Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020

In reaching their decision to remove the provisions, the Government have listened to stakeholders and to Parliament. Three parliamentary committees have recommended that we take this step. The Joint Committee on Human Rights report on the Government’s response to Covid argued that the need to maintain robust safeguards for patients detained under the Mental Health Act was heightened, and cautioned that if we enacted the provisions they would weaken the protections available. The Women and Equalities Committee noted concern that the provisions went against the direction of travel towards reform of the Mental Health Act, to

“a more balanced system with more safeguards, more choice and less restriction”,

as set out in the independent review of the Mental Health Act 1983. Further, the Public Administration and Constitutional Affairs Committee report on the Government’s response to Covid and the Coronavirus Act noted the concerns of the mental health charity Mind and its call for the removal of these temporary powers.

The decision to expire these provisions has been positively received by a wide range of stakeholders—including the Law Society and Rethink Mental Illness, which said that the decision came as a relief to many people living with mental illness and their loved ones—and by the House of Commons.

The Secretary of State was not persuaded, even during the initial Covid peak, that switching these powers on was necessary because our mental health services have shown incredible strength and ingenuity, for which I express immense gratitude to NHS staff. These powers are no longer required, and these regulations seek to expire them.

I will take a moment to briefly remind noble Lords about the contents of the provisions that these regulations seek to expire. The provisions would have enabled an approved mental health professional to apply to detain an individual under the Mental Health Act following the advice of one registered medical practitioner, where securing two recommendations was considered impractical or would have led to undesirable delay. The provisions would also have allowed for an extension of the time that hospital in-patients could be temporarily detained, pending an application for longer detention under the Mental Health Act.

For those in contact with the criminal justice system who have a mental illness, the provisions in the Act would have extended the amount of time a person can be remanded to hospital, allowed an accused or convicted person to be sent to hospital on the recommendation of just one registered medical practitioner rather than two, and extended the procedural time limits for transferring a prisoner to hospital.

Since the Coronavirus Act was enacted, the Government have remained committed to keeping all its aspects under close review and have stated that any provisions no longer necessary will be sunsetted. The Act will expire in its entirety two years after the date it was passed, but also contains a power allowing for the expiry of some provisions to be brought forward ahead of that time. It should be noted that these regulations will not expire the transitional provisions within Schedule 8 to the Act; however, those will have no legal or practical effect.

The Mental Health Act 1983 applies to both England and Wales. The application of the regulations differs for each country. I will therefore seek to clarify their effect on Wales. First, those easements which relate to health services in Wales will remain available to Wales. Health is a matter devolved to the Welsh Government. But, secondly, those easements concerning the operation of justice under the Act—that is, for patients under sentence or subject to criminal proceedings—will be removed for both England and Wales. These remain matters reserved to Her Majesty’s Government. With the exception of provisions relating to the Welsh mental health review tribunal, none of these provisions has been commenced. Should it ever be deemed necessary to return to these provisions, the Government will seek to introduce new legislation.

I thank the staff of NHS mental health services, who have coped without the need to turn on these emergency powers through their hard work, supported by the department and NHS England and NHS Improvement and through innovative approaches. I beg to move.

Capacity will remain a major question for all of us, and I hope that the Minister will be able to confirm that a proportion of the additional resource being allocated to getting the health service back onstream and undertaking the diagnostic and treatment requirements that have so often been delayed will also apply to the capacity of the mental health services. With that, I welcome the regulations very strongly.

In the long term, it is not just a case of mental health services surviving the pandemic; they will need drastically to expand and improve to deal with the long-term impact of social isolation, mass unemployment and pandemic-induced anxiety.

The powers we are debating weakened an Act that was already in need of major reform. The independent review of the Mental Health Act put forward proposals to improve the system and increase patient rights. Can the Minister update the Committee on when the Government will provide a full response to the independent review and publish their proposals to take forward reform of the Mental Health Act, with a clear implementation timescale? The two-year anniversary of the publication of the Mental Health Act review will be 6 December 2020. I strongly hope that the Government’s response will not be delayed beyond that point.

Turning to the statutory instrument before us today, I must state my keen and continuing interest in mental health. We know that these extraordinary powers were not required during lockdown, which is testament to the hard work of our mental health staff. They have coped without recourse to such drastic emergency measures and it is clearly right that they should now be expired. Mental health difficulties need to be discussed during this pandemic. We should understand the importance of social and financial stability in the face of the virus. We now realise that resilience lies not within an individual but within our community. Given the dire economic effects of both Brexit and the pandemic, it is vital to consider the NHS response to the increase in mental health difficulties. The proposed investment in mental health services is welcome, but it is still inadequate and barely makes up for the loss of support over the past 10 years. We need more investment. We also need to modernise the Mental Health Act. Public attitudes have improved markedly in the past 10 years, but the law has failed to keep pace. Of course, the pandemic has slowed progress, but we need the promised White Paper. Can the Minister promise to bring it forward as a matter of urgency?

Will the Minister comment on the devastating impact that we have heard about so eloquently from fellow noble Lords that lockdown measures have caused a lot of damage to mental health in the community. Many, both young and old, are consumed with anxiety, deprived of their autonomy, subject to a form of solitary confinement and feel lonely and isolated. There is also fear not only of the virus but about the cataclysmic effect of lockdown on jobs and livelihoods.

Sufferers of dementia in care homes are locked away from families and stimulation, leading to a deterioration in their mental capacity, and in some instances, tragically, to premature death. In other words, lockdown and its ugly sister, tiering, are bad for the mental health of the well, let alone the mentally ill.

I have a final question. I note with horror that the Welsh Government are not expiring Schedule 8. Will the Minister do what he can to cajole or persuade his counterparts in the Senedd as soon as possible? I declare an interest as I am from north Wales, but I find it rather shameful that the mentally ill in Wales seem to need safeguarding from their own Parliament.