Health and Social Care Committee

Welcome back to committee, then. We resume with item 3, another legislative consent memorandum, this time on the Mental Health Bill. The UK Government introduced that Bill on 6 November of last year. It aims to modernise the Mental Health Act 1983, to provide patients with greater autonomy, enhanced rights and improved support. The Bill contains several provisions that intersect with devolved matters. Consequently, the Welsh Government has laid a legislative consent memorandum before the Senedd. That LCM outlines the Welsh Government's position on the Bill and its implications for devolved competencies. A supplementary LCM has also been laid, which takes account of changes to the Bill, during its passage through the UK Parliament.

This committee has been invited to consider and report on the LCM and the supplementary LCM, given our responsibilities for health. I'm very pleased to welcome, to assist the committee in considering the LCM and reporting on the LCM, Sarah Murphy MS, Minister for Mental Health and Well-being, and also some of the Minister's officials: Alex Slade, who's director of primary care, mental health and early years; Matt Downton, who's deputy director of mental health, substance misuse and vulnerable groups; and Elizabeth Lockwood, who's in charge of delivery and the oversight board implementation. Thank you all very much for coming in. Welcome back so quickly, Minister.

Perhaps I might begin again with some initial questions around policy alignment: why has the Welsh Government chosen to submit a legislative consent motion for the Mental Health Bill, rather than introducing its own legislation? How does that Mental Health Bill align with the Welsh Government's vision for mental health services and support here in Wales?

Thank you very much, Chair. So, as you know, the Mental Health Act was brought in in 1983, so it's 42 years old now. It was always an England-and-Wales piece of legislation, and I think that it's been a long time coming to have this reform. As we know, in the previous Westminster Parliament, they did a tremendous amount of work on this: engagement with stakeholders, people with lived experience, there have been reviews, the joint committee have taken evidence and presented recommendations, some of which have been added in to the new reform. I think that this a huge—. I feel, actually, very proud and privileged that I get to be the Minister for Mental Health and Well-being as this reform is implemented in Wales.

So, specifically, as you know, we do follow the principle that primary legislation in devolved areas should be enacted by the Senedd. But we've been working so closely with the UK Government on this—my officials meet with UK officials on a weekly basis—what we’ve asked for has always been accepted, and the Mental Health Bill reflects the principle that, with close collaboration, we can develop the provisions in the Bill. Utilising UK Bills does not equate to Welsh Government needing the support of a different Government and different Parliament to deliver the legislative objectives. So, I feel very pleased that this is now happening.

Okay, Minister, in terms of that importance, then, of the Mental Health Bill, and applying some of its provisions here in Wales, what would you say are the key provisions of that legislation that are particularly important to Wales, and why?

Absolutely. So, the independent review of the Mental Health Act 1983, which happened in 2018, led to a White Paper in 2021. There were 154 recommendations for improvement, and the key issues that were mentioned in it were the misuse of detention, especially for learning disabilities and autism, and also discrepancies in care quality between detained patients and those in community settings.

So, the Bill then proposes several key reforms, which have been, on the whole, very, very welcomed. So, that includes revisions to detention criteria, to ensure it is only used when absolutely necessary; enhancements to patient representation, including allowing patients to choose their advocates—this is something that James Evans has always spoken so passionately about—reducing detentions of individuals with learning disabilities and autism, with a strict 28-day assessment limit; introducing duties on commissioners to monitor and prevent crises among vulnerable groups; revising community treatment orders to ensure appropriate oversight; removing police stations and prisons as places of safety for individuals in a mental health crisis; creating a 28-day time limit for transfers for individuals from prisons to hospital for mental health treatment; and, of course, introducing supervised community discharge for certain criminal justice patients who no longer benefit from hospital care, but need conditions to manage their risks.

And also, of course, as I mentioned, the joint committee presented other revisions that they would like to see made, and these, then, included the removal of a requirement to consider how soon harm might occur in detention criteria; adjustments to the nominated persons, as I’ve mentioned, so reducing the practical concerns for approved mental health professionals; modifications to advance choice documents; and updates to the code of practice to incorporate the four guiding principles of the independent review.

Thank you very much, Minister. James.

Minister, you mentioned places of safety, and it’s positive that police stations and prisons are taken away as places of safety, because we know that’s not the best place to put somebody in a mental health crisis. I’m just interested in what discussions the Welsh Government has had, actually, around hospitals in that as well, because A&E departments are also not the best place for somebody who is having a mental health crisis; it's actually probably one of the worst places you can place somebody—they’re just put in a chair and tend to be forgotten about, and could be left there for hours and hours and hours, not seen in crisis. So, I’m just interested in what discussions you’ve had with the UK Government around A&E departments in particular not being classed as places of safety, because all the front-line professionals that I speak to, who work in A&E departments, are not trained to deal with mental health crises. They don’t know how to deal with these people, and they’re not getting the best care.

So, I’m just interested in what discussions you’ve had around, in the Bill, having certain hospital places not classed as places of safety, because what will happen is—. If the police can’t take them to the police cells, or they can’t take them to a prison, what will end up happening is all those people will end up in A&E departments, which isn’t the best place for them.

Absolutely. So, in terms of what you initially said about the place of safety, we know from people with lived experience, and just from our own kind of empathy for these situations, how traumatising and long-lasting that trauma is, actually, when you’re put maybe into a police cell or a car, or anything like that, when you’re in that crisis. So, I completely agree with you, and I’m really pleased to see that that’s been incorporated.

When it comes to where people should go, in that case, in a hospital, we already have the requirement within health boards and for hospitals that they always have a crisis bed that is available. And that is something that we have to ensure is being taken forward and implemented. Again, this will give us that opportunity now to insist, because it will actually be illegal to not have that, to not have that opportunity to have that.

I’ll come back later because I could spend ages on that.

Okay. And Hannah Blythyn.

I’m actually going to come in on what James said there—

Yes, of course.

—because, sadly, I've had a very tragic circumstance in my own constituency of somebody who went to A&E, it wasn’t the right place for them, there wasn’t the support, and then it had a tragic outcome afterwards, and I've been kind of supporting people close to that person through that. I think it's about provision of support and services, isn't it, and people knowing where to go for them. So, how is this legislation going to support that, and actually what plans, alongside it, is the Welsh Government making to improve that access to support and provision? Because a lot of the time it's at capacity, or people just don't know where to go either.

Yes, thank you for that question, because so much of this is actually about prevention. We never want anybody getting to the point where they need to be in this position, where they need to be detained, and that is why the mental health strategy that we have coming this year is going to be absolutely crucial to this. So, there will be many elements in there that will reinforce that need for the prevention. But we also, as you know, have the national helpline, the '111 press 2', for when people are in crisis, to be able to direct them to the best place that they need to go to. So, the JCC are doing a tremendous amount of work in terms of promoting that, as I know that many of us are as well, and that's been a key element of this, and we can provide you with the data as well, of how that's being rolled out. When I went to the Children, Young People and Education Committee, we also specifically looked at how many young people are also using that service, and that has also had a huge uptake in that particular cohort. So, thank you, because it does help us to reinforce that we never want anybody, really, getting to the point where this is necessary. And that's where we want to be, and that's what our mental health strategy is going to be setting out.

