Child and Adolescent Mental Health Services

Adam Afriyie Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Mr Robinson]

Easington. I beg my hon. Friend’s pardon. The CAMHS budget has been cut to £716 million, which is a cut of £50 million. That is an enormous cut.

[Adam Afriyie (Windsor) (Con)]

The hon. Gentleman is making a powerful case, particularly on resourcing. Clearly, we would all like to see more resources going into adolescent mental health challenges, but does he share my view that if we get this right, with proper standards, proper implementation and early intervention, there could be a net saving to the Exchequer overall?

[Mr Robinson]

I absolutely agree with the hon. Gentleman. I think the whole House would agree with his intervention, which was short and to the point. As in so many situations, prevention is better than cure. It is also a lot cheaper. We all know that, and there is a case for it in this context, but it will require investment up front. That is where the Government do not get it, because they usually take a short-sighted view of these matters.

I wish to make two points in closing. First, if local councils do not have the resources at the moment, we cannot look to them to provide these services and so they are likely to get overlooked. Lastly, will the Minister confirm something about the leak—I am sure he will have read about this in the press—from his taskforce, which speaks of the perverse incentives that have arisen, particularly in relation to mental health, from the Government’s reorganisation? Have they exacerbated the problem? As a result, is the real cost of that reorganisation to the mental heath services not £50 million, but possibly a much higher figure?

In any event, we all know from our constituency experience that we have had losses. Last night, I saw in a television programme that we have lost hundreds of doctors and thousands of nurses, and the prospect in the next few years is an accelerating trend on both. So the Labour party’s commitment for 20,000 new nurses and 8,000 new doctors is a bold one, but it is manageable. It is also absolutely necessary if we are to deal with any of our current problems. That is the message I would like to leave the House with. We need early intervention; a commitment to increase the number of doctors and nurses; parity of treatment—and even ahead of that— in the integration of mental health services; and the restoration of the CAMHS budget as soon as possible.

--- Later in debate ---

[Adam Afriyie (Windsor) (Con)]

I apologise for not arriving for the first part of the debate; sadly, I was detained elsewhere. I wanted to say a few words about this excellent report. I commend the Chair of the Health Committee and its other members for producing a very well-balanced report that does not appear to be partisan in any way but does point to some of the problems that still exist in our child and adolescent mental health services, and to some of the possible solutions, if any future Government were to adopt its recommendations. The other impressive thing about the report is that it does not apportion blame. It merely observes that there are challenges, without attributing blame on a partisan basis or to a particular group or individual. It can often be hard to implement the recommendations in these reports if it is felt that a finger is pointed at a particular body.

Clearly, mental health challenges are widespread. As other Members have observed, they generally start when people are younger; it is unusual for a mental health challenge suddenly to appear out of the blue. That is why this report and looking at early intervention is very important if we want to tackle mental health services for citizens and mental health outcomes for our constituents. The mental health unit at Heatherwood hospital in my constituency has been transferred to Reading. It strikes me that that is very positive in many ways, because it enables more integrated services to be provided in a larger establishment, which has more resources and is better able to deal with the people who present themselves there.

I want to focus on a couple of positives that I very much welcome among the recommendations. One is the recommendation to develop, implement and monitor minimum standards. It seems to me that that is exactly what we do in every other area of health care. When I was shadow Minister for Science and Innovation, it was precisely what the Medicines and Healthcare Products Regulatory Agency and the then National Institute for Health and Clinical Excellence intended when it came to interventions requiring medical trials and proper evidence. Minimum standards are an absolute minimum, to put it that way, if we are absolutely serious about ensuring that care is consistent and does not fall below a well defined level in services and the way in which they are provided.

It is clear that the recommendations on intervention and recognition in schools and GP surgeries are already very well known among Members. In the 10 years that I have been here, I have heard debates in which such points have been highlighted. It is good to see a recognition in print that there needs to be more awareness in schools. I thank my hon. Friend the Member for Brigg and Goole (Andrew Percy), who was a teacher for many years before he entered this place, for his words on this subject. Without the relevant guidance, it is quite tricky to distinguish between children who, just from their background or families, one thinks are just being tricky, and children who are presenting with a diagnosable and observable emotional or clinical mental health condition.

