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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is an honour and a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Bath (Wera Hobhouse) on securing today’s debate and raising this important topic—as she always does. I also pay tribute to her for her long-standing advocacy on this topic and for all the work she does in the eating disorders all-party parliamentary group. She is joined today by a number of hon. Members from across the House, who have made thoughtful contributions.
One hon. Member who is conspicuous by his absence—he has already been mentioned, and I informed him in advance that I would mention him too, Ms Vaz—is my hon. Friend the Member for Isle of Wight West (Mr Quigley). He is my friend, and he is conspicuous because of the tireless work he does and the way he advocates for persons with eating disorders. I know that that is born out of personal interest and pain. We miss his presence here today and send him our good wishes from across the House.
It is important that we are having this debate today to note Eating Disorders Awareness Week. This year’s theme rightly places the focus on the power of community, which speaks to a simple but profound truth: no one should face an eating disorder alone. Recovery is not only about clinical treatment, vital though that is; it is also about the networks of support that surround that individual—not only health professionals, but mums, dads, grandparents, siblings, friends, teachers, colleagues and many others.
Wera Hobhouse
One of the most harrowing things that we hear again and again when taking evidence in the APPG is how families feel completely abandoned. People have to give up work, often over years, because they are meant to care for someone with a severe condition and they do not have the capacity to do so by themselves. It is only when that condition is finally so bad that the loved one is then readmitted to hospital. That revolving door must end. The human cost to that tragedy—apart from the cost to the NHS—must end. It is absolutely tragic and wrong.
Dr Ahmed
I wholeheartedly agree. The Government are committed to ending the revolving door for many conditions—this is an exemplar, in many ways—by joining up care and the streams of information that underpin it. One of our main commitments in our 10-year health plan is to have more joined-up care, to move it from sickness to prevention and to move from hospital into community, where that join-up can happen.
This community can thrive only when it is built on a foundation of timely, effective care. That is why we are focused on reforming eating disorder services so that people can access help when they need it, not after their condition has escalated. That approach underpins the new NHS guidance for children and young people’s eating disorder services, published last month, which is clear that care should be timely, joined up and delivered as close to home as possible.
As many here know, demand for mental health support, including eating disorder services, rose sharply during the pandemic, and the rise has been sustained thereafter. Although services remain under significant pressure, as a result of the additional investment there are some green shoots in system capacity and capability to better meet rising demand and reduce the waits that hon. Members have described.
In December 2025, 83.3% of routine referrals to children and young people’s community eating disorder services and 78.8% of urgent referrals started treatment within four weeks and one week respectively. That is a marked improvement in performance, compared with the situation six months earlier. In June last year, only 72.2% of routine referrals and 63.7% of urgent referrals were seen within four weeks and one week respectively. Although those are encouraging signs, I am under no illusion: too many children and young people are still waiting far too long for support. That is exactly why further reform and delivery are needed.
The Government’s long-term approach to mental health reform is set out in the 10-year health plan, which is clear in its direction. It shifts care from hospital to community, from sickness to prevention and, of course, from analogue to digital, which will be so important when it comes to having joined-up care. I assure hon. Members that those shifts are not abstract principles, but practical changes that are already being embedded. I know that they matter deeply for people living with eating disorders, and the families and loved ones who support them.
But I recognise that plans alone do not deliver care. Delivery depends on people and having the right workforce with the right skills in the right places. That is why, on top of the workforce plan that will come to fruition in late spring or early summer, we are investing in the workforce. We are committed to providing an additional 8,500 new mental health professionals across child and adult mental health services, to cutting waiting times and to ensuring that people access treatment and support earlier than ever before.
We are also working to strengthen skills and capability across the system. NHS England has introduced comprehensive training to ensure that staff across mental and physical health services can recognise eating disorders early and respond safely and effectively. That training supports clinicians working not only in the community but in primary and, crucially, acute care settings, where I used to work. I often saw such patients on my acute general surgical receiving ward rounds. The training includes specialist programmes, including the Royal College of Psychiatrists’ eating disorders credential, expanded access to family-based therapies, cognitive behavioural therapy for eating disorders, and dedicated training on ARFID, which the hon. Member for Sleaford and North Hykeham (Dr Johnson) mentioned. That work is about giving staff the skills, confidence and, crucially, clarity they need to deliver safe, high-quality care and reduce some of the avoidable harm that we have discussed today.
