Eating Disorders: Prevention of Deaths
(3 weeks, 3 days ago)
Westminster HallRead Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Richard Quigley (Isle of Wight West) (Lab)
I beg to move,
That this House has considered the matter of the prevention of deaths from eating disorders.
It is a great pleasure to serve under your chairship, Sir Desmond. I thank all hon. Members for attending this debate on a topic extremely close to my heart. As hon. Members may know by now, I am the very proud Member for Isle of Wight West and do my utmost to champion the island in this place, but I have brought forward this debate not only as an MP, but as a father who for some years was genuinely fearful as to whether I would see my child reach their 18th birthday.
From the moment someone becomes a parent, their instinct is to protect and nurture their children—often, admittedly, much easier said than done—yet nothing can truly prepare anyone for the overwhelming sense of powerlessness that comes when their child develops an eating disorder. Eating disorders, in all their destructive forms, are one of the few types of illness where the person affected does not want to recover and they actively work against you. Watching your child struggle not only with the illness but with the very treatments meant to help them is truly something I would not wish on any parent, yet it is the reality faced by thousands of parents, families and friends up and down the country.
We all know by now that the pandemic has taken a wrecking ball to children and young people’s mental health, but we cannot pretend that these issues do not predate 2020. Since the mid-1990s, eating disorders have been found to carry the highest mortality rate of any psychiatric illness. However, in the UK, we are unable even to quantify the true havoc that eating disorders cause, because of the lack of a national register for eating disorder deaths. The most recent year with confirmed data from the Office for National Statistics is 2019, when 36 deaths were recorded. However, a US study suggests that the real figure in the UK could be closer to 1,860 deaths, which I am sure people in this room would more than agree with.
Richard Foord (Honiton and Sidmouth) (LD)
A constituent got in touch with me because sadly his daughter did not see her 30th birthday owing to an eating disorder. The point that my constituent made was that that was in part because of a lack of adequate services for those affected by these life-threatening conditions. Does the hon. Member agree?
Mr Quigley
I agree entirely. We are fully aware of the political situation and the condition that the NHS was left in under the previous Government, but the point of today’s debate is not to make cheap political attacks; it is to focus on the matter in hand, which is eating disorders, so I thank the hon. Member for his intervention.
With widespread under-reporting, misclassification and inconsistencies across the country, many of these deaths are wrongly recorded as organ failure, masking the true role of eating disorders and preventing us from fully grasping the scale of the crisis, especially among otherwise healthy young people.
Liam Conlon (Beckenham and Penge) (Lab)
Does my hon. Friend agree that, further to masking the scale of the crisis, excluding eating disorders as a contributing factor on death certificates also cruelly extends the pain that families feel, insinuating that otherwise healthy young people have died from organ failure?
Mr Quigley
I thank my hon. Friend for that important point—it does. The loss of a loved one is harrowing enough without the true cause not being recorded. That is why we are calling for a confidential inquiry into eating disorder deaths.
Given the concerns about under-reporting and inconsistencies in the data, it is even more alarming to read the findings from the Health Service Journal that revealed that between 2018 and 2023, 19 deaths related to eating disorders could have been entirely avoided. These tragic outcomes are attributed to severe failures in care, including missed or poorly managed safety risks, a lack of specialist knowledge among healthcare professionals and unacceptable delays in accessing appropriate treatment. If I were to ask for a show of hands in this room, I am sure many would be raised on that point.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
As the MP for Bury St Edmunds and Stowmarket, I take a great interest in the progress of the Norfolk and Suffolk NHS foundation trust under the leadership of Caroline Donovan and Zoë Billingham, who I met recently in Parliament. Does my hon. Friend agree that early intervention is no more expensive and in many cases cheaper than delayed intervention, but is much more effective and saves lives?
Mr Quigley
I thank my hon. Friend for his extremely pertinent point. Early intervention saves not only lives but a huge amount in costs to the NHS.
I know the vast majority of NHS staff go above and beyond to support patients, often under immense pressure, and many of us here would like to put on record our thanks to them. However, these failures point to a systemic issue.
Ms Julie Minns (Carlisle) (Lab)
One of the issues in geographically remote areas like Carlisle and Cumbria is that, sadly, the in-patient treatment for young people with eating disorders is delivered by an out-of-area NHS trust. Tragically, the inquest into the death of a young woman from my constituency earlier this year found that there had been a failure in collaboration between the two trusts, resulting, sadly, in her death. Does my hon. Friend agree that it is not just a question of resource, and that we also need a culture of collaboration and patient-centred care across all our trusts if we are going to prevent deaths?
Mr Quigley
It is true that a lack of understanding among professionals about the severity of the problem contributes to the situation. To have it put down to a lack of collaboration would be infuriating for that parent, as well as truly tragic.
We know well by now that early intervention is crucial for identifying and supporting recovery in patients with eating disorders. However, as a parent of someone affected, I must say that has not been my experience on the ground. Hospital admissions for eating disorders have surged, exceeding 30,000 for the first time in 2023-24, which is a 60% increase compared with pre-pandemic levels. While the NHS struggles to meet this growing demand, private equity firms are profiting from the crisis by owning many of the in-patient units the NHS depends on.
John Whitby (Derbyshire Dales) (Lab)
Does my hon. Friend agree that his point highlights the urgent need for the Department to examine the influence of private equity in NHS in-patient mental health services? It is vital that private sector involvement complements the NHS’s mission to deliver high-quality patient-centred care and does not serve as a vehicle for profit-making at the expense of vulnerable patients.
