Category: Health

The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 27 June 2022.

With permission, Mr Speaker, I would like to make a statement on our plans to bring the Mental Health Act 1983 into the 21st century. Today, just as we pledged in the Queen’s Speech, we have published a draft Mental Health Bill to modernise legislation that was passed by the House almost 40 years ago and make sure that it is fit for the future.

Last year, we invested £500 million to support those with mental health needs who were most affected by the pandemic and, as we set out in the NHS long-term plan, we are investing record amounts into expanding and transforming mental health services. That will reach an extra £2.3 billion each year by 2023-24. Later this year, we will also publish a new 10-year mental health plan followed by a 10-year suicide prevention plan, which, as I set out in a speech on Friday, will place a determined focus on this major source of grief and heartbreak so that fewer people will one day get the news that turns their lives upside down. But we cannot make the critical reforms that we need and that are so essential to the country’s mental health system without making sure that the law that underpins our country’s mental health system is up to date, too.

Since the 1983 Act, our understanding of and attitude towards mental health has transformed beyond recognition, and it is right that we act now to bring the Act up to date. The Mental Health Act was created so that people who have severe mental illnesses and present a risk to themselves or others can be safely detained and treated for their own protection and that of those around them, but there are a number of alarming issues with how the Act is currently used. Too many people are being detained. They are also being detained for too long, and there are inequalities among those who are detained. The previous Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), asked Professor Sir Simon Wessely to lead a review into the Act. I pay tribute to my right hon. Friend for her tireless commitment to this most important of issues and to Sir Simon for his illuminating report, which made a powerful case for reform and was rightly welcomed on both sides of the House. It made for uncomfortable but essential reading, vividly showing how currently the Act fails patients and their loved ones and deprives people of autonomy and control over their care.

The draft legislation that we have published today builds on Sir Simon’s recommendations as well as those in our White Paper, which was published in partnership with the Ministry of Justice last year. Just like Sir Simon’s report, the White Paper was welcomed by both sides of the House. It was also welcomed by leading charities including Mind, the National Autistic Society and Rethink, countless mental health professionals and, critically, the people who use mental health services and their loved ones. Today, we are showing how we will put the vision into action. The Bill is a once-in-a-generation reform, and I would like to set out briefly to the House the important themes that sit behind it.

First, the Bill rebalances the criteria for detention so that it will take place only as a last resort when all other options have been explored and considered. Under the new criteria, people will be detained only when they pose a significant risk of harm to themselves and others, and patients should be detained only if they will benefit from the treatment that is made possible by their detention.

Secondly, the Bill shows how we will give patients more control over their care and treatment. It will ensure that, in most cases, clinicians can administer compulsory treatment only if there is a strong reason to do so. In future, all patients formally detained under the Act will have a statutory right to a care and treatment plan, drawn up between the patient and their clinician, and personalised based on the patient’s needs. It will give them a clear road map to their discharge from hospital.

There are some cases when patients are not able to make decisions about their own care or feel that they could benefit from greater support. Currently, patients are not always able to choose who can represent them, as their nearest relative automatically qualifies to act on their behalf. The Bill will change that, allowing patients to choose a nominated person who they believe is best placed to look after their interests. The Bill will also increase the powers of that nominated person, so that they can be consulted about the patient’s future care.

Thirdly, the Bill will tackle the disparities in how the 1983 Act is used. Black people are four times more likely to be detained under the Act than white people, and 10 times more likely to be placed on a community treatment order. The Bill provides for greater scrutiny of decision making, including through greater use of second opinions on important decisions, and through expanded access to independent tribunals; that will help us to address the disparities in the use of the Act.

Fourthly, the Bill will enhance support for patients with severe mental health needs who come into contact with the criminal justice system. Under the 1983 Act, too often, people in prison experience delays in getting treatment in hospital. Courts are sometimes forced to divert defendants who require care and treatment, some of whom have not been convicted, to prison as a so-called place of safety. The Bill will make crucial improvements so that vulnerable offenders and those awaiting trial can access the treatment that they need. It will tackle delays and speed up access to specialist care by introducing a new statutory 28-day time limit for transfers from prison to hospital, and it will end the use of prison as a so-called place of safety, so that patients can get the care that they need in the appropriate hospital setting.

The Bill will also amend the Bail Act 1976 so that courts are no longer forced to deny a defendant bail if the judge’s sole concern about granting bail has to do with the defendant’s mental health. The Bill will allow the judge to send them to hospital instead, so that they can be in the best environment for their mental health and can receive any treatment that they need.

