Andy Burnham
Prime Minister · MP for Makerfield · Labour (Co-op) · United Kingdom
“The right hon. Lady mentions leadership. Let me tell her and the whole House where Britain is showing leadership. There have been Conservative politicians at this Dispatch Box—Labour politicians, too—for decades who have talked about the importance of the two-state solution between Israel and Palestine.”
“I cannot comment today on quasi-judicial decisions, but we will take a pragmatic approach to oil and gas, as I have said before at the Dispatch Box. Let us get to the heart of this question, as the right hon. Lady invites me to do. What is the right way to fund defence and, yes, bring the welfare budget down?”
“I do not think the right hon. Lady is on strong ground when it comes to defence spending. It was 2.5% of GDP when the last Labour Government left office. It was 2.3% of GDP when the Government she was in left office. It is now set to be 2.7% in the next year.”
“This Chancellor, of all Chancellors, will be willing to provide that funding to our armed forces and back our defence investment plan. This Government’s commitment to the defence of this country is absolute. We have taken the strongest possible stance in supporting President Zelensky and Ukraine.”
“I think there are many people watching Prime Minister’s questions across the south of England who would now like Mr Speaker to be demoted in the way that my hon. Friend suggests. [Interruption.] This is very thin ice for a Leigh Leopards supporter to be on.”
“I remember well my visit to Stourbridge; it will not leave me, actually, because of the devastation, and the loss of everything in a moment for so many families. My hon. Friend’s support for them was really visible on the day, and the community is clearly very strong; that was evident.”
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Every one of 2,246 lines we hold for Andy Burnham, in date order, each linked to its source. Free to read, in full, without an account. Page 45 of 45.
“If the Government were to leave a vacuum in terms of advice and communication, it could of course be filled by less scrupulous elements of the legal profession seeking to initiate compensation claims. We have already read warnings today that efforts may be made to encourage patients to sue for £500 or £600 a day, the amount that a prisoner would receive in compensation for unlawful detention. I am sure the Secretary of State agrees that any such activities would be highly unsettling, and would amount to the potential exploitation of vulnerable people. I hope he will join me in sending the clearest of messages to the legal profession that that would not be at all welcome.”
“Families of the people involved will have heard yesterday’s news, and will no doubt have been unsettled by it. Does the Secretary of State agree that it is important for the Government to make arrangements, urgently, for direct communication to take place with the families who have been directly affected so that the issue can be explained to them more fully, and in isolation from some media coverage that may not give them the reassurance and support that they seek? Have such arrangements been made, and has any facility been provided enabling questions to be answered so that people can be given that reassurance and support? That, in turn, brings me to another important point.”
“Does the Minister—or, indeed, the Secretary of State—agree that it is essential to conduct such a review, and to put a precise number on the extent of the problem? I asked yesterday whether the Department could tell us how many of the people concerned were in high-security hospitals. I think that that is an important aspect of the issue, and I should be grateful if the information could be given to us at some point this afternoon. Without detailed case-by-case checks, how can we be sure that this procedural defect was the only technical irregularity in the process that was operating in the four SHAs concerned? We need to be reassured that there are no further problems that will need to be corrected at a later date. That brings me to another question that was not answered yesterday.”
“I therefore today ask for more clarity on this matter. As things currently stand, what will the NHS arrangements be for sectioning people under the mental health provisions to be introduced from April 2013? I do not yet know with confidence what those arrangements are, and if I do not know there is a good chance that the wider public and many people working in the NHS have no idea. The Government need to answer these questions. There is a further specific question the Department needs to answer, and it goes to the heart of the issues under discussion. I am sure I heard the Secretary of State say yesterday that the secondary approval function that SHAs are meant to carry out will come back to the Department of Health following the Government’s current reorganisation of the NHS.”
“We have not had anywhere near enough clarity from the Secretary of State—or his predecessor, the right hon. Member for South Cambridgeshire (Mr Lansley), who has just left the Chamber—on how some of the essential functions of NHS bodies to do with safeguarding and public protection are to be handled in the new NHS structure. Many months have passed since the publication of the Government’s first White Paper, yet there are still doubts in the minds of clinicians and others practitioners on the ground. That is an indictment, and shows the confusion the reorganisation has created. We are seeing the emergence of myriad new bodies in the NHS whose functions are not yet fully understood or specified by the Government. This crowded landscape has the potential to cause for further uncertainty.”