I am pleased to say that funding for children and young people’s eating disorder services has increased significantly, from £46.7 million in 2017-18 to an actual spend of £106.3 million in 2024-25. With that extra funding, we have focused on enhancing the capacity of community eating disorder teams across the country, because we know that timely, effective care leads to better outcomes, supports recovery and helps to prevent conditions escalating to the point at which hospital admission becomes inevitable.
When admission is necessary, stronger community care can reduce length of stay when it is safe. We recognise the concerns that in-patient capacity remains under pressure in some parts of our country. There are reports of individuals being discharged at very low body mass due to bed availability, as the hon. Member for Bath highlighted. Discharge decisions must always be about clinical judgment and patient safety, not capacity constraints. NHS England reassures me and continues to work with providers and integrated care boards to ensure that sufficient specialist provision and safe step-down pathways will be in place.
Dr Caroline Johnson
The Minister’s speech is very interesting. He talks about an increase in capacity, much of which will require workforce. I noticed that when he mentioned the workforce plan, he said “spring or early summer”, which is a change from his previous wording, which was always “spring”. Is that a sign that it is being delayed further?
Dr Ahmed
As always, the hon. Lady reads too much into my words. I am a Scot, so for me, spring and summer sometimes mean the same thing—and indeed winter. I can reassure her that there was no subtext to that nuance earlier in my speech. We remain committed and are on track to deliver on the workforce plan.
We recognise concerns, of course, and NHS England is addressing them. Prevention must be central to how we respond to eating disorders, particularly for children and young people. That is why we are also providing £13 million to strengthen the role of mental health support teams in schools and colleges through enhancements, so that concerns about disordered eating and body image can be identified and addressed much earlier. Acting sooner improves outcomes, reduces the need for more intensive treatment later and helps to ensure that our young people get the support they need, at the right time.
We are encouraged by the progress being made, but I am under no illusions. I know that sustained improvement depends on clear, consistent expectations for high-quality care across the whole pathway. That is why, alongside the 10-year health plan, we are developing a modern service framework for severe mental illness, which I can reassure the House will include eating disorders, to help to reduce avoidable harm from them and improve outcomes for persons affected by them. However, to get it right, we need expert input across the system, so my noble Friend Baroness Merron, the Minister responsible for mental health, will be hosting a roundtable discussion with eating disorder charities, clinicians and those with lived experience, to ensure that the modern service framework delivers meaningful improvements for people with eating disorders, with lived experience at the heart of it.
We have spoken, rightly, about online safety issues as they intersect with mental illness and eating disorders. As a parent, I of course remain deeply concerned about the widespread availability online of harmful material promoting eating disorders, suicide and self-harm, which can be far too easily accessed by people, including young people, who may be vulnerable. The UK’s Online Safety Act 2023 makes platforms—including social media, search and pornography services—legally responsible for keeping people, especially children, safe online. All providers must mitigate the risks of illegal harm on their services, and all providers of services likely to be accessed by children must take steps to mitigate their risks to children, especially as regards content related to eating disorders.
Wera Hobhouse
The Minister is very generous with his time. I mentioned this issue in my speech and I see it across the board, not just with regard to eating disorders. The Online Safety Act provides that Ofcom can intervene, but only if the content is reported, so we are relying on often very vulnerable people to report something before Ofcom intervenes. That cannot be right. There has to be a stronger emphasis on the social media platforms actually taking down accounts very quickly and, as I have also said, ensuring that they do not just reappear under a different name.
Dr Ahmed
The hon. Lady makes a really valid point. She will know, as I do, that the regulation of these platforms in relation to children’s access is a live issue at the heart of Government at the moment. She is right: the current provisions are not strong enough to be adequate safeguards. We do need more proactive intervention from our technology partners. My right hon. Friend the Secretary of State for Science, Innovation and Technology takes that very seriously and is pushing very hard on it in relation to not only harm in this space, but harm in general, for children online.
Ofcom ensures that services uphold these duties, including for smaller online sites. Its small but risky services taskforce has assessed 20 services relating to this harm, over half of which have been at high risk for eating disorder content. I am happy to write to my colleagues in the Department for Science, Innovation and Technology, on the back of this debate, to learn from them what further action specific to eating disorders is coming down the pipeline, and I can relay that information to hon. Members assembled in this Chamber today.
I also share the deep concern about reports of people with eating disorders being offered end-of-life care.