Mr Quigley
My hon. Friend is entirely correct. Our experience of private equity is that it is selective in terms of the patients accepted. It profits from misery. We were put in the awful position of having to choose to send our youngest child to a hospital that had just seen the tragic death of Ruth Szymankiewicz—I take this opportunity to pay tribute to Ruth’s parents. Our second trip to a private equity-run hospital led to them forgetting to feed my daughter 11 times. My hon. Friend’s point is, unfortunately, well made.
More concerning still is that I do not believe that our approach to treatment is changing year on year to confront the heightened demand. If these admission increases were associated with a disease such as cancer, the treatment would quite rightly adapt. Our approach to mental health treatment, especially eating disorders, remains stagnant, outdated and alarmingly resistant to progress.
Another deeply concerning issue is how we respond when patients with severe anorexia refuse treatment and are subsequently diagnosed as terminally anorexic, a classification that holds precedent in UK Court of Protection rulings. In such cases, treatment may be withdrawn entirely, resulting in preventable deaths, such as that of a young patient known as BG who tragically died aged 19 in 2022. For those who may argue that treatment will be withdrawn only when a patient is terminally ill, I point to the case of Patricia, previously deemed untreatable by the Court of Protection, only to have the judgment overturned last month—August 2025. That reversal highlights not only the fallibility of such decisions but the danger in labelling eating disorder patients as beyond help.
We cannot ignore the fact that eating disorder deaths are most likely to occur due to suicide. Following an evidence session of the eating disorders all-party parliamentary group, one expert stated that their research found that anorexia sufferers are 18 times more likely and bulimia sufferers seven times more likely to die from suicide than the average patient, due to a combination of pre-existing and untreated mental health conditions, early discharge and the physical effects of eating disorder recovery triggering suicidal ideation. I do not wish to pre-empt the response from the Minister, who I know is keen to make improvements in this area, but I believe that eating disorders must be included in the suicide prevention strategy if we are to meaningfully tackle this worrying trend and stop patients from falling between the gaps in the already patchy world of child and adolescent mental health service provision.
The eating disorders APPG and campaigners from Dump the Scales are urgently calling for a confidential inquiry into avoidable deaths of eating disorder patients. Eating disorders are treatable illnesses. They are dangerous and life-threatening when untreated, under-treated or poorly treated. The risk to life is entirely preventable; deaths from eating disorders are not inevitable. With integrated, well-resourced and evidence-based treatment, recovery is possible, even in the most severe cases and after many years of suffering. Despite that, coroners, families and communities continue to see too many lives needlessly lost. That should not happen, and it does not need to be that way.
Although the facts I have set out today are difficult and harrowing, they must be heard. I also believe, however, that there are reasons to remain hopeful. I know at first hand that the Department, right up to the Secretary of State, is committed to improving outcomes and getting this right. As a Back Bencher, and more importantly as a father, I see it as my responsibility to push for this change to go further and faster.
Jade Botterill (Ossett and Denby Dale) (Lab)
I congratulate my hon. Friend on securing such an important debate. I recently met a constituent who has been living with an eating disorder for years and who raised a number of important issues. She is fortunate to have a loving, supportive family but they often feel the system is impossible to navigate. Would my hon. Friend join me in encouraging the Minister to look at how the Government can support the families and loved ones of those living with an eating disorder, and to consider how care could be better structured to effectively treat the combined mental and physical effects of eating disorders in healthcare settings?
Mr Quigley
I thank my hon. Friend for her excellent intervention. I agree that this is a family-wide illness. We must reach the point where no one in the UK dies from an eating disorder, where every individual—man, woman, girl, boy—regardless of age, location or clinical classification has access to the support they need when they need it.
I want to finish with the story of a young woman called Zara. She was diagnosed with anorexia nervosa in May 2013 and was admitted to an eating disorder unit almost immediately. Instead of being good news for her recovery, that was when the nightmare began. From May 2013 to June 2021, Zara endured 13 in-patient admissions across seven different units, including three years as a continuous in-patient, nearly two of which she spent without leaving one of the units or going outside. With each admission, her eating disorder and mental health deteriorated further.
During that time Zara was restrained daily, often by a minimum of six people holding her down. She received very little therapy; instead there was a culture of patient blaming and shaming. In the last two years of her life, Zara was crying out for help but no one would listen. The eating disorder unit eventually discharged her completely, handing her over to the community mental health team. Her mum, who is with us today, spent nearly every day taking ligatures off her neck, lifting her down from a wardrobe when she was nearly unconscious, and performing CPR when she was found unresponsive in the shower.
Zara’s mum states there was little to no support from the community psychiatrist; her family were left to cope alone. No matter how much they pleaded for help, it was a constant battle and they never received the support Zara so desperately needed. Zara should never have died of this illness. There was a whole world out there for her and she had so much to give, but ultimately she felt everyone had given up on her. She was only 24 when she died, but she was exhausted and did not know any other way to keep going without support.
Unfortunately, Zara’s story is just one of many, and it is a story unfolding for countless others across the country. Behind these tragedies are systemic failures, often overlooked and hidden behind a lack of national data, questionable legal decision making and cost-saving agendas. In many parts of the UK, the treatments available to patients are not supported by evidence and can even be harmful, rather than providing integrated and evidence-based care. Underfunded services and poorly trained staff often leave high-risk patients institutionalised or without any meaningful or appropriate support. The system currently fails to listen to those who matter most—the patients, their families and supporters. Too often, it fosters a harmful culture of patient blaming rather than delivering compassionate, personalised care that supports recovery. We now know that eating disorders do not discriminate, and neither should our services.
