Stephen Kinnock
MP for Aberafan Maesteg · Labour · United Kingdom
“I thank the shadow Secretary of State for her kind words and look forward to our exchanges across the Dispatch Box. I am ready to engage with her on getting the maximum benefits for the people of Wales.”
“I thank the right hon. Lady and look forward to working with her. My understanding is that there were challenges around the helicopter capability. Decisions were taken by Natural Resources Wales some time ago to change the way that the tendering for helicopter capability works. We certainly need to look at that.”
“I thank my right hon. Friend for his question. Like him, I pay tribute to all those involved in the collective and heroic response to the wildfires.”
“I thank the right hon. Lady for her question. Many of the ideas coming forward for devolving power right across our United Kingdom, beyond Cardiff Bay and Holyrood, are very exciting, and I look forward to exploring them with her.”
“Just to be clear, this is not about staying out of the issue; it is about respecting the devolution settlement, but being prepared to work constructively where we can in partnership with the Welsh Government. The hon.”
“I know about and welcome the right hon. Gentleman’s strong connections to Wales. I recognise the connectivity benefits that WSMR’s proposal could deliver, particularly for passengers in Wales and the west midlands.”
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“As part of our shift to community, we have already launched six pilot neighbourhood mental health centres to deliver a 24/7 service, with open access to anyone who requires mental health support. Through the shift to prevention, we are putting more emphasis on early intervention and recovery to support people to live well and thrive, ensuring that we improve the conditions for creating good mental health. Alongside that, I remind the Committee of the existing prevention concordat for better mental health: a voluntary agreement signed by local authorities and integrated care boards. Signing the concordat involves a commitment to take evidence-based, preventive and promotional action to support the mental health and wellbeing of their populations.”
“I am grateful to the hon. Member for Winchester for tabling the new clause. Like him, we are committed to preventing mental ill health and promoting good mental health. Achieving our vision for mental health requires a spectrum of interventions across the whole of society and across the life course, from prevention and early intervention through to treatment and specialised care for those with a severe mental illness in community and in-patient settings. We are committed to the shifts from treatment to prevention, hospital to community and analogue to digital, and our forthcoming NHS 10-year health plan will affirm those commitments. With our commitment to neighbourhood health, we are encouraging stronger partnership working between local government, mental health services and the voluntary and community sector.”
“We will need to invest to deliver these reforms, as the impact assessment makes clear; however, the new clause is flawed and not the right mechanism to achieve the necessary investment. Parliament already has the power to scrutinise departmental spend via the estimates process. We are required to report on the share of spend on mental health under the National Health Service Act 2006. This is sufficient to hold the Government to account. I therefore hope that the hon. Member for Winchester feels able to withdraw the motion.”
“It would not be feasible or desirable to try to restructure accounting and reporting based on which patients are subject to the Act and which are not. Secondly, the Government believe in prevention. We want to see better mental health outcomes, with more people cared for in the community so that the need for use of the Act is reduced. Over time, we want to see a shift in spend into preventive community services, which should in turn lead to a fall in the need for the use of the Mental Health Act. Few would disagree with that general aim, but the new clause would prevent that. By requiring share of spend under the Act to increase or remain the same, we are necessarily limiting the share of spend that could instead go towards preventing people from needing to use the Act in the first place.”
“I thank the hon. Member for Winchester for his new clause. This was raised in the other place and there are several issues with it that have not yet been fully addressed. First, the new clause would apply only to spend under the Mental Health Act. The mental health system, and its accounting, is not structured based on the legal framework that patients are subject to. A single ward may contain a mix of patients under the Mental Health Act and informal patients who would not usually be considered to be under the Act. Community services will support some patients on community treatment orders, who are therefore subject to the Mental Health Act, but also many who are not and have never been subject to the Act.”
“The original Mental Health Act commission was brought within the CQC to reduce Government spending and realise the benefits of aligning the CQC’s functions under the Mental Health Act with its functions under the Health and Social Care Act 2012, and to give it new powers to monitor via potential enforcement. Bearing in mind the radical reforms that we are making to the national health system to rid it of duplication, inefficiency and waste, we believe that now is not the time to reverse course on these matters.”
