Baroness Fox of Buckley (Non-Afl)

My Lords, as we approach the end of Committee, it has been refreshing, even though we are not in the main Chamber, that there has been so much general consensual, constructive discussion. We have had a lot of interesting, erudite, probing amendments—erudite inasmuch as they have been thoughtful and have tried to get to the heart of what we think is happening with this Bill and what we need to see changed. It has been enjoyable working across parties, including the Front Bench, the Opposition, Back-Benchers, Cross-Benchers, non-affiliated Peers and so on. I have got that out of the way so that I can say that I do not know why on earth the main Opposition are obsessed with sickfluencers and have tabled this amendment, and I therefore want to speak to it. One of the reasons is because I think the amendment misses the target completely and draws together some of the issues around why I have had some worries about the Bill in general. Let me explain. I am speaking against Amendments 125A and 129A, which focus on the problem of sickfluencers and those using electronic communications and the internet to help people “circumvent eligibility checks”. This should not be made into any kind of criminal offence—with, according to the amendment, a threat of up to one year in prison—but we do have a cultural problem of encouraging and inciting increasing numbers to identify themselves as sick and in need of state support. I think that is where the focus should be, not on these malevolent so-called sickfluencers corrupting the nation. I am worried that these amendments miss the target and potentially distract our gaze from where we should be targeting. For example, in relation to circumventing eligibility checks, I am sure noble Lords are aware of a recent story from Oxford University, which has admitted that, because of a long waiting list and a logjam for diagnosis in relation to ADHD, it has decided that it will use as supporting documentation a referral to a GP or to an NHS assessment service as sufficient for students to get special concessions in exams and assessments. This is one of our top academic institutions allowing young people to circumvent the eligibility checks that were there until recently. They can gain benefits from this much lower eligibility check, which is inevitably likely to incentivise self-diagnosis among those students. It is in that context that we have seen the growth of sickfluencers. Videos with the hashtag “#mentalhealth” have amassed something like 17 billion views on TikTok over recent years, according to an academic study. But they have been about self-diagnosis, not about how we can rip off PIPs. They are, broadly, a cultural problem. My worry is that we are seeing the growth of what one psychiatrist has labelled the “mental health industrial complex”: increasing numbers of people prepared to enter into this discussion about what mental health is beyond the medical profession. That often comprises a plethora of therapists, who are unregulated, well-being experts and even mental health charities with huge budgets—some from government contracts—that have got us into a situation where increasing numbers of people are culturally incentivised to view the trials and tribulations of life and feelings of unhappiness and depression through the pathologised prism of medical labels. This is something that Tony Blair talked about last year, on which I uncharacteristically agreed with him. These sickfluencers are leading to a huge spike in numbers adopting an identity of mental fragility and illness and creating an increasing cohort of citizens demanding official diagnosis statements, NHS interventions, pharmacological and therapeutic treatment and, of course, welfare support. That is fuelling and feeding into some of the controversies around personal independent payments, increasing the numbers on disability living allowance and so on. I am trying to avoid that particular row about cuts in welfare, which are causing such consternation for the Government at the moment. My point is that it is not online sickfluencers—it is such a stupid word—who have created this culture of encouraging people to view themselves as in need of support. I have a lot of sympathy with the Health Secretary, Wes Streeting, who conceded that mental health conditions are being overdiagnosed, meaning that the number of working-age adults who we officially designate as incapacitated and in need of various forms of state support are being effectively written off as young people. It is to do with overdiagnosis. That is where all our energy should be. One of the reasons why I have kicked back against a lot of Part 2 of this Bill, some parts of which are draconian overreach, as a sledgehammer to crack a nut is that there is a much deeper problem in why the welfare bill is so huge that goes beyond people acting fraudulently in relation to benefits. I would be more sympathetic if the Opposition had taken on the real problems here. Governments of all parties, the previous one and this, have pushed official awareness campaigns, which encourage ever greater numbers of people to see themselves as in need of welfare and provide a script for people to follow. I have written extensively about this in a different context. Children in playgrounds use the therapeutic language of mental ill health. They got that from adults. We have to ask what is going on. Dr Alastair Santhouse, a neuropsychiatrist at Maudsley and author of a new book called No More Normal: Mental Health in an Age of Over-Diagnosis, notes that “the more people are aware of a particular illness, the more people start to identify with the symptoms”. Officially backed awareness campaigns are really problematic. I have just written the foreword to a new pamphlet entitled Suffer the Children: Why Having a ‘Mental Health Professional’ in Every School is not the Answer, brilliantly written by Lucy Beney. She notes that schools now have a veritable army of educational mental health practitioners, emotional literacy support assistants, mental health first-aiders and so on, and the outcome of this is more and more pupils describing themselves as suffering from mental ill health.