Several hon. Members rose—
Sir Desmond Swayne (in the Chair)
Order. There will be a formal time limit of one and a half minutes, and I will not be able to call everyone.
Danny Kruger (East Wiltshire) (Con)
I will be quick, in that case. I express my appreciation to the hon. Member for Isle of Wight West (Mr Quigley) for a very important speech; I am grateful to him. I particularly welcome the points made by him and the hon. Member for Carlisle (Ms Minns) about the need for better understanding and collaboration in the system, and I echo his call for the national register of deaths to reflect deaths from eating disorders.
I pay tribute to the Cotswold House unit, run by the Oxford Health NHS Foundation Trust in Marlborough in my constituency, which is a really important in-patient and out-patient unit working with adults. I echo the points, which I think are shared across the Chamber, about the value of NHS units as opposed to operations run by private equity companies, whose work I have real concerns about.
I want to add a couple of points to those made by hon. Members about the very legitimate campaigns of the organisations to which we are all indebted for their work. First, the point about early intervention has been made and I will not repeat it, but we clearly need to invest in more understanding both at GP level and among communities and families, and support people while they are still at home. Secondly, we must ensure we have a better and more adequate transition from children’s to adult services, which is a real issue I have come across in casework.
My final point is about the importance of step-down provision. It is not enough just to get people back to a healthy weight and then leave them to themselves; they need proper support for many months—
Mr Connor Rand (Altrincham and Sale West) (Lab)
First, I congratulate my hon. Friend the Member for Isle of Wight West (Mr Quigley) on securing this debate and—if he will permit me—on his strength and resilience as a parent.
There have already been many profoundly moving contributions, and I think everyone here understands that the care and support for those with eating disorders, and for their families, are not good enough. The average wait of three and a half years between onset and start of treatment is not acceptable. In the Government’s 10-year plan for the NHS, where we are delivering record investment and groundbreaking reform, we must ensure that eating disorder services are part of that agenda.
There are great services out there, leading the way in showing what change for patients could look like. I am fortunate to have one of those in my constituency. The ABBI eating disorder clinic in Altrincham is an outstanding facility offering specialist day care and intensive out-patient services. It is an alternative to far more costly in-patient care, and in practice it means that patients remain at home with their family support networks around them. That is what patients want and what their families want—and it is what works. Such services change lives and save lives, but they face huge issues with highly fragmented commissioning. This disjointed commissioning creates significant inefficiencies; we need a change in commissioning to ensure proper pathways for patients and early intervention.
In this debate, we must also look at what young people are exposed to online, with one in three adolescents saying that they have engaged in disordered eating behaviours due to social media content. I look forward to hearing the Minister set out in more detail the good work the Government have already done, and what we will be doing to build on that success to prevent tragic deaths caused by eating disorders.
Wera Hobhouse (Bath) (LD)
I have been the chair of the eating disorders all-party parliamentary group for six years and, frustratingly, things have become worse, not better. We set up the APPG six years ago to make eating disorder services better. I had hoped this Government would finally confront the crisis in eating disorder services after years of Conservative neglect, but in the entire 10-year health plan eating disorders were not mentioned once—not a single word. Other mental health disorders were rightly highlighted, but the one with the highest mortality rate was overlooked.
Screening data from England shows that the proportion of adults with a likely eating disorder rose from around 6% in 2007 to 16% in 2019. This is a national emergency hiding in plain sight. In the APPG’s most recent report, “The Right to Health”, we highlighted significant barriers to accessing treatment: insufficient training for healthcare providers, fragmented care pathways and a lack of standardised data for research.
Each death caused by an eating disorder must read like one, yet death certificates routinely list organ failure, cardiac arrest and other conditions rather than the disorder that primarily contributed to the person’s death. By masking the true cause, we underestimate the scale of the crisis and fail to target lifesaving resources.
In the debate here in April on eating disorder awareness, the Minister for Care said that he did care. I hope that this is the one thing that the Minister will look at.
Liam Conlon (Beckenham and Penge) (Lab)
It is an honour to serve with you in the Chair, Sir Desmond.
I will keep this fairly brief. Many of the points I was going to raise have been mentioned, but I want to say that tackling this issue is not new, and contrast the challenges we now face under this Labour Government compared with the previous Labour Government.
I had the pleasure of working for Tessa Jowell, and I remember her telling me that as Culture Secretary one thing she focused on was banning size zero models from the catwalk at London Fashion Week, and the impact that that made on the promotion of unhealthy body images.
This week I have two students from Beckenham and Penge, Claudia and Arek, doing work experience with me, and they are here today. Speaking to them about the challenges that they and their generation face as sixth formers today, they mentioned the constant bombardment of images on social media and trends such as #SkinnyTok. Our previous Government did not have to face that, but we have to face it today.
It will be really interesting to hear from the Minister how he thinks we can, all of us, address the new emerging challenges for the new generation, where we see eating disorders and associated conditions at a record high, in no small way down to the prevalence now of social media and smartphones.
Mr Paul Kohler (Wimbledon) (LD)
I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing this vital debate.