Okay. Well, I'm sure we'll come on further to those matters later in this scrutiny session, Minister. One further question from me. Could you tell committee what consultation you've carried out with stakeholders, mental health professionals, advocacy groups and service users?

Yes, of course. So, the previous UK Government had planned to introduce the Mental Health Bill, as you know, and to deliver the recommendations of the Wessely review, which actually again specifically looked at inequalities and how they felt that people from the black, Asian and minority ethnic communities were being disproportionately impacted. The draft Bill, then, was published, and the Welsh Government worked with the UK Government, even then, to ensure that the voices from Wales were heard as part of the consultation on the Bill, with the consultation being publicised widely with stakeholders in Wales. So, then, whilst the consultation responses to the White Paper were received directly by the UK Government, responses from Wales were shared with the Welsh Government, so that we could consider responses in relation to these devolved matters that we're discussing today. So, whilst the Bill didn't progress, we had good engagement with stakeholders in Wales through a public consultation, who broadly welcomed the proposals, and as you'll see as well from your written evidence today—you've had Mind Cymru, you've had the Royal College of Psychiatrists as well—in a way, the beauty, sometimes, of the stakeholder engagement is that they are across all of the nations. They have this perspective, which is invaluable, as well, so having their evidence is really crucial and very welcomed, and all of them have support for this very, very long needed refom.

Okay. Thank you very much, Minister. Mabon ap Gwynfor. Mabon.

Diolch, Gadeirydd. Yn dilyn ar y pwynt yna, cyd-ddigwyddiad llwyr ydy o, wrth gwrs, fod James Evans wedi cynnig Mesur ei hun ar iechyd meddwl a bod y Bil iechyd meddwl yma yn dod ymlaen, felly cyd-ddigwyddiad ydy o eich bod chi wedi medru cael elfen reit gynhwysfawr o ymgynghori efo'r cyhoedd a rhanddeiliaid yng Nghymru cyn bod yr LCM yma yn dod. Dydy hynna ddim yn digwydd efo LCMs eraill. Felly, dwi yn pryderu pam mae'n rhaid i ni hongian ar gynffon deddfwriaeth yn Lloegr yn hytrach nag ein bod ni wedi bod yn rhagweithiol a chreu ein deddfwriaeth ein hunain. Mae mawr angen deddfwriaeth newydd ar iechyd meddwl wedi bod yng Nghymru ers sawl blwyddyn, felly pam na gychwynnwyd arno fo ynghynt, a pham mae'n rhaid inni aros i Loegr weithredu ac felly gweithredu o fewn cyfyngiadau deddfwriaeth Lloegr?

Thank you very much for that question, Mabon. It echoes a question that I've received in writing from the Legislation, Justice and Constitution Committee as well, asking if we're piggybacking onto England proposals and trying to fit them into Wales. I would actually say that it's very much the opposite. So, as I've said, this is and has always been a piece of England-and-Wales legislation. It was always going to require us to work together to be able to do the reforms. As you said, so much work has been done on this. I've read through all of the reports that have been done by the UK Parliament on this, I've read through the review, through the White Paper; there has been huge stakeholder engagement. I think that the community were extremely sad when it wasn't progressed by the previous UK Government, and I think that we have to grab this opportunity.

In response to your point on what James Evans was proposing to do, which had support from Government as well, Welsh Government, that was to amend the Mental Health (Wales) Measure 2010, because we could not amend the Mental Health Act ourselves, on our own. So, of course, I have tremendous respect for Jonathan Morgan, who brought in the mental health Measure in Wales, which attempted to bring in that more community, holistic, prevention element to what we try to achieve here in Wales. And many of the things that James Evans, as you have said, was trying to attempt with that are also now in this mental health reform. But specifically, in terms of are we piggybacking on it, well, no, because, again, the mental health Measure brought in that key element of advocacy, of patient voice and of it being patient centred. And this is something that we've been doing in Wales for a very long time. It's interesting now that this reform is going to bring in that advocacy element. So, I would actually say that England, in many ways, is looking to Wales, and we're certainly not piggybacking. We've been a crucial part of this all the way through, and it's important, as we've heard today, that we have that consistency across a lot of the cross-border working that we do as well.

Diolch am yr ymateb. Os caf i wthio nôl ychydig, dwi yn gwerthfawrogi bod yna Fesur wedi bod yng Nghymru, ond y gwir anffodus ydy bod neb yn gwrando ar y Mesur yna ac mai deddfwriaeth Lloegr ydy'r un mae pobl yn edrych tuag ati. Felly, mae'n gwestiwn gen i pam dydyn ni ddim wedi datblygu ein deddfwriaeth ein hunain yn y maes yma ynghynt er mwyn gorfodi rhai o'r hyn rydym ni'n dymuno neu'n deisyfu ei weld yng Nghymru, ac felly rydym ni'n ddibynnol ar ddeddfwriaeth yn cael ei chyflwyno yn Lloegr er mwyn gwireddu lot o bethau sydd yn y Mesur iechyd meddwl yng Nghymru. Dwi'n meddwl bod yna anghysondeb ac mae'n anffodus.

Dwi hefyd eisiau pwyntio allan—. Onid ydych chi'n meddwl bod hwn yn gosod cynsail beryglus iawn i'r ddeddfwrfa sydd gennym ni yng Nghymru ac i ddatganoli? Mi ydych chi'n dweud, er enghraifft, yn eich papur chi fod—. Y geiriau rydych chi'n defnyddio yw bod:

'significant amount of cross-border provision'.

And therefore that justifies supporting this English legislation. You also say that, if Wales were to go down its own route, it

'risks increasing divergence',

Ac yn y blaen. Mae hwnna'n gosod cynsail beryglus oherwydd mae yna lot o waith trawsffiniol yn digwydd yn iechyd rhwng Cymru a Lloegr. Dydy hynny ddim yn rheswm neu'n gyfiawnhad i beidio â datblygu ein Mesurau Cymreig ein hunain, deddfwriaeth Gymreig ein hunain. Ac, o ddefnyddio'r ddadl yna, onid ydych chi'n dweud, 'Gadewch i ni adael i San Steffan benderfynu ar bob deddfwriaeth yng Nghymru?' Ac wrth gwrs mae yna risg o divergence. Onid dyna beth ydy pwynt datganoli, ein bod ni'n canfod datrysiad Cymreig i broblemau Cymreig? Felly, ydych chi ddim yn credu ei fod yn gosod cynsail beryglus?

