“Educational Excellence Everywhere”: Academies

Debate between Baroness Morgan of Cotes and John Pugh

Monday 9th May 2016 Commons Chamber

[Nicky Morgan]

We remain committed to a national funding formula review. It cannot be right to have 152 different local formulae operating across the country. As I have talked about having a strong, consistent education system across the country, that must mean that we have a strong, consistent funding system too.

[John Pugh (Southport) (LD)]

Can the Minister specify why she objects to the line put across in The Times today by PricewaterhouseCoopers—presumably, a vested interest—who argue that academisation is neither a necessary nor a sufficient condition for school improvement, or is evidence utterly irrelevant?

[Nicky Morgan]

Plenty of evidence can be cited in favour. I point the hon. Gentleman to the PISA and the OECD evidence, which I have already talked about, which sets out clearly the benefits of autonomy in our school system.

Oral Answers to Questions

Debate between Baroness Morgan of Cotes and John Pugh

Monday 30th November 2015 Commons Chamber

[John Pugh (Southport) (LD)]

T1. If she will make a statement on her departmental responsibilities.

[The Secretary of State for Education (Nicky Morgan)]

Last week my Department published a call for evidence to help broaden our understanding of out-of-school education settings and the potential scope of the system of oversight announced by my right hon. Friend the Prime Minister last month. We are committed to safeguarding all children and protecting them from the risk of harm and extremism, including in out-of-school settings, many of which provide valuable learning opportunities. I would ask all interested parties to make a contribution before 11 January.

[John Pugh]

Local education authorities are Ofsted-inspected, which is a good and rigorous system. What plans are there to inspect academy chains, by Ofsted or any other means?

[Nicky Morgan]

It is very nice to hear the hon. Gentleman, who I believe is his party’s education spokesman, although we have not heard much from him on education since he took up that position. He will be aware that these matters were explored fully by the Education Committee in the previous Parliament. We want Ofsted to inspect individual schools and the support they get. It is able to question multi-academy trusts and chains as part of those inspections.

Oral Answers to Questions

Debate between Baroness Morgan of Cotes and John Pugh

Monday 26th October 2015 Commons Chamber

[Nicky Morgan]

I think that I can therefore welcome the hon. Gentleman’s support for the principle of fairer funding. As he will know, we are of course looking at all elements of funding as part of the forthcoming spending review, but we have made it clear that we are protecting per pupil funding in this Parliament, which means that the amount going to schools will go up as the number of pupils goes up.

[John Pugh (Southport) (LD)]

With due respect to the hon. Member for Lichfield (Michael Fabricant), I must say, as one of the “wicked Liberal Democrats”, that equitable funding requests do not always seem to sit happily with the pupil premium policy. Has the Secretary of State any thoughts on either revising or reviewing that policy?

[Nicky Morgan]

I think that we can all agree that pupil premium funding has been hugely successful. It is absolutely right that over £2.5 billion is given to schools for additional funding to help those who are most disadvantaged, and schools, by and large, are spending it extremely effectively. The hon. Gentleman is absolutely right to say that obviously the school funding formula reflects both deprivation funding and pupil premium funding, which has since been introduced, but we absolutely want to ensure that the same pupils with the same needs attract the same funding. I reiterate that pupil premium funding has been very successful.

Oral Answers to Questions

Debate between Baroness Morgan of Cotes and John Pugh

Monday 19th January 2015 Commons Chamber

[Nicky Morgan]

As I said earlier, I strongly support faith and Church schools in this country. They offer an excellent education, but the Government have already made moves to ensure that all schools have to teach a broad and balanced curriculum, which many, if not all—almost all—faith and Church schools already do. There is the importance of teaching values of mutual respect and tolerance of others with other faiths and beliefs. If that is not happening, we will not hesitate first of all to inspect and then to take further action.

[John Pugh (Southport) (LD)]

T9. An hour ago, in Mr Speaker’s House, there was a broadcast edition of Michael Sandel’s “The Public Philosopher” and many parliamentarians were present. What are the Government doing to encourage philosophy and critical teaching in schools?

Oral Answers to Questions

Debate between Baroness Morgan of Cotes and John Pugh

Monday 27th October 2014 Commons Chamber

[Nicky Morgan]

Well, what wishful thinking and, indeed, guff from the hon. Gentleman. If he wants to talk about the quality of teachers, he needs to look at the outcomes. This country has more good and outstanding schools than in 2010. He ought to listen to the families who want their children to be taught well. If he is so worried about unqualified teachers, what does he say to the schools in Stoke that allow him in to teach?

