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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Mr Dowd, and it is also a pleasure to respond to this debate on World Mental Health Day. I am grateful to my hon. Friend the Member for Ashford (Sojan Joseph) for securing the debate and for drawing on his long-standing experience of working in mental health care to raise so many important points in the debate. As several others have, including the shadow Minister, I thank everybody who works in the field of mental health, whether as a mental health practitioner or as one of the very many volunteers who give up their time freely to help people who are facing particular difficulties in their lives.
I am responding to this debate on behalf of Baroness Merron, the Minister with responsibility for mental health, so apologies if I do not answer everybody’s questions. I have taken copious notes and am sure that the powers that be sitting behind me have taken even more. If I do not answer all the points raised, Members can expect to receive something from the relevant Minister in due course.
It has been a great debate. I thank my hon. Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Members for Epsom and Ewell (Helen Maguire) and for Hinckley and Bosworth (Dr Evans). The latter made a really important point about the interrelationship between education and health in the whole sphere of special educational needs, autism and so on. I reassure him and others who made that point that the beauty of being part of a mission-led Government that has five missions—one is the health mission and another is the opportunities mission—is that it allows Ministers the opportunity to look at things in the round and break out of departmental silos. I assure him that on these issues I am having bilateral meetings with counterparts in the Department for Education about how we drive forward key elements of the health mission, and also about the role that the Department of Health and Social Care can play in achieving the Government’s opportunities mission. That work is taking place at departmental level.
I thank my hon. Friend the Member for Gateshead Central and Whickham (Mark Ferguson) for his contribution, and the hon. Member for Leicester South (Shockat Adam), who is not in his place but made some really important points, particularly about the impact of the Mental Health Act on black and minority ethnic groups. I, and the Government, think it is shameful that under the existing Mental Health Act black people are three and a half times more likely to be detained than white people and eight times more likely to be placed on a community treatment order. Our mental health Bill will give patients greater choice and autonomy and enhanced rights and support, and we will ensure that it is designed to be respectful in terms of treatment with the aim of eradicating inequalities. I put that on the record because the hon. Member for Leicester South made an important point.
I thank my hon. Friends the Members for Gravesham (Dr Sullivan) and for York Central (Rachael Maskell). My hon. Friend the Member for Hastings and Rye (Helena Dollimore) made a powerful contribution about Phoebe and about her ICB—I hope the ICB has listened. My hon. Friend the Member for Chatham and Aylesford (Tristan Osborne) made a contribution, as did my hon. Friend the Member for Stroud (Dr Opher). I reiterate to him that of course the arts have a powerful role to play in the health and wellbeing of the individual. I was fortunate last Friday to see the Manchester Camerata, one of the great orchestras in my home city, at the Gorton Monastery in my constituency, which is now a health and wellbeing hub. As well as understanding the work that it does, I also learned a lot more about social prescribing and about its powerful listening service.
Sonia Kumar (Dudley) (Lab)
As an NHS physiotherapist working in Dudley, I know very well that mental health is multifaceted. It affects not just one part of a person’s life, but everything: sleep deprivation, diet, overeating, undereating and building relationships. Does the Minister agree that we need more care in the community, including first contact practitioners, social prescribers and councillors in the community as the first line of treatment?
Andrew Gwynne
My hon. Friend is absolutely right. At the heart of the health mission that the Labour Government want to see is the shift from hospital to community, from analogue to digital and from sickness to prevention. What we do in the community really matters. Our ambition for the future of mental health services is wrapped up in those shifts, particularly the shift from hospital to community.
John Glen
Could I share my experience as a Minister? When we looked at social prescribing when I was in the Treasury, it was always difficult to establish an evidence base to justify the allocation of resources. I urge the Minister to continue that battle to make the case, because I am sure that the instinct of all Members throughout the House is that there is something in that ambition, and we must find a way of unlocking it so that we can get social prescription out into the community where a variety of provision is available.
Andrew Gwynne
The right hon. Gentleman is absolutely right. That will be one of the big challenges with the prevention agenda more generally, because often the investment we have to make today does not pay dividends immediately and there is a bit of a punt. Having been a Treasury Minister, he will know the challenges that that can present to the Treasury orthodoxy, but we have to push on this agenda.
