Neil Shastri-Hurst MP: speeches

Speeches

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

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  You will be delighted to know that I will be mercifully brief, Mrs Harris, because I am broadly supportive of all three clauses. Having worked as a doctor in clinical practice, and as a barrister, I am cognisant of the importance of transparency, patient autonomy and procedural fairness, in particular with vulnerable patients who are often seen in a mental health care setting. I welcome this trio of clauses, but I have some gentle challenges to put to the Minister for when he gets to his feet. First, how will data be captured on the information that is to be provided to patients and their families? What feedback mechanisms will be in place, not just for patients but for those who support them—their carers and families—and for clinicians, on the practicalities of how the system is working?

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

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  My hon. Friend makes a pertinent point. We all know, from our casework or personal experiences outside of this place, about the pressures on the Courts and Tribunals Service. Mental health tribunals are not exempt from that pressure. Changing the timeframe on which tribunals operate, and the frequency with which reviews take place, will inevitably increase the burden on the service. Therefore, although these changes are broadly welcome, it is important that we are cognisant of their impact on the resources that will be required, the number of judges and wing members that will be needed, and of course the hard standing of the court and tribunal infrastructure that will need to be made available. Other issues, such as those around the digitalisation of the service, will also need to be addressed. Clause 31 will recast the regime for automatic tribunal referrals, replacing the prior six-month structure with the concept of “a relevant period”. For detained patients, referrals will now occur at three months, then 12 months, and annually thereafter. For community patients, they will occur at six months, then 12 months, then annually. Most significantly, hospital managers will be under a new duty to refer a case when no review has occurred in 12 months, regardless of whether an application has been made. That is a sound reform. The clause will introduce coherence to a previously fragmented system, and establishes a minimum standard of legal oversight. The inclusion of a backstop provision—that no individual should go more than 12 months without review—is essential. In a system in which patients may not always have the means or capacity to apply for a review themselves, it offers a critical safety net. Clause 31 will also repeal section 68A of the 1983 Act, which has become unwieldy and duplicative. By streamlining the referral process, the Bill enhances legal clarity and administrative efficiency, but I would caution that the increased complexity of the new timeframes may require significant training of those responsible for their implementation. Clause 32 will provide for restricted patients who are subject to deprivation of liberty conditions. It goes further than clause 30 by imposing mandatory referral duties on the Secretary of State. Under the clause, a tribunal must be convened after 12 months, every two years thereafter, and at four years if no review has occurred. Crucially, the clause also codifies the tribunal’s powers. It may now vary or impose conditions, including those that constitute a deprivation of liberty, provided that they are necessary to protect the public from serious harm and are no more restrictive than hospital detention. That clause introduces a principled, proportionate framework for balancing public protection with patient liberty, and avoids vague or discretionary use of such powers. Finally, clause 33 will apply the same principles to restricted patients not subject to deprivation of liberty orders. Such individuals, although under fewer constraints, are none the less subject to significant legal orders. The new requirement for a tribunal review at two years, and every four years thereafter, ensures that oversight is regular and non-discriminatory. All four clauses are united by a clear objective to rationalise tribunal access, enhance procedural safeguards and bring the Mental Health Act into alignment with modern standards of fairness and proportionality. However, I will close with a caveat: rights without resourcing are hollow. If we are to place greater demand on the tribunals service, and to rely on it as the guardian of liberty for thousands of individuals, it must be adequately funded, staffed and supported. Legal representation must be accessible. Tribunal members must be properly trained. Hospital managers must be equipped to meet their new responsibilities. With those reservations, I broadly welcome clauses 30 to 33 as a necessary recalibration of our mental health law. They reflect the dignity of the individual, the demands of public safety, and the enduring principle that no one should be deprived of liberty without fair or timely review.

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

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  My hon. Friend makes a pressing point. Does she agree that if the amendment is accepted, there will be a requirement for additional training to deal with financial and social support, which goes outside the current scope of these important advocates?