[John Pugh (Southport) (LD)]

4. What assessment she has made of the effect of pension changes on school budgets; and if she will make a statement.

Oral Answers to Questions

Debate between Baroness Morgan of Cotes and John Pugh

Tuesday 24th June 2014 Commons Chamber

[The Financial Secretary to the Treasury (Nicky Morgan)]

The Department for Work and Pensions, and the Ministers responsible for disabilities and for employment, launched a strategy last December to help those with disabilities to find work. What this Government have not done is what the previous Government did, which was to say to people, “We don’t think that you can work.” We want to empower people to work, and schemes such as Access to Work are all about doing that.

[John Pugh (Southport) (LD)]

T6. May I congratulate the Chancellor on his excellent HS3 proposal? It follows on from an equally visionary plan from the Deputy Prime Minister—in the previous Government. How does the Chancellor’s plan exceed Lord Prescott’s ambition?

Mental Health

Debate between Baroness Morgan of Cotes and John Pugh

Thursday 14th June 2012 Commons Chamber

[Nicky Morgan]

I entirely agree with the hon. Gentleman. The Centre for Mental Health has shown that for a person who has a physical and a mental health condition, the costs of treatment are increased by 45%. Those are additional costs around mental health problems, which are often untreated initially and then have to be treated at a later stage, so the hon. Gentleman is absolutely right.

According to the Centre for Mental Health, only a quarter of people with mental health conditions—children as well as adults—receive any treatment. I have no reason to doubt that statistic, and I find it shocking that three quarters of people with mental health conditions are not being treated. We should ask ourselves why that is.

Recent figures have shown that depression alone is costing the economy £10 billion a year. As we all know, we do not have a lot of money to spend, so we should be working as hard as we can on preventive measures. One in every eight pounds spent on dealing with long-term conditions is linked to poor mental health, which equates to between £8 billion and £13 billion of NHS spending each year.

I welcome the Health and Social Care Act 2012. I hope that today’s debate will be conducted on pretty non-partisan terms, but I realise that that may strike Opposition Members as a controversial comment. I welcome the opportunities that the Act offers for the commissioning of mental health services. I spoke in the Third Reading debate, and I especially welcomed the Government’s acceptance of an amendment tabled in the other place to ensure parity between physical and mental health. Although those are only words in a Bill, they are very important words, and they send a very clear signal not only to sufferers from mental health conditions and their families, but to those working in the NHS. I hope that, in his annual mandate to the national commissioning board, the Secretary of State will insist that the board prioritise mental health.

How are we to achieve parity between physical and mental health conditions? The question is about money, certainly, but it is also about awareness. Confessing to having a mental health condition carries far too much stigma. That is part of the reason for our wish to hold a debate on the Floor of the House. If we do not start to talk about mental health in this place, and encourage others to talk about it, how can we expect to de-stigmatise mental health conditions and enable people to confront their problems?

I find it interesting that, when I was preparing for the debate, a few people who had initially said to me “Yes, go ahead, mention my name” came back after thinking about it for a couple of days and said “Actually, I would rather you didn’t, because I have not told my employer,” or “I have not told all my friends and my family.” It is clear that mental health conditions still carry a considerable stigma. Admitting to having been sectioned is traumatic, especially when the information appears on Criminal Records Bureau checks connected with job applications.

I welcome the work of Time to Change, which has been funded partly by the Department of Health as well as by Comic Relief. I also welcome the Sunday Express campaign on mental health. However, the de-stigmatisation of mental health conditions is down to all of us, and it is especially important for those of us who are employers not to discriminate against people who may be working for us and who tell us that they have a mental health condition. I hope that today’s debate will constitute another firm step on the path to ensuring that mental health conditions are de-stigmatised, because I think that without that de-stigmatisation, successful treatment will be very hard for a person to achieve.

We asked for today’s debate to be kept deliberately general, so that Members in all parts of the House could raise many different issues on behalf of their constituents and, perhaps, themselves or their families as well as looking at the mental health policy landscape. Mental ill health is no respecter of age or background. It can strike anyone, often very unexpectedly. That includes people in senior positions such as Members of Parliament, company directors and school governors. I am sure that my hon. Friend the Member for Croydon Central (Gavin Barwell) will refer to the private Member’s Bill that he will be presenting, which would end discrimination against people in such positions who have mental health conditions.