I always say that being an MP and a GP is only one letter apart. We are often dealing with the same people who present with the same problems but from a different angle. We go away as Members of Parliament trying to fix the issue as they have presented it to us, and the GP will write a prescription and send them off having sorted out the issue as it was presented to them. However, the beauty of social prescribing is that there is an opportunity to deal with the whole issue in the round. The argument has been won with almost everybody, and any tips from the right hon. Member for Salisbury (John Glen) so we can get this over the line with the Treasury will be welcome.
I should mention my hon. Friend the Member for Darlington (Lola McEvoy), and welcome the hon. Members for Winchester (Dr Chambers) and for Runnymede and Weybridge (Dr Spencer) to their Front-Bench positions.
In the minutes I have left, I want to say to the House that many of the issues raised by Members during the debate are symptomatic of a struggling NHS. If we look at the figures, the challenges facing the NHS are sobering. In 2023, one in five children and young people aged eight to 25 had a mental health problem, which is a rise from one in eight in 2017. The covid-19 pandemic has exacerbated need, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.
Dr Luke Evans
I want to raise an issue as the Minister is the Minister responsible for prevention. One of the biggest and most shocking things we saw during the pandemic was the increase in eating disorders, which is a very difficult topic for any Government around the world to try to break down. We know that the impact of eating disorders lives with people for the rest of their life and can cause them to lose their life, so will the Minister ensure that they are looked at as a priority? There was previously a roundtable; will he look into doing something similar again to bring experts together?
Andrew Gwynne
I am reluctant to commit Ministers to roundtables when I am covering another portfolio, because then they will do the same when they cover me in Westminster Hall debates, but I will say that we take this agenda incredibly seriously. When we were in opposition we gave support to the then Government, and I assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time to the people who need it.
As I was saying, the covid-19 pandemic has exacerbated the need for mental health support. Around 345,000 children and young people were on a mental health waiting list at the end of July this year, with more than 10% of them having waited for more than two years. Some groups of children and young people are disproportionately impacted by mental health problems largely driven by a complex interplay of social and environmental determinants of poor mental health, as we heard in the debate.
We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults do not receive the mental health- care that they need, and we know that waits for mental health services are far too long. We are determined to change that, which is why we will recruit 8,500 additional mental health workers across child and adolescent mental health services. We will also introduce a specialist mental health professional in every school and roll out Young Futures hubs. We are working with our colleagues at NHS England and in the Department for Education as we plan the delivery of those commitments.
Early intervention on mental health issues is vital if we want to prevent young people from reaching crisis point. Schools and colleges play an important role in early support, which is why we have committed to providing a mental health professional in every school. However, it is not enough to provide access to a mental health professional when young people are struggling; we want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact on the promotion of good mental health and wellbeing. Doing this will require a holistic approach, drawing in many aspects of the school or college’s provision. I know there are many schools that already do this work, and my Department is working alongside the DFE to understand how we can support best practice across the sector.
As I have said, our manifesto commits us to rolling out Young Futures hubs. This national network will bring local services together and deliver support for teenagers who are at risk of being drawn into crime or who face mental health challenges. The hubs will provide open-access mental health support for children and young people in every community.
On other aspects of our plans, the mental health Bill announced in the King’s Speech will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and it will ensure that everyone is treated with dignity and respect throughout their medical treatment. It is important that we get the balance right to ensure that people receive the support and treatment they need when necessary for their own protection and that of others. The Bill will make the Mental Health Act 1983 fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better and more personalised care. It will also limit the scope to detain people with a learning disability and autistic people under the 1983 Act.
Finally, Lord Darzi’s report identified circumstances in which mental health patients are being accommodated in Victorian-era cells that are infested with vermin, with 17 men sharing two showers. We will ensure that everyone is treated with dignity and respect throughout their treatment in a mental health hospital, and we will fix the broken system to ensure that we give mental health the same attention as physical health.
If I have not answered Members’ questions, those Members will be written to by the relevant Minister. I again congratulate my hon. Friend the Member for Ashford on securing the debate.