In answer, no. I think that what would be really dangerous is if we didn't now take the opportunity to have this LCM to right many of the wrongs that have come about because of the mental health Bill that goes back over 42 years. I think that what I've heard from people, especially people with learning disabilities and autism, is that what they've experienced has actually been quite dangerous. Because we have to think that, 42 years ago, there was a very different landscape in terms of mental health and our understanding. You'll see now in the mental health strategy that we have coming forward and from our stakeholders that we much more, now, understand that mental health has that parity with physical health. There is a life course. You can't expect people to be physically well all their lives, and you can't expect people to be mentally well all their lives.

With respect, I understand what you're saying, that is absolutely true, but we could have developed our own legislation on this many years ago. Simply because the Westminster Government is doing it now is not a reason to say that we have to follow Westminster's lead because people in Wales are suffering; people in Wales have been suffering for the last 40-odd years because of poor legislation. We could and we should have done this earlier. What I'm asking about is the principle; not the need—we know there's a need— but the principle of not developing our own legislation and hanging on the coat-tails of England and waiting for the Westminster English model to come forward first for us to then say, 'Yes, let's do something.'

Okay, so, just to be very clear, no, we could not have—this has always been an England-and-Wales piece of legislation, so, no. And I don't think it's setting a dangerous precedent. I think that, at times, we have to be able to work together and we have to be able to bring forward what is in the best interests of people. I think what's happened in the past is that—and if you let me finish this time—there's been a long period of changes in the mental health landscape. We now understand trauma; we are trauma informed. We understand complex needs; we understand adverse childhood experiences. And I think that, back in the time when this was first formulated, it was done with a very top-down approach—we had no understanding of listening to people with lived experience; we still had asylums in parts of the country. It’s extremely different, and it was a way, in a way, of potentially seeing it as a way to manage people in these crises.

What this should be seen as, and what it was always meant to be and what this reform will bring about, is, actually, that this is fundamentally a piece of human rights legislation—it is actually to ensure that that person knows what their rights are under the Mental Health Act and under the mental health reform. And the Measure and the Act do have an interface, and you will see that, in the mental health strategy, we will actually be committing to updating the Measure to go alongside this as well. But, fundamentally, they are different—under the Mental Health Act you are detained, and that’s why we have to ensure that people’s human rights are absolutely upheld. I do not believe that we should lose this opportunity—and bearing in mind that I am also the Minister for people with learning disabilities and people who are neurodivergent as well—to ensure that they have the human rights that they require and that they deserve when they are detained under the Mental Health Act in England and in Wales.

Just before you go on, Mabon, I'm just going to bring in James Evans. James.

Thank you. I have sympathy with Mabon's argument, but I also know the realities of the situation as well. I'm just interested, Minister, or perhaps your officials could give a bit of background, perhaps, in why this couldn't be taken forward on a Wales basis. I think it's more to do with the legal context and actually the complexities of the devolution settlement here in Wales. And I'm just interested if you or your officials could perhaps highlight that just for the record, I think, because I think it would be useful to get that out—why we can't do it here, because of some of the legal contexts around the issues of why—. You know what I'm going to say.

Yes, absolutely, and, of course, James Evans, you know this better than anybody. This is why I thought it was very clever in what you were proposing with your Member's Bill, because you had to navigate each of these areas. So, you are right—when I say that it would not have been possible, it would not have been possible. I will bring in Alex Slade, though, to go into more of the narrative around that, as you said.

Thank you, Minister. As the Member knows, the challenges we encountered with your private Bill were around the cross-border issues. They turned into very complex, legal aspects in terms of how we progress those, and even within the competence, in Wales, in terms of detention criteria. So, clearly the England-and-Wales legislation is much broader in terms of what it is able to deliver and aligns—. Clearly, this process is about how it fits with our policy intention, the direction of Government, and the focus has always been about the individuals and the focus on Welsh population rather than how we achieve those, and in this situation, as the LCM states, we're supportive of the components within the Mental Health Act.

There are specific provisions within the document that would constantly create cross-border issues where we had disparity in the legislative frameworks—detention being one of those, and aftercare being another one of the components. And thinking about the individuals who live with those border issues, who could find themselves in a different legislative territory for what are very serious areas, for which we’d want robust safeguards in place, the alignment is for both the competence of the Welsh Government to be able to pursue those areas, but also for the individuals in terms of the way they are treated by a number of different agencies.

Lovely, thank you. I thought it would be useful to get that on the record.

Yes, okay. Diolch yn fawr. Mabon.

Thank you very much, Chair. The other element I wanted to address, in your letter, Minister, under paragraphs 17 and 18, you mention the cost of introducing this legislation, and the cost to Wales. And I think you estimate that it'll cost £425 million for Wales over a period of 20 years—I think that's what you said. And then, in paragraph 18, you state that you are asking for consent for this LCM on the understanding that there will be match funding from Westminster to fund this. Can I just ask if I'm correct in that before I move to my question?

Yes, that's correct.

Thank you, Minister. So, quite understandably in terms of the principle, you agree, as do I, with the aims of this legislation, but your support is conditional on funding coming from Westminster. What if there was a change of government in Westminster? What would happen if, let’s say, Reform or any other party would win the next Westminster election and decided that they’re not going to fund the services to the extent that the current Government does? There would be serious implications for Wales in that regard, so what consideration have you given to that issue?

I would point to the answer that I gave on funding that we will receive from UK Government when it comes to the Tobacco and Vapes Bill as well, so it will be part of Barnett consequentials, and then it will be decided how that is used. It’ll be very phased as well. As you know, the mental health budget on an annual basis in Wales is £820 million, and £425 million over 20 years will be added in, so I’m very confident that that will continue, because that is a requirement that we have in Wales for our funding.

Y pwynt dwi'n ei wneud ydy, wrth gwrs, pan fydd yna lywodraeth newydd yn dod, y bydd gan lywodraeth newydd flaenoriaethau newydd, ac, felly, hwyrach na fuasai llywodraeth newydd yn San Steffan yn ariannu i’r graddau yr ydych chi'n rhagweld, ac mi fuasai hynny’n dod â goblygiadau andwyol i'n gallu ni i ddelifro'r ddeddfwriaeth yma.

Yes, of course—hypothetical, but I’m afraid I can’t really answer. I would hope that that would not be the case. However, it would never be prohibitive to us ensuring that people’s human rights are upheld under the Mental Health Act reform.

Okay, Mabon. If we move on, then, we have Hannah Blythyn next.

Diolch. So, Mental Health Matters and the Welsh NHS Confederation have called for some clarity in the Bill regarding the roles of independent mental capacity advocates and rule 1.2 representatives in the context of the new detention criteria, particularly to make sure that vulnerable individuals aren’t deprived of their legal protections. Do you have any views, Minister, on those calls for clarity, and what assurances could you give to those organisations around those concerns?

Yes, of course, and both, of course, we work very closely with. These are people who are supporting people and see this very much up close. So, it’s worth adding that there will be a code of practice that goes along with this, so any additional clarity that is sought will be done collaboratively, will be done to ensure that there isn’t any ambiguity in what we’re expecting to be rolled out. It’s been really helpful to be able to go through this process, receive that evidence and be able to take that on board. So, absolutely, we don’t want any ambiguity here, and that will be confirmed then in the code of practice.