I expect that during today’s debate we shall hear about new mums with post-natal depression. For them, a time of life that should be one of the happiest is often one of the most difficult. I welcome the recent Government announcement that health visitors will be properly trained to recognise signs of post-natal depression, which I think was long overdue. I expect that we shall also hear about veterans from our armed forces who suffer from mental health conditions, and about older people who suffer from dementia. Particular issues affect our black and ethnic minority communities, as well as those who find themselves in the criminal justice system. I am sure that we shall hear from the Minister abut the Government’s widely welcomed framework document “No health without mental health”, which was published last year. We now await the detailed implementation plan on which the Department of Health is working alongside leading mental health charities.

I want to talk, very briefly—I have noted Mr Speaker’s strictures about time limits—about three specific matters: listening to patients, integrated care, and the wider mental health well-being landscape. We made it clear during the passage of the Health and Social Care Act that one of the developments that we wanted to see, as a Government, was “No decision about me without me.” That means patients having a voice in their care. It seems to me from my discussions with those in the mental health system who have been sufferers that once the initial crisis has been dealt with, they tend to want choice and involvement in their treatment. They are facing a lifetime condition. They will have to self-medicate, look after themselves and identify the point at which they may be deteriorating or potentially reaching crisis point for years and years to come. They want a voice. They want to be heard by the health care professionals, and I think that it is up to us as a Government to help them to achieve that.

[John Pugh (Southport) (LD)]

The hon. Lady has just said that people who suffer from mental health problems have a lifelong condition. I think that many people have an occasional mental health problem.

[Nicky Morgan]

I am not sure that I entirely agree with the hon. Gentleman. I agree with him that people often enter the system at a time of crisis and experience a single episode, but others who experience episodes will get better. For years they may have no problems at all. The hon. Gentleman shakes his head, but I can tell him on the basis of the experience of constituents and family members that it is possible to go in and out of the system. One of the hardest things for people to accept when they are diagnosed with a mental health condition is that they will be on drugs for years and years. That is often difficult for people to admit, particularly when they are striking up a new relationship or working for a new employer. I think that that is why people want to have a voice in the way in which they are treated.

According to Mind, people are three times as likely to be satisfied with their treatment if they are presented with a choice of treatments, and failure to stay on medication is the main cause of relapses, when people often have to re-enter the system at a time of crisis. There is a need to work with and trust health professionals. According to a recent study by the university of Kent,

“Low levels of trust between mental health patients and professionals can lead to poor communication which generates negative outcomes for patients, including a further undermining of trust”,

and

“trust can play a significant role in facilitating service users’ initial and ongoing engagement with services, the openness of their communication, and the level of co-operation with, and outcomes from, treatment or medication.”

In 2009, a mental heath in-patient survey by the Care Quality Commission revealed that in some mental health trusts as few as 40% of people diagnosed with schizophrenia felt that they were involved as much as they wanted to be in decisions about their care and treatment. I am no health professional—I hope that some Members who are health professionals will speak later this afternoon—but what people have said to me suggests that medication is not always the answer, at least in the long term. Research by Platform 51 has found that a quarter of women have been on anti-depressants for 10 years or more, that half of women on anti-depressants were not offered alternatives at the time of prescription, and that a quarter of women on antidepressants have waited a year or more for a review of their medication

I welcome the Government’s investment of £400 million in treatments under the improving access to psychological therapies programme. I should add, to be fair, that that builds on announcements made by the last Government. I also commend the report by the Centre for Social Justice on talking therapies, which calls for a broadening of therapies. Every patient is different, and patients will respond differently to different medications and therapies. Mental health patients must have real choice, and I think that Any Qualified Provider and Payment by Results must be extended to them in the way in which they are being extended to patients with physical health conditions. We must also ensure that patients’ voices are heard within the management structures of both clinical commissioning groups and health and wellbeing boards, whose job it is to hold services to account for the care that they are giving.

I expect that Members will refer to integrated care: the need for all services to work together. Poor mental health has an impact on every area of Government policy: health care, benefits, housing and debt, social exclusion, business and employment, criminal justice and education, to name but a few. One person with a mental health condition may need help from many different agencies, but too often care is not joined up, and each agency deals with its own bit and passes the person on. Sometimes there is no follow-up, and the person is lost in the system.

In a 2011 survey, 45% of people contacted by Mind said that they had been given eight or more assessments by different agencies in a single year. YoungMinds, which campaigns on behalf of children and young people with mental health conditions, has called for one worker to be allotted to each child needing support for a mental health condition, so that children can avoid multiple assessments and need not re-tell their story each time they see a new person in the system. However, there must be a clear care pathway, whatever the point at which access is gained to the mental health system.

