instead, young people are remanded to youth detention accommodation. Given that the clause is purely technical, I support it.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  I do not know whether the hon. Member for Winchester will press his amendment to a vote, but if he does, would my hon. Friend support the idea of having a pilot roll-out of the system before we go the whole hog, because of all the potential problems that she has highlighted?

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  Thank you, Minister.

• 17 Jun 2025 · Mental Health Bill [ Lords ] (Sixth sitting) · Hansard source

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  I rise to speak in favour of clauses 42, 43 and 44, which together strengthen the duty to inform patients—whether detained in the community or conditionally discharged—about how to make a complaint about their treatment and the outcome of that complaint. The Mental Health Act has long included duties to tell patients their rights, but too often that information has been patchy, hard to understand or buried in paperwork. The clauses tackle that by requiring clear, repeated information about not just detention, but treatment and the complaints process. Clause 42 relates to information about complaints for detained patients. Section 132 of the Mental Health Act 1983 originally required hospitals to inform detained patients of their rights, but that was often inconsistently applied. This clause responds to long-standing concerns about transparency and patient empowerment, aligning with the broader goals of the Bill to enhance autonomy and dignity in mental health care. Specifically, there is an expanded duty of information. Hospital managers must now ensure that detained patients understand how to make complaints, not only about their detention, but about their treatment, along with the outcomes of any complaints. There are some timing requirements, i.e. that the information must be provided as soon as practicable after detention begins and be repeated annually for restricted patients, or after each section 20 report for others. That will improve patient’s awareness of their rights and how to seek redress. It will promote accountability and mental health services by encouraging feedback and complaints, and support better outcomes by addressing grievances early and constructively.