So, that will be supported with the workforce too, so they’re fully informed and trained-up to deal with these changes?

Yes, of course.

Just on another point, then, how does the Welsh Government plan to address—we’ve heard about this—the potential overlap between the Mental Health Act and the Mental Capacity Act, and what steps are being taken to ensure people don’t end up falling under the wrong framework when it comes to detention?

Thank you. This is a really important question, and I know that this is something, from my stakeholders in the learning disability ministerial advisory group and the neurodivergence ministerial advisory group, that they want assurances on as well. So, as you know, currently there is overlap in the interface between the MHA and the MCA, and it is covered in the existing code of practice that we have, and the narrowing of the detention criteria under the MHA should make the interface clearer. That is our hope, but this will need to be addressed within that code of practice that I mentioned.

My understanding is that the interface between the two regimes only occurs in a very small number of cases at the moment, but professionals are already working closely to ensure the appropriate legal frameworks are used, and there are a number of safeguards in place to ensure the legislation is applied appropriately, and this includes the tribunal services that we have in Wales, and all health boards have legislation committees to ensure appropriate use as well.

And there have also been some concerns raised by the Royal College of Psychiatrists and Adferiad. So, do you agree, or what is the Welsh Government's view, on the suggestion that advance choice documents should be made a statutory right for patients, and, if so, how could this be incorporated into the legislative framework to improve patient autonomy and, hopefully, reduce detentions?

Thank you. This is a question that I've discussed with stakeholders. So, the Bill will place a duty on the health board to provide people at risk of detention with that opportunity to set out their wishes—so, it's that prevention work, again—choices and values, should they become too unwell to protect them. Clearly, as we move to implement the Bill, we will need to ensure that we have the strength and the data to monitor that implementation, and the Bill will enable us to ensure that all those individuals that are eligible for that ACD receive one. As you know, then, you've got the CTPs, which are a statutory right in Wales, and compliance is good on that, and they all work together. So, at the moment, we wouldn't be looking to do that.

So, you just referenced it—is it care and treatment plans?

That's right, yes. Sorry.

Are you able to clarify the relationship between advance choice documents and the care and treatment plans as set out in the mental health Measure and how they would potentially work together?

Yes, of course. So, we have got work at the moment going on to look through the detail, because there are links between the two, and that is already included in the information about the patient's views and wishes regarding their treatment, so they should all be carried through. Again, I actually see this as a really important opportunity to strengthen what we already have in Wales, with more opportunities for patients to share their views, and that's what's absolutely crucial here. This was not part of people's real understanding or commitment years ago, but now we really understand that need for that patient-centred, holistic, having a say in how they're treated if they end up becoming too unwell, and also then, as people go back into the community, that they get that support that they really need to make that recovery.

Absolutely. As you say, the world has changed, and understanding has changed in the last 40 years dramatically. So, just one final question from me, on safeguards: what safeguards will the Welsh Government implement to ensure that the nominated person role is accessible to all individuals, particularly those groups that may currently be under-represented, as well? And how will it prevent undue influence in decision making for more vulnerable individuals?

Thank you. Again, as I've referenced before, this was something that James Evans, I think, really championed and brought to the attention of the Senedd. In the past, unfortunately, it's just been assumed that the next person of kin—sorry, I can't—. What is it—the next kin?

Next of kin.

Next of kin—that the next of kin would automatically be that person, and, of course, as we know, that's not always the best thing for many people. So, having that nominated person is really, really crucial. The provision then aims to give individuals a greater say and choice in selecting that person, and it does replace the more restrictive process, as I've mentioned.

We are aware that some groups are concerned that these changes could lead to increased abuse of the deprivation of liberty orders, and we will work really closely to monitor this. That's when, maybe, they wouldn't be able to choose. And then, the Bill will provide further clarity for clinicians and individuals, which, in itself, will also act as that additional safeguard as well to ensure that that is absolutely the case, and also for children and young people.

Thank you.

Okay, Hannah. James.

On nominated persons, there always was that conversation around when that person can nominate somebody—you know, when they're well or in plenty of time. I'm just interested in if you think how it's worded within the Bill gives enough provision for somebody to have time to nominate somebody, because it's very difficult for somebody to nominate somebody when they're in crisis, because sometimes that might not be the best thing for them because they're not making the right decisions. So, I'm interested if you think the Bill is sufficiently worded to give people enough choice around nominating someone when they're well. You know what I'm trying to get to.

Of course. I think that it is as far as it can go, but I also think that this is something that's going to be crucial in that code of practice as well, and the monitoring and ensuring that this is happening. It comes back to what I was saying before, which is that we want that prevention work, through that mental health strategy, to really change and revolutionise the way that we provide mental health support in Wales. So, I believe that by doing that through the code of practice, through this legislation, which makes it very, very clear what people are entitled to be able to do, we will be able to achieve that.

I'll just bring in Mabon ap Gwynfor at this point. Mabon.

Diolch. Jest i adeiladu ar hwnna, a mynd nôl, maddeuwch i fi, i’r pwynt roeddwn i'n ei adeiladu a’r pwynt roeddwn i’n ei wneud ynghynt, sydd yn clymu i mewn i’r cwestiwn yma, mae'r elfen yna o pam nad ydym ni wedi gwneud pethau yng Nghymru yn barod ar y pwynt rydych chi wedi ei godi rŵan a sicrhau bod gan bobl yr hawliau yna yng Nghymru. Rhan fawr o’r broblem yng Nghymru ydy nid o reidrwydd yr angen am ddeddfwriaeth drwy'r amser, ond pethau sydd o fewn ein gallu ni, o fewn eich gallu chi fel Llywodraeth. Mae diffyg gweithlu. Does yna ddim cynllun gweithlu ar gyfer seiciatreg, er enghraifft; does yna ddim digon o seiciatryddion gennym ni. Mae'r gallu i ddarparu gwasanaethau i bobl fyddar neu i bobl gyfrwng Cymraeg yn gwbl annigonol. Mae trafnidiaeth er mwyn cyrraedd y gwasanaethau yma'n gwbl annigonol. Mae'r rheini i gyd o fewn eich gallu chi fel Llywodraeth, felly, ynghyd â'n bod ni'n cael deddfwriaeth eto, pa gamau tangible ydych chi'n mynd i'w cymryd er mwyn gwella'r sefyllfa fel y mae yng Nghymru er mwyn i bobl medru cael mynediad at y gwasanaethau yna, a medru sicrhau bod yr hawliau yma rydych chi'n eu gosod iddyn nhw'n gallu cael eu gweithredu oherwydd eu bod nhw'n medru cael mynediad i'r gwasanaethau?

Yes, of course. So, as I've mentioned, with the mental health strategy that we have coming, many of those issues that you've raised will be incorporated into that. As you know, I was a member of the Health and Social Care Committee for a number of years; we did a number of very important pieces of work, including the mental health inequalities piece of work that we did. All of this has informed the mental health strategy that we've done.