As has been said, early intervention is vital—but sufferers and their families invariably face an overstretched and underfunded system, with services unable to meet demand and treatment offered far too late, if at all, while those who manage to get seen early on are not infrequently told, in effect, “Go away and come back when you are thinner.”
It is not only difficult to get help early on, but also, at that stage, to recognise there is a problem in the first place, as my wife and I know personally. One of our daughters, who has given me permission to tell her story, suffered with an eating disorder for many years. Neither my wife Samantha nor I recognised the early signs. By the time we realised, she was deep in the grip of this terrible disease. She did not want help, and actively and strenuously tried to refuse it.
Young people with eating disorders become adept at hiding them, and health education interventions can sometimes be counterproductive. My daughter told me that her PSHE—personal, social, health and economic education—lesson at school, which was supposed to educate pupils on the dangers of anorexia, was more like a how-to guide for the various means of hiding the condition from family and friends. That is why it is so important that parents, teachers and all those who work with children are better educated to be aware of potential warning signs. It is also a salutary riposte to those siren voices that, in other contexts, urge us always to accede to a child’s wishes.
Josh Newbury (Cannock Chase) (Lab)
It is a pleasure to serve with you in the Chair, Sir Desmond. I would like to draw on the time that I spent working at the brilliant Coventry and Warwickshire Partnership trust. That part of my career still has a huge impact on me and what I do in this place. In particular, I would like to focus on T1DE, or type 1 diabetes with disordered eating—a dangerous, often fatal condition that combines the comorbidities of type 1 diabetes with an eating disorder. Sufferers often stop insulin in order to lose weight, often coupled with well-known symptoms of disordered eating, such as obsession with nutritional information, binging and purging, and the use of laxatives. Consequences can be incredibly severe, including bone loss, blindness, amputations and even death.
The condition can sometimes be seen as niche, but actually 100,000 people in this country are sufferers of T1DE, including a staggering 40% of women and girls with type 1 diabetes. Because it sits at the intersection of physical and mental health, historically T1DE services just have not existed and many people have been bounced between different consultants. To their credit, the previous Government realised that and set up pilot sites for T1DE services, but, sadly, some of those closed last year. In response to calls from across the House, the Government extended the funding for the remaining pilots by 12 months, but now we once again face their closure in April 2026. I hope the Minister can give us some assurances on that, because T1DE specialist services are a literally matter of life and death for people suffering with this rare eating disorder.
Cameron Thomas (Tewkesbury) (LD)
I thank the hon. Member for Isle of Wight West (Mr Quigley) for securing this important debate. My constituent Katie is mother to a daughter who, at the age of 14, became unwell from anorexia in the aftermath of the covid pandemic. She identified the warning signs early, but when she sought help, early intervention was unavailable. She describes how her daughter was eventually admitted to a hospital, only to be put on a waiting list. Her health would crash, she would go back to another facility and of course the cycle continued. Katie described how her whole family now lives with the eating disorder. I hope that she will take some measure of comfort from the fact that her experiences and those of her family have been echoed so consistently across this House, but that also speaks to the prevalence of eating disorders. It is astonishing that there is no reference to or strategy on them at all in the Government’s 10-year health plan, and I hope that the Minister will put that right this afternoon.
Josh Dean (Hertford and Stortford) (Lab)
I thank my hon. Friend the Member for Isle of Wight West (Mr Quigley) for securing today’s debate. I will focus my remarks on the more than 360,000 children and young people living with an eating disorder in England. What work is the Department undertaking to ensure that the access and waiting time standard for children and young people with eating disorders is being met? When does NHS England intend to publish its refreshed guidance on young people’s services?
I would also like to raise the case of my constituents Amy and Kester. Their six-year-old son has been diagnosed with ARFID, or avoidant/restrictive food intake disorder, a less known and understood eating disorder. They found that few healthcare professionals are aware of ARFID and, once they finally received the diagnosis, they discovered that there was no treatment pathway available in our area. While there is a specialist team at Addenbrooke’s hospital, referrals are only available for children aged eight and over, meaning that their son will not be able to access services for two years. More damage is still being done, so could the Minister set out what work is being done to open up further pathways and help to better understand ARFID?
On artificial intelligence, the Centre for Countering Digital Hate recently published a report in which a fictional 13-year-old girl was given instructions and material related to disordered eating by an AI chatbot. What work is taking place across Government to ensure that we are tackling the potential harm being done, and that young people are not being given misinformation by AI that will drive more eating disorders?
Tom Gordon (Harrogate and Knaresborough) (LD)
It is a pleasure to serve under your chairmanship, Sir Desmond, and I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing this important debate.
Prior to entering this place, I worked in the charity sector for type 1 diabetes charity JDRF, as it was then. In the last Parliament, Theresa May and Sir George Howarth published an inquiry report into T1DE, or type 1 diabetes and disordered eating, which the hon. Member for Cannock Chase (Josh Newbury) outlined. Over the course of the summer recess I met with Dr Tony Winston at the Aspen Centre in Coventry. One of the key takeaways when it comes to diabetes and disordered eating and that complex condition is making sure that there are clear criteria. At the moment, as has already been outlined, as an eating disorder, T1DE falls through the net: it is referred to diabetes services, but often diabetes services try to refer it on to eating disorder services too. There is a bit of a gap in the net.