On in-patient care for people under section 136 of the Mental Health Act 1983, times have moved on. The days when the idea was that somebody in such a unit should feel that it was akin to a prison must be well behind us. I very much welcome much of the work already done in the NHS and elsewhere to make sure that although such units are secure and can protect the vulnerable young people housed in them, they are developed not just as a location in which to keep them safe, but as a place with the services—the cognitive behavioural therapy, the psychiatrists and the psychologists—required to reintegrate them into society.

Without criticising the report, I would have liked it to go a little further on online resources and the digital world. It seems to me that we often see Twitter, social media and technology as a huge danger with all sorts of negative consequences, and that we seldom see the positive applications that could be made in the online and digital world. I very much welcome the acknowledgment of the extra stresses and burdens that social media place on young people in particular. I also welcome the allusion to how, perhaps with more resources and more proactive health care providers and more proactive people with an interest in mental health conditions, technology could be made part of the answer. When somebody is being bullied on Twitter or social media, technology could be used to create a little pop-up saying, “Hey. This looks like bullying. Would you like to analyse how you’re feeling about that?”

There could be all sorts of excellent uses of digital technology to help people through a process, through a partial process of CBT or in identifying the problems they face, and online resources could be exceptionally helpful in that regard. A lot of the process is about acknowledgment and recognition and then of leading people on to the next step, but if they do not feel that fulfilling the criteria for having a mental health challenge will be an embarrassment or that stigma will be attached to them, such technology could guide and lead them to getting additional help. When the Government look at the report, perhaps they could look even further into using the online world and digital technology as part of the cure.

As a former shadow Minister, I would like to say that if we had a pill that cured 50% of people of any illness or mental health condition that they had after six weeks, we would say that it was a miracle cure. Certainly for less acute mental health conditions among adolescents, cognitive behavioural therapy is that wonder pill. We need to see more investment in, further roll-out of and quicker access to such services.

Oral Answers to Questions

Adam Afriyie Excerpts

Tuesday 11th June 2013 Commons Chamber

[Adam Afriyie (Windsor) (Con)]

T9. For the last decade, in the face of constant threats of closure to Heatherwood and Wexham Park, I have campaigned alongside local councillors, activists and residents to try to get the right balance of services across my constituency. The people I work with are very reasonable, as is the Secretary of State, so will he meet me and a small delegation from Windsor to discuss their options?

[Mr Hunt]

It would be my great pleasure to do so.

Mental Health

Adam Afriyie Excerpts

Thursday 14th June 2012 Commons Chamber

[Paul Burstow]

I thank the hon. Gentleman for his question. May I undertake to write to him about that matter in more detail? It has come up in our work on our suicide prevention strategy in relation to the nature of suicide verdicts, and narrative verdicts in particular, in coroners’ courts. I would be happy to come back to him on that issue.

In the past year, we have made progress across a broad front. We have committed £400 million to make psychological therapies available for adults of all ages, as well as for people with long-term health conditions and with severe and enduring mental illness. When it comes to our focus on recovery, the latest figures show that 44.4% of those who complete programmes recover and that more achieve lasting improvement. That puts us on track to achieve our target rate of recovery of over 50%.

Given that we know that the first signs of more than half of all lifelong mental illnesses can be detected in adolescence, we have to go further. That is why the Government are breaking new ground by investing in a new training-led approach to re-equip children and young people’s mental health services to offer a range of psychological therapies. I pay tribute to the leadership shown by YoungMinds. Without its support, we would not have come as far in this area as fast as we have.

I want to say something about the necessity of achieving the best possible outcomes for people in mental health crisis. Secondary mental health services across the country have made significant changes, both in community and hospital settings, including the provision of alternatives to psychiatric hospital admission. For example, more than 10,000 people with an early diagnosis of psychosis were engaged with early intervention services last year. That is the highest figure ever recorded. The improvements in community-based early intervention services are driving up standards of care, as well as reducing the demand for hospital admissions. I freely acknowledge that there is more to do and I take on board the point that my hon. Friend the Member for Broxbourne made about the need to look at the variability in the accessibility of mental health advocacy.

The development of recovery-focused services is a critical part of the Government’s strategy. That work is being led by the NHS Confederation’s mental health network and the Centre for Mental Health. They are supporting pilot sites that cover almost half of England and are making the kind of changes that service users have sought for years. The programme has identified 10 key changes to the way in which staff work, the types of services that are provided and the culture of organisations to embed recovery principles into routine practice.