“It seems to me that the crux of the issue is the interrelationship between the 1983 Act and the potential for reorganisations of the NHS to disturb important existing arrangements and procedures for the carrying out of these essential public functions. That is the crux of the matter. I accept that a problem may have arisen as a result of the introduction of SHAs and PCTs in 2003, and we will have to wait and see whether that was the case. Regardless of the answer to that, however, the Government still have to face a relevant and current issue: they have to be absolutely sure that the changes they are proposing—and which the Opposition continue to believe are unnecessary and highly disruptive to an NHS that is functioning well for the vast majority of people—will not run the risk of causing further confusion.”
“I hope that the Minister or the Secretary of State will be able to enlighten the House further. We want the Harris review—which I support—to cover all the technical issues surrounding mental health, so that the House and the public can be absolutely certain that no other technical failures or breaches of regulation have been identified. Let me make two appeals to the Secretary of State. First, I ask him to consider widening the remit of the review, and ensuring that in future it can take the broadest possible view of arrangements for sections under the Mental Health Act 1983. Secondly, I ask for the review to be conducted as swiftly as possible, so that it can inform the current reorganisation of the NHS.”
“We would certainly not support the Bill if it were intended to wipe away an individual’s rights retrospectively, and I am sure that the hon. Gentleman would not either. We are grateful for that reassurance from the Government. Along with the urgent steps that are being taken to correct the legal position, we need a review of how this came about in the first place. If it had happened in a single SHA, the explanation might have been easier to ascertain and understand, but the fact that it happened in four SHAs points to a more widespread issue of concern. It raises the question whether the problem arose from historical practice among clinicians and NHS bodies in the four regions concerned, or whether a piece of Department of Health guidance that was circulated in the past may have been responsible.”
“That is a good point. So many cases are involved that challenges may have already been in progress before this technical problem arose. There may have been complaints about the nature of the decision-making process, the number of professionals involved, or any matter relating to the process by which the decision was made. I hope that it will reassure the hon. Gentleman to learn that I have been given access to Government lawyers—the Secretary of State promised that yesterday, and I am grateful to him for arranging it—and I have been assured that the Bill will not wipe away an individual’s right to issue a legal challenge on a different point of process. That is a fundamentally important point, and I am glad that the hon. Gentleman has given me an opportunity to put it on the record.”
“The Secretary of State is nodding from a sedentary position, so I assume that is correct. Surely, therefore, a concern arises that the SHA part of the process is no more than a rubber-stamping exercise. The Department will be entirely remote from the local situation on the ground relating to the individuals involved and the clinicians and institutions making the judgments. If this process is taken up to the national level, will that not give rise to more concerns that mistakes might be made in the future, because of the distance between the process of approval and the individual cases on the ground? Has the Secretary of State had discussions with mental health organisations about whether they believe those arrangements are acceptable? I must say that I have serious concerns about them.”
“I must say that it was a Labour amendment in another place that introduced that improvement into the Act, but, to be fair to the Government, I should add that I am pleased that they accepted it. Will the Secretary of State explain what parity of esteem means in practice? What action has the Department thus far taken to put parity of esteem into effect in the national health service, and what plans does it have for the future? We have learnt in recent days that the budget for mental health has been cut in the last financial year, which suggests to me that the NHS is reverting to its default position in tough times.”
“They are not. Any family can suffer the terrible consequences of serious mental health issues. In such circumstances, we would all want to be assured that those affected are not forgotten and pushed to the fringes where proper procedures are not carried out because there is a somewhat out-of-sight, out-of-mind approach. These issues are central concerns because they go to the heart of 21st century living. Mental health must no longer be left at the edges of our national debate about health and care policy. It has to come to the very centre of our health care system. The Health and Social Care Act 2012 includes one good measure at least: to create parity of esteem between physical and mental health.”