We're doing a tremendous amount of really good work in Wales already, and I think that we're actually at a very exciting point where we're going to have this reform coming through at the same time as we will have a mental health strategy, which will not just be like any other one that we've maybe had before; this is really going to look, now, at a different approach and at people getting the support that they need as quickly as possible, and really trying to achieve that parity that we have with other parts of the health service. So, I'll be more than happy to come back and answer many more detailed questions, Mabon, on how we're trying to address all of that. But I really do see this reform as being a really crucial part.

And if I can say, as well, which we haven't touched on so much today yet, what this means for people within the learning disability community is everything. It's absolutely tremendous to have this real recognition of how the Act has been misused, which, in my view, has been sometimes cruel—'cruel' I think is the word that I would use. This is absolutely what we're trying to achieve here; we're trying to make sure that this doesn't happen, that this mental health reform really makes it a human rights Act—that's what we want to see. But, coming back to your questions, I assure you that, within the mental health strategy—. And we also have the suicide prevention and self-harm strategy, as well, coming imminently, Chair, and I would be more than happy to come back and answer many of those questions.

Thank you for that, Minister. We're just about to, actually, come on to vulnerable groups.

Oh, good.

But, first of all, James. James Evans.

Yes, just really quickly. Minister, I'm just interested—. As Mabon said, we've got numbers of different strategies, the Measure, the Act and different Acts that have come in subsequently since the original Mental Health Act 1983. I'm just interested, because, when you talk to clinicians on the front line, there seems to be a priority of which legislation or Acts they follow, and it tends to go: the main Mental Health Act, a few other things that have come from Westminster, then the Measure. And I'm interested, with the discussions that you and your officials have had with the UK Government, in how many of those elements of the Measure you're trying to slip into the mental health Act in terms of amendments that may come forward at the House of Lords stage or Government amendments that the UK Government might make. Part of my Bill, for example, was around the reassessment of children, which is in the Measure, but could quite easily be part of the mental health Act, which would actually improve outcomes for children in England as well. So, I'm just interested in what work you're doing inter-governmentally and with Members of the House of Lords, perhaps, to insert amendments into this legislation, ways in which you can beef up in respect of the mental health Measure and pull things across to give them more prominence, really, in the legislative framework that professionals work under.

Yes, of course. Yes, I mean, the Mental Health Act is about when people are detained and obviously, the Measure, then, is meant to be for people who aren't. And the purpose of that was meant to be for ensuring that, if you aren't at that crisis point, and you aren't going to be detained, your capacity won't be looked at and your deprivation of liberty, that you still get all of those things that you should get, isn’t it? That’s what it was about. And that advocacy and that person-centred and holistic and listened to—. So, I think, honestly—. Of course, we’re having these discussions with UK Government, but a lot of this has come from stakeholders, a lot of this has come through lived experience—you know, a very, very thorough review that was done, White Paper, consultation. We’ve consulted with people in Wales as well. So, they’ve really tried to put all of those things through as well.

I can bring in Liz, who is the expert on each of the clauses. But I would say that we have had some kind of success with some of the asks that we’ve had. So, for example, there have already been amendments. And the Government amendments were largely aimed at clarifying and improving the drafting, but it has also included the drafting of a new clause at our request, which is 51A, and that provides, then, the Welsh Ministers with equivalent powers to the Secretary of State’s powers under the Bill to make consequential provision to amend primary legislation in relation to the Welsh devolved areas. So, as well as ensuring that those elements and many of them that you called for are in the Act, we’ve also, of course, been having to be very, very focused on the powers too, as Mabon referred to earlier on. But Liz, are you able to give an answer—or Matt—on more of what James is saying especially around children and young people?

I think the main thing for us has been around how we continue to develop the Measure alongside the Act, because a big part of the Measure looks at a different part of the population. It’s for people with mild to moderate mental health issues, it’s about accessing primary care, whereas, as the Minister said, the Mental Health Act is around the more serious mental illness and admission to hospital et cetera. So, in the strategy, we’ll be setting out the changes that we'll be looking to do within the Measure to continue to develop it, but alongside, because we see them working alongside each other, as opposed to confusing each other, if you like.

Can I quickly come back in, John, just on what the Minister said? You said that you’ve asked for an amendment—and rightly so—that Welsh Ministers can amend things that are in the devolved competence area, which is in, but what sort of power is that going to be for the Welsh Ministers? I’m just interested. Is that going to be an affirmative, if we want to change things? Is that going to be done by regs or is that going to be done via a vote? I’m just interested. It’s quite a broad power that is, that you’ve asked to be included, which I think is right. I’m probably getting into the Legislation, Justice and Constitution Committee stuff, I do apologise, but—

No, that's fine.

—I’m just interested in how Ministers will enact that power. Is it going to be by ministerial direction, by regulations, or is it going to be things that we'll have to pass here in the Senedd? I’m just interested in how that’s going to work. Because, on the scrutiny element of it, which we’re here to do, that’s very important, that we get oversight of where you’re going to amend things for a Welsh context, and that we’ve got the right to, as Senedd Members I believe, scrutinise those in an appropriate manner, being the policy committee here that looks at health and mental health in particular.

Yes, of course. As you know, James, I was the Chair of the LJC for four weeks—four whole weeks—so I completely understand the point that you’re making and where you’re coming from. I am going to bring in Liz though, particularly, on these. But it does relate obviously to the consequential powers that we will have and whether or not those all each individually come through the Senedd.

Yes, the point that I’d make in general about that is that that particular clause of the Bill is an overarching piece at the end, as you are aware. It mirrors the same thing for the UK Government, so it would apply to the whole edifice, if you like, of the Act. It’s not like we’ve got a consolidating Bill that’s bringing everything together and we can list all those different regulation-making powers or whatever. We’re going to need to go through—. As part of the next stage, we’re going to need to go through and map out where we want to make those changes and what the different levers will be for doing that. So, I would imagine that some will be in front of the Senedd and some will be a narrower Order, perhaps. But the power is exactly equivalent to what the UK Government will be doing and they’ll do exactly the same process.

I don’t dispute that. My view is on the scrutiny role that we play here, to make sure that, if there are amendments that the Government will make, which are right for Wales, that we get, as a policy committee, the opportunity to scrutinise those. And I think, it would be useful perhaps if Sarah—the Minister, sorry—if Government could keep the committee updated properly on that process, because I think it’s really important.

Absolutely, I concur. I think at the moment our concern obviously with any LCM is to ensure that we have the powers for the Senedd, for Welsh Ministers, to be able to do that, and that's what this is about. And then, as Liz mentioned, that work then, in terms of how each of those will progress forward and where the need for votes will come in, will be determined in the next phase, and we will absolutely keep the committee up to date with this, as we will the LJC.

Okay. Thanks for that. Joyce Watson.