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

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  It is a pleasure to serve under your chairmanship this afternoon, Mrs Harris. I rise to speak on clauses 30 to 33, which go to the core of the rights architecture that surrounds mental health law in this country—namely, the oversight and challenge mechanisms available to individuals subject to detention, supervision or conditional discharge. I think we are all aware that the 1983 Act, although fit for its time, has failed to keep pace with the evolving understanding of mental health illness and modern expectations of legal accountability or procedural fairness. The clauses, although technical in nature, seek to rectify a number of the long-standing shortcomings in the operation of the mental health tribunal system. Clause 30 will extend and clarify the time period within which patients may apply to tribunals. Essentially, it will do two things. First, it will extend the application window for section 2 patients—those detained for assessment—from 14 to 21 days. Secondly, it will reduce the initial waiting period for section 3 patients and those under guardianship from six months to three months. Those are sensible and overdue changes, because 14 days is a narrow window for any legal action, let alone one initiated by an individual who may be experiencing acute psychological distress. Extending the application window to 21 days provides a fairer opportunity to seek representation and prepare a meaningful application. Equally, the reduction of the initial period for section 3 and guardianship patients to three months offers an important safeguard against prolonged detention without scrutiny. It restores a measure of clarity between the gravity of the detention order and the speed with which it may be challenged. The clause will also clarify the rights of conditionally discharged restricted patients who are subject to deprivation of liberty conditions—that is, those who are discharged from hospital but required to comply with supervisional residence requirements that are so restrictive that they cross the legal threshold for a deprivation of liberty. At present, those individuals occupy a legal grey zone: they are not formally detained, yet the liberty they enjoy is so curtailed that it raises significant questions as to their article 5 rights. Clause 30 will properly address that anomaly by creating a defined, regular route of appeal, initially between six and 12 months from the imposition of the deprivation of liberty conditions, and biannually thereafter. Those are measured and proportionate changes that enhance access to justice, improve compliance with human rights obligations and restore clarity to a field that has suffered, at times, from legal opacity. The reforms are not without consequences. A wider cohort of eligible applicants and more frequent review periods will inevitably increase the burden on the tribunal service, on legal aid provision and on clinical teams who must prepare documents and attend hearings. That challenge is not to be dismissed lightly.

• 16 Jun 2025 · Child Sexual Exploitation: Casey Report · Hansard source

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  The sexual exploitation of vulnerable children in this country is a stain upon our society, and the victims want not just the truth out but transparency. With that in mind, will the Home Secretary confirm whether the Government asked Baroness Casey to change any elements of her report—yes or no?

• 12 Jun 2025 · Mental Health Bill [ Lords ] (Third sitting) · Hansard source

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  My hon. Friend is making a powerful point about some of the challenges around the interpretation of the Bill. Does he agree that there needs to be a clear plan for the training of professionals so that there is consistency across the board?

• 12 Jun 2025 · Mental Health Bill [ Lords ] (Fourth sitting) · Hansard source

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  I rise to address three broad points on clause 19. I entirely understand where this is coming from—it is to improve accessibility, efficiency and flexibility in delivering assessments. It reflects the broader observations from the independent review and aligns with the NHS digital transformation goals. However, I have three specific concerns. My first concern is about the risks around the assessment quality. I suspect we have all experienced virtual meetings or consultations with clinicians. Subtle cues can often be missed in a virtual hearing, particularly when it is on the sensitive issues we are dealing with in the Bill. I am concerned that we will miss those subtle signs that doctors would pick up on in a face-to-face assessment; they can easily be lost through the medium of a virtual assessment. My second concern is about the consistency in clinical judgment of when to use these virtual assessments. I suspect we all have experience through constituency or personal work of general practitioners who, since the covid-19 pandemic, have moved to more online and virtual assessments. Some patients enjoy that and like the flexibility; others would rather see a clinician face to face, but are not always offered that option. We must ensure a consistent approach to these assessments across the country. My third concern is about digital exclusion. The assumption is that individuals will be able to access this readily and be comfortable with the technology. Many will be able to, but a significant number will struggle with it. We must ensure that those individuals are not forced down a route of having a virtual appointment or assessment, when that would not allow them the satisfaction of the consultation they sought. It is important that patients are put at the front and centre, and that any change to the assessment process is made with them in mind.