“While we are confident in the progress that the CQC is making, we recognise that those reviews did not closely inspect the CQC’s statutory role and responsibilities in relation to monitoring the use of the Mental Health Act. Therefore, in response to an amendment tabled in the other House, we committed to report on the CQC’s monitoring functions under the Act in the first of the Government’s annual reports on the implementation of the Bill. That will include reflections from the new chief inspector of mental health, Dr Arun Chopra, on the CQC’s statutory functions and its role as a key partner in delivering the reforms. I am looking forward to meeting Dr Arun Chopra very shortly in his new role. Lastly, creating a mental health commissioner with a supporting office would require significant resources that we simply cannot justify.”
“That is why last year we asked Dr Penny Dash to assess whether the current range and combination of organisations deliver effective leadership, listening and regulation for the health and care systems in relation to patient and user safety, or whether a new delivery model is needed. We will shortly see the results of her much-anticipated review. We appreciate that our argument that the proposed mental health commissioner’s role would be duplicative of the CQC has previously been met with concerns about the effectiveness of that organisation. I reiterate that two major independent reviews into the wider role of the Care Quality Commission have reported under this Government, the recommendations from which the CQC has accepted in full.”
“I am grateful to the hon. Member for Winchester for bringing this issue, which was also debated extensively in the other place, before the Committee. Our view has not changed: the functions of the proposed commissioner clearly duplicate existing responsibilities of other organisations, most notably the Care Quality Commission. The Children’s Commissioner has expressed concerns that introducing a new mental health commissioner risks interfering with her own role in relation to children and young people’s mental health. We recognise that the patient quality and oversight landscape is not working effectively, but I strongly doubt that inserting another body whose role overlaps with those already in place would help to address that issue. The landscape is already cluttered and fragmented.”
“The Dash review is looking at the landscape regarding all the different institutions and organisations, including the PHSO and the CQC, to map out how they interact with each other. Our view is that there is a lot of confusion and a lack of clarity, but we await the outcome of the review. I can confirm, however, that Penny Dash is looking at those matters. For those reasons, I ask the hon. Member for Winchester to withdraw the motion.”
“For that reason, I ask the hon. Member for Guildford to withdraw new clause 9.”
“That includes veterans in mental health in-patient settings under the Mental Health Act and those within the criminal justice system. In England, these services are Op Courage and Op Nova, and in Wales there is Veterans NHS Wales. These bespoke services link with wider NHS mental health services to advocate for and support veterans to receive care tailored to their needs. We are committed to giving veterans and armed forces personnel fair access to mental health care services and special consideration where appropriate. That is reflected in the core principles of the armed forces covenant, to which public bodies such as the NHS are legally bound to give regard. It is our firm view that a wealth of measures are already in place that respond to the unique needs and experiences of those who serve and have served in our armed forces.”
“I am grateful to the hon. Member for Guildford for bringing the issue before the Committee. While most veterans lead healthy and successful lives following their service in the armed forces, we know that some may need mental health support. This Government are proud of the courage and dedication of our armed forces, and we are committed to ensuring that those who serve and served in the armed forces receive the best possible care. All service personnel have access to mental health support throughout their career. The Defence Medical Services provide a responsive, flexible, accessible and comprehensive treatment service and, for leavers from the armed forces, NHS mental health services are available that are specially designed to support the unique needs of veterans.”
“Those powers and duties are entirely distinct from those that the CQC uses to regulate the health and social care sector under the Health and Social Care Act 2008. In recognition of that gap, as the Opposition spokesman pointed out, we committed in the other place to report on that specific aspect of the CQC’s role in the first of the Government’s annual reports on the implementation of the Bill, which will be laid before Parliament one year after Royal Assent.”
“I am grateful to the Opposition spokesman, the hon. Member for Hinckley and Bosworth, for bringing this issue forward. Two major independent reviews into the Care Quality Commission have reported under this Government: one by Dr Penny Dash, on the CQC’s operational effectiveness as a regulator of all health and social care providers including those in mental health, the other by Professor Sir Mike Richards on its single assessment framework. The CQC has accepted those recommendations in full, and although we are confident in the progress that the CQC is making, we recognise that the reviews did not closely inspect its statutory role in relation to monitoring the use of the Mental Health Act.”