Finally, the Bill will improve the way that people with a learning disability and autistic people are treated under the 1983 Act. One of my priorities in my role is personalised care. The current blanket approach cannot be allowed to continue; it means that too many autistic people and people with a learning disability are admitted into institutional settings when they would be better served by being in the community. The Bill will change this. It limits the scope for detaining people with learning disabilities and autistic people for treatment unless they have a mental illness that justifies a longer stay or they are admitted through the criminal justice system. It also gives commissioners of local authorities and integrated care boards new duties to make sure that the right community support is available instead.

I look forward to working with hon. Members in all parts of the House as we take these plans forward. This momentous Bill deals with one of the most serious and sombre responsibilities of any Government: their responsibility for the power to deprive people of their liberty. Mental ill health can impact any of us at any time. It is essential that we all have confidence that the system will treat us and our loved ones with dignity and compassion. That is what the Bill will deliver. I commend the statement to the House.

The speech made by Sajid Javid, the Secretary of State for Health and Social Care, on 24 June 2022.

Last Monday would have been my brother Tariq’s birthday. I say it would have been because Tariq is no longer with us. He took his own life.

And on that Monday it was the first thing I thought about when I opened my eyes and the last thing I thought about when I closed my eyes. Nothing can prepare for you for the loss of a loved one.

But I want to use this privileged role that I have as Secretary of State to do right by his memory, but also the memories of thousands of others each year who have left us before their time, by preventing more people from going down the same devastating path.

Almost everyone in this country has been touched by suicide in some way.

The Samaritans – doing amazing work – answer a call for help every 10 seconds and tragically, around every 90 minutes someone dies from suicide in the UK. When we look across the last decade and look at Government initiatives like the previous Suicide Prevention Strategy no matter how well intentioned, the trends have broadly been going in the wrong direction.

We must treat suicides with the same urgency that we treat any other major killer and take determined action that reflects the changes and progress that we all want to see in society.

So we will be publishing a new 10-year mental health plan. At the moment we have a call for evidence asking for people’s views and shortly afterwards we will be publishing a new 10-year suicide prevention plan.

I want to hear views from far and wide to help shape this work and the roundtable that I chaired here earlier this morning was so illuminating to help us do just that.

I heard heart-breaking tales of love and loss but also inspirational stories of the work being done to divert people from this painful path including of course the work of Papyrus here.

I am determined to make a difference on this issue and I wanted to take this opportunity to come and speak to you all, and talk about some of the principles that will drive this future work.

The first is encouraging those people who are at the greatest risk to come forward and to get the help they need. Talking about our innermost feelings can be uncomfortable and upsetting of course. But it is so important.

I am 52 years old, the same age as Tariq was when he left us.

Men in their 40s and 50s they make up a disproportionately high proportion of male suicides, around 40%. We can achieve so much if we encourage people to talk about how they feel and they come forward and ask for help.

Thanks to the trailblazing courage of campaigners in the public eye and thousands of quiet conversations in homes, schools and workplaces more and more people across the country are being open about their mental health.

We must keep these conversations going as we live with Covid and look at how we can bring in groups of people together traditionally more reluctant to come forward.

Last week I heard about a survey published showing that 75% of construction workers said that they regularly discussed emotions with colleagues. Yet there were some people who derided this, some newspapers who said this was evidence of a stereotypically male-dominated industry that had supposedly lost its way. I found the data shocking too.

I want it to be 100%. Not 75%. Because too many people suffer in silence, based on outdated ideas of what it means to be a man.

Mental health must not be only talked about in whispers. We must shout about it. Because keeping quiet can kill.

Traditionally, the construction trade has a suicide rate that is three times higher than the national male average rate and so the fact that people who work there are talking more is a cause for celebration, not castigation.

To build on this progress, I want to see more local areas doing outreach activities in places that men are likely to attend.

I’ve heard wonderful stories of a Tyne and Wear gym that gives men a safe space to share their feelings, a group of barbers who are trained to recognise symptoms of mental ill health, and there is a Talk Club, where a talking and listening club has been established and hosted at football clubs for their supporters.

We know, from all the research that’s already out there, that it’s easier to talk about your feelings when you’re pursuing your passion.

When we recently awarded over £5 million of funding to the voluntary sector as part of our Suicide Prevention Grant we backed a number of organisations that work specifically with men.

As we take forward our plans for suicide prevention we will also keep focusing on those communities where suicide is the greatest risk so for instance, the LGBT community which makes up a third of people who access an organisation called SHOUT, a suicide prevention hotline.