“It is very much seen as a fringe consideration, pushed to the edges of the system—a peripheral concern in PCTs and SHAs, and all the way up to the Department of Health. That situation must not be allowed to continue. The culture of separateness in the way we consider mental health, as opposed to other NHS issues, has deep roots in our society. Mental health services have often been provided in buildings that are out of sight, out of mind and on the fringes of the mainstream health care system. That has to change. In the 21st century, we demand it. In our lives, we are all now dealing with much greater levels of stress, change and upheaval, and sometimes we are all left reeling by the sheer pace of modern life. We are discussing today between 4,000 and 5,000 very vulnerable people as though they are somehow apart from the rest of us.”
“I will end by addressing a point of wider principle about mental health policy and the place of mental health within our society. I believe it is possible that this whole unfortunate episode is symptomatic of a wider cultural problem: that mental health simply does not get sufficient focus and resources in the NHS at both the local PCT level and the regional SHA level—and, indeed, within the Department of Health. Beyond that, I do not believe that mental health gets the consideration it needs in Government or in this place. We do not give sufficient consideration to the hugely important issues relating to mental health. When I was Health Secretary, hundreds of submissions would come across my desk in the course of an average week, and it was unusual if just one of them related to mental health.”
“That is a tremendously important point. Over the years, in terms of crucial public functions such as those we are discussing—and, indeed, in wider considerations such as assessments of new treatments with the National Institute for Health and Clinical Excellence—there has been a trend towards independent decision making, so that people can feel that there is no political, or departmental, interference, such as through changing local resource decisions. The taking of these powers, and the rubber-stamping of approvals to section people, up to the national level will give rise to concerns about whether the process is sufficiently independent and people’s rights are being properly considered. I hope Ministers have listened to the important point my right hon. Friend the Member for Oxford East has just made.”
“The further problem with that legislation is that it prevents those people from being in leadership positions in those organisations—in schools, in Parliament and in companies—where they could develop a better understanding of mental health and what policies need to be put in place to support people who may experience those problems.”
“My feeling is that Parliament is finally waking up to the full scale of the mental health challenge we face. A Bill before us at the moment will outlaw the discrimination that exists whereby somebody who has suffered a serious mental breakdown is unable to be a Member of Parliament, a company director, a juror or a school governor. It is so important to remove that discrimination from the statute book because it sends a message that recovery is not possible, and that if someone has a serious mental breakdown there is no possibility of their coming back and playing a full part in our society.”
“My hon. Friend makes a very important point, and we have the seen the beginning of the kind of campaign he advocates with the work of the Time to Change group. There has also been incredible bravery from individuals such as the cricketer Marcus Trescothick, who spoke out very publicly about the difficulties he had faced, and just a few weeks ago in this House we witnessed some incredibly powerful contributions from Members on both sides of the Chamber: for the first time Members spoke personally and publicly about the difficulties they faced. I think a change is under way, therefore. People who have been suffering alone will take great heart and encouragement from these developments. We are beginning to challenge the last taboo—the last form of acceptable discrimination in our society—but that does not come a moment too soon.”
“We are issuing almost 40 million prescriptions for anti-depressants, which suggests to me that insufficient alternatives to medication are available in our communities and people are being given very old-fashioned, outdated interventions by the authorities which are not meeting their needs. That is why we cannot allow this complacency any more and why we need a modern approach to good mental health care.”
“We need to look carefully at those trends. I remember the moment when my thinking about mental health changed. It came when I was Secretary of State for Health and I received the Bradley report on mental ill health in the criminal justice system. I recall the moment when I read the statistic that seven out of 10 young people in the system have some form of undiagnosed or untreated mental health problem. My jaw dropped and at that moment I realised that we were seriously failing many thousands of people by failing to give them the support they needed when they needed it, and so they went into detention and down a path of failing to fulfil their potential. That is a terrible indictment of our life today. In addition, the level of prescribing of anti-depressants has almost doubled over the past decade.”
“That is a worrying sign, so we press the Government to say what parity of esteem means in practice. What actions are the Government taking to change this culture to ensure that the resources and the focus are in place? In conclusion, although the Opposition will give the Government the co-operation they need to get this measure through the House today, I say again that we need to have full answers to all the concerns I have outlined. That is the least the Government owe Opposition Members. One of the good things that we hope may come from this unfortunate episode is that it may jolt us out of our complacency on mental health, and that Parliament will begin truly to work for more parity of esteem between physical and mental health and ensure that finally mental health gets the resources and the focus it desperately needs.”