“It will include reflections from the new chief inspector of mental health, Dr Arun Chopra, on the CQC’s statutory functions under the Mental Health Act, as well as its role as a key partner in the delivery of the reforms. The written ministerial statement—the report—will be laid before both Houses of Parliament within 12 months of Royal Assent. I hope the hon. Member for Hinckley and Bosworth therefore feels able to withdraw his new clause. Question put, That the clause be read a Second time.”
“I can confirm that the information will be in a section of the written ministerial statement that will be tabled within 12 months of Royal Assent. We think that requirement makes the Bill more robust and effective, because it is an integral part of the entire ecosystem that we are looking at in terms of implementing this legislation and making sure we have the institutional capacity and capability. We think it helps to have the information as an integral part of the written ministerial statement, but the hon. Gentleman is right to point out that we should be clear in the definitions and language we use. The written ministerial statement will be an overall implementation report. It will contain a number of sections, one of which will be on the role of the CQC and the inspection function.”
“I am grateful to the hon. Member for Winchester for bringing this issue before us. We are committed to closely monitoring the quality of in-patient care and driving continuous improvement in services. Indeed, we are already in the process of doing that, and a further review is not necessary to drive the changes forward. The CQC’s role is to monitor the quality of in-patient services. Its annual “Monitoring the Mental Health Act” report specifically discusses the in-patient environment, and considers the quality of accommodation under the 1983 Act. The independent review in particular made a recommendation to replace dormitory provision with private rooms. To date, the NHS has invested £575 million in doing that, and we are committed to completing our programme of investment.”
“I congratulate Lynfield Mount on the important work it is doing—and I congratulate my hon. Friend on that extremely strategic intervention. Yes, I would of course be more than happy to meet her, and we will make sure to get that in the diary. The Government have allocated £750 million for estates safety in 2025-26, to address high-priority estate issues across the NHS systems, including in the mental health estate. The CQC will continue to monitor the impact of the reforms through its existing monitoring and reporting duties. A further statutory review is therefore not required, so I ask the hon. Member for Winchester to withdraw his new clause.”
“We are committed to ensuring that all children are able to access the care and treatment they need. We plan to develop bespoke guidance in the revised code on the care and treatment of children and young people, to account for the specific needs of that cohort. I hope that hon. Members will not press their new clauses.”
“We are committed to monitoring and evaluating the reforms to understand their impact on different groups affected by the legislation. On new clause 18, we recognise the devastating impact that an eating disorder can have on someone’s life. The earlier treatment is provided, the greater the chance of recovery. The implementation and evaluation of the reforms will be a long-term, staged exercise. It would not be possible to assess the impact of the reforms on people with eating disorders within 12 months, as not all reforms will have been implemented. We will continue to work closely with NHS England to improve access to appropriate and timely care and treatment for people with an eating disorder. On new clause 23, we recognise that there are inequalities in mental health prevalence and outcomes for children and young people in care.”
“We will monitor the impact of the reforms on the number of detentions and disparities in detention rates, all of which are already published under the monthly Mental Health Act statistics. We have also committed to providing Parliament with an annual update on the implementation of the reforms. As we already plan to commission an independent evaluation of the Bill, and as the timescale set out in new clause 15 would not be feasible, I ask the hon. Member for Guildford to withdraw the new clause. On new clauses 18 and 23, we have already published an impact assessment alongside the Bill, which was scrutinised by the Regulatory Policy Committee and rated fit for purpose. We have also committed to laying an annual report on the Bill’s implementation, through the written ministerial statement.”
“Following Royal Assent, our priority will be to update the code and for staff to be trained on the new legislation and code, before commencing the first phase of the reforms. The first phase of significant reforms cannot take effect until the work on the code and the training of staff are completed. Few, if any, of the sections mentioned in new clause 15 could therefore be commenced within 12 months, and it would be premature to commission a review of their effect on detention rates within that time period. We plan to commission an independent evaluation of the reforms, subject to funding and fundable research applications. This will be a long-term, staged exercise, given the long period over which different reforms are expected to be sequentially commenced following the initial primary legislation.”
“On new clause 15, we want more people cared for in the community and fewer people reaching a point of crisis and detention, but we do not think it is right to use the legislation to drive down the numbers in an arbitrary way that could interfere with clinical decision making and create a risk that people do not receive the help that they need. An evaluation of the relevant clauses should therefore focus not purely on the reduction in detentions, but on the overall improvement of experience and outcomes. Such improvement is predicated on the independent review principles of choice and control, therapeutic benefit, and the person as an individual, as well as the principle of least restriction. The timescales suggested in new clause 15 are not feasible.”
