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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
It is a pleasure to serve under your chairmanship, Mr Pritchard. I am grateful to the hon. Member for Tooting (Dr Allin-Khan) for securing this debate ahead of Children’s Mental Health Week. I thank all hon. and right hon. Members for their thoughtful contributions, and I will try to answer as many points as I can in the time that I have.
It is absolutely clear that we face a challenge in ensuring timely support is available for children and young people’s mental health. Two factors are proving the greatest challenges. The first, as was pointed out by a number of speakers today, is the historic underinvestment in mental health services in this country. No other Government before us had tackled this, trying to introduce a parity in esteem between mental and physical health. The Government are investing £2.3 billion extra a year—I know the hon. Member for Tooting is tired of this figure —in mental health services. That is making a difference.
I just want to correct one figure that the hon. Member raised, about only 8% of funding going to children and young people’s mental health services. Actually, 1.63 million people were in contact with mental health services in November last year, and 31% of those were children aged between nought and 18. That shows that children are making up a large proportion of those benefiting from the funding. The extra £2.3 billion a year is going into projects such as our capital investment programme to eradicate mental health dormitories, and is being invested in our crisis centres, our crisis cafés, and 27,000 additional staff. We are seeing evidence that that is making a difference already. Our crisis cafés are associated with an 8% lower admission rate and our crisis telephone services with a 12% lower admission rate, and detentions under the Mental Health Act 1983 are 15% lower.
Our second challenge is the sheer scale of demand for services in the past few years. Even though we are investing more than ever before in children and young people’s mental health services, as the hon. Member for Tooting pointed out, one in five children now suffers with a mental health problem, compared with one in nine in 2017. There were 743,000 new referrals to children and young people’s mental health services in 2022, up 41% from just the year before. We recognise that we have to put in more funding. We are doing that, but it is difficult to meet the sheer demand for the support that children and young people need.
This is true across all four nations of the United Kingdom and not just here in England, where the Government are responsible for health. In Cardiff, for example, where Labour runs the health service, 83% of CAMHS are not on target for seeing children and young people. The Welsh Labour Government target of 80% of children and young people being assessed within 28 days had not been met for the five years up to 2021, the dates covered by the latest figures. I was quite surprised by the contribution from the SNP spokesperson, the hon. Member for East Dunbartonshire (Amy Callaghan), as Scotland have been missing their national targets. Under some health boards, children and young people have been waiting for more than 1,000 days for services. In Northern Ireland, 60% of those targets have not been met, either. All four nations of the United Kingdom are facing exactly the same pressures.
In England, however, we have a plan, and I can assure hon. Members that it is far from just warm words. While our spending on children and young people’s mental health services has increased from £841 million in 2020 to just over £1 billion in 2022-23, it is not just about how much we spend, but about how we spend it. An additional 345,000 children and young people are getting the mental health support they need. As of August last year, 703,000 children and young people aged under 18 were being supported through NHS-funded mental health services. That is a 13.1% increase on the year before.
Amy Callaghan
I recognise what the Minister is saying. Things are not perfect, but we in Scotland are investing more in the NHS and mental health services than they are in England. We recognise the problem, but we are doing something about it. That is more than can be said for down here.
Maria Caulfield
Let me point out what we are doing with our funding. We have introduced two waiting time standards for children and young people. The first is for 95% of children up to 19 with an eating disorder to receive treatment within one week for urgent cases and four weeks for more routine cases. I can showcase for the hon. Member for Tooting figures from her local integrated care board for eating disorders: 82% of children and young people under 19 are seen within four weeks. That is not 95%, so we are not where we want to be, but a significant proportion are being seen according to our new target. Our extra funding to children and young people’s services for eating disorders will rise to £54 million in the coming financial year, creating more capacity, but we absolutely acknowledge that there is more to do.
The second waiting time standard we have introduced is for 50% of patients of all ages, including children and young people, experiencing a first episode of psychosis to receive treatment within two weeks of being referred. That target is being met across the country.
Our plan for children and young people is cross-Government, because this is not just a health and social care problem. Mental health is everyone’s business. That is why we are working with the Department for Education to implement proposals from the children and young people’s mental health Green Paper.
Dr Allin-Khan
If the Government are interested in implementing cross-party proposals, why on earth have they scrapped the Mental Health Bill?
Maria Caulfield
I will touch on what we are doing and come back to the hon. Lady on that point.
Last week we met the Education Secretary and the chief executive of the NHS to discuss how we can better support school attendance, because we know that children with mental health problems are the most likely not to attend school. I do not think there was a single proposal from any of the Labour MPs, apart from on mental health support teams in schools, which we are already rolling out. We have rolled out 400 mental health support teams, covering 3.4 million pupils in England—something that Labour has not started to do in Wales, where it runs the health service. Our original ambition was to cover 25% of pupils, but we have done that a year earlier than expected; we are now on track in March this year to cover just under 50% of pupils with a mental health support team. We will also have 13,800 schools and colleges with a trained senior mental health lead, including seven in 10 state-funded schools in England.
