Dr Danny Chambers
MP for Winchester · Liberal Democrat · United Kingdom
“The Government invested more than £560 million in AMR programmes between 2020 and 2024, so it is reasonable that Parliament should receive an annual assessment of AMR-related deaths to ensure that that significant public investment is delivering results, represents value for money and is targeted where it can have the greatest impact.”
“Surveillance has already identified significant variations by age, deprivation and geography. Understanding where deaths are occurring, and in who, would help direct resources to the communities and services that are most affected.”
“I thank the Minister for her comments. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 32 Review on deaths related to antimicrobial resistant infection “Within six months of the passage of this Act, the Secretary of State must conduct and publish a review into the number of yearly deaths in the UK which…”
“This is not simply a matter of people dying from infections that could not be treated; nearly all the advances in modern medicine over the last 50, 60 or 70 years would be null and void.”
“We very much welcome the Government’s initiative to give children free bus travel throughout the summer—it is a great idea. The only problem is that in Winchester and its surrounding area, Hampshire county council keeps cutting funding for bus services.”
“I thank the Minister for her comments. We understand that the Government take this matter very seriously, but we are working on estimated numbers of deaths for something that will eventually be killing more people than covid. We really need some tangible figures, so I will press the new clause to a Division.”
The complete record
Every one of 601 lines we hold for Dr Danny Chambers, in date order, each linked to its source. Free to read, in full, without an account. Page 11 of 13.
“I jumped the gun this morning, so I have already spoken in detail about the amazing initiative at Melbury Lodge with Winchester Citizens Advice. I will not bore the Committee with the details again, except to say that it is a brilliant example not only of delivering really good care for patients, but of a really good cost-effective intervention for the taxpayer. If it is not appropriate for it to be set out in secondary or primary legislation, will the Minister consider a meeting with me, Melbury Lodge and Winchester Citizens Advice to discuss how this type of initiative could be rolled out across the country?”
“I beg to move amendment 49, in schedule 2, page 87, line 13, at end insert— “(18A) In section 130B (arrangements in relation to independent mental advocates: England), after subsection (3)(d), insert— ‘(e) support the patient’s carer and family members to prepare for the patient’s discharge from hospital treatment, and (f) support the patient to access help with social and financial stressors that might otherwise increase their likelihood of future detention.’” This amendment extends the support offered by Mental Health advocates to cover social and financial stressors and support for family carers and other members of the household when the patient is discharged. It is an honour to serve under your chairmanship, Mrs Harris.”
“I appreciate the valid points that hon. Members have made. The point about running a pilot was a sensible suggestion. We have had something that could be viewed as a pilot in Winchester for two years. We know that it works well, and every £1 spent on it saves £14.08. If I have suggested this amendment in the wrong part of the Bill through my naivety and inexperience, or if mental health advocates are not the right people to deliver a solution that we know works, may I ask the Minister whether there is a more appropriate part of the Bill in which to include it or another way to implement this proven system, such as by amending a different Bill, before I decide whether to press the amendment to a vote?”
“indicated assent. Amendment 49 negatived. Schedule 2, as amended, agreed to. Clauses 25 to 28 ordered to stand part of the Bill. Clause 29 Detention periods Question proposed, That the clause stand part of the Bill.”
“We should be looking to empower patients and their families and carers across the whole system, not just in relation to those who are sectioned.”
“His words were quite profound: “If we can’t navigate the system, what hope has anyone else got?” Even when young people have secured desperately needed in-patient care, often after many months of delay, they can face real challenges in understanding the care being implemented and its impact. Often, such young people are cared for far from home. Enabling them to benefit from mental health advocacy that ensures the pressures on the system do not lead to unfair or damaging decisions for mentally ill young people is crucial. It can help to ensure that the patient’s whole situation and entire history is always taken into account, and that treatment is always appropriate, rather than symptoms just being addressed in isolation.”
“I do not know whether we could combine yoga with our proceedings, Mrs Harris. The hon. Member for Hertford and Stortford spoke really well in a similar vein to what I am about to say. Our amendment 19 to clause 41 would extend the provision of opt-out advocacy services in England to informal patients under 18 years old. Young people and their families and carers often face a nightmare navigating the mental health system. We find this on every level. A psychiatrist who came into my office in Winchester said that he and his wife, who is also a medical professional, were struggling to navigate the system to get care for their own child.”