“Similar international models have achieved significant reductions in hospitalisation. NHS England is developing a new model for specialised children’s and young people’s mental health services that aims to ensure that children and young people are treated in the least restrictive environment close to their family and home. I hope that that satisfies the hon. Gentleman and that he will withdraw the new clause.”
“We believe that everyone should receive treatment for mental illness as close to home as possible, but there are circumstances in which placement on a ward outside the area where a person usually resides is clinically necessary. Some specialised services—for example, treatment for an eating disorder—may require a person to be transferred to a placement away from home, and we wish to retain that option. However, we know that too many patients are placed outside their local area, which is why we have set aside £75 million in capital funding for local systems to invest in reducing such placements for all patients. We are also trialling new models of care, including six pilots of 24/7 neighbourhood mental health centres, with the aim of treating more people in their local communities.”
“We will update the code of practice following the passage of this Bill, including the statutory guidance to the Mental Health Act, and will work with patient groups to consider what further guidance is needed to reduce disparities in use of the Act. That consideration will cover issues based on sexuality, gender, race and other protected characteristics. We are also committed to monitoring and evaluating the reforms, which will include an assessment of whether new safeguards and support mechanisms are being equitably accessed through different groups. For those reasons, I ask the hon. Member to withdraw the new clause.”
“I am grateful to the hon. Member for bringing this issue before the Committee. This Government are committed to tackling health inequalities. The NHS continues to pursue its advancing mental health equalities strategy, which sets out plans to address inequalities in access, experience and outcomes in mental health care, including for LGBTQ+ people. However, we do not think that a review within 12 months of the passage of this Bill is the right approach. First, there are known data quality issues with the recording of sexual orientation in the mental health services dataset, which, combined with small numbers, limits our ability to monitor outcomes accurately and reliably. Secondly, we do not need a review before acting to improve patient experience under the Act.”
“There will be no more rewards for failing; instead, ICBs and providers that do well will be rewarded with greater freedoms, while the most challenged will receive focused intervention. For those reasons, I ask the hon. Gentleman to withdraw the new clause.”
“Although we of course agree that the workforce is an important consideration in ensuring safe in-patient care, it is not the only factor. By comparison, NHS England’s in-patient quality transformation programme takes a more comprehensive view of the factors that contribute to safe and effective in-patient care. For example, it includes support for the cultural changes required to create and sustain an in-patient environment in which patients and staff can flourish. The programme’s progress will be measured using a range of data and evidence, for example on patient and staff experience. We know that more needs to be done to support the providers of mental health care to improve the quality of their services in a sustainable way, which is why we are putting in place a robust package of reforms to help to improve performance.”
“We all agree that patient safety is paramount. Anyone who receives treatment in an in-patient mental health facility deserves safe and high-quality care. There have been too many incidents of poor-quality and unsafe care resulting in trauma and sometimes tragedy. Although we agree with the principle of the new clause, the overriding objective duplicates NHS England’s in-patient quality transformation programme, a national initiative aimed at improving the quality and safety of care in in-patient mental health, learning disability and autism services. The programme has been developed with service users, families and staff, and sets out a long-term vision for improving in-patient services. The new clause focuses specifically on staffing arrangements.”
“I am very grateful to my hon. Friend for bringing this issue to the Committee. I thank her for her powerful speech, which drew on specific experiences of people who have been through very terrible and tragic processes. I have discussed some work on the broader issue of quality of care, but this is a vital issue, and I reiterate how grateful I am to her for enabling us to discuss it on the public record. We recognise that there have been too many incidents of poor-quality and unsafe care, which sometimes result in tragedy. I hope my hon. Friend is reassured by the measures we are taking to support providers of mental health care to improve the quality of their services. We have carefully considered her new clause, and I am afraid that we do not think this needs to be addressed through the Bill.”
“I would be more than happy to meet my hon. Friend. It is also worth mentioning the independent advisory panel on deaths in custody report, which she mentioned. We are considering that carefully, so we should include it in our discussions.”