This work goes hand-in-hand with our mission to tackle disparities across the country and transform local communities.

Men in the lowest socioeconomic groups, who live in some of the most deprived areas are up to ten times more at risk of suicide than those in the highest socioeconomic groups, in other words those living in the most affluent areas.

There are regional disparities too.

For instance, you are twice as likely to die in the North East by suicide, than you are in London. It’s fantastic that we have charities from across the UK here today many I met in the roundtable we just had and my Department is working with many of you here today to get to the bottom of these disparities and work out how we can put them right.

One of the golden threads running through all my work in this role has been a commitment to tackling disparities of all kinds that have been overlooked and ignored for far too long.

A relentless focus on suicide prevention will help us to break the cycle of devastation and deprivation in some of our most deprived communities and so too, focusing on transforming communities can lift so many of the strains on our health and happiness what the economist and Nobel Prize winner Sir Angus Deaton recently called the ‘deaths of despair’ that sit behind so many of the tragic stories in this country.

As well as looking at those communities at greatest risk we must also look at the risk factors that lead to suicides across all communities and this is the second area of what I wanted to talk about today.

We know that the causes of suicide are complex and intertwined but the data does show that there are some areas where we can have a big impact.

For example, there is a project in Kent that found that 30% of all suspected suicides in a two year period were linked to domestic abuse.

Our new Plan will look at risks like domestic abuse and gambling these weren’t looked at in the previous strategy.
It will also place a greater focus on the online world which has created new challenges when it comes to suicide prevention.

Now we have made real progress in some areas like working with manufacturers and online platforms to limit access to methods of suicide online. But there are also areas where we’ve found it harder to keep up with the proliferation of digital content for example when it comes to pro-suicide related content.

Research has found that suicide-related internet use was relevant to a a quarter of suicide deaths in those aged under 20 and Google searches for suicide methods from UK browsers have risen by over 50% in two years.

Just think about that. When we use the internet we use google and search for suicide rates has gone up by 50% in two years.

When I was Home Secretary I spoke at the launch of the Online Harms White Paper. I talked about how we cannot allow leaders of some of the tech companies to simply look the other way and deny their share of responsibility for content on their platforms. Because if you run a business, of any kind, you have a duty to protect your customers.

I believe this strongly then as Home Secretary when I was thinking about sexual abuse but is just as important now.

Although the Internet contains a wealth of helpful content for those who are struggling too many people, especially those who are young or vulnerable they are also exposed to abhorrent and unacceptable content that promotes suicide and self-harm.

I will be convening a roundtable with social media platforms and search engines to encourage them to take more action and the Online Safety Bill that we have already brought before Parliament which will give us a once in a generation opportunity to tackle this issue.

I will also work jointly across Government to look at both upcoming and current legislation to make sure it meets the rapidly evolving challenges that we face.

Because when it comes to the encouragement of suicide and related harmful behavior we are currently relying on legislation that was primarily created long before the digital age and there is currently no specific offence that covers those who encourage or assist others to self-harm, or in my view of course a grave and heinous offence.

We have already announced that we will be creating a new offence of encouraging or assisting self-harm and I will work with my colleagues to see what else we can do where we might be falling short.

Our Suicide Prevention Plan will set out more about how we will do this.

We know that debt and economic uncertainty can be a factor too. We saw from the recession in 2008 which tragically led to a rise in suicide rates over the following years especially among men.

I know that people are facing real strains over the cost of living. There is a huge cost of living challenge now for so many people.

We protected millions of jobs during the pandemic through man incentives and we are now providing economic security at a time of great uncertainty.

During Covid-19 the suicide rate mercifully remained stable, despite the monumental impact on people’s lives.

But the next few months are critical and we must do everything in our power to make sure that we support the most vulnerable as they deal with these financial pressures.

Our public servants of course have a hugely important role to play here. They interact with people when they are at their most vulnerable and they deal with issues like debt and gambling that can be major risk factors.

I want to ensure that all front line Government employees and workers who interact with people in these situations have suicide prevention training and I’m also going to be working with the Speaker of the House of Commons to encourage access to suicide prevention training for all MPs and their staff.

I’ve been hosting surgeries in my own constituency for over 12 years, and often people come to see me when they feel they have nowhere else to turn.

As a result, I think it is really important MPs and their staff who have a unique window into the lives of many people in distress in their local area that they get this training. To recognise the signs of suicidal behaviour, and signpost options for support we can help them to intervene before it’s too late.