One of the key needs is integration of services between those two Departments. There must also be better collection, integration and use of data to prevent death before it occurs. People with T1DE have a three times higher chance of mortality, and we know that over 100,000 people are at risk of it. One of the key findings of the inquiry report that I helped to work on was the lack of education for healthcare professionals when it comes to identifying eating disorders, particularly in other areas and specialisms. Can the Minister comment on what his Department is doing to pick up that report and implement some of those recommendations?
Baggy Shanker (Derby South) (Lab/Co-op)
It is a pleasure to serve under your chairship, Sir Desmond. I thank my hon. Friend and very good friend the Member for Isle of Wight West (Mr Quigley) for securing this important debate and for his tireless campaigning on the issue, which I know is close to his heart. It cannot be at all easy.
According to Beat, one in 50 people in the UK are living with an eating disorder. Among 17 to 19-year-olds, the figure rises to a staggering one in eight. These are not just statistics. Behind every single number is a person struggling with what is often the most difficult moment in their life; behind them are families and friends who are heartbroken as they watch their loved one deteriorate.
We hear about GPs who, through no fault of their own, have received minimal training on these disorders and have just 10 minutes with their patients to make life-altering decisions. We know the cost of delayed treatment: longer recoveries, deeper relapses and, in most cases, lost lives. That is why early support is so vital. In my constituency, Derby-based charity First Steps ED is leading the way, from delivering body image workshops in schools and across Derby and Derbyshire to its brilliant Scroll Safe campaign.
Catherine Atkinson (Derby North) (Lab)
I strongly endorse what my hon. Friend says. The majority of the people First Steps ED support are children and young people, but sadly demand is at a record high, outpacing the support available. I welcome the additional funding that the Government are giving to these services, but does my hon. Friend agree that ensuring early support for young patients is vital and cannot be left to charities alone?
Baggy Shanker
That is the point that I was just about to make. It is absolutely vital that Government support be available, because the charity sector alone cannot be left to provide that support and fill the gap. We need a national response that matches the scale of the challenge that we face.
I welcome the Government’s commitment to expanding community-based disorder services, but I urge the Minister to act swiftly. We know what works: early interventions, properly trained professionals and joined-up care that is close to home—a point that some hon. Members have made already. What we need now is urgency, because behind every delayed referral and every missed diagnosis is a life at risk.
Jim Shannon (Strangford) (DUP)
It is a pleasure to serve under your chairship, Sir Desmond. I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing the debate. In the short time that I have, I want to make three points about Northern Ireland.
Stats show that 22 individuals—20 women and two men—died from eating disorders in Northern Ireland between 2008 and 2018. Reports have highlighted that these deaths can often be connected to complications such as heart failure and organ damage, and are frequently misclassified on death certificates, so realistically the figure could be even higher.
Secondly, there has been rising demand for support for those with eating disorders. There is a higher prevalence of disorders today than 20 or 30 years ago, especially among young people. A youth wellbeing survey undertaken in Northern Ireland in 2019 showed that 16.2% of 11 to 19-year-olds exhibited signs of a disorder in eating—a much larger figure than in previous years.
Thirdly, the Northern Ireland Council for Voluntary Action revealed that between 2017 and 2021, 26 people had to travel outside Northern Ireland for specialist care in relation to eating disorders. We must ensure that across this nation that is not the case, as it would leave us with prolonged recovery times, excess stress, anxiety and avoidable hospital admissions. Everyone is worthy of support, but we are simply not doing enough to make the recovery process as simple as it should be. I look to the Minister, as always, for his commitment to the country as a whole. I ask him to endeavour to ensure that treatment does not fall behind in different regions.
Liz Twist (Blaydon and Consett) (Lab)
It is a pleasure to serve under your chairship, Sir Desmond. I thank my hon. Friend the Member for Isle of Wight West (Mr Quigley) for organising this important debate.
I come to this debate through my work with the all-party parliamentary group on suicide and self-harm prevention. There is a clear link with eating disorders, which has been drawn to my attention by the charity Eating Distress North East. Up to a third of people with eating disorders have made suicide attempts, and they are 18 times more likely to die by suicide. Measures to prevent this are really important and must be a priority. The suicide prevention strategy does highlight the need to tackle issues for eating disorders, but I know that lots of organisations in the field would like to see more done in that area.
I want to talk about the role of online harms, which are really problematic. Attention has been drawn to particular sites, and I know that the Government will want to work with Ofcom to make regulations effective for these people, but it is also about the impact of less harmful content. We need greater agency for people to control what they see. Saying that they are not interested is not sufficient. AI, of course, presents new issues.
Eating disorders are devastating and on the rise. Eating Distress North East recorded 78% more referrals in 2024-25—
Sir Desmond Swayne (in the Chair)
Order. I call the spokesman for the Liberal Democrats.
Dr Danny Chambers (Winchester) (LD)
It is a honour to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Isle of Wight West (Mr Quigley) for securing this important debate, but also for very bravely and emotively discussing his personal experience.
Those of us in this Chamber who have had relatives suffering from these disorders know that it can be so frustrating when someone does not appear to want to help themselves. It causes a huge amount of stress for the family and for the carers who are looking after them. We know that eating disorders kill more people than any other mental health condition. Those who do recover have been robbed of years of life: they have missed their adolescence and have had their school and social life affected. That can have ongoing effects for the rest of their life.