We are already doing what Labour says it plans to do if it ever gets into government, and our evidence shows that that is making a difference across the country. In addition, in October we announced £4.92 million of new funding to develop new mental health and wellbeing support hubs for young people across all of England. We will be announcing in the next few weeks the successful hubs and where they will be based. That clearly shows that the work we are doing is on track and amounts to far more than just the warm words we have been accused of.
Dr Allin-Khan
Let me point out two things. First, 12,140 children are on waiting lists at my ICB, an increase of 18.15% on last year. Secondly, the Minister spoke about 1.63 million people accessing mental health services and said that 38% of them were children, but that is actually up on the 25% that I cited. She used that figure in her argument about the amount of money that has been spent on children’s mental health services. She was incorrect, and all she did was highlight that the situation is getting worse, rather than arguing against my point that only 8% is being spent on children. She did not address that point.
Maria Caulfield
The hon. Lady is making my argument for me. We are seeing a significant increase in demand, and that is why we are spending more on rolling out these services. She did not welcome the progress we are making on mental health support teams across our schools, or the fact that we are set to announce new mental health support hubs across England.
Last year we published our new suicide prevention strategy; my hon. Friend the Member for Penrith and The Border (Dr Hudson) talked about 3 Dads Walking, who I was pleased to meet. We are also rolling out mental health and wellbeing support in our school curriculum, teaching young people what good mental health looks like and about support mechanisms. Our strategy sets out over 100 actions to help reduce suicide and to ensure that young people in particular, who are identified as a high-risk group in the strategy, are getting the support they need. That includes making mental health and wellbeing part of the school curriculum.
Jim Shannon
Has the Minister had the opportunity to look at how to ensure that young people have some church activity and pastoral care, which is very important?
Maria Caulfield
The hon. Gentleman is absolutely right. Part of that can be done in our schools. With the increase in mental health support teams, which will now cover 4.2 million pupils, there will be different levels of support, from pastoral support right through to acute help for those with more acute mental health needs. It is really important that we ensure that those teams are rolled out as we are planning. Our hubs in local areas will also be able to provide more bespoke services for the communities they represent, which is crucial. I would like to thank Dr Alex George, the Government’s youth mental health ambassador, who has been leading much of this work, particularly on the suicide prevention strategy and making children and young people a priority group.
I reiterate my thanks to everyone who has contributed to the debate. The Government have a plan to improve mental health services for children and young people by investing in services, with capital projects to improve infrastructure in order to provide the care that is needed, from crisis centres right through to the 27,000 extra mental health workers; rolling out mental health support teams in schools and our new children and young people’s mental health hubs, which will be announced shortly; and dealing with the sheer tsunami of demand, whether it is due to the fallout of covid or the fact that people are coming forward because we are encouraging them to talk about their mental health and ask for support.
Our plan is making a difference. I am hopeful that, with the investment we are putting in to tackle the lack of investment for decades under many Governments, we are providing the building blocks to improve the mental health of our young people in this country.
Dr Allin-Khan
I thank all Members, including the Minister and my hon. Friend the shadow Minister, for their contributions. Disappointingly, I have not heard anything about the scrapping of the Mental Health Bill, which the Minister conveniently avoided.
Dr Allin-Khan
No, I will continue. The Minister had ample opportunity to respond to a direct intervention, and she chose not to. That Bill was a great piece of cross-party work that would have improved the lives and outcomes of so many people in our country, particularly minority groups. The Minister did not address the fact that only 8% of funding is spent on children’s mental health services, but she highlighted that the need is greater than ever.
The £2.3 billion was promised before covid. We have heard multiple arguments today that the situation has got worse post covid. There has been no money to make up for the increased need related to covid, and no assessment of how we are going to deal with the fact that adverse childhood experiences and poverty are contributing so greatly to our nation’s mental ill health.
The Minister talked about the fact that there are many new referrals. There are many new referrals, but she did not mention that in so many parts of this country, and even in parts of this city, it is a postcode lottery. In some places, up to 50% of referrals are closed before the person has even been seen. While I welcome the fact that efforts are being made—it would be churlish of me to suggest that they are not—the fact remains that they are not good enough, they do not reach far enough and they are not ambitious enough. Even on the £2.3 billion, I know for a fact that the head of mental health services in the NHS asked for more, and that was before covid.
I thank everyone for being here and for their contributions. Although we are all on the same page in the sense that this is an issue we all care about, regardless of how we vote, where we live or what our socioeconomic background is, this Government still lack ambition for children in this country and for their mental health. Let me again, on the record, thank all the organisations that work so tirelessly in this space.
Question put and agreed to.
Resolved,
That this House has considered Children’s Mental Health Week 2024.