I am determined to focus not just on those who are at risk of suicide, but of course also their loved ones too. The sudden and unexpected circumstances of death from suicide can bring huge trauma. And I know the toll of losing a loved one and we need to be better at supporting those who are left behind. Not only because it is the right thing to do but because those who are bereaved from suicide are themselves at greater risk of suicide.

The evidence suggests that for every suicide, 135 people are directly affected and so we need to do everything we can to break this cycle of grief and suffering. Through putting in place for example the NHS Long Term Plan, every local area now has services for suicide bereavement support. By the end of this year, those services will proactively communicate with bereaved families within days of a death to offer their support. Removing the onus from the bereaved at their time of grief.

Third, we must keep improving services to help people who are struggling with their mental health.

The NHS is offering care and support to more people with mental health conditions than ever before with record levels of investment and more comprehensive round-the-clock support.

After all, your suicidal thoughts don’t keep office hours.

They are more likely to emerge when people are alone or perhaps late at night and we hear from our charity partners that their helplines are often busiest between the hours of 9pm and midnight.

All mental health providers now have 24/7 urgent mental health helplines in place that, together, are managing over 200,000 calls each month. My aim is that by 2023/24, anyone in the country can dial NHS 111 to reach their local mental health team at any time of day, 24/7 which would make England one of the first countries in the world to offer this service.

We are also making greater use of talking therapies which were pioneered in England and have now been emulated across the world.

Over a million people have accessed talking therapy in the past year and we’re expanding this access even further. The vast majority of these people who have accessed these therapies have done so through self-referral meaning they can get the help they need more quickly and so the median waiting time to start treatment is now only two weeks.

But despite this progress we must keep working to drive up service levels and address any unevenness in provision across the board. As part of this, I want to see an improvement in the quality of safety plans.

These are practical tools to help someone to navigate suicidal feelings and urges for example, removing objects that could be used for suicide or self-harm.

At the moment, there’s a stark variation in the standard and quality of these plans. I’m pleased to announce today that we will be working with experts in the sector to publish some standalone, best practice guidance on safety plans showing what good looks like, and how we can save lives.

These urgent services work extraordinarily hard to help people at the greatest risk. But sadly, some two thirds of people who take their own life are not in contact with mental health services at all.

I was just reminded of this a couple of hours ago when I spoke to a bereaved parent.

Of course, we want to get this number down but it reinforces the importance of the communities we need around.

A report for the Adolescent Mental Health programme finds that, and I quote, “in cohesive neighbourhoods defined as a place where people know their neighbours adolescent wellbeing and mental health are stronger”.

We all know the power to make a positive impact on the mental health of people around us and the answers can often lie within the communities where we live.

There are two central pillars of my overall NHS reform programme that I think are crucial here, prevention and personalisation. One wonderful initiative that intersects both of these areas is social prescribing where we draw on all parts of the local community that shape our health and happiness.

This work will benefit the whole community but especially those at risk of suicide reconnecting those who feel lonely or isolated with the world around them.

I talked earlier about how we need to do more to reach middle aged men, who are at greatest risk. Men of that age typically find it harder to build social connections than women and I’ve been really inspired by groups like Men in Shedswhich give men a place to meet like-minded people and share their concerns.

Through tailored opportunities for social prescribing and personalised support we can help those who are traditionally reluctant to come forward and give them the help and support that they need.

There have now been almost a million referrals to social prescribing services in this country with now some record 2,500 social prescribing workers in place who have all been encouraged to do e-learning on suicide awareness.

I’ve set a target of four million people to benefit from personalised care, like this, by March 2024 and I want to get more people into community-led schemes to tackle the social and economic drivers of their distress.

Finally, we will make the most of the kind of new technologies that helped this country through the pandemic.
This was a time when our mental health system just like others across the world, was put under huge strain.

But it was also a time when we saw new ways of accessing care that we can take forward now as we enter this next chapter.

We must make greater use of the apps and online services that can provide new pathways for care and help us to give more people the kind of access they need more quickly.

We must apply this approach to data too. During the Covid crisis, our decisions, my decisions were underpinned by real-time data that gave us an up-to-date picture of the situation on the ground.

But there are currently too many gaps when it comes to data around suicide prevention that means we don’t currently have a clear picture in certain areas for example, any link between suicide and ethnicity.

By bringing data together, we can identify concerning trends and respond at a much faster pace. We’ve been working with OHID – the division in my department- to trial a national suspected suicide surveillance system.

