The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
My Lords, I shall now repeat in the form of a Statement the Answer given by my honourable friend in the other place.
“I am grateful to my honourable friend for this important question. Like him, I have been horrified by the treatment of vulnerable people at the Edenfield Centre, which has been brought to light by undercover reporting from the BBC. There is no doubt that these incidents are completely unacceptable. My ministerial colleague, the Parliamentary Under-Secretary of State for Health, has met with the Greater Manchester Mental Health NHS Foundation Trust, and a number of steps are being taken.
As a matter of first priority, my department is working with the trust to make sure all the affected patients are safe, and a multidisciplinary team has completed clinical reviews of all patients. Secondly, a significant number of staff have been suspended pending further investigation. Thirdly, the trust has agreed there will be an independent investigation into the services provided at the Edenfield Centre. Fourthly, Greater Manchester Police is investigating the material presented by BBC ‘Panorama’. For this reason, I will not be commenting on the specifics of the case. The trust will continue to work closely and collaborate with local and national partners including NHS England, the Care Quality Commission, the police and, of course, my department.
These are important first steps, but they are by no means the last. There are serious questions to be answered, especially in light of other recent scandals. I want to put on the record my thanks to the whistleblowers, the BBC and, above all, those patients and families who have been so grievously affected. Anyone receiving mental health treatment is entitled to dignity and respect. On that principle, there can be no compromise, and this Government will work with whoever it takes to do right by those affected.”
Lord Markham (Con)
My Lords, I completely agree with the question in making sure that this does not happen or is not happening elsewhere. We have been in touch with the CQC, as one would expect, which has made significant changes to protect people in specialist services, people with learning difficulties and autistic people in mental health patient settings. These include making it mandatory for all staff to undertake specialist training before inspecting these settings and introducing a new single assessment framework, which would allow more frequent inspections of the worst-performing providers. The CQC is doing a number of things around that framework, including six key evidence categories, which set out the type of evidence that will be collected. These categories are: people’s experiences; feedback from staff and leaders; observation of care; feedback from partners; processes; and outcome of care. The new assessment means that more targeted time can be spent on site, taking longer to talk to people using services and making every minute count.
Those are some of the standing replies. On a personal level, there clearly need to be questions about how the CQC can go in on an ad hoc basis because, when an investigation or inspection has been announced, a place has an opportunity to put things right. One area of my interest—and I do not claim to be an expert on this—is how we can pick up those ad hoc cases quickly. Clearly, we should not be expecting people such as “Panorama” to be doing that; we want to pick those up ourselves.
Baroness Brinton (LD)
My Lords, despite the Minister just commenting on the way it is possible for some organisations to game-play inspections, it is noticeable that the CQC inspection of 2019, published in 2020, was “Good”, despite the finding that,
“In acute wards … records did not show that supervision of staff in the service was effective”,
which was a “breach of regulation”. This is really concerning.
Reform of the Mental Health Act is long overdue. It was created over 40 years ago, and many noble Lords have been fighting for that to happen. It was good to hear in the Queen’s Speech that there will be a draft mental health Bill, but there are real concerns that it is about to be shelved. My honourable friend Munira Wilson MP asked the Minister responding to this Urgent Question whether it was going to come forward. She did not get a straight answer. I ask the Minister whether Parliament, and this House in particular, will see the mental health Bill this Session.
Lord Markham (Con)
My Lords, like the noble Baroness, I am aware that the White Paper is in draft, but I have not seen its latest status. I know it will address some of the issues that we all agree are not to our satisfaction. At the moment, I can undertake only to understand the position of the White Paper and come back to her, if I may.
Baroness Chisholm of Owlpen (Con)
My Lords, first, I congratulate the Minister on his position. It is a baptism of fire, but I know he is up to the role. Would it be better if we engaged with the CQC better, so that these issues did not arise, rather than leaving it to undercover reporters? Thinking outside the box a little, what about body cameras? The police have them, after all, and they can protect not only workers but those the carers are looking after.
Lord Markham (Con)
My noble friend is correct that these are the sorts of things that we need to think about in this situation. It is a complex situation because, of course, as well as the advantages of body cameras being able to pick up things like this, these are first and foremost patients in need of care and there are all sorts of privacy issues to take into account in such a situation. I think that what this shows is that more intensive dialogue and thought on this whole area is required. I do not believe that there is an easy solution such as body cameras; that might be one approach, but first and foremost I want to feel that these are places where patients feel that their privacy is respected.
What I would violently agree on is the need for further conversations with the CQC, so that it is aware of the need to do a review on this. We need to be looking at exactly these types of things to see if a more intrusive type of system is what is required to stop these sorts of things happening again.
Baroness Browning (Con)
My Lords, I declare my interest, which is in the register, as a vice-president of the National Autistic Society. I welcome my noble friend, and I hope that he and I will have an opportunity in the very near future to discuss autism and learning disability. He mentioned more recent cases. I quite take his point, but these are not just recent cases. These have gone back over decades. I have listened, in both Houses, to Minister after Minister say that there is going to be change, and it does not come. In the vast majority of cases, it is totally inappropriate—in fact, I think it is criminal—for people with autistic spectrum disorders and learning disabilities to be placed in mental health institutions. It is not the place for them. There are proven records, over and over again, that it is not the right course of treatment, any more than you would think of putting someone with a coronary heart condition into such a place. So I say to my noble friend that this needs urgent attention from the Government.
Lord Markham (Con)
I agree with the points that my noble friend makes. I have some personal experience of people with learning difficulties, and I completely agree that the right setting for them should actually be in the community. I know that is the direction of travel of this Government, and I know that there is an objective to make sure that that is the major place where they are cared for. I have some further details on that, which I would be happy to share, and to meet with my noble friend.
Baroness Blackwood of North Oxford (Con)
My Lords, I have been in the Minister’s place, answering on similar scandals, and I think that the whole House shares the dismay of my noble friend that we are in this place once again. I hope that the Minister will take back the condemnation of this House that such a thing should happen in this country. We want to say that it will never happen again, but I think that we feel as though we will be back here once more.
If I could raise one single point, it is that the CQC, the police, the Government and all those involved in the investigations that go forward should take particular care with the patients and families as they go forward, to have the utmost respect and transparency in the way in which they communicate. Too often in these cases, information is leaked to the media or there are failures in communication, which leads to even more distress over and above what has already happened. Please can that not happen in this case, and can those who have already been so grievously affected be protected going forward?
Lord Markham (Con)
I am grateful for my noble friend’s comments. She is absolutely correct that, although we are grateful to the likes of the BBC for highlighting these issues—and I speak here as a former director of ITV—and for the undercover work they do, I believe that there is a responsibility there as well, when they have found these sorts of cases, to allow the patients and the people affected some sort of early indication, because the impact on them is central to all of this. I do not know what the BBC did in terms of an early warning on this, to make sure that there were no surprises. I think it is a very good point. We need to make sure that, although independent journalists are correctly doing their job and highlighting important issues, for which we are grateful, we first and foremost need to make sure that when this happens, patients and their family are made aware first and that their concerns are foremost in any action that is taken.