“I will indeed, Madam Deputy Speaker. This is a Second Reading debate, so I was just taking a moment to speak more widely. However, I believe that this comes back to the central point I made: the reason why this situation has arisen and why it was undetected for so long—10 years—in the Department was because of this culture of failing to put sufficient focus on and give attention to mental health. The issue is still on the fringes of our system. My hon. Friend makes an incredibly important point. We hear that not only is the budget for adult mental health being cut, but the budget for children’s mental health is being cut even further. That brings me back to another point I was making: in tough times the NHS reverts to its default position, which is to focus on the mainstream and to ignore mental health.”
“We welcome the exercise being carried out by the NHS chief executive, but it is not the same as a personal communication to the individuals directly affected, so will the Secretary of State address the specific point of whether or not they will receive explanatory information from him or the Department?”
“But overall there has been a significant real-terms reduction in spending on mental health, as the figures given by the right hon. Gentleman’s colleague in the House of Lords a few weeks ago indicate, which suggests that the NHS is making disproportionately more redundancies in the field of mental health than in other areas and that it is reverting to that default position. Therefore, although I appreciate the Secretary of State’s words at the Dispatch Box today, the reality on the ground suggests that, as ever, mental health is bearing the brunt of some of the reductions and redundancies taking place and that the capacity of people to deal with these kinds of issues will perhaps be reduced. What will he say about safeguarding against that?”
“The clause refers not only to “Any person” but one who “has done anything in the purported exercise of an approval function”. On both counts, it is incredibly widely drawn and could take us into the territory of other elements of the approval process that may have been defective. Will the Minister assure the Committee that the clause is as narrow as it needs to be? It seems to be uncomfortably wide and may well restrict somebody’s ability to challenge an element of their section other than the fact that the doctor was not approved by the SHA. It is very loose in its current form.”
“I am grateful. It is important to get clarity before we leave this clause. I know that the Government have not yet undertaken a full case-by-case review of the up to 5,000 cases involved. That prompts the question how the Government can be sure that the whole team involved in each case was qualified to a suitable level, and that there were not some instances of under-qualified people making decisions. That gives rise to concern that we may be retrospectively approving processes that were defective.”
“I do not want to detain the Committee unnecessarily, but because the clause is drawn so widely it will possibly take away some people’s right to challenge whether there was a deficiency in the process or whether someone involved in the sectioning decision was under-qualified. Given that the Government have not undertaken a case-by-case review, I wonder how we can have absolute confidence that the power in the Bill is not too widely drawn.”
“We must have absolute clarity about this. In that case, why does the Bill mention “Any person” rather than “any doctor”? Our understanding is that a broader team of people can be involved in a sectioning decision, such as a social worker. If it is only doctors, the Bill should just say “any doctor”, but it does not.”
“We do not want any further distress caused to those people, or for them to suffer any unsettling effect, and that is why the Opposition believe that the legislation is justified. It is crucial that no legal doubt hangs over arrangements that are made for patients and public safety. This Bill removes that doubt, but we do not want to remove any of the rights held by the individuals concerned, and in particular the 5,000—or more—people who may currently be challenging their detention. Having made that point as clearly as I can, the Opposition give the Government their support. We will seek to ensure that co-operation is continued in another place so that the Bill can be put on the statute book, and any uncertainty removed. Question put and agreed to. Bill accordingly read the Third time and passed.”
“Clause 1 essentially states that “any person” who has undertaken any activity “had the power to do so”. If I heard the Minister and the Secretary of State correctly, that is not carte blanche to justify anything—including something inappropriate—that may have happened over the course of a decision, but simply means that the person who made the decision had the power to do so. I hope that people outside this House will hear those words clearly and understand that that is the only permission the House is giving this afternoon on this exceptional basis. In doing so, we return to the point about balancing our concerns about the exceptional nature of this legislation with the fact that this issue affects thousands of the most vulnerable people in our society and their families.”