When I visited the South West London recovery college, I heard powerful personal testimonies from people who were living purposeful and fulfilling lives, and who were living with their illness rather than having to be cured of symptoms or illnesses. It is important that recovery is not just seen in medical terms, but is self-defined. Students at the college learn not only how to manage their condition, but skills to help them back to work and to form new relationships. Some become lecturers at the college themselves. I was told that being called a student, rather than a patient, helped people take control of their recovery, gave them more confidence and, crucially, made them feel normal, as opposed to being treated as a helpless, passive recipient of care.

Part of a good recovery is the ability to exercise more control over one’s life. In health care, that means that there must be more shared decision making and choice. In opening the debate, my hon. Friend the Member for Loughborough mentioned the principle of “no decision about me without me”. Undoubtedly, the any qualified provider policy and tariff reform have a part to play in that.

[Adam Afriyie (Windsor) (Con)]

Many of us recognise that many people who come to our constituency surgeries, perhaps with a housing benefit inquiry or other benefit inquiry, are actually struggling with mental health challenges. It seems to me that the lack of control that results from the way in which Government services are designed can be a great contributing factor to stress and, therefore, to depression. The Minister is speaking about control. Can the design of public services, such as housing benefit and other benefits, be taken into account as a way of relieving the stress on a great number of our constituents?

[Paul Burstow]

That intervention rather helpfully moves me on to the point that has been made by several hon. Members about Atos. Although it is not my ministerial responsibility, a number of important points have been made about how it operates in particular cases. I will ensure that those points are taken into account by my ministerial colleagues at the Department for Work and Pensions. I will gladly pass them on.

Oral Answers to Questions

Adam Afriyie Excerpts

Tuesday 18th October 2011 Commons Chamber

[Paul Burstow]

That was a good example of bluster—perhaps that is what we will see from the Opposition under the right hon. Gentleman’s stewardship.

The right hon. Gentleman ought to be aware, because it happened on his watch, that primary care trusts and strategic health authorities have seen their management costs increase by more than £1 billion. There was a 120% increase from 2002 to when this Government took office. That is why we are determined to cut overhead costs in the NHS, so that we can reinvest every penny in the front line.

[Adam Afriyie (Windsor) (Con)]

7. What recent representations he has received from Berkshire East primary care trust on the future of Heatherwood hospital in Ascot.

[The Secretary of State for Health (Mr Andrew Lansley)]

I have received no such representations.

[Adam Afriyie]

My constituents are shocked to discover that yet again, the future of Heatherwood is under threat. I have had sight of a major petition, and I am actively campaigning with hard-working local councillors, activists and residents to uncover why Heatherwood’s future is under threat when the funding from the Government to the region has increased. Does my right hon. Friend agree that the Berkshire East PCT must cut its bureaucracy costs and introduce efficiencies before threatening the money to Heatherwood hospital and other local services?

[Mr Lansley]

I am grateful to my hon. Friend and completely understand what he is saying. In this financial year compared to the previous one, revenue available to Berkshire East PCT increased by £16.3 million. That is just one part of the £3.8 billion increase in revenue resources available to the NHS this year compared with last year.

Although I very much welcome the shadow Secretary of State to his new position, we will miss his predecessor. We welcome the new shadow Secretary of State not least because he might begin to explain to the NHS why he thought it was irresponsible to increase resources to the NHS in real terms by about £3.8 billion—

Contaminated Blood and Blood Products

Adam Afriyie Excerpts

Thursday 14th October 2010 Commons Chamber

[Adam Afriyie (Windsor) (Con)]

My constituent Sarah Vergopoulos came to see me when her brother died because of infected blood just last year. She was most concerned to ensure that something would actually happen as a result of this debate. It seems to me that this debate—I commend the Backbench Business Committee on it—has already been a success, because something has already happened. The review has been announced and a timeline has been given to ensure that something will come forward this side of Christmas. I can thus report back to my constituent that just by holding this debate, something has already moved, which might not have moved without it.

[Jenny Willott]

The hon. Gentleman is correct. This debate on the Floor of the House is something for which many of those affected have called for a number of years. For them, it is important that that has been recognised and that Ministers are now listening to Members of all parties expressing their views.