“I think the hon. Member for Farnham and Bordon has spent more time discussing our amendments than I have, so I would like to give him the opportunity to vote in favour of one of them. Amendment proposed : 19, in schedule 3, page 91, line 13, after “patient” insert— “or English qualifying informal patient under 18” — (Dr Chambers.) This amendment extends the provision of opt-out advocacy services in England to informal inpatients under 18. Question put, That the amendment be made.”
“That is not to say that they cannot and should not be improved where possible; we want to make progress. When we talk about ending the use of farrowing crates, we must also talk, as many Members have done, about supporting farmers to transition away from them. Any change must be practical as well as ethical. The hon. Member for Bridlington and The Wolds (Charlie Dewhirst) gave us a valuable insight, pointing out that many pig farmers struggled after a sudden change was brought in back in—was it 2000?”
“It is an honour to serve under your chairmanship, Mr Mundell. I thank the hon. Member for North Ayrshire and Arran (Irene Campbell) for introducing the petition, and I thank all the petitioners who have turned up to watch the debate. The people of Winchester are certainly passionate about the subject; I have received a lot of heartfelt emails about it. As a veterinary surgeon, I have always believed that how we treat animals reflects our values as a society, and as someone who grew up on a farm and who now represents very rural areas in Winchester such as those around the Meon valley, I understand the deep connection between animal welfare, food production, conservation and the livelihood of farming families. We should first acknowledge the reality that UK farmers operate to some of the highest animal welfare standards in the world.”
“We urge the Government to ensure that any trade agreements require imported food to meet UK standards and ban the sale of food that would be illegal to produce here. That is really important, because there are plenty of imported egg and dried custard products that could be produced by battery hens. It is not only vets and farmers who are proud of our high animal welfare standards, but the British public. We should not compromise those standards. There are farming systems around the world that not only are worse for the environment and for animal welfare, but do not have the same judicious use of antibiotics. That is driving antibiotic resistance, which is creating a public health crisis. Already, 1 million people around the world die because of antibiotic-resistant infections every year.”
“Those chickens feel pain and distress as much as any pig or other more intelligent animal. I summed up at our party conference this year. We are calling for new policies for farming in general, investing in training and peer-to-peer farming learning networks, better access to apprenticeships in agriculture and animal welfare, and a proper workforce plan to ensure that there are enough vets, farm workers and abattoir staff across the supply chain. However, those steps alone will not be enough if we allow lower welfare imports to flood British shelves. The previous Government’s trade deals undercut UK farmers with Australia and directly undermined the standards that we ask them to uphold.”
“Their behaviour was completely different from that of the pigs on the intensive farms on which I had to spend time as a veterinary student a few years later. They all had their own personality. We have discussed intensive chicken farming, and we have mentioned battery hens, which are still seen in some parts of the world. Pigs are hugely intelligent and require a lot of enrichment, and although people acknowledge that chickens are not as intelligent—there is no doubt about that—the level of intelligence does not change the capacity to suffer or feel pain. At the moment, in broiler farming, chickens are selectively bred to grow so quickly that their legs do not develop quickly enough and they start to develop sores, infections or even broken limbs because of the rate at which they are growing.”
“That strategy must come with clear funding commitments, practical guidance and research and development support to trial alternatives that work in the UK’s diverse farming environments. One of the five freedoms, which I mentioned earlier, is the freedom to express natural behaviours. That remains a vital benchmark for animal welfare, but we must ensure that the sows and piglets are kept physically safe as well as psychologically enriched. When I was 11 years old, I brought 13 pigs home from market. My dad was not too happy about that: we were a sheep farm, and I turned up with these piglets. They turned into pets, really—we used to play football with them. We had a great time with them.”
“It was a long time ago, and it devastated the industry. Farrowing crates are used to reduce piglet mortality by preventing crushing. It is a serious concern that no responsible farmer would take lightly. As the NFU has rightly pointed out, we need a science-led, managed approach to phasing out their use that gives farmers the time, investment and confidence to transition to higher welfare systems such as free farrowing pens. That is why the Liberal Democrats are calling on the Government to develop a comprehensive national strategy to end the use of farrowing crates—one that is built in full consultation with farmers, vets, welfare scientists and industry stakeholders.”
“I believe that we should work towards ending the use of farrowing crates, but we cannot do so overnight. We must do it in partnership with farmers, not at their expense. We must be honest with the public, fair to producers and ambitious for animal welfare. I will finish by quoting probably the most famous veterinary surgeon of all, James Herriot: “If having a soul means being able to feel love and loyalty and gratitude, then animals are better off than a lot of humans.””
