The Minister of State, Department of Health (Paul Burstow)
I congratulate the hon. Member for Preston (Mark Hendrick) on securing this debate. On the many occasions during my 13 years in the House that I have secured these Adjournment debates, I have always taken the view that one should see them as an opportunity to present a case, not to try to score party political points. There are plenty of other opportunities to do that. Indeed, my hon. Friend the Member for Wyre and Preston North (Mr Wallace) perhaps demonstrated the way in which a case can be made without scoring cheap points.
There are also some points that I would like to spend some time making. In my view, the hon. Gentleman’s comments about students being under pressure and his suggestion that this causes them to rely on mental health services were deeply stigmatising and really unhelpful in trying to promote a sense of mental health and well-being. He does students a disservice by portraying them in that light. The suggestion has also been made that there is some sort of hidden agenda. Well, if there is a hidden agenda, let us be clear that this issue goes back to 2006. The work done then—which resulted in the plans that we are discussing, including the proposals for Avondale—came out of a set of principles in a national service framework for mental health that was drawn up by a Government of whom the hon. Gentleman was a member. That prompts some questions about quite where his attention ought to be focused now and where it ought to have been focused in the past.
Mark Hendrick
I will indeed make reference to the 2006 consultation and the report that came afterwards. It recommended that new facilities be built, but as I said, those facilities are very unlikely to be built, because of the financial pressures created by the Government’s cuts. On the one site there is only planning permission, and on the other two sites there is no sign of any building or any commissioning of building yet to take place.
On the question of students, many are indeed suffering great deals of stress and worry about debt. There are cases up and down the country of students who have committed suicide or who are suffering from mental illness as a result of stresses associated with debt, worries about exams, and pressure from parents and society. It is glib of the Minister to dismiss that in the way that he has.
Paul Burstow
The hon. Gentleman’s contribution may well have been glib; my concern is about stigmatising people and creating even more concern about mental health problems.
The 2006 consultation looked at strengthening community-based services, in order to reduce reliance on acute hospital care, as well as phased closures of 15 facilities over a number of years, as demand reduces owing to other measures. They were to be replaced by a smaller number of purpose-built units, which I will talk about in a moment. Lancashire primary care trusts spend £23 million a year on community-based mental health services—an increase of 46% since the 2006 consultation, which has resulted in spending per head that is higher than the average for England. Just 4% of service users now need in-patient care in Lancashire, and many facilities are significantly underused as a result.
Many existing in-patient facilities are not fit for purpose—dormitories rather than single rooms; problems separating male and female sleeping areas; no outside space; privacy compromised. Indeed, my hon. Friend the Member for Wyre and Preston North made a case about some of those facilities in his speech. The PCT has plans for four new purpose-built units, the first of which, at Whyndyke farm, is due to open in 2013. The PCT assures me that plans to develop the Ribbleton hospital site are proceeding.
The hon. Member for Preston mentioned concerns about beds. I am assured by the PCT that the closure of facilities has been carefully phased to ensure sufficient capacity. I have looked at the figures, and I have been told that there is an average of 35 spare beds across Lancashire. I shall take no lectures from the hon. Gentleman on the use of taxpayers’ money to get the best possible results for patients, but it hardly makes sense to have an excess of supply of beds such as we are seeing in Lancashire. Indeed, only last week, the King’s Fund demonstrated that better outcomes could be achieved through effective use of resources.
Paul Burstow
I will in a moment.
That is why we believe that the proposals make sense, and simply to talk about a potential mental health beds crisis is unnecessary scaremongering.
Mark Hendrick
This is far from scaremongering. People are committing suicide in Lancashire, and people are being turned away because of a lack of beds. People come to my surgeries who are suffering from stress and mental illness, or who are caring for someone who is trying to get into the Avondale unit. The Minister mentioned the 36 spare beds, but that is the figure across the whole of Lancashire. The occupancy rates across Lancashire range from 85% to 90%, which are rates that any hotel would be proud of.
Paul Burstow
It is important that the changes that are resulting from the consultation in 2006 are properly implemented, that they are led by clinical evidence, that they take account of legitimate public concerns, and that they involve appropriate scrutiny. That is why I have asked questions about the nature of the consultation that took place in 2006. More than 115,000 consultation documents were sent out, 74 public meetings and events took place, and independent evaluation by Salford university found that the engagement process was robust and comprehensive. All Members of Parliament, including the hon. Gentleman, were sent the consultation documents and offered briefings by the chair of the primary care trust’s joint committee. However, the only MPs to respond were the hon. Member for West Lancashire (Rosie Cooper) and the former Member for Fylde. I am surprised that the hon. Gentleman appears to have come late to this issue. I understand that he started to get interested in it only earlier this year. I must question why he did not pursue it when it was being consulted on in 2006, when he might have had an opportunity to shape the proposals a little more than he has so far.
Paul Burstow
In a moment.
When the proposals went to the Lancashire joint overview and scrutiny committee, which was formed in 2006 to consider the proposals, it was committed to ensuring that there was proper engagement. It took the view that there had been significant engagement around these proposals.
Mark Hendrick
I want to address two of the points that the Minister has made. First, we were happy with the consultation that took place in 2006, and with the report. Now, however, the NHS trust is reneging on that report, because it will not have the necessary resources—and, in my view, it does not have the determination—to complete the new units that were promised. On the Minister’s point about not contributing to the consultation or making any objections, we were perfectly happy to see the Ribbleton Hall site extended and improved to accommodate extra beds, but at the moment there is no sign that the extra beds will go there. Until the new facilities are built, I see no logic in closing the Avondale unit, or any other facilities.
Paul Burstow
I have just given an indication of the PCT’s position in respect of Ribbleton Hall. The PCT is in the process of conducting a further review of the proposals and has produced a revised case for change. That explores the overall clinical model, but does not alter any plans for specific site closures. It does revise the case, which is supported by GP commissioners. I will, however, make sure that the points that both hon. Members have raised in the debate are passed to the PCT, so that it is aware of their ongoing concerns.
The hon. Member for Preston also talked about a city the size of Preston having the right to be consulted. It is worth bearing in mind that, while the city council raised its concerns in August this year, and objected to the closure of Avondale ward, Preston councillors who were sent the original consultation—just like everyone else in Lancashire—and invited to offer feedback and comments about the proposals, did not offer a response, yet the proposals in 2006 included the proposal about Avondale.
I am of course aware of the petition that the hon. Gentleman has mentioned, but I do not think that his presentation of the case has helped his constituents advance this matter at all. He has been stigmatising in some of his remarks about mental health, and I think it is important to value community-based care. It is essential that we see continuing developments in that regard. There is clear evidence that it leads to better clinical outcomes for patients, and the NHS in Lancashire should be congratulated on its strong record of investing in community services.
Changes to acute mental health services, including the closure of outdated facilities, are a necessary part of the local NHS’s strategy for mental health and are necessary to deliver better results and better value for money as well. It is the right approach, delivered in the right way with proper engagement and careful management of available beds, to deliver better results for people in this area of health care.
I have listened carefully and I will make sure that the hon. Gentleman’s representations are fed back to the primary care trust and other NHS organisations concerned. I am sure that he will continue to make these points, and we will continue to improve mental health services, as this Government are determined to do. We entirely reject the notion that there is in any way an agenda of cuts and closures driven by this Government. These initiatives started under the previous Government. They were about improving services then, and they are about improving services now. That is what this Government will deliver.
Question put and agreed to.