“My officials have also written to the CQC to commission it to develop a viable and proportionate mechanism for reporting use of restraint to the CQC, drawing on the views of NHS Providers and NHS England. Any potential changes can be made in regulations and would not require primary legislation, so we can continue this work in parallel with the passage of the Bill, delivering on our commitment to reduce the use of force for mental health patients. For those reasons, I hope that my hon. Friend the Member for Thurrock will withdraw the new clause.”
“Although the new clause would go further in requiring the recording of use of force outside mental health units, it does not require any further use of that data to develop policies or train staff, which is a key element of the 2018 Act. As drafted, the new clause would introduce new duties to record and report data, without there being any clear further use of that data. I accept, however, that we need to do more to reduce the use of restraint for all patients detained or at risk of detention under the Mental Health Act. NHS England has an ongoing programme of work, overseen by the reducing restrictive practice oversight group, to address this issue for people experiencing acute distress and mental health difficulties.”
“I thank my hon. Friend the Member for Sheffield Hallam for tabling this important new clause, and I thank my hon. Friend the Member for Thurrock for moving it on her behalf. The new clause seeks to recreate some of the duties from the Mental Health Units (Use of Force) Act 2018, but apply them to patients detained under sections 2, 3, 4 or 5 of the Mental Health Act or those at risk of detention under that Act. This would cover patients receiving mental health treatment who are not in specialist mental health beds, such as young people with eating disorders who are detained in general paediatric wards. There are practical reasons why we do not support the new clause as it is drafted. For the vast majority of mental health patients, this duty would duplicate duties that already exist under the 2018 Act.”
“Regulations that make consequential provision will be subject to the affirmative scrutiny procedure where they amend or repeal primary legislation, and to the negative procedure where they amend or revoke secondary legislation. Clause 57 sets out the extent of the Bill. The majority of the Bill will extend to England and Wales, but the general provisions in clauses 55 to 59 will apply UK-wide. We have tabled two amendments, Government amendments 37 and 38, that will modify section 6(3)(b) of the Human Rights Act 1998, extending its protection to cover private care providers when providing certain services arranged or paid for by public authorities. That change, if accepted, will extend UK-wide; we tabled the amendments to clause 57 to reflect that position.”
“Clauses 55 to 59 are the general provisions of the Bill. They include the powers to make provision that is consequential on the Bill by regulations. The clauses also set out the territorial extent of the measures, and the commencement and short title of the Bill. Clause 55 will allow the Secretary of State to make regulations that make provisions that are consequential on the Bill. The power may be used to “amend, repeal or revoke provision made by or under primary legislation passed— (a) before this Act, or (b) later in the same session of Parliament as this Act.” Clause 56 will provide an equivalent power for Welsh Ministers to make consequential provision in areas of their devolved legislative competence.”
“Amendment 38, in clause 57, page 68, line 4, leave out “This section, section 55” and insert— “Section (Human Rights Act 1998: extension to certain private care providers), section 55, this section”.— (Stephen Kinnock.) This ensures that NC10 extends to England and Wales, Scotland and Northern Ireland. Clause 57, as amended, ordered to stand part of the Bill . Clause 58 ordered to stand part of the Bill . Clause 59 Short title Amendment made: 39, in clause 59, page 68, line 25, leave out subsection (2).— (Stephen Kinnock.) This removes the privilege amendment inserted in the Lords. Clause 59, as amended, ordered to stand part of the Bill . Bill, as amended, to be reported .”
“I note the shadow Minister’s point about the Barnett consequentials. I will look into it and come back to him. It remains for me to thank you, Mr Vickers; everyone in Committee, for their very hard work; and all the staff and officials, to whom we are hugely grateful. I commend the Bill to the Committee. Question put and agreed to. Clause 55 accordingly ordered to stand part of the Bill . Clause 56 ordered to stand part of the Bill . Clause 57 Extent Amendments made: 37, in clause 57, page 68, line 3, at end insert “subject to subsection (2).” This is consequential on amendment 38.”
“I cannot say at this moment whether it will be a forward plan all the way through the proposed 10-year commencement period, because some of that will go beyond the spending review period, for example, but I assure the hon. Member that a timetable will at least cover the period of the initial spending review. I do not know whether there will be tracking reports—I will check that point with officials—but my sense is that the written ministerial statement will be the main hook to hang this on. The shadow Minister asked about the money resolution. We have the overall financial envelope for the DHSC. There is now—how should I describe this?—intense dialogue going on between departments within the DHSC and across portfolios, so I think it will take a couple of weeks before we get the carve-up of the envelope across the different portfolios.”