Moving on to safeguards for individuals with learning disabilities, autism and other vulnerable groups, how will the Welsh Government ensure that new provisions for individuals with learning disabilities or autism under the Bill don't lead to unintended consequences, like pushing individuals into the Mental Capacity Act framework, which could reduce protection?

Thank you very much. I think, as I've mentioned, being the Minister for learning disability and people who are neurodivergent has taught me so much. I've spent so much time with people, with their families, to really understand the implications and, as I said earlier on, how traumatising it can be, this experience, if you are detained under the Act. So, I know that those people will be here, and they will be listening today, and they will be watching. This is something that's very, very close to them, in particular. I think that, from the stakeholders I've spoken to, like the National Autistic Society, they very much want us to use this again as an opportunity to talk about this and to talk about their rights and to talk about their human rights.

So, I actually share your concerns about the capacity assessment as well and the capacity framework. What we absolutely do not want to see is that, because of this new reform, because you cannot be detained under the Mental Health Act, you are then detained under the Mental Capacity Act instead. We know that, already, as I mentioned earlier on, there is that kind of interface and we monitor it very closely. However, what I would say is that, in a very similar way that the UK Government did the work around reforming the Mental Health Act, that work has also taken place for the Mental Capacity Act as well, and I would be very, very keen for the UK Government to also bring that forward in the same way.

What I would say as well, though, is that, as I've already mentioned, in the mental health strategy, we will be updating the mental health Measure, and we would be in support of having that reform for that Act as well. But it is my absolute commitment, as it is the commitment of all of Welsh Government, that that does not happen—that that unintended consequence does not happen. It is imperative.

Excuse me. There is—. I'm really pleased to hear what you're saying and I don't doubt your intentions. But, underneath this—and it's not part of the Act, of course—is the understanding, particularly of neurodiversity. There is a lot of evidence of where neurodiversity and mental health get confused. Individuals seeking help for either their neurodiversity in and of itself, or their mental health in and of itself, get pushed back and forth and are told that it's one or the other, and nothing happens for those individuals, who clearly need help.

Of course, the other thing with neurodiversity is waiting for it to be recognised. I know that it’s not part of the Bill, but I think that what people who are listening would want to be reassured about is the recognition and the aim to help them—I know you've outlined some of that, but it’s about giving recognition to what I've just said; and I've said it because I have been informed by people who experience this—that that those intricate but necessary changes are going to happen.

Absolutely, and thank you for giving me the opportunity to be absolutely clear on this. A learning disability or neurodivergence is not a mental health condition, and we do not view it like that. However, of course, those people will sometimes have mental health needs and issues, and it is appropriate then that they may be detained under the Mental Health Act. The reform, though, makes it very, very clear that that is only if they are experiencing mental health issues, and if they are going to be detained in a way that is going to give them the support to recover and be able to get better, just like anybody else.

In terms of what you were saying about the waiting times for neurodivergence and diagnosis, as you know, this is something—the assessment—that I'm absolutely committed to. We are really now making strides in bringing down those waiting lists for children and young people. My goal is to ensure that 99 per cent of people have their assessments when they're a child. I still have people, I'm sorry to say—even last week—who will say to me, 'This didn't exist in my day', and imply that it's made up, which it's not. We just have increased awareness, and I think we will probably all know adults who have struggled without that assessment—not only maybe they haven't received the appropriate medication and support, as you've referred to, but also it's such a huge part of their own identity as well. So, that is something I'm absolutely committed to.

And then, when it comes to the community for learning disability awareness, you will have heard me give a statement in the Chamber recently, where I've said that one person who is in a bed and not a home, who shouldn't be, receiving that care at that time, is one person too many. One person being detained under the Mental Health Act, or the Mental Capacity Act, who should not be, is one person too many. And that's why I'm working so closely with my learning disability ministerial advisory group, and I also now have the invaluable input of a group that includes members from the Stolen Lives 'Homes not hospitals' campaign, who will be making recommendations to me this summer as well, and that's going to be much more focused on that community provision.

Although I would like to point out as well, which I think is also going to be a positive in this space, that, of course, we recently had the new GP contract, and they have agreed to do the annual health checks for people with a learning disability, which is something that that community has been calling for for a really long time. Hopefully, we'll be able to incorporate that very much, like making every contact count, and do a bit of prevention work there as well. So, it's all very much intertwined. They're always very, very much at the forefront of my mind.

Thank you. There have been stakeholders who have raised concerns about a care gap for individuals—this is the other side—with learning disabilities or autism, who might not meet the new threshold for detention. So, it's the other side now. So, how are you going to ensure that those individuals aren't left without the appropriate care or treatment?

Absolutely. Again, as I was saying, we have the mental health strategy that will be coming through, and one of the things in that will be looking at the updating of the mental health Measure, which would be, again, as Matt Downton was saying, for people who should be, really, accessing primary care support, and that would also include people with a learning disability. Again, that annual health check now will hopefully also incorporate that as well. It's very much coming back to our ethos around the life course. You're not going to be physically well all your life, you're going to struggle with your mental well-being. We know the trigger points for this as well. So, that's going to be absolutely crucial, and it will absolutely be incorporated into that prevention space. Again, I don't want anybody, really, ever reaching this point, and especially without having those advance conversations, having a nominated person, it's even more important for those people.

And focusing on, again, children and young people, how will the Bill ensure that individuals admitted informally have clear care and treatment plans and access to advocacy to support their autonomy and ensure their voices are heard?

Absolutely. Thank you very much. So, overall, we are seeing a reduction in the number of admissions to mental health units for children and young people, and this reduction does reflect our investment in those community services and in that early intervention, which I'm really pleased to see. It also points to an overall reduction—a steady reduction—in those informal admissions. So, that's really positive. Whilst informal patients are not subject, as you said, to the Mental Health Act, in Wales, informal patients still have the right to an independent mental health advocate—the Measure—and should be at the centre of their care and treatment planning. I'm a big advocate for advocates and that active offer that children and young people should have. We have advocacy services for young people at both our CAMHS in-patient units in Wales too.

How does the Bill address concerns regarding the lack of safeguards for children and young people? What measures will be implemented to ensure they receive the same level of protection as adults under the Mental Health Act, particularly in terms of the nominated person provision and decision making for those under 16? And I would refer to what James said earlier in terms of a nominated person here.

Absolutely. Thank you very much. The changes will apply to adults and children, and aim to strengthen those safeguards, and so more say in the care and treatment, more choice, more autonomy will absolutely apply to all. We do need to work through the detail as part of the implementation, but 16 to 17-year-olds will have the same rights as adults. As I think James Evans was referencing, for some under 16, they will have the right to choose a nominated person if they are Gillick competent. If they don't have the necessary competence, there will be a process for a nominated person to be appointed to them.

And finally from me, we hear all too often about children and young people ending up on adult wards and out-of-area settings. So, how is this Bill going to ensure that any placement decisions are made in the best interests of the child, not the provision that's available?

