Dr Luke Evans

When we last debated the Bill on Second Reading, I said that protecting someone’s freedom for their own safety is not a licence to own their life, but a duty to help them find it again. That principle still guides us today, because good intentions alone do not mend a troubled system. Compassion without competence is not care; it is sentiment without substance. On Second Reading, I spoke of bridges and rough roads, and of how resilience and recovery depend on the strength of the structures that carry people through their hardest times. Tonight, we return to that bridge. The question before us is not whether we believe in reform—after all, there is cross-party agreement on that—but whether the Government have built the foundations to make it stand. Warm words are plentiful, but the reality is that too many people are still falling through the gaps: detentions are still present, community services are stretched, and families are left navigating a maze of bureaucracy while waiting for help that may never come. We all know that reform cannot be delivered on aspiration alone. It requires a delivery plan, a workforce and a system capable of learning from its own mistakes. We know the chapter on delivery is missing from the 10-year NHS plan and there is further risk tonight that we miss another opportunity. After all, the principles in the Bill are the right ones. They are even on the face of the Bill—choice and autonomy, least restriction, therapeutic benefit, and treating the person as an individual—but those principles need power behind them and that power lies in delivery. This Report stage is our chance to turn those words into commitments. New clause 31 requires the Government to publish a fully costed delivery plan within 18 months of the Act passing into law, setting out how integrated care boards and local authorities will deliver adequate community services. Crucially, the plan must be developed through consultation with those who know best. That is vital, because although we support the many aims of the Bill, the Government already have a pretty dismal record of announcing reforms without any credible plan to deliver them. Let us take the ongoing NHS reorganisation. In March, Ministers made a surprise announcement of the abolition of NHS England and its absorption into the Department of Health and Social Care, yet six months on they cannot say what it will cost, how many staff will be lost or how it will be paid for. The Health Service Journal reports growing confusion inside the system and warnings from NHS leaders that the lack of clarity risks paralysing decision making. Written questions to the Government simply receive the answer “some upfront cost in the millions” yet independent estimates say the cost is over £1 billion. Even the chief executive, Sir Jim Mackey, points out that the Treasury must agree funding for integrated care board redundancies within weeks or the NHS will have to turn to a plan B. The same chaos is playing out across integrated care boards, with local leaders warning that there is already destabilisation due to the 50% reductions. If Ministers cannot manage their own top-down reorganisation, why should anyone believe they can deliver a more ambitious overhaul of mental health services without a clear costed plan, especially when waiting lists have risen in the last three consecutive months? This Labour Government have already cut the proportion of spending on mental health. As Dr Lade Smith CBE, the president of the Royal College of Psychiatrists, said at the time: “It is illogical that the share of NHS funding for mental health services is being reduced at a time of soaring need and significant staff shortages.” Going on, she said that: “The proportion of NHS funding allocated to mental health services will decrease”, which will “equate to these vital services missing out on an estimated £300 million or more that they would have received if their share…had been maintained.”