• 12 Jun 2025 · Mental Health Bill [ Lords ] (Fourth sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Vickers. I rise to speak briefly to clause 7, which in many ways is a tidying up of the other changes in the Bill to ensure alignment. In that sense, it is a necessary part of this legislation. For too long, mental health tribunals, which have an important function, have been operating under criteria that are too broad. As my hon. Friend the Member for Hinckley and Bosworth pointed out, that can lead to inconsistencies with modern clinical practice. It is therefore right that we move to clearer, more risk-based criteria to ensure that detention is maintained only where absolutely necessary. There are obvious reasons behind that, such as to ensure greater consistency in tribunal decision making and strong safeguards to ensure that patients are only detained or kept under community treatment orders when absolutely necessary. I want to pick up some of the arguments my hon. Friend the Member for Hinckley and Bosworth was developing around the demands on the tribunal service. The Minister will be well aware of the challenges facing the court and tribunal system in this country. If, as anticipated, this will lead to an increase in the number of hearings—both in first instance and potentially in appeal—what assessment has been made as to the number of not only judges, but wing members that will be required to facilitate this process? What has been determined regarding the capacity of the resources of His Majesty’s Courts and Tribunals Service—in terms of not only physical hard standing, but the vital role that clerks and tribunal staff play in ensuring that hearings are done in a timely manner and the paperwork is completed consistently? Thirdly, what is the expectation of the sustainability of that workload as the Bill comes into fruition? I pick up on that in particular, because, given the transition arrangements that appear to be within the legislation, this will be a retrospective as well as a prospective change. I would be grateful if the Minister in summing up could address those issues.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  Building on the Minister’s last point, can he reassure the Committee that any consultation will have a strong focus on ensuring that practitioners have the training and, most importantly, the resources that they need to achieve a seamless transition from one set of regulations to another?

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  Will the hon. Lady give way?

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  I have a certain degree of sympathy for the amendments, but I am sure the hon. Lady will recognise that patients and their families often find the review process overwhelming in and of itself. Bringing it forward to six months, when such reviews would often not be required, can cause a huge amount of stress and place pressure on those family units and patients. Of course, reviews can be brought forward when clinical need requires it. To stipulate that within the legislation puts an enormous burden upon those families and, most importantly, the patients.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  Not quite: Solihull.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  Does my hon. Friend share my concerns that not resolving housing and accommodation at the point of discharge could lead to a delay in transition? Patients would remain in hospital for longer than might be beneficial to them.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  Does my hon. Friend agree that there is a risk that the amendment would not only increase the workload of practitioners, but divert attention from patient care?

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Question proposed, That the clause stand part of the Bill.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (First sitting) · Hansard source

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  I beg to move amendment 56, in clause 3, page 3, line 19, at end insert— “(4) The Secretary of State may by regulations update the definitions in subsection (2) in response to scientific advancements. (5) A statutory instrument containing regulations under this section may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.” This amendment would allow the definitions for mental disorder, autism, learning disability and psychiatric disorder to be updated by secondary legislation as science evolves. It is a pleasure to serve under your chairmanship, Mr Vickers. I rise to speak to amendment 56, which is in the name of my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), who has extensive clinical experience. The amendment provides for a narrowly drawn but important power, namely, to update, via regulations and subject to affirmative procedure, the statutory definitions in clause 3, in response to developments in scientific and clinical understanding. I recognise that any clause that confers powers on the Executive to amend the statutory definitions must be treated with due caution. There could be concerns that changes could be made without broad clinical consensus. However, on this occasion, I believe that my hon. Friend, who brings to the debate the weight of his clinical expertise, has struck the right balance. The proposed power is tightly scoped. It is triggered only by new scientific knowledge. It cannot be exercised on ministerial whim. Crucially, it is subject to the full rigour of parliamentary approval under the affirmative resolution procedure. It is not a case of Executive overreach; it is a recognition that the pace of medical and neuroscientific research is such that legislation risks obsolescence unless we allow for responsible adaptation. One need only look at the evolution of our understanding of conditions such as autism spectrum disorder and complex post-traumatic stress disorder to appreciate how quickly definitions can move on. Clearly, any change must reflect best practice and take place under broad consultation. However, I argue that we are not opening the back door to arbitrary change; we are safeguarding the front door against stagnation. For that reason, I support the amendment.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  Does my hon. Friend agree that, although the intention behind the amendment may be worthy, there is a lack of clarity in the drafting? In particular, it is unclear what “seek to ensure” means and how that would be legally defined.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  It seems a lifetime ago since I was last on my feet. I am sure the Minister was waiting in anticipation for the crescendo of my speech. He heard my observations on amendments 52 and 53, and I know he will be mindful of ensuring that the balance between intervention and detention is held in equilibrium. I would be grateful if he addressed the points I raised before the interlude in his response. New clause 24 would amend section 5(1) of the Mental Health Act 1983 to clarify that a formal application for detention can be made not only for a patient already admitted to hospital, but for individuals who have attended or been brought to a hospital seeking help or admission. It would therefore expand the legal basis for initiating detention procedures under the Act. The new clause makes an important distinction. While the Act currently allows for the detention of an individual who is already an in-patient, there is ambiguity about whether that applies to individuals who are on hospital grounds—who have attended A&E, for example—but have not yet been formally admitted as a patient. In those cases, the Act fails to capture people who arrive voluntarily or are brought to such an institution during a crisis. New clause 24 seeks to close that gap by explicitly allowing an application for detention to be made in such circumstances, ensuring that a timely intervention can occur when necessary for safety or treatment. A number of significant benefits would arise from the new clause. It would provide firm legal clarity; remove any ambiguity about when detention procedures can begin; allow timely intervention, enabling quicker responses for an individual in crisis who is already at hospital but has not been admitted; reduce the risk of harm by allowing earlier application of safeguards; and align the legal framework with the reality of hospital procedures. The distinction between those who are in attendance at a hospital and those who have been admitted in a state of crisis is a false one.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  Solihull West and Shirley.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  My hon. Friend is right. An individual can attend an emergency department to be assessed and be seen by a doctor before a decision is made on whether that patient should be admitted to that hospital, transferred to a tertiary centre or discharged back into the community. New clause 24 seeks to provide clarity and certainty for practitioners on that grey area and, crucially, it seeks to provide a safeguard for patients who have yet to be formally admitted to an institution—a hospital, community placement or wherever—but need a crucial intervention.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  I have listened carefully to the Minister, who has addressed the issue with his usual thoughtfulness. I ask that he looks into sharing that data, particularly around new clause 24, but on the basis of the reassurances that he has provided, I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Ordered, That further consideration be now adjourned. —(Taiwo Owatemi.)