I am reminded of several people I spoke to while knocking on doors in Winchester. Securing mental health care for children seems to be one of the top issues with which people are struggling. In particular, I remember two different mothers saying that they had been told that their daughters, who were suffering from eating disorders, had to reach a lower BMI before they qualified for treatment. We know that that means having to be sicker for longer, so not only is a successful outcome less likely, but it will require longer and more intensive treatment and will be more expensive for the NHS. As the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) highlighted, with the benefit of his expertise, it is more cost-effective to have early intervention than to treat people once they have been sick for a long period.
The Minister and the Opposition spokesperson both served with me on the Public Bill Committee on the Mental Health Bill. It was a conciliatory piece of legislation with cross-party support; there was genuine intention and passion on all sides to improve mental health in the UK. The disjointed provision of mental health care, especially for eating disorders, was one reason why I tabled an amendment to review how services for eating disorders are delivered. I will never forget a consultant psychiatrist coming to my surgery. He said that he was trying to get mental health care for his own child; it was not specifically about eating disorders, but he was struggling to navigate the system. He said, “If I, as a consultant psychiatrist, am struggling to navigate the system to get healthcare for my own child, what hope does anyone else have?” It is a very confusing situation.
There are plenty of other elements of this topic that are a real cause of concern. I will not repeat what everyone else has said, but I am really concerned that eating disorders are increasing, with hospital numbers doubling in a decade, and yet 24 of the nation’s 42 NHS integrated care boards are due to reduce their spending on under-18s in 2024-25, once inflation is taken into account. It is a really difficult situation: there will be increased pressure and less real-time resource to deliver.
We must all remember that although they are very serious, eating disorders are treatable. No one should be condemned to suffer for years on end because they cannot access treatment. We must all be committed to tackling damaging stigma. We must take an evidence-based approach to preventing eating disorders, which are hugely multifactorial. The factors are often non-clinical; social media has been mentioned already.
Eating disorders are the mental health crisis hiding in plain sight. They carry the highest mortality rate of any psychiatric illness, yet services are being cut, waiting time standards have been abandoned and young people are being left to deteriorate before help arrives. Early intervention saves lives, and we must be bold and move heaven and earth to deliver it. We must reinstate waiting time targets, protect funding and build a properly resourced national strategy so that no child or family is left trying to fight this illness alone.
Dr Luke Evans (Hinckley and Bosworth) (Con)
The hon. Member for Isle of Wight West (Mr Quigley) said that he wants to push for change, and he is a tremendous advocate for doing exactly that. We are six months on from a very similar debate on eating disorders. The fact that so many Members across the parties are here to support the debate shows the strength of feeling.
In the short time that I have, I will not repeat everything that I said last time. Following the debate in April, I wrote to the Government to find out more and ask some questions. I received a letter from Baroness Merron on 12 June. The first question I had asked was whether the Government had a plan for eating disorders. The reply stated:
“The Department has no current plans to create an eating disorder strategy”.
It went on to say:
“NHS England is currently refreshing guidance on children and young people's eating disorders. The refreshed guidance will highlight the importance of awareness and early recognition of eating disorders within schools, colleges, primary care, and broader children and young people’s mental health services.”
I hope that the Minister can provide us with an update on when that updated guidance will be brought forward.
Back in April, I also posed the question whether the Government would be open to having a cross-party meeting or roundtable with experts in APPGs. I have not yet had a response to that question, either in a debate or in the letter that I received, but I think it would go a long way towards helping to explore this issue in a way that would make a difference.
In the previous debate, the hon. Member for Bath (Wera Hobhouse) raised an issue around the recording of death. She said:
“Accurate recording will raise awareness and ultimately save lives.”—[Official Report, 1 April 2025; Vol. 765, c. 30WH.]
The Minister responded:
“I share the concern of the hon. Member for Bath about accurate recording of deaths to understand the extent to which eating disorders and other factors have caused or contributed to deaths. This matter is being explored with the national medical examiner for England and Wales, the Office for National Statistics and the Coroners’ Society of England and Wales.”
Can he provide an update on where that has got to and what the outcome is?
Back in April, the Minister also gave us great expectations about the 10-year health plan:
“Through the 10-year health plan, this Government will overhaul the NHS and ensure that those with mental health needs, including those living with eating disorders, are given the support that they need.”—[Official Report, 1 April 2025; Vol. 765, c. 49WH.]
He also said:
“Raising awareness of eating disorders and improving treatment services is a key priority for the Government, and a vital part of our work to improve mental health services.”—[Official Report, 1 April 2025; Vol. 765, c. 47WH.]
I will be grateful if the Minister can respond to the Beat CEO, who has said:
“We’re very disappointed to see that mental health hasn’t been consistently highlighted as a priority throughout the Government’s 10 Year Health Plan, and that there are no specific commitments on eating disorders.”
That is a concern—not as a party political point, but because people who are suffering can now see it written that there is no strategy, and it is not mentioned in the 10-year health plan. I will be grateful if the Minister can alleviate the concerns about whether this issue is truly a priority.
Finally, one of the big plays that the Government have made is changing integrated care boards. In the last debate, the Minister said:
“The Government’s view is that ICBs are best placed to make decisions as close as possible to the communities that they serve and to target and, if necessary, reallocate funding accordingly.”—[Official Report, 1 April 2025; Vol. 765, c. 47WH.]
The changes brought forward by this Government have seen a reduction in staffing of 50% in many ICBs. Are the Government concerned? Has any analysis been done of whether there will be an impact on commissioning in respect of eating disorders, given the severity that has been highlighted across the Chamber?