Absolutely, thank you. I will say that this always really impacts me, because as I've talked about before with my experience as a child, I wasn't detained under the Mental Health Act, fortunately, but if I had been, I would have been sent to an adult in-patient facility, and that still really triggers me, to think about that. So, I take this extremely, extremely seriously.

All health boards do have a designated bed on an adult ward for use in emergencies to admit a young person if other beds are not available. However, that designated bed means that, whilst on the adult ward, the person will be cared for by CAMHS and appropriate staff. We can do better, of course, but that's where we are at the moment.

It is absolutely unacceptable for them to ever be taken to a police station or a police cell as a place of safety. And our aim is also—. This very much comes back to that our aim is to reduce admissions through new services like the ‘111 press 2’ for mental health and our alternative to admission pilots, which have now been introduced in all health boards. I've been to visit some of them, they're absolutely superb, and really have that person-centred wraparound support for the child and young person. That's where we need to get to. I'm really pleased that it has started to reduce. We want to continue on that path, and the pilots will be evaluated, but early operational data is showing that young people are being well supported and actually diverted away from accident and emergency. So, I'm more than happy to give the committee an update on that as soon as we can, as well.

Yes, that would be useful, Minister, thank you very much. Okay, Joyce? Yes. James, it’s over to you now.

Yes, sorry—I was writing notes down. Really quickly on two of the issues that Joyce was raising, we know, and evidence has always proved it—it was proved through the Wessely review as well—about the treatment of people from ethnic minority backgrounds in the system, that they're actually treated a lot worse by the system, that they're more likely to be detained, more likely to have worse outcomes. I'm just interested: do you think, as the Welsh Government, that the Bill goes far enough to recognise the needs of and sometimes the prejudices that are faced by ethnic minority groups within the mental health sphere?

Yes, thank you very much. I think that was so crucial to the Wessely review that came out. I think it shocked people, but again, having done the mental health inequalities review that we did here in this committee, this is something that came out very strongly as well, and just absolutely has to be addressed. So, it is a priority, and it is an underpinning principle in the new strategy that we'll be coming forward with. We will be looking at this across all mental health services and not just those for people with serious mental health disorders, which is really crucial, and the clearer criteria for detention and more opportunities to challenge detentions will also help to ensure the legislation isn’t used inappropriately, because that's really where it was being misused, in the evidence that was given.

I did want to reassure the committee, though, that where we do have ethnicity data, we don't see significant disparity here in Wales. So, for example, under the section 135-136 data, in the last two quarters, the published data show around 4 per cent of people detained were from a black and minority ethnic group. And what I think needs to strengthen is our mental health data, if I'm really honest. I think that's what I would say, and that's something that we need to do here in Wales, and that's something that, of course, we're already progressing with the Betsi health board's electronic mental health record, which is currently being led on by them. Cwm Taf Morgannwg health board are also participating in that. A lot of this will make a huge difference, so I would say that that's more on us to strengthen the data that we have.

That's good to hear. One thing that Joyce mentioned was advocacy for children as well. Minister, you'll have to forgive me because I'm not aware, but I don't think the Bill gives a statutory right—I don't think so; I might be wrong—for children to have access to advocacy. I may be incorrect, but if you could prove me wrong, I'd be grateful, because I think it's very, very important that children are given that statutory right to advocacy. Because what we do see—and we've seen in it in other areas, haven't we, with looked-after children as well—is that where young people should have a right to advocacy—it tends to be put in codes of practice—it doesn't actually equate to it on the ground, and people aren't offered that independent advocacy. I'm just interested: if it isn't on the face of the Bill, is that something that the Welsh Government—with the Welsh Government's commitment to children and young people—would look to have included in the Bill, if it's not there currently?

I also share your passion, really, for advocacy. I think it's absolutely crucial and also children having that active offer. It's not everywhere it should be in Wales. I've been part of lots of campaign teams trying to push that forward. A lot of this, though, comes under the Minister with responsibility for children. So, I think this is something that I would have to go away and discuss with her, but I will bring in Matt just to clarify.

For mental health services, it's advocacy, as you know, in the Measure, so young people would get that if they're in contact with secondary care services. So, they already receive that through the Measure in Wales.

I know it's in the Measure, but do you think it would be useful to have it on the face of the Bill? You can write to me.

I can write to you, but, yes, I think there's not just this area, but I think there are other areas where it should be a statutory requirement, personally.

That's fine. I just want to move on to community treatment orders. There are different views across whichever organisation you speak to about the effectiveness of community treatment orders. The Bill has changed the system to make it more clinician based, a bit more beefed-up. You talk to certain organisations that want them completely abolished, that don't think they work, that don't think they're right. You speak to some of the royal colleges, perhaps, who think we need to have more reviews into community treatment orders, their effectiveness and how they actually work in practice. I'm just interested: do you think that the way it's been beefed-up within the legislation—and I think has improved on community treatment orders—do you think it goes far enough? And this is something that does sit within the devolved competence of the Senedd.

It's something that, perhaps, when these changes could come you could look to review it and see how it works. Is that something, perhaps, the Welsh Government would look to do after this Bill is introduced, with those powers that you have, because an awful lot of organisations, including clinicians, are saying it's not working? This new, improved model might not go far enough. It may be something. But I'm just interested: is that something the Welsh Government will look at when it comes through?

This is something that I've been keeping a close eye on because, of course, the UK Parliament joint committee recommended that they should be abolished completely. I know that some of the stakeholders who provided evidence agree with that. I can understand why, when I read through the evidence that they gathered. However, the Wessely review said that we need the reform, and I think I would agree with that, because without knowing what would be in place, I don't think we should be abolishing them. People really need them, sometimes. They really, really do need that support. Really, they should be used as a mechanism for people to go home earlier and to be able to be back out in the community. I think it was a mistake that there wasn't a more person-centred approach, sometimes, in that, and I think that's why having the community clinician now having to play a role is really, really important, as well as being very person centred.

But I think, again, the beauty of this is that it has highlighted and given clinicians and people with lived experience a voice to say, 'This is how it worked and this is how it didn't work', and we are absolutely committed to monitoring closely the changes as they're implemented. All health boards have mental health administrators and mental health committees to oversee the operation of it as well, and so this is something that will be a really critical element of it. But I welcome the attention that has been drawn to it, the debate that has been had around it. I'm content with where we are at the moment in terms of what is being proposed, but this is something that will have to be closely monitored. Yes, Matt.

I was just going to add, Minister, that you talked about improving the data, and one of the things we will be doing is getting patient outcome and experience measures, which are not routinely measured now in mental health services. So, that will help us when we're looking, both alongside the strategy and the Bill, in terms of implementation and looking at outcomes for individuals in terms of monitoring the impact.

Lovely. I know we're over time, Cadeirydd, and I've got a couple of questions I'd like to ask on implementation, but I'm not sure if the Minister's—

If the Minister and the Minister's officials are able to remain with us a little longer, then—

Absolutely. I'm content. I will be honest, though—in terms of the implementation, the code of practice is to come and the mental health strategy is to come, so I will do my very best.