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  It is a pleasure to serve under your chairmanship, Ms Furniss. I rise to speak to Liberal Democrat amendments 20, 10, 22, 24 and 21, and set out why, although I think they are honourable in their intent, I am unable to support them today. I will start with amendment 20. The purpose of the amendment is to require ICBs to ensure the availability of specialist crisis accommodation for people with autism and learning disabilities. The aim is to provide a safe and therapeutic alternative to detention, which I think we would all agree is a sensible course of action. Section 136 of the Mental Health Act 1983 allows police to remove an individual who is experiencing a mental health crisis from a public place to a place of safety. That can, on unfortunate occasions, lead to detention in inappropriate settings, which may include police cells. That can obviously be deeply harmful, particularly to those with conditions such as autistic spectrum disorder or other learning difficulties.

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  I beg to move amendment 52, in clause 5, page 11, leave out lines 20 to 22 and insert— “(b) in the case of a patient who lacks capacity or competence to consent to admission for assessment (or for assessment followed by medical treatment), serious harm may be caused to the health or safety of the patient or of another person unless the patient is so detained by a constable or other authorised person, or in the case of a patient who does not lack capacity or competence to consent to admission for assessment (or for assessment followed by medical treatment) serious harm may be caused to the health or safety of another person unless the patient is so detained by a constable or other authorised person; and”

• 10 Jun 2025 · Mental Health Bill [ Lords ] (Second sitting) · Hansard source

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  All the amendments in this group have been tabled in the name of my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). Amendments 52 and 53 deal with grounds for detention and treatment—specifically, with how those grounds differ depending on whether a patient has the capacity or competence to consent. At the heart of both amendments is the simple but vital proposition that capacity matters, not only ethically, but legally. The ability of an individual to make decisions about their own care must shape the basis on which the state may act against their will. The revised wording introduces an important distinction between the two scenarios, where a patient lacks capacity and where they retain it. In the first case, where a patient cannot consent because they are unable to understand or weigh up the relevant information, then serious harm either to the patient or to others may justify detention or compulsory treatment. However, in the second case, where capacity is intact, the threshold for overriding a person’s autonomy is rightly higher. In such circumstances, the justification for intervention must rest solely on the risk of serious harm to other people. This is more than legal tidiness; it is a matter of fundamental rights. The law should not permit the detention or forced treatment of a capacitated individual on the basis of a paternalistic judgment about their own safety—that is not a liberal mental health framework, but an arbitrary power. These amendments achieve something critical: they preserve the protective duty of the state, particularly to those who cannot protect themselves, but they do so without blurring the line between necessary intervention and justified intrusion. They are grounded in legal precedent, echoing the principles found in common law, the Mental Capacity Act and article 5 of the European convention on human rights. They introduce clarity where ambiguity once stood, and they ensure that the Bill reflects both compassion and constitutional restraint . [Interruption.]

• 9 Jun 2025 · Winter Fuel Payment · Hansard source

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  There appears to be universal support for this damascene conversion by the Government. Last year, they told pensioners that the right course of action was to scrap the winter fuel payment for millions, but they are now telling them that a means-tested system is right, so how can pensioners possibly believe anything that the Government say?