It is often said that treatment is about progress, not perfection. I guess that much the same could be said about formulating policy as we deal with the rising number of people with eating disorders. To that end, I hope that the Government will take these questions as part of the process, helping to highlight this area in which we all want to see progress as the Minister brings his policies to bear on this country.
The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Sir Desmond. I begin by congratulating my hon. Friend the Member for Isle of Wight West (Mr Quigley) on securing today’s debate and speaking so bravely and movingly about his family. I pay tribute to his work in the all-party parliamentary group on eating disorders, and I know that he and many other hon. Members present have worked tirelessly to advocate for those with eating disorders.
Every death from an eating disorder is a tragedy. We have heard from hon. Members about the devastating effect of these conditions, both for patients and their loved ones. But we must be clear that eating disorders are not terminal illnesses. With the right treatment and support, recovery is possible. Many across the Chamber have made that point, and I pay tribute to everyone who has contributed so powerfully. I also congratulate Arek and Claudia, who I know made outstanding contributions to drafting the speech made by my hon. Friend the Member for Beckenham and Penge (Liam Conlon).
Through the 10-year health plan, the Government will ensure that those living with eating disorders are given the support they need. We will cut waiting times and ensure that people can access treatment and support earlier. Improving eating disorder services is a priority for the Government, and a fundamental part of our work to transform mental health services. Last financial year, we provided £106 million in funding for children’s eating disorder services, an increase of £10 million since 2023-24. That increase in funding is helping our clinicians to support more people, and to change and save lives.
Tom Gordon
One of the great organisations that does a lot of work on the accountability of services, including eating disorder services, is Healthwatch. We know that these organisations are going to be scrapped. They have done loads of valuable work at local and regional levels. What levels of accountability will the new systems put in place for eating disorder services?
Stephen Kinnock
I agree that Healthwatch did some important work, but what we are doing is changing the culture of how our NHS works. As the hon. Gentleman will have seen, we are abolishing NHS England. That is of a piece with our belief that proper leadership, proper accountability and proper management of a complex system such as our NHS, and particularly its interaction with ICBs and trusts, is about having a clear line of accountability from the Secretary of State through Ministers into the system and those operating at the coalface. We believe that if more layers are put between, and cut across, those lines of accountability, that does not actually drive better outcomes—it drives poorer performance. That is the approach we are taking to the entire system.
Wera Hobhouse
As I said, I have been the chair of the APPG for six years, and nothing has changed and got better. I really trust that this Government will make a difference—I hope they will. This is about culture change, but eating disorders are a very complex illness. The APPG has therefore called repeatedly for a dedicated strategy on eating disorders. Will the Minister please look at that?
Stephen Kinnock
I will come on to talk about the guidance that is being produced. There is a risk that we can end up with a proliferation of documents, strategies and plans. Our view is that the more streamlined we are and the clearer the lines of accountability, the better the performance becomes. We are committed to the guidance, and I will talk a bit about that, but we are not convinced that having strategies alongside guidance, plans and other documents will help the process.
Members here will be well aware of the increase in the prevalence of mental health conditions, including eating disorders, since the pandemic. The increase in demand has placed significant pressure on services, but the extra funding is making a difference. The latest quarterly figures from NHS mental health services monthly statistics show that, between April and June 2025, 3,138 children successfully entered treatment in community eating disorder services. That is the highest figure on record since NHS England began collecting this data in 2021.
At the same time, waiting lists to begin routine eating disorder treatment have shortened by 20% from the year before. NHS England has also commissioned the Royal College of Psychiatrists to carry out a national audit of eating disorders. That audit is collecting data on eating disorders across community and in-patient settings to drive improvements in the identification and treatment of eating disorders. The audit will monitor how services are performing against standards, and highlight any inequalities in access to care. That will help services to provide safe, effective, patient-centred, timely, efficient and equitable care.
In addition to improved services for the treatment of eating disorders, we are also working to tackle their underlying causes. In particular, we are deeply concerned about harmful online content that promotes negative body image, harmful eating behaviours, suicide or self-harm to those who are most vulnerable. The Online Safety Act 2023 has now come into force and delivers on our commitment to make the United Kingdom the safest place to be online. By now, all sites with a significant user base in this country are required to have conducted children’s access and risk assessments, and to follow the new children’s safety codes to prevent them from accessing harmful content, such as promotion of eating disorders. Ofcom now has the ability to investigate or carry out enforcement action against any site that will not abide by those codes.
Hon. Members today have raised the need for early intervention to lower the numbers of hospital admissions from eating disorders. We know that the earlier the treatment is provided, the better the chance of recovery, and we are committed to ensuring that everyone with an eating disorder can access specialist help. As part of our mission to build an NHS that is fit for the future, there is a critical need to shift the treatment of eating disorders from hospital to community, including children’s community eating disorder services, crisis care services and intensive day-hospital or home-treatment services. Improved care in the community will give young people early access to evidence-based treatment involving families and carers, thereby improving outcomes and preventing relapse. By preventing eating disorders from progressing into adulthood, we will build on our aim of raising the healthiest generation of children.
We have also committed to expanding mental health support teams to reach full coverage in England. To date, we have expanded MHSTs to 52% of pupils; they are working hard in schools to support staff and students alike in meeting the mental health needs of children.
