Wednesday 3rd June 2015

(8 years, 11 months ago)

Lords Chamber
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Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (LD)
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My Lords, let me start on a positive note. I was delighted that the gracious Speech, for the first time ever, I believe, contained a specific commitment to improving the plight of people with mental health problems. This demonstrates how much attitudes to mental health are changing. It is hardly a niche issue if you consider that one in four people in the UK is affected by mental health conditions, so pretty much every family in the land is touched by the problem. The commitments in the Conservative Party manifesto and the gracious Speech build on the ground-breaking work undertaken by Liberal Democrat Ministers in the coalition Government. I particularly pay tribute to the great work instigated by Paul Burstow and driven forward with such passion and commitment by my right honourable friend Norman Lamb.

Real strides were taken in the last Parliament by enshrining parity of esteem for physical and mental health services in legislation, and then starting to make a reality of it by the introduction of new waiting time and access standards for mental health services, crucially backed up by an injection of much-needed cash. We finally saw a real recognition of the links between physical and mental health issues.

Much more must be done to ensure that the historic underfunding of both adult and children’s mental health services is properly addressed. The Conservative manifesto commits to increasing spending on the NHS by at least £8 billion by 2020, although as other noble Lords have already said, it is far from clear where that money is coming from. The Government have also committed to take mental health as seriously as physical health and to increase funding for mental health care, which is very welcome. The big question for me is how much of this £8 billion will be spent on mental health services. In our manifesto, the Liberal Democrats pledged a total of £3.5 billion additional funding over the Parliament, covering both children’s and adult mental health services.

Can the Minister say what figures the Government will be committing to mental health over the lifetime of this Parliament? What proportions of that money will be spent on the commitments in the Conservative manifesto to ensuring that there are therapists in every part of the country, that new access and waiting times standards are enforced, and that women have access to mental health support during and after pregnancy? Of course, once the money is secured, we need to ensure that there is strong political and managerial will to make these things happen. Can the Minister confirm that in the next version of the NHS mandate, there will be a clear commitment from NHS England to publishing a comprehensive timetable for the introduction of new access standards and maximum waiting times across all mental health services?

It is noticeable that there was no mention of the pressing needs of people from black and minority ethnic communities, who have for too long been poorly served by mental health services, being both more likely to be diagnosed with mental health conditions and less likely to be able to access appropriate services and therapies. Will the Minister say what plans the Government have to address this wholly unacceptable state of affairs?

As a country, we must do better to support the one in 10 children and young people who have a mental health problem. Half of those people who go on to have lifetime mental health problems first experience symptoms by the age of 14, and 75% of children and young people experiencing a mental health problem do not access treatment. The consequences of failing to support these children and young people are profound.

Schools have a golden opportunity to protect and promote children’s mental health and at the same time help children attain good educational outcomes. So it is vital that the Department of Health works hand in glove with the Department for Education to promote good mental and emotional health and, in particular, to ensure that all schools offer good resilience and well-being education.

It is widely acknowledged that children’s mental health services have been seriously neglected and starved of cash in recent times. The Children and Young People’s Mental Health and Wellbeing Taskforce Report, Future in Mind, published in March by the Department of Health and NHS England, was an excellent piece of work with strong cross-party and sector support. It would be a travesty if it ended up gathering dust on shelves. It contains important recommendations on access and waiting time standards, on lead commissioning arrangements and on expanding IAPT services for children and young people, among many others. Will the Minister restate the commitment made in the March 2015 Budget to increase investment in mental health services for children and young mothers by £1.25 billion over the lifetime of the Parliament and make a firm commitment to respond to the task force recommendations?

It is totally unacceptable that hundreds of children experiencing a mental health crisis are held in police stations, and I therefore welcome the announcement in the gracious Speech that police cells will be eliminated as places of safety for children. This is long overdue. However, a change in the law alone is not enough. The current excessive use of police cells as places of safety is mainly the result of operational and commissioning failures, which lead to crisis care services for children being poorly developed in comparison to those for adults. It is vital that clinical commissioning groups prioritise investment in this area.

Finally, I strongly welcome measures outlined in the gracious Speech to expand access to early education and childcare, as they have the potential to improve child development and promote social mobility. I say “potential”, because it is vital that childcare and early years provision is of a high standard and that quality is maintained and improved, particularly to help children from disadvantaged backgrounds. That policy objective is as important as making it easier for parents to work. Both are critical, but sometimes those two objectives pull in opposite directions. The proposed extension of provision for 30 hours’ free childcare, while very welcome, raises many questions. I have no doubt that other noble Lords will raise those questions in their contributions, but I want particularly to ask whether additional help will be offered to disadvantaged parents, as recommended by the Lords Select Committee on Affordable Childcare, of which I had the privilege to be a member, or whether it will be a flat-rate scheme which, in effect, favours the better off. I look forward to hearing the answers to these and the other questions I have posed.