“I absolutely applaud that. That is a very important intervention. The Responsible Use of Medicines in Agriculture Alliance has reported that since 2015, overall antibiotic use in livestock has been reduced by 59%. That is a huge reduction and is very much industry-led. In the UK, farmers are not permitted to treat unless there is a diagnosis of an illness and an appropriate antibiotic, whereas in other countries antibiotics are essentially given as a substitute for low hygiene standards and to act as growth promoters. The previous Conservative Government promised the biggest boost to animal welfare in a generation, but they scrapped the Animal Welfare (Kept Animals) Bill, failed to act on the 2018 Stacey review and abandoned their own pledge to consult on ending the use of cages for farmed animals.”
“I beg to move amendment 12, in clause 8, page 15, line 11, after “treatment” insert “including the setting in which treatment takes place,”. This amendment ensures that the definition of appropriate medical treatment includes the setting in which treatment takes place.”
“One CQC inspection report found that the seclusion rooms had low ceilings that contained electrical wires overhead, creating a safety hazard, and staff could not see people clearly through the window panels because they were cloudy. Is the Minister confident that the mental health estate is adequate to fulfil the objectives of the Act? In particular, is he satisfied that the mental health estate is sufficiently safe in structural terms and designed appropriately for those using it, such as being free of ligature points and with sufficient in-patient capacity for children and young people?”
“It is a pleasure to serve under your chairmanship, Mr Vickers. Amendment 12 attempts to ensure that the needs of patients in terms of setting and the design of their wards are considered in their treatment. We are particularly concerned that many people are being treated, as Lord Darzi’s report highlighted, in Victorian-era former asylums, which cannot be conducive to effective treatment. Multiple sites have been designated as not functionally suitable. The independent review of the Mental Health Act and the Care Quality Commission also found that many mental health wards are unsafe for staff and patients, and provide poor-quality care in unsuitable buildings.”
“I appreciate the Minister’s considered reply to the amendments. I just spoke in a debate in the main Chamber about NHS infrastructure and buildings. Although I understand that that is not specifically in scope of the Bill, it is another good example of how the Bill is only as good as the system that it works within. I will happily withdraw my amendment, but it is good to hear that the Minister understands the importance of hospital infrastructure. When substandard Victorian-era asylums are still being used for mental health care, not only is it inadequate for patients, but it affects the public perception of mental health and mental health treatment, which is an important aspect of the issue. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn .”
“I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.”
“We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system. Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues.”
“Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages. We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about.”
“To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need. When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket.”
“In Winchester, we are fortunate to have the beautiful south downs and a lot of very productive farms. We had Open Farm Sunday last week. Does my hon. Friend agree that outdoor education, engagement with farms and agriculture and residential weekends are a great way to inspire the next generation of agricultural students, conservationists and environmental scientists?”
“It is an honour to serve under your chairpersonship, Ms Furniss. I know that the hon. Member for Farnham and Bordon will have spent his lunch time anticipating the responses to his long series of questions. The tension is palpable— I hope he is excited to hear our replies.”
“Yearly reviews are used for many medical conditions, and I would argue that a year is also an arbitrary period, rather than one based in evidence. Why six months and not a year, or why a year and not six months?”
“Hampshire county council is struggling to provide the care these people need. Housing, which often affects young people’s mental health, is probably the single biggest issue that comes up in my inbox and when I knock on doors. I thank the hon. Member for Hinckley and Bosworth. As a clinician, his point about the evidence base, especially when it comes to reviews, is really important. We are discussing a Mental Health Bill that may not be changed significantly for another 40 years, so it is important that we use the best evidence. As a long-time trustee of an evidence-based medicine charity, I am passionate about this. I thank the hon. Member for Thurrock for pointing out that clinical guidelines suggest six-month reviews.”
“We strongly support the Bill, but we need to recognise that, on its own, it will not improve mental health or do anything to prevent people from developing mental health issues. If our amendments are not within scope or are not appropriate for the Bill, we urge the Minister to work with other Departments, such as the Ministry of Housing, Communities and Local Government, to ensure that this good piece of legislation, which we support, can be successful. The hon. Member for Farnham and Bordon made a point this morning about local authorities. He is right that local authority reorganisation is a challenge, especially when it comes to providing accommodation for young people and for people being discharged from mental health care centres. It is also an opportunity, because the current situation is not fit for purpose.”