Dr Arthur
Before we move on to end-of-life care, I welcome the great offer that the Minister has given to reach out to the Department for Science, Innovation and Technology to better understand what they are doing on digital platforms. I expect that many of the people who are going to respond to the consultation around the banning of social media for under-16s will come from the healthcare profession, because of the connections between mental health and eating disorders and the use of these platforms. Will he be proactively asking for action to make sure that young people are protected? That would also mean more resources for people who have eating disorders, because hopefully fewer people would be coming forward.
Dr Ahmed
My hon. Friend is absolutely right. Being proactive and following the evidence should be our north star when we are formulating policy; I know that is true of my right hon. Friend the Secretary of State for Science, Innovation and Technology.
The Royal College of Psychiatrists has been explicit about eating disorders and end-of-life care. Anorexia nervosa is not a terminal illness in its own right. The college’s guidance on medical emergencies in eating disorders was developed precisely to ensure that preventable deaths become a thing of the past. NHS England is clear that no patient with an eating disorder should routinely be placed in palliative care. Our focus must always be on treatment and recovery, and underpinned by the hope of recovery.
We also share concerns about the accurate recordings of deaths where eating disorders may have been a contributing factor. The hon. Member for Bath outlined some of her frustrations regarding correspondence with the Ministry of Justice and I would be happy to take up that call on her behalf to make sure that she gets the correspondence that she is entitled to. The statutory medical examiner and coroner system provides a clear framework to ensure that deaths are properly investigated and recorded so that lessons are identified and patient safety is strengthened.
Although it is for the coroner to exercise independent judicial discretion to determine what is recorded as the medical cause of death, I can reassure hon. Members that the coroner’s office has been undergoing training to ensure that the recording of deaths associated with eating disorders is done more accurately and proactively. Accurate recording matters, and we will continue to work with our partners, including colleagues in the Ministry of Justice and clinicians, to ensure that not only are the statistics captured, but the learning underpinning those statistics is reflected in genuine improvements to care.
Eating disorders are serious and complex mental illnesses that can affect anyone at any age and in any community or family. They require timely treatment, skilled professionals and sustained support thereafter.
Helen Morgan
The Minister is probably about to draw his remarks to a close, but can I press him again on the mental health investment standard, which should ensure that the proportion of NHS spending on mental health goes up every year? In the last year for which we have numbers, it had gone up as a proportion of ICB spend, but had fallen as a proportion of overall NHS spend. Can the Minister commit that the Department will not be abandoning that standard, and that we will see mental health spending go up each year?
Dr Ahmed
I can certainly commit to the hon. Lady that mental health spending in real terms will go up every single year. It went up by £688 million in real terms this year. The good nature of this debate permits me to push back only gently against the hon. Member for Sleaford and North Hykeham, who talked about spending in the NHS, but I do feel I need to push back a little: one of the reasons why that percentage in statistical terms is lower, but the spend in real terms is higher is because we had to spend so much more money—the record £26 billion that was afforded in additional spend by the Chancellor in the Budget—in other parts of the health service to compensate for the decay and decline in the NHS over the last 14 years. But the hon. Member for North Shropshire (Helen Morgan) has my commitment to the overall philosophy that mental health spending will increase year on year.
As I was saying, eating disorders are serious and complex; over and above skilled professionals, they also require compassion, understanding and collective responsibility. Through the 10-year health plan, we are shifting care closer to home; strengthening early intervention; expanding the workforce where necessary, such as with community mental health workers; improving standards and investing in the community services that make recovery possible. We are also equipping staff with the right training, protecting young people online—while continuing to improve and explore the mechanisms through which we can do that—and working with experts and those with lived experience to ensure that the reform we are choosing to pursue delivers real and lasting change.
We know that the policy framework alone is never enough. Change also depends on the voices of campaigners, including many who join us here today, clinicians, families and those who have shared their lived experience. I can assure everyone that their advocacy continues to shape this Government’s approach, and it will continue to do so.
To those living with an eating disorder, and to the families supporting them, I want to say this: “You are not invisible. You are not alone.” This Government are committed to building a system that responds with urgency, expertise and compassion. Our task—across this House and beyond it—is to ensure that when someone reaches out for help, the system we create is ready to respond with urgency, expertise and, crucially, hope. I once again thank hon. Members for contributing to this debate and I look forward to continuing this work with colleagues from across the House.