Dr Luke Evans
I thank the Minister for giving way. I am pleased that his Government have continued the roll-out, because we share the aim of trying to deal with this early. On that point, there was mention of the updated guidance, and clearly these hubs are going to need that guidance if it is updated. Will he set out when that guidance will be brought forward?
Stephen Kinnock
I absolutely will; that is just coming up in my comments. I am not sure that the shadow Minister will be satisfied with the answer, but I will refer precisely to the question that he is asking.
The MHSTs will continue to provide assistance to school staff in raising staff understanding, recognition and awareness of eating disorders, ensuring that they can provide crucial early intervention for children at risk.
Early intervention is also a priority for adults with eating disorders, as set out in the NHS’s adult community mental health framework. NHS England has established 15 provider collaboratives focusing on adult eating disorders. Those collaboratives are working to redesign care pathways and focus resources on community services. By providing treatment earlier and closer to home, we will see better outcomes for adults with eating disorders and their families.
Turning to the guidance, which a number of hon. Members, including the shadow Minister, have raised, we are producing updated guidance to help services to implement those transformations. NHS England first published guidance in 2019 for adult eating disorder services to ensure that they are integrated with day-patient services or in-patient care. A new service specification for adult eating disorder in-patient provision has been through a public consultation and will progress to publication this year. So I can guarantee that it will be published before 1 January, but I cannot give the shadow Minister a precise date.
Stephen Kinnock
Can I come back to the hon. Gentleman on that? I will double-check. My understanding was that this was for both. My notes do say “for adult eating disorder services”, but my understanding was that this was a holistic process that would include children and schools. I will come back to him to confirm that point, so apologies if that is not entirely clear. Actually, I am sorry—it is next in my comments. NHS England is also producing updated national guidance for eating disorders in children and young people. That will reflect the full range of eating disorders in children and young people, and the treatment options available to CYP and their families to address them. It will focus on early identification and intervention, community treatment and support, and it will highlight the importance of integrating schools, colleges and primary care to improve support. Before the hon. Gentleman intervenes, he will have noted, as I have, that there is no specific date for that, so I will come back to him on that. The adult one will be before 1 January.
I would like to address the very serious concerns that have been raised about reports of people with eating disorders being offered end-of-life care. Let me be absolutely clear: these reports are deeply troubling, and I acknowledge the distress that they will have caused to families and all those affected by eating disorders. The Royal College of Psychiatrists has been crystal clear that eating disorders are not terminal illnesses. It has updated its guidance to re-emphasise that important point, so that no person, nor their loved ones, should ever feel that treatment has reached a point of no return.
NHS England is clear that all those with severe, complex or long-standing eating disorders should have access to eating disorder services, including hospital care when needed. A personal recovery model, with a focus on harm minimisation, symptom management and quality of life, is well established in providing hope and opportunities for recovery for many people with eating disorders. English law provides a robust framework for safeguarding a patient’s best interests.
I assure hon. Members that we take these concerns very seriously. We will continue to work with clinicians, NHS England and families to ensure that the highest standards of care are upheld, and that every person is given hope and support in their recovery.
Hon. Members have raised how those with eating disorders are disproportionately at risk of self-harm or suicide. The national suicide prevention strategy has highlighted the increased risk, and is committed to working with policy, clinical and personal experience experts to explore bespoke suicide prevention activity when needed. Specialists in eating disorders must ensure that they take a holistic approach to eating disorder treatment, and ensure that they are not likely to inadvertently increase the risk of suicide.
Several hon. Members, as well as the APPG report published in January this year, have raised the creation of a national register for eating disorder deaths, and the holding of a confidential inquiry into all eating disorder deaths. I reassure colleagues that the Department of Health and Social Care is wholeheartedly committed to learning from deaths, in order to prevent future tragedies and to improve quality of care.
The Department receives and responds to prevention of future deaths—PFD—notices relating to eating disorders, and it uses that work to inform practice going forward. For example, the medical emergencies in eating disorders—MEED—guidance was created following a coroner’s report and has since been rolled out nationwide. This Government are determined to focus funding directly to frontline services, in order to best support those currently struggling with this deadly illness.
Similarly, we share the concerns that have been raised about eating disorder deaths not being accurately recorded. It is vital that the extent to which eating disorders have caused or contributed to deaths is properly known. That matter is currently being explored with the national medical examiner for England and Wales, the Office for National Statistics and the Coroners’ Society of England and Wales.
To draw my remarks to a close, I would like to thank all the hon. Members here today. The fact that the debate was so well attended reflects how important the issue is to all of us and our constituents. The service that we provide can often be a matter of life and death. We are all very conscious of the gravity of the responsibility that we hold in that context. I thank all those in attendance for advocating for their constituents and all those across the country who have been affected by an eating disorder.
Mr Quigley
I thank the Minister for his response and all hon. Members for their thoughtful contributions. It has been truly heartening. This is the main message I hope to leave today: one death from any eating disorder is one too many. These deaths are not inevitable; they are preventable, yet far too many lives have already been lost, and far too many people continue to suffer needlessly.
I am pleased that the Minister and the Department have committed forcefully to improving the area, and to working with members of the APPG and me. We look forward to launching our report, at the end of October, on preventing eating disorder deaths. I hope to see many of my colleagues there when we do.
Lastly, I pay tribute to Zara’s mum, to Debs and cousin Tricia, and to all the parents fighting for the wellbeing of their children.
Question put and agreed to.
Resolved,
That this House has considered the matter of the prevention of deaths from eating disorders.