Queen’s Speech

Baroness Hollins Excerpts

Wednesday 3rd June 2015 Lords Chamber

[Baroness Hollins (CB)]

In Her Majesty’s gracious Speech, we heard that her Government intend to,

“secure the future of the National Health Service”.

There would be widespread dismay if this intention were not honoured. However, the NHS is limping. That is not helped by an overdose of bureaucracy, and is made worse by a grave shortage of general practitioners and nurses, continuing shortages of mental health professionals, and serious underfunding of mental health services.

However, Her Majesty’s Government have recognised some key areas for investment, notably the need to introduce measures,

“to improve access to … mental healthcare”.

This is a very welcome promise, because during the last Parliament, funding for mental health services was cut in real terms by 8.25%—almost £600 million. I join the noble Baroness, Lady Tyler, in asking the Minister how much of the additional £8 billion committed to the NHS by 2020 will go towards these measures to improve mental health care.

For too many years, mental health has been considered the poor cousin of physical health—something I know all too well as a past president of the Royal College of Psychiatrists. A staggering 7 million people experience mental illness at any one time, touching an estimated one-third of all households. A further 2 million British people are expected to experience mental illness by 2030. We need public mental health prevention strategies, not just better access to treatment.

During the last Parliament, the burden of mental illness was at last recognised, in part because of the courage of Members in the other place in speaking about their own mental illness, and in part because of my own amendment to health and social care legislation, which defined health as mental and physical health, and illness as mental and physical illness. The principle of parity of esteem for physical and mental illness was adopted, with parity of outcomes becoming a policy objective. Effective legislative and funding decisions will be needed as levers to sustain a government focus on parity over the coming years, as well as investment in developing the evidence about what works best.

Only 5.5% of the UK health research budget is spent on mental health, despite mental illness accounting for 25% of all illness. I was pleased to hear that an overarching goal of the Government is to promote social cohesion through legislating in the interests of everyone in our country. There was no specific mention in Her Majesty’s Speech of how the needs of people with learning disabilities, a particularly vulnerable group, will be protected in the legislative programme. This is a significant group, numbering about 1.5 million people in the United Kingdom—people who live their whole lives with a learning disability.

I worked clinically as a psychiatrist for more than 30 years with people with learning disabilities, retiring from the NHS in 2008. People with learning disabilities have six times the risk of mental health problems and three to four times the risk of developing dementia, so when talking about mental health problems, we are also talking about issues that particularly affect people with learning disabilities. These issues are all the more pertinent to me, as the mother of an adult with a learning disability. I have lived experience, through my son, of the challenges arising from the lack of integration of health and social care, limited personalisation of commissioned care packages, the lack of nurses specifically qualified to care for people with a learning disability, and the lack of doctors and nurses who know how to use their skills for the benefit of this patient group.

The coalition Government’s Green Paper of March 2015, No Voice Unheard, No Right Ignored, proposed to strengthen the rights of disabled people and their families, and in particular to challenge hospital admissions and to support people with learning disabilities to live independently in their local communities. The consultation period has ended. Can the Minister confirm the timetable for reporting on this consultation?

Simon Stevens, the chief executive of NHS England, has placed,

“support and care for people with learning disabilities”,

as one of the four priorities in the NHS business plan for 2015-16, alongside mental health, cancer and diabetes. In February, he also committed at the Public Accounts Committee to begin a closure programme of assessment and treatment units for people with learning disabilities. This followed Sir Stephen Bubb’s report, Winterbourne View—Time for Change, which highlighted the outdated and inappropriate practice of keeping people in long-stay institutions a long distance from home.

Care and treatment reviews undertaken by NHS England in the last few months are beginning to bear fruit, with the number of discharges beginning to reduce the number of people inappropriately placed in in-patient hospitals. The Government’s intention to integrate health and social care is welcomed and is expected to improve the lifelong mental and physical health and well-being of people with learning disabilities—a seamless service, co-created with each service user, as envisaged by my noble friend Lord Bichard.

Mencap highlights the need for training on learning disabilities for all health professionals. In the last Parliament, I introduced two debates on inequalities in healthcare for people with learning disabilities. The confidential inquiry reporting two years ago found that 37% of deaths were considered avoidable had there been an adequate health response. This equates to more than 1,200 people across England dying every year because they do not get the right healthcare. Therefore, there is a huge training agenda if we are to address some of the gaps in service provision.

Slow progress was made by the coalition Government in both learning disability and mental health care. I intend to focus my efforts in this Session on scrutinising legislation and progress in these two areas.