“The Opposition thank the Secretary of State and the Minister for attempting to answer all the questions that colleagues have raised. We appreciate that they have acted in good faith in bringing this legislation before the House with such speed, but, as my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) rightly said, this takes us into unprecedented territory. We are legislating retrospectively on matters of fundamental importance concerning people’s basic rights and public safety, and it is therefore right for the House to pause for thought and consider those issues before giving its assent to the legislation. We had an important exchange on the precise drafting of the legislation, and a concern arose during the course of that debate.”
“We will press him for answers in the areas that I have outlined, but we believe that his action is justified. He will have our support in removing any uncertainty.”
“This area is currently the responsibility of SHAs, which are due to be abolished next April. So, as well as establishing the historical facts, will the Secretary of State ask his review to consider whether the new arrangements for sections, following the Government’s reorganisation of the NHS, are sufficiently well understood? Will he also ask the review to advise on how any danger of further confusion arising from the process of transition can be prevented? I commend the Secretary of State for the pragmatic approach he is taking to this difficult issue. His request of the House is exceptional, but failure to act could cause unnecessary distress and uncertainty to many thousands of vulnerable patients and their families, and present risks to public safety.”
“Will the Secretary of State therefore explain precisely what alternatives to legislation were considered, and why it was decided that they were not acceptable in these circumstances? Let me turn to the investigation. We support the review under Dr Harris that will try to get to the facts and ensure that lessons are properly learned. We do not want to prejudge it, but is the Secretary of State in a position to confirm today whether the review is already proceeding on the basis that this is a failure of policy implementation rather than a defect in the original legislation? That is important, as practitioners working in this field will not want any unnecessary question marks hanging over the Mental Health Act 1983. We also need clarity about the future.”
“We understand and support the Secretary of State’s wish to remove any doubt about the legal status of the patients concerned, but that must be set against the undesirability of asking the House to legislate tomorrow on an issue that it has found out about only today. Over the next 24 hours, will he ensure that Members have access to the fullest possible information, including a summary of the legal advice he has received? There will be concerns about precedent. This is the first time that the House has been presented with emergency legislation in this area that will affect people’s rights. The public will want to know that it is being used in exceptional circumstances as a last resort, and not as a convenient means of correcting administrative failures.”
“When exactly was the Department made aware, when was the Secretary of State informed and what action has been taken to establish the full extent of the problem? Have extensive checks been undertaken in all 10 SHA areas, and is he absolutely confident that no more patients and families are affected than the 4,000 to 5,000 he has mentioned? I want to press the Secretary of State for more information on the people affected. Will he say whether he has any plans for direct communication with the patients and families affected? Are the patients living not only in the four regions mentioned but in all parts of the country? How many are in high-secure hospitals, and how many could pose a risk to the public?”
“However, I am sure I speak for both sides in saying that the House will have been reassured by the Secretary of State today on three crucial points: first, that no patient has been wrongly detained, received care that was not clinically appropriate or will see their legal rights restricted by the legislation; secondly, that no doctor was unqualified to make decisions; and, thirdly, that urgent action is being taken to correct the situation and bring the clarity that is so essential. Let me now turn to the serious questions that need to be answered. Will the Secretary of State say more about the events that brought this issue to light last week? Was it discovered in one SHA first, and by what process did the Department establish that it extended to three more?”
“I thank the Secretary of State for his statement and for notice of it. Detaining people under the Mental Health Act raises the most serious issues of fundamental rights and of patient and public safety. Any reported failure will therefore always be a matter of the highest concern. I know this House will want to get to the bottom of the unacceptable breaches of procedure that we have just heard about.”
“May I welcome the Secretary of State and his new team to their positions? As the only other person to have made the jump from Culture to Health, I am sure that he will find me a constant source of useful advice. The Secretary of State has not said much since his appointment, but he did set out his mission in The Spectator : “I would like to be the person who safeguards Andrew Lansley’s legacy”. Let us talk about that legacy. Just last week, the Secretary of State slipped out figures on the latest costs of NHS reorganisation. Would he care to update the House on the current estimates?”