“I thank the shadow Minister for his question about devolved powers. We have worked closely with the Welsh Government on the Bill. The Senedd has yet to vote, but the Welsh Government in their legislative consent memorandum recommended that it grants consent to the Bill. We also seek a legislative consent motion from the Northern Ireland Executive for extending—in Government amendments 37 and 38—the remit of the Human Rights Act 1998 to cover private care providers when providing certain services arranged for or paid by local by public authorities. I will look into the cross-border issues and, if something is there, I will certainly write to update the shadow Minister. On the published timetable, the written ministerial statement will absolutely be a report on progress over the 12 months and will have a forward plan in it.”
“Our manifesto pledged to reset our relationship with the devolved Administrations, to put country before party, and to work with them on issues from trade and tackling child poverty to a whole range of issues around the economy and growth that affect all of us. I welcome this chance to hear the perspective of the hon. Member for North Down and to exchange ideas across the Floor of the Chamber. Access to timely GP appointments is at the heart of a strong and responsive healthcare system.”
“Of course, health is a devolved matter in Northern Ireland, and decisions about GP services there rightly sit with the Northern Ireland Executive and at Stormont. Nevertheless, this Government are committed to being an active partner in helping to deliver better public service outcomes across the UK while respecting the devolution settlement. I am delighted that the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for Putney (Fleur Anderson), is here with me on the Front Bench this evening, showing how important the teamwork between the UK Government and the Northern Ireland Executive is. Ultimately, the underlying challenges are the same. Whether it is access, capacity or workforce pressures, we recognise those issues across the UK.”
“I thank the hon. Member for North Down (Alex Easton) for raising GP access, which is a vital matter for so many of our constituents. I congratulate him on securing his first Westminster Hall debate—well done on that. [ Interruption. ] His first Adjournment debate—sorry. We are not in Westminster Hall right now. It has been a long day; I thank hon. Members for their forbearance. When we ask people what their top priority for the NHS is, the chances are that they will say it is to fix general practice, because GPs are the front door to our national health service. They are the first port of call for millions of people, and they perform a vital service by delivering care in communities right across our country.”
“I agree absolutely with the points that the hon. Gentleman makes. We will very shortly publish our 10-year plan for the NHS. As I will say a little later in my speech, a big part of that is about the shift to a neighbourhood health service and shifting from hospital to community so that the front door of the NHS is fixed, and access is a vital part of that.”
“Member for North Down will welcome the fact that we secured £82 million of additional funding through the additional roles reimbursement scheme, leading to the recruitment of an additional 1,700 GPs. The challenge is more about getting GPs in the places where they are most needed, which is something we need to work on—other colleagues have talked about the geographical imbalance. We need to look at the formula for the way that funding is allocated across the country, as it is an important part of the access issue that the hon. Gentleman raised.”
“I am sure the hon. Gentleman will welcome the fact that we secured a record £889 million increase in the GP contract. That is a first step in digging us out of the very deep hole that the previous Government left for us. When I look across my portfolio, whether it is GPs, mental health, dentistry or pharmacy—you name it—it is a car crash right across the piece. I was frankly shocked by what I saw when I first went into the Department back in July. We are, I hope, beginning to get things back on an even keel. The hon. Gentleman is right, though: we do not have a shortage of people coming through GP training, but supply and demand are not matching up. That has to change. I am sure that the hon.”
“We also have the £102 million capital infrastructure scheme for primary care, which will go some way towards addressing the issue, but this is fundamentally about getting much clearer and stronger commitments from developers.”
“The hon. Gentleman is right; one challenge we face is that, where we are developing new centres of housing, we are not getting the social infrastructure wrapping around them. We need to use things such as section 106 agreements and the CIL, as he mentioned. That process is not always working—the developers are not always coming forward with real, concrete commitments—so the integrated care boards do not commission because they are not sure that the infrastructure will be there, and we end up in a chicken-and-egg situation. We are working closely with colleagues in the Ministry of Housing, Communities and Local Government to break through some of that and attach stronger strings to the deals being done with developers.”