The other thing patients are calling for is the ability to self-refer. We need to do all we can to prevent people from reaching crisis point, and often it is patients themselves who are best able to tell when they are about to reach that point. My West Leicestershire clinical commissioning group is developing an acute care pathway in partnership with Leicestershire Partnership NHS Trust. It plans to replace the many and varied access routes to secondary care and mental health services with a single access point, in order to provide speedy access at times of greatest need. That move has come out of both patient and GP feedback.

Health and Social Care Bill

Debate between Baroness Morgan of Cotes and John Pugh

Tuesday 20th March 2012 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

I will speak very briefly. Let me begin by pointing out to the hon. Member for Leicester West (Liz Kendall), who said that we did not have enough time to consider all the amendments, that if we had not spent an hour and a half discussing the risk register yet again, we would have had more time to discuss the amendments.

I congratulate the Government on accepting Lords amendment 1, which relates to parity of esteem between physical and mental health. As the Minister said, genuine parity cannot be laid down in legislation, and the mental health framework will be very important to the achievement of it. However, research findings published by the Centre for Mental Health, which I mentioned to the Minister during health questions recently, show the link between physical and mental health conditions. As I am sure we all know from our constituency casework, when someone presents with a physical health condition, it may be clear that there is an underlying mental health condition which has been either undiagnosed or untreated, and which is therefore hampering the person’s physical health recovery.

The Minister spoke of the “symbolic significance” of including a reference to mental health. He is right, but I think that on a day when we have seen Her Majesty the Queen address Parliament, we should recognise that there is sometimes a place for symbolism, particularly when it comes to something that is as cherished on the Government Benches as the NHS. I know that the Opposition claim ownership of the NHS, but in fact it is cherished by all of us, and by our constituents.

I also thank the Government for accepting Lords amendments 19, 32 and 33, which concern the duty of commissioners and commissioning groups to provide patient-focused care—the “No decision about me without me” duty. My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) rightly spoke of the importance of mental health care in that regard. I have certainly found, when listening to patients in the mental health system, that they want their doctors, consultants and everyone else in the system to ensure that they are involved in their own care. I am glad that the clinical commissioning groups will be given guidance on that, but I do not expect the very best CCGs and GPs to need to follow it. They are likely to know that treatment is more likely to succeed if patients are involved in it.

Having spent 10 weeks on the Public Bill Committee, and having been present during all the debates on the Floor of the House, I am especially pleased to be able to welcome the amendments.

[John Pugh (Southport) (LD)]

Let me begin by paying tribute to my colleagues in the House of Lords, who have improved the Bill significantly.

I want to raise two issues relating to conflicts of interest. Subsection (1) of the new section proposed in the amendment tabled by Baroness Barker states:

“Each clinical commissioning group must maintain one or more registers of the interests of—

(a) the members of the group,

(b) the members of its governing body,

(c) the members of its committees or sub-committees or of committees or sub-committees of its governing body, and

(d) its employees.”

I looked in vain for a paragraph (e) specifying “parties with which it is contracted for commissioning support”. I think that that is a live issue. There will be commissioning support organisations—some of which will be private institutions, and some of which will be allied with organisations that provide the clinical services that are commissioned—and there may be occasions when those advising the commissioners make recommendations that benefit some parties with which they are contracted. That model, involving the influence of the executive, will be fairly familiar to those who have been members of local authorities. Councillors, like doctors, are often very busy. They rely heavily on expert advice provided by officers, and they generally follow it.

The issue was raised in the House of Lords—I believe that it was raised by Lady Barker—but, when I read the report of that debate, I could not help feeling that it had been glossed over. I should welcome any enlightenment from the Minister on how such a quandary can be dealt with. Clearly it must be dealt with, because otherwise it will create general anxiety about how commissioning will proceed.

The second issue is a bigger one. I think that it is of particular interest to us all, because it affects the general position of the commissioning consortia themselves. There is a view that PCTs are more or less in the same legal boat as GP or clinical commissioning consortia would be. I disagree with what the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said about that. The PCT, as a unit, is not built around general practices, which, as we have said several times in this place, are small businesses. It is possible to view a clinical commissioning consortium as an association of undertakings, which creates serious issues as to how it is able to use public money. If it used public money to benefit itself, that would obviously become a big issue immediately.