“Unfortunately, I was busy meeting Brian May and talking about farming, so I have not had a chance to work up a really good response. The point of the Liberal Democrat amendments is to recognise that mental ill health requires holistic care and that many non-clinical factors directly influence mental health. Although the Bill’s scope is understandably narrow, very much focusing on people once they are admitted to hospital for treatment, we need to recognise that, if someone is discharged back into the situation from which they were admitted, they are very likely to have a relapse and to need treatment again. Some of those factors are non-clinical. For example, people living in poverty—those in the lowest 20% of income—are more than twice as likely to suffer mental health issues than those on an average income.”
“I completely agree with everything the hon. Member just said. Atul Gawande did a fantastic piece of work on checklists that emphasised the need for them not to become tick boxes. They are meant to involve active thinking and decision making. I thank the Minister for reassuring us about housing. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn.”
“I beg to move amendment 8, in clause 4, page 8, line 27, at end insert— “(ba) the person is under 18 years old and satisfies the conditions in (b)(ii).” This amendment inserts a new subsection that extends the duty on integrated care boards to establish and maintain a register for those at risk of detention to all children and young people under the age of 18.”
“We are alarmed that the targets for mental health are being dropped, so I press the Government for assurances that the upcoming 10-year plan will ensure that children who are referred can expect swift and efficient support and treatment, with binding duties on health bodies to deliver that. Alongside this Bill, what requirements and resources will ICBs have for preventing mental health crises? As part of that, will the Department make specific changes to CAMHS?”
“Early intervention, delivered through regular check-ups and cutting waiting times for treatment by community services, is critical. We should not pretend that acute mental health services and in-patient care exist in a vacuum. The pressures they face are directly impacted by the quality of community services. We need stronger steps to ensure that fewer people require detention in the first place, especially children. We are pleased that the Government are taking steps towards having mental health support in every school, for which we have long campaigned. We would like them to go further by ensuring a dedicated professional in every school.”
“Child and adolescent mental health services are in a state of near collapse, with many children unable to access the care and treatment they need until their mental ill health has reached the point of crisis. Waiting 15 months in great mental distress is far too long, especially for children. It is a huge disruption not only to their personal development but to their education. Waiting up to two years for treatment is a huge proportion of a 12-year- old’s life. We are pleased that the Bill, as it currently stands, includes specific provisions to prevent people with learning disabilities from requiring detention under the Act. The Government should take that approach for more people, especially our young people.”
“Amendments 8 and 9 would insert a new subsection to extend to all children and young people under the age of 18 the duty on integrated care boards to establish and maintain a register of those at risk of detention. Amendment 9 would extend the duty on integrated care boards and local authorities to exercise their marketing functions in a way that seeks to ensure that children and young people’s needs can be met without detaining them. Far too many children are unable to access the mental health care they need, leaving them more vulnerable to experiencing a mental health crisis that then requires detention, which all too often ends in tragedy.”
“No one would ever say, “We’ll wait until your cancer reaches stage 4 before we start treatment,” but that is happening with eating disorders. The treatment will end up being longer, more complicated, more costly for the taxpayer and maybe less successful. A question often comes up—the hon. Member for Farnham and Bordon alluded to this—about the pressures on local authorities to deliver mental health care. Actually, the question is “How we can afford not to deliver it?” People with mental health disorders are ending up in A&E or prison and costing police time. It costs £52,000 a year to keep someone in prison, yet apparently we cannot afford to give them the community interventions that might stop them going there in the first place.”
“On the surface, what the shadow Minister says seems logical and makes sense. I am not a mental health clinician, so I want to be really careful about pushing in one direction. Whether someone has an eating disorder or is waiting for a diagnosis of something like ADHD, the waiting times are too long. We must better structure a system that ensures that everyone gets healthcare when they need it, rather than prioritising what we perceive as most important. One of the most heartbreaking things that I hear from parents in Winchester, who are worried sick, is that young teenagers with an eating disorder have been told that they have to hit a lower BMI to reach the threshold to qualify for treatment. That is essentially saying that someone has to be sicker for longer.”
“The Government need to ensure that people can get mental health assessment and support at key points in their life, including the most traumatic moments.”