This allows us to look at patterns of risk like data on new and emerging methods of suicide and on suicide rates across different population groups to provide more sophisticated real time information that will allow us to make better decisions.

These trials have already shown to be a great success and I’m pleased to confirm today that we will now be rolling this initiative out nationally and it’ll be operational from early next year.

Last week, during London Tech Week I also launched our Data Strategy which shows how we will use the intrinsic value within data to tackle the twin challenges of recovery and reform.

I called the strategy, I named it Data Saves Lives and there are few greater opportunities to save lives than this vital work on suicide prevention.

This issue is deeply personal to me, and I feel a heavy sense of duty to use my time in this role to make a difference.

The dark cloud of suicide means that too much potential has gone unfilled and that there are too many families that have been left incomplete.

I’m determined to work with you to tackle this source of grief and heartbreak so that fewer people get the news that will one day perhaps turn their lives upside down.

Thank you all very much.

The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 22 June 2022.

The life sciences have played an essential role in helping us to learn to live with covid-19. The UK’s natural strengths, and our world-beating vaccine programme, have allowed us to lead the way in this. As we learn the lessons of covid-19, it is essential that we take steps to further strengthen UK life sciences and our resilience against both future threats and a possible future resurgence in covid-19.

To date over £380 million has been invested to secure and scale up the UK’s vaccine manufacturing capabilities and we have ambitious plans to invest more alongside industry to further our domestic vaccine resilience. As announced in the spending review in October 2021, the Government have now made available £9.6 billion for key covid-19 programmes and related health spending and continues to work closely with industry to ensure our life sciences sector thrives.

Looking to the future, we are determined to take action to secure further investment into the UK’s thriving life science industry and cement our position as a science superpower. To that end, the Government have agreed a detailed heads of terms with Moderna to create a strategic partnership over the next decade. A binding contract will be negotiated with Moderna over the coming weeks and, subject to approval of a full business case, will be in place by early Autumn. The proposed partnership, led by the vaccine taskforce, will strengthen domestic mRNA capability and better equip the UK to respond to covid-19 and future health emergencies.

Moderna would establish their global research & development centre in the UK as part of an R&D strategic partnership, siting R&D capability onshore, with academic and wider vaccine ecosystem engagement, including extensive use of the clinical trials network in the UK. Their facilities would support vaccines not just against covid-19 but other diseases such as flu and RSV. The industry-leading, future-proof design of the plant will permit the addition of capability to manufacture a wide range of medicines and will be a massive boost to the UK’s R&D capability. The site will also allow the UK to be better prepared in the event of future health emergencies. The project, which will provide an important boost to the local economy and to the country’s life sciences sector, was developed with the support and collaboration of the vaccine taskforce and will be a key investment to bring novel technologies and pandemic resilience onshore in the UK.

A consistent and resilient supply of covid-19 vaccines will be critical in protecting against a possible future resurgence in covid-19, ensuring jabs are provided in time to protect those who are most vulnerable to serious covid-19. That is why one of the objectives given to the vaccine taskforce was to strengthen the UK’s onshoring capacity and capability in vaccine development, manufacturing and the supply chain to provide resilience for future pandemics.

Moderna has demonstrated expertise in mRNA development and has offered a strategic partnership with Her Majesty’s Government under which it would invest in a new state of the art manufacturing facility in the UK for the production of respiratory vaccines. This would be capable of accelerating production, with UK priority access, in the event of a future health emergency.

The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 22 June 2022.

The United Kingdom Health Security Agency (UKHSA) yesterday published its updated vaccination strategy in response to the current monkeypox outbreak.

Based on the currently available vaccine supply, UKHSA recommends that the available doses of the vaccine should be used for a selective vaccine strategy with the aim of interrupting transmission in the subset of individuals at increased risk. This approach is supported by the Joint Committee on Vaccination and Immunisation (JCVI).

Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within, but not exclusive to, the social networks of gay, bisexual, and other men who have sex with men (GBMSM). Therefore, the updated strategy recommends that vaccination should be offered as soon as feasible to GBMSM at highest risk. Targeted pre-exposure vaccination is also recommended for others, including healthcare workers who are at high risk of exposure.

In view of the current epidemiology and vaccine supply available, wider vaccination in low-risk GBMSM individuals or the general population is not advised at this time.

NHS England is due to set out details on how eligible people can get vaccinated shortly.

To see the full updated strategy, which includes details of the recommendations for both pre and post-exposure vaccination, please visit: https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-