“Look at the figures: the previous Secretary of State gave the budget a real-terms cut for two years running. Let me give the exact figures, which the Secretary of State did not give the House. The costs of the reorganisation are up by 33% or £400 million, making the total £1.6 billion and rising. And what is that money being spent on? A full £1 billion is being spent on redundancy packages for managers: 1,300 have got six-figure pay-offs and there are 173 pay-offs of more than £200,000. Scandalously, that news comes as we learn today that the number of nurse redundancies has risen to more than 6,100. Six-figure pay-outs for managers, P45s for nurses and the NHS in chaos—is that the legacy that the Secretary of State is so proud of?”
“There can be no doubt of the incredible emotional impact that the panel’s work has already had on the people most directly affected by the tragedy. As my hon. Friend the Member for West Lancashire (Rosie Cooper) said, to be in Liverpool on the night of 12 September this year was to see a collective weight lifted from so many shoulders, which I will never forget. I do not think we have begun fully to appreciate the scale of the suffering and loss, the true human cost of the tragedy, and the devastating psychological impact on survivors. From the midst of the most harrowing scenes imaginable—truly, hell on earth—thousands of them were simply left to drift home from Hillsborough, to try to make sense of what they had seen without counselling or support.”
“Tonight, I pay particular tribute to Professor Phil Scraton. Of this I am sure: the full truth about Hillsborough would never have been known were it not for his meticulous efforts over many years, turning over stones that others had walked past. Professor Scraton has done a huge service not just to the Hillsborough families but to this country, and I hope the House will join me in acknowledging it tonight. What is striking about the panel’s report is its thoroughness and the sheer comprehensiveness and quality of the painstaking researching that underpins it, carried out by the research team at Queen’s university, Belfast. I hope that the Government will consider that approach, with the emphasis on disclosure, not adversarial argument, a model for resolving other contested issues arising from our past.”
“In the Church’s history, it is hard to think of a better example of one of its leading members fulfilling the functions of his office with more distinction or doing a greater service for the city and people under his direct pastoral care. The Right Rev. James Jones, Bishop of Liverpool, has brought light to people who for 23 years have been trapped in the blackest of tunnels, but he has done more. Through his leadership, he has shown the relevance of the Church to Britain today. Through him, the Church has succeeded where the state had failed, in bringing truth and the beginnings of reconciliation to a tragedy arising from a divided Britain. We thank all the members of the panel for what they have done, and we thank the secretariat, under the leadership of Ken Sutton and Ann Ridley, for its outstanding support.”
“On the other side of the House, we have heard from the hon. Member for Thurrock (Jackie Doyle-Price), who spoke from her personal experience, and from the hon. Member for Elmet and Rothwell (Alec Shelbrooke). What is clear from those outstanding speeches is that, rather than the closure that people glibly talk of, the report has opened questions of the most profound kind for the institutions of our country, our Parliament and our society. As the debate comes to a close, I want to set out clearly what I believe those questions are. Before I do so, I want to speak for the Opposition in adding to the tributes that we have heard.”
“Those truths were also told because of the people of a city that truly understands what solidarity and loyalty mean, who locked arms around these families—red and blue together—and supported them for every step on the hardest road imaginable. At last, the entire country can see what Liverpool has lived with for 23 years. Parliament, too, has finally woken up to the full horror of Hillsborough. We have heard many powerful speeches this evening from both sides of the House. We have heard from my hon. Friends the Members for Halton (Derek Twigg), for Liverpool, Walton (Steve Rotheram) and for Garston and Halewood (Maria Eagle), who have done so much to help the campaign, and from my hon. Friend the Member for Wirral South (Alison McGovern) and my right hon. Friend the Member for Sheffield, Brightside and Hillsborough (Mr Blunkett).”
“A year has passed since our last Hillsborough debate. That year has brought momentous events that many people thought they would not live to see. The truth has finally been established—more difficult to take, not less, for the passage of time, as the Home Secretary said. The tragedy was entirely foreseeable —it could and should have been prevented. Lives should have been saved. There was a campaign of vilification with no justification. Those truths have been told only because of the sheer love of mothers, fathers, brothers and sisters—a love that would not let them give in, a love that provided strength when hope was lost and provided dignity in the face of provocation.”