The Minister of State, Department of Health (Paul Burstow)
I congratulate my hon. Friend the Member for New Forest East (Dr Lewis) on securing this debate. Having had the opportunity to deal with two Adjournment debates this week, I reflect on the fact that this was an entirely fitting and appropriate way to raise very serious matters, which was not entirely the case in the debate that I replied to yesterday.
My hon. Friend is absolutely right to raise these issues and to bring a distressing case to the House’s attention. It is the most appalling human tragedy when a young person with so much to live for ends their own life. For the friends and family, the tragedy is all the greater when there is a sense that more could have been done to prevent the person from taking that action. I know that the parents of the young lady in this case continue to grieve for the desperate loss of their daughter. I can absolutely understand their need for answers and explanations, and for assurances from the relevant authorities that out of these tragic circumstances, some good may come. That is what I hope to be able to offer in my response.
I am afraid that I have to start my remarks by saying that this case has some painful similarities to that raised in another debate to which I responded a couple of months ago. In both cases, the clear and consistent flaw was that families and carers were not properly listened to or involved. Indeed, evidence from the National Confidential Inquiry into Suicide and Homicide points to this being a flaw in too many cases. Where things go wrong in mental health services, it is so often due to communication breakdown between agencies and families. While there has been progress in mental health services in recent years, there is more to be done. In some parts of the country, the system is too secretive and defensive, and not sufficiently joined up to secure the best results for the patient.
My hon. Friend will know that we set out in our coalition programme a commitment for hospitals to be open, and always to admit if something has gone wrong. That is why we plan to give effect to a duty of candour in which health professionals and managers would be expected to inform patients and families about actions which have resulted in harm. Mistakes happen—to err is to be human—but the key thing is that the NHS learns and improves practices so that the same errors are not repeated. I know that that is what the Edgell family are looking for. I expect all parts of the NHS to engage constructively with families like them to understand and learn from their concerns. That is also why we are determined to strengthen the arrangements for whistleblowing so that where standards slip or practice is poor, staff can raise their concerns in the knowledge that they will be treated seriously.
Patient confidentiality emerges as a consistent theme in the correspondence that I have seen between the family and the local NHS; I am grateful to my hon. Friend for passing it to me. He recognises, I think, that the judgments that mental health professionals make are often finely poised. They can be damned if they do and damned if they don’t. There is a balance to be struck between respecting the patient’s wishes, on the one hand, while also acknowledging how friends and family can contribute significantly to the person’s safety, ongoing treatment and recovery.
All NHS organisations have clear legal and ethical obligations to ensure that patient information remains confidential. To resile from this principle, particularly in an areas as sensitive as one’s mental health, would undermine the trust and confidence on which effective treatment is based, increasing the risk of the patient distrusting and disengaging from clinical care. It is very important to stress, however, that, as guidance provided by the Department of Health and the General Medical Council makes clear, patient confidentiality can and should be overridden to prevent significant harm either to themselves or to others. That very much goes to the point raised by the hon. Member for Wirral West (Esther McVey) in her intervention.
As my hon. Friend rightly said, patient confidentiality should not be a barrier to having conversations with families and carers. Those closest to the individual can play a crucial role in helping clinical teams to understand a patient’s illness, and in providing an early warning if their condition changes or deteriorates. I am deeply concerned that not all trusts are applying this principle in practice. We need some basic common sense and compassion in how health professionals deal with concerned families. Having read the paperwork that my hon. Friend shared with me, I cannot help but feel a sense that some medical teams were ticking the boxes but missing the point.
I cannot stand here at the Dispatch Box and enunciate lots of new principles. My hon. Friend is absolutely right that there is already very good practice guidance, as well as clear guidelines from the Department of Health, the GMC and others. However, what we need to do to achieve real change in practice is to ensure that it is clear where professional leadership comes from to drive the practice into everyday action on the ground. One of the actions that I will be taking as a result of this debate is to meet the relevant royal colleges to discuss how we can change and challenge attitudes within general practice—where this all began—and mental health services to ensure that the voice of families and carers is never ignored. Improving mental health is a clear priority for this Government.
There is no health without mental health. Next year, as a result of our commitment to prioritise mental health, we will publish a new mental health strategy, which will set out how the Government will invest in early interventions and the extension of talking therapies, to which my hon. Friend referred, for children and older people. Those things are not all that we must do, but they will make an important contribution to tackling the burden of mental health at an earlier stage, thus promoting recovery and reducing the burden on individuals and society in the long run.
In addition, we will publish a new suicide prevention strategy to set out the steps that the NHS and others need to take to further reduce suicide. I will ensure that the points that have been made in this debate are taken into account as we finalise that strategy.
There is no adequate answer that I can give tonight to my hon. Friend’s constituents to make up for their loss. However, I hope that my remarks and the fact that we have looked very carefully at what my hon. Friend said in his correspondence, assure him and his constituents that the Government are determined to do everything they can to ensure that the lessons from this case, and a number of other tragic cases, are translated into better practice in the future and that the good practice that is out there is not the exception, but the consistent norm.
Question put and agreed to.