Yes, and on implementation, I'm interested in how this is going to work in practice, because we have a lot of layers of government, and bureaucracy—I always like to call it—within the NHS in Wales. I'm interested what role the NHS executive is going to play in this, actually, about the roll-out of the code of practice, how it's going to be disseminated across, because there's an awful lot of work that needs to go in to making sure that clinicians are up to date on this, the time, and everything that's required with the new rules. So, I'm just interested what role the NHS exec is going to play in this.

I'm so glad you mentioned them, because I almost went the entire session without mentioning them. We're actually very fortunate—we've got wonderful people on the NHS executive that we work with in this space. So, already they've established an acute and crisis care board. They've suggested and are going to be working with me to do a ministerial summit on patient safety. There's so much happening in this space, and they're really the ones who have really plugged in with all of the health boards. I think that everybody wants to be providing the best care that they possibly can. So, the NHS executive will play an absolutely crucial part in the delivery aspect of this, and whenever I meet with them and discuss this, they're very confident that they will be able to do this. It will be phased, and it will very much come down to, as well, the mental health strategy, which they've had huge engagement with and feed-in to as well. So, yes, absolutely, the NHS executive is really crucial to the delivery of this.

One thing that I know has been called for—. You know, updating this piece of legislation is a very positive step; the Measure is outdated. That was found through my Bill—the Measure needs to be updated. There are an awful lot of things in there around data, around children, around different things. So, I'd just be interested where you see that now being updated. We haven't got long left for this term of the Senedd, and there's an awful lot of work to do around that. If the new mental health Act is going to work, it has to work with other pieces of legislation we've got, and it has to be updated, in line with what's going to be brought through in Westminster. So, I'm just interested in what the timetable is that the Welsh Government have for updating the Wales mental health Measure, along with the mental health strategy as well, because you can't have a new, updated piece of legislation with an outdated piece of legislation here in Wales; it all needs to be coming forward at the same time, in the best interests of clinicians and patients, I think, and I'd just be interested in what the timetable is going to be on that.

Yes, of course, and, as I said before, the Measure was brilliant. What I do hear a lot, from people who work across all the borders, the stakeholders who work across all the nations, is that, in Wales, we do listen to lived experience particularly well and we work in partnership really, really well. I think that what you were trying to do with updating the Measure was to bring that through. So, to be clear, the strategy will be with us by the end of the financial year. In the strategy, there will be a commitment to update the Measure. I do not have a timescale for that at the moment, but I will be able to write to the committee as soon as we do.

I think we need to see that sooner rather than later. I'm not telling you what your ministerial priorities are, but, when this piece is done, I really do think it'd be important to bring this forward before this Senedd term is up, I would imagine.

Yes, of course. I'll bring Alex in here, if he would.

Yes. From an official perspective, we recognise and we've discussed that the Measure needs changes, and, I suppose, we are focused on the implementation of the legislation we're discussing today, and the Minister described some of the role of the NHS executive. Of course, we've got changes in tribunals, we've talked about the alternative pathways around LD and ND, and so there's a lot of work in that space. If you look at the impact assessment that the UK Government have tabled, and the money that we were touching on earlier, all of that will need to take place, and so the focus is on that. The question about the changes to the Measure is probably a decision for the next Senedd term, as to the timing for that to be tabled, given where we are with the legislative programme. That's not to say we're not supportive of doing so, but, as you know yourself, in terms of the programme heading up over the next year, 14 months, it's not currently tabled. So, we would then need to make a decision with the Government at that point about pursuing that, and we will be in the implementation stage for mental health Act implementation.

Okay. I think it's quite useful for us to know that as a committee. My final question—it's probably the million-dollar question, really: all this stuff requires resources, requires staff, it requires clinicians, it requires expertise across the board. Mental health, as Ministers quite proudly will say, is the biggest spend in the health budget, but you know as well as I do that a lot of that money goes into dementia care, it goes into Alzheimer's care; it doesn't actually go on this type of the mental health element, which we're more familiar with. I'm interested in how the Government is going to ensure that, to implement these changes, it's adequately resourced properly, because you can have the best Act, the best strategies, the best code of practice, but if the money doesn't follow it, it's worthless. I'm just interested, from the Government's perspective, in how you're going to allocate money to this to make sure that health boards are prioritising mental health as I see it within this Bill, and not having that money going into other areas, which diverts away from the aims and objectives of this piece of legislation. Cadeirydd, I think you'll be glad to know that's it from me.

It's a really important question to end on. So, of course, as I've mentioned, the mental health budget in Wales is £820 million. It was before my time, but the people who are sitting either side of me have always fought for that parity, that ring fence, to ensure that we have that. The majority of it does go directly to health boards. So, it comes back to what I was saying before about the NHS executive working really closely to help us to achieve those deliveries. I wouldn't say that we ever really have an issue with health boards not being able to or not wanting to spend the money on mental health. I think, sometimes, what we've seen, though, is that it's very difficult to sometimes shift the funding more towards the prevention and the lower tiers, because you kind of need the modelling to show that, and you need to be able to then work really closely with those health boards to ensure that you minimise that risk as we start to make that shift, and that's ultimately where we want to be. So, for example, within eating disorders, we want to see more of that money moving from tier 4 into tier 3, but that's not something that can happen overnight, so that we can mitigate any risk. So, that's what I would say for each of those parts of it.

We are investing, of course, way more in prevention. You can see that with the '111 press 2'. So, that's the space, I think, that we're in at the moment. So, yes, I do believe that it is important as well that you have the funding in place. But, I would also say that the NHS and the workforce itself are crying out to be able to deliver a much more face-to-face, stepped approach, and not having to say to people, 'We'll see you in three months'. People want to be able to give that service at a primary care level that is addressing those needs as soon as people come forward with them.

So, honestly, it's really exciting. I'm really excited about the mental health strategy coming through. I can't wait to come back, and I hope you will have me back so that we can discuss it further and you can ask me more questions about it. But I just wanted to end, I guess, by saying that the reform of this Mental Health Act, as I've said before, has been a really, really long time coming. It's had huge support. It is about human rights. It is about ensuring that people have their human rights protected and that we update it, from a time when—. It was such a long time ago, and the landscape has changed so much in mental health. I come from a place where, with support and care and having that advocacy and empowerment, all people can live healthy lives and people can recover.

Okay. Diolch yn fawr, Gweinidog, and diolch yn fawr to your officials for coming in to give evidence to committee this morning. Thank you for staying with us beyond the allocated time. You will be sent a transcript to check for factual accuracy in the usual way. Diolch yn fawr.

Thank you very much. Diolch yn fawr. Thank you.

Okay. The next item on the committee agenda today, item 4, is a motion to resolve to exclude the public from the remainder of today's meeting, under Standing Order 17.42. Is committee content to do so? I see that you are. We will move to private session.