“Well over a third of women with mental health problems have been a victim of domestic violence, and 50% of rough sleepers have mental health problems. The disastrous impact that bereavement can have on anxiety and depression, which are key factors in suicide, has been well documented. It seems obvious, frustratingly, that public services do not currently reflect that key fact. There are no registers of bereaved children to ensure that they get the right support in the community and in school. There are no registers of veterans, despite their far higher risk of mental ill health and suicide. Women who have suffered a miscarriage do not receive an automatic referral, including to mental health services.”
“We support all efforts to keep young people happy and healthy in their communities. I visited Winchester Youth Counselling recently, where pupils can self-refer to talk through their issues. That does not involve any clinical personnel. It is hugely impactful and cost-effective and is part of the community. We support those community hubs. Amendment 47 would specify risk factors for detention for people on the register of people at risk of detention under clause 4, including homelessness, addiction, domestic abuse, miscarriage and traumatic birth, experience of armed conflict, and bereavement. For anyone, including people with learning disabilities, life events can have a profound impact on mental ill health and can drive mental disorders.”
“I do not know the best place for it to be held. That is an important point. For a lot of the issues that Members are bringing up, we are not expecting there to be answers today. However, we want to ensure that they are all being considered, given that the subject might not return to Parliament for another 40 years.”
“That is a very insightful point. The list could be longer and is not meant to be exclusive. I am not sure of the answer to the hon. Lady’s question but, taking a step back, we know that the single most common cause of death in women 12 months after giving birth is suicide, and there is no proactive automatic care. If a person is addicted to alcohol, they are admitted to hospital for treatment for their physical symptoms. When they are physically well enough to go home and they are discharged, there is no automatic enrolment or follow-up in mental health care. I would not want to bring in a system, as the hon. Lady says, that ends up being too prescriptive. However, at the moment, we have one that is not prescriptive enough. I could list a handful of demographics of people who desperately need that proactive care.”
“The point of having an at-risk list is that ideally there is proactive contact with people—perhaps in quite a soft way, and perhaps through community hubs, as we have discussed—before they demonstrate a severe mental health crisis. I assume that the people the hon. Gentleman is talking about have already been admitted to hospital and have received treatment, and that they are being followed up after they have been discharged. That is not a proactive list; it is a reactive register. Am I correct? I apologise if I have misunderstood his question.”
“I thank the hon. Member for his intervention. In my maiden speech, I focused primarily on mental health and on the fact that there are so many demographics of people who we know are at significantly higher risk of suicide and mental ill health than the general population. Whether the issue is more appropriately addressed in the Bill or outside it, but using the Bill as a mechanism to highlight it and to cause the proactive engagement of other relevant Departments and other pieces of legislation, I am determined that we are not going to discuss the biggest piece of mental health legislation in 40 years and not even have a discussion about how we proactively engage with groups of people who we know are at very high risk of mental health issues.”
“Will the Government finally implement a register of all bereaved children to ensure that they get the support they need? Will the Government ensure that all women who go through miscarriage, stillbirth or traumatic birth access mental health support quickly and effectively? Will the Government establish a veterans register to ensure that those who have served in the armed forces and who face particular challenges as a result get the tailored mental health support that they need and do not reach the point of requiring detention?”
“I will carry on, if that is okay. Our social and health services need to see the whole person, including their social needs and the factors in their environment that threaten their wellbeing. Trying to treat a mental disorder but failing to account for that person’s lack of housing, which drove their anxiety and depression in the first place, is doomed to fail. A lack of support for a child who has lost their parents at a young age could lead to significant harmful consequences further down the line. There are a huge range of areas that require change, but for now we would like to press the Minister on three specific issues. We understand that some of them may turn out not to be within the scope of this Bill, but it is still important that they be addressed in some capacity.”
“I know how much the hon. Member for Farnham and Bordon enjoys speaking in Bill Committees—we were on the Tobacco and Vapes Bill Committee together a few months ago—and I am really pleased that our amendments have given so much material for discussion. I really appreciate the input from Members on both sides of the Committee; it has been really insightful, useful and constructive. It has been rightly pointed out that the current state of local authorities—their funding and their capacity—means that they might not be able to deliver the more holistic care we are pushing for in the amendments, but I do not think that the Mental Health Bill should be limited by the current state of local services and funding. If that is the underlying problem, that is what should be addressed, not the measures in the Bill.”
“I thank both hon. Members for their input and their valid points. We appreciate the Minister addressing these concerns. We will not press amendment 9 or 47, but we would like to vote on amendment 8. Question put, That the amendment be made.”