Commitments within this week’s Queen’s Speech promising to address the COVID-19 backlog and reform mental health services have been dubbed ‘hollow words’ as NHS employees warn that without urgent action to address workforce shortages patients will ‘continue to suffer’.
Delivered by Prince Charles on behalf of the Queen, who missed the State Opening of Parliament for the first time in 59 years due to ongoing mobility issues, this week’s speech focused on levelling up and the regeneration of public services.
With regards to health and care, the speech included details of the draft Mental Health Act Reform Bill and the Conversion Therapy Bill, both of which have been widely welcomed.
And Prince Charles stated that government ministers would also ‘fund the National Health Service to reduce the COVID-19 backlogs.
But details of specific funding, or indepth plans to reduce waiting times, were not provided, leading to criticism from health watchdogs and staff and patient groups.
With tens of thousands of vacancies in health and care across the country, nursing staff are facing a losing battle in trying to provide safe and effective care without the staff to do it
In particular, there is growing concern that continuing NHS staff shortages will scupper any action aimed at reducing the backlog.
Pat Cullen, general secretary and chief executive of the Royal College of Nursing, warns: “Ministers say supporting the NHS to clear the COVID-19 backlog is one of their key priorities – but without the workforce to do it these are only hollow words.
“With tens of thousands of vacancies in health and care across the country, nursing staff are facing a losing battle in trying to provide safe and effective care without the staff to do it.
“Clearing the COVID-19 backlog is just one part of the picture – there has been a sharp rise in people leaving the profession in the last year and without a credible workforce plan, patients will continue to suffer.”
Miriam Deakin, director of policy and strategy at NHS Providers, the membership organisation for NHS acute, ambulance, community, and mental health services, added: “The pandemic has taken its toll on overstretched NHS staff, with the soaring cost of living now adding more pressure.
“Trusts are working hard to safeguard the mental health and wellbeing of their workforce, but we need a long-term plan to attract and retain staff, as well as more support.”
The speech included plans to reform the Mental Health Act and introduce a new Conversion Therapy Bill. Images, UK Houses of Parliament
The proposed reforms to the Mental Health Act will see a raft of changes aimed at giving patients more control and better access to services.
These include:
- Amending the definition of mental disorder, ensuring nobody can be detained solely for having a learning disability or being autistic
- Changing the criteria for detaining people so the Act is used only where the person poses a genuine risk to their own safety or others and there is therapeutic benefit
- Better support for patients, including the offer of an independent mental health advocate, and allowing patients to choose their ‘nominated person’
- Introducing a 28-day time limit for transfers from prison to hospital for acutely-ill prisoners and ending the temporary use of prison for those awaiting assessment or treatment
- Introducing a new form of supervised community discharge, allowing the discharge of restricted patients into the community with the necessary care and supervision to adequately and appropriately manage their risk
- Increasing the frequency with which patients can make appeals to tribunals on their detention and provide tribunals with a power to recommend that aftercare services are put in place
- Introducing a statutory care and treatment plan for all patients in detention written with the patient and setting out a clear pathway to discharge
Commenting on the plans, a spokesman for NHS Confederation, which represents many NHS employees, said: “We welcome the commitment to bring forward new mental health legislation.
“The bill will have positive and far-reaching impacts for patients, creating opportunities for them to challenge decisions made about their care, changing the criteria for detention, and removing having a learning disability or autism as grounds for detention.”
Cullen also welcomed the legislation, but reiterated calls for action over staff shortages.
She said: “Plans for reforms of the Mental Health Act are a step in the right direction, but that also requires a fully-funded workforce plan.
“Despite government rhetoric, the number of unfilled nurse jobs in the NHS is not coming down.”
And Deakin said: “Reform here is long overdue and we are pleased that this is a priority for the Government.
The bill will have positive and far-reaching impacts for patients, creating opportunities for them to challenge decisions made about their care, changing the criteria for detention, and removing having a learning disability or autism as grounds for detention
“We support proposed changes to the Act that will give people a greater say in planning their care and recovery.
“[But} a new Mental Health Act on its own won't be enough to guarantee high-quality mental health services or transform the way we deliver them for years to come.
“Mental health services are under severe strain from huge demand and limited resources.”
In particular, she said, the focus needs to be on the mental health and wellbeing of NHS staff and addressing mental health inequalities between different sections of society, particularly Black, Asian and minority ethnic communities.
And Vicki Nash, head of policy, campaigns and public affairs at mental health charity, MIND, said: “We welcome the Government’s commitment to a new Mental Health Bill. “Being sectioned is one of the most-serious things that can happen to somebody experiencing a mental health problem and more than 53,000 people were detained under the existing Act in England in 2020/21 – an increase of 4% on the year before.
“As these numbers continue to rise, we urgently need to see the UK government implement the long-overdue legislative changes needed to give people greater choice and control over their treatment.
A new Mental Health Act on its own won't be enough to guarantee high-quality mental health services or transform the way we deliver them for years to come
“[But} we must see more investment in early intervention to reduce the number of people becoming unwell in the first place.
“Mental health problems become more difficult to treat if left unchecked, as well as more costly to the NHS.”
Prince Charles also announced plans for a Conversion Therapy Bill which will ban conversion therapy practices intended to change sexual orientation, though notably it does not include gender identity.
Under the Bill there will be a ban on non-physical conversion therapies to complement existing legislation which protects people from acts which inflict physical harm.
The offence will protect under-18s, regardless of circumstance, and over-18s who do not consent and who are coerced or forced to undergo conversion therapy practices.
The legislation also introduces Conversion Therapy Protection Orders, which will set out certain conditions to protect a person from undergoing conversion practices, including removing a passport for those at risk of being taken abroad.
Nash gave a mixed response to the new laws, telling BBH: “We are pleased to see the Government will continue with its plans for a ban on conversion ‘therapies,’ which harm those subject to them and have a terrible impact on a person’s mental health.
“However, we remain dismayed the Government has not yet rowed back on the exclusion from the ban of protections for trans people.
“Trans people are much more likely to have undergone, or been offered, conversion ‘therapy’ than cis-gendered people, so protecting them is essential to ban the practice effectively.
“Bans that include trans people have been implemented in other countries, so it is certainly possible, despite legislative complexity.
“We need a complete ban, without loopholes, which protects everybody.”