Child and Adolescent Mental Health Services

Debate between Diana Johnson and Norman Lamb

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

If the diary allows I am certainly up for that, and I pay tribute to the hon. Lady for the work she has done in her county in trying to improve children’s mental health services. We must do that across the country, and there are many examples of real and significant improvements.

[Diana Johnson (Kingston upon Hull North) (Lab)]

We are discussing young people, and Natalie Carmichael has e-mailed me. She is 17, lives in Hull and suffers from anorexia nervosa, yet she had to go to Manchester—more than two and a half hours away—to access 24-hour care. She states:

“The illness itself is distressing enough…but I feel it made it ten times more traumatic the fact that I was hundreds of miles away from home and I couldn’t reach to my family for comfort and support in the tough experience I was battling.”

What does the Minister say to Natalie?

[Norman Lamb]

I find it as intolerable as she does, and that is why we are investing to improve access to beds in the locality. Indeed, we identified the hon. Lady’s region as an area where there were shortages of beds for children and young people’s mental health, and we have taken action to increase that number.

Care Homes

Debate between Diana Johnson and Norman Lamb

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

I hope that the changes will be implemented in October, but of course criminal investigations take time. The whole purpose is for the changes to act as a deterrent to stop bad things happening, but I take the view that if there is evidence that awful things have happened, the CQC must use its new powers. If it were to do so, it would send a very clear signal to the rest of the sector that this is a serious regulator that will use its powers effectively.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Because of the high turnover of staff in the adult care sector, intelligence on care staff, especially those who have committed abuse and are barred, is very important. Why has there been a 60% drop in the number of people barred from working with vulnerable adults on the basis of information from care home providers in the last three years?

[Norman Lamb]

I will investigate the figures that the hon. Lady mentions. She is right to suggest that it is important that if employers—both in the social care and health sectors—dismiss a worker for abuse of patients or residents, they refer the case to the barring scheme. If employers are not doing that, they are failing in their responsibilities. We have to protect people in such cases and I will look into the point she raises.

NHS Commissioning Board

Debate between Diana Johnson and Norman Lamb

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

I congratulate my hon. Friend on getting an issue of local concern into his question. He is entirely right: I will take no lessons from the Opposition, given what happened when they were in government, and patients’ interests must indeed always come first.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Minister tell me which part of the NHS preferred provider status, which was introduced by the last Labour Government, his Government do not understand?

[Norman Lamb]

According to my recollection, at the last general election all three parties committed themselves to any willing provider. The degree of hypocrisy that we sometimes encounter beggars belief.

Winterbourne View

Debate between Diana Johnson and Norman Lamb

Tuesday 30th October 2012 Commons Chamber

[Norman Lamb]

First, abuse is unacceptable and horrifying wherever it takes place, whether in the public sector or the private sector. The review that followed Winterbourne View being exposed revealed poor standards of care in too many places in both the public and private sectors. We need to be clear on that. Secondly, I have questioned whether there is adequate corporate accountability and whether adequate rules and regulations are in place to ensure that accountability. If people are making a profit out of providing care, they have to be held to account for the standards of that care.

[Diana Johnson (Kingston upon Hull North) (Lab)]

May I raise with the Minister my concerns about the relaxation of checks on people who work with vulnerable adults and children, as set out in the Protection of Freedoms Act 2012? As a new Minister, will he undertake to look at the specific provisions in that Act and see whether he is satisfied that our most vulnerable people are protected?

[Norman Lamb]

I am happy to discuss the matter further with the hon. Lady. It is clear, though, that when a care home provider seeks to recruit a member of staff to work with people in a care home setting, they have to—[Interruption.] They are obliged in law to carry out criminal records checks on people who work within that setting. I repeat, however, that I am happy to discuss the matter with the hon. Lady and to look again at the issues.

Social Care (Local Sufficiency) and Identification of Carers Bill

Debate between Diana Johnson and Norman Lamb

Friday 7th September 2012 Commons Chamber

[Norman Lamb]

I absolutely agree with what the hon. Lady is saying: the information, guidance and support have to be made available. That is the key point, and I do not think there is any disagreement between us on it.

However, imposing a duty on public and private bodies to identify carers could be seen by some as intrusive. This depends on how the body seeks to exercise the duty, but it will be exercised in a variety of ways and this could conceivably be intrusive for some who want to be private about their family circumstances. We know that some families in which a young person is providing care can be very wary of letting others know. It is very important that they are given all the information, guidance and support they might need, but they may be afraid that the child will be taken into care, or they may be concerned about the opinions and reactions of others, including schoolteachers; the hon. Lady herself talked about the stigma that, outrageously, sometimes attaches to young carers. Public and private sector bodies need to be aware of such sensitivities, as I believe she accepts. They need to tailor the way they act and support carers in order to be responsive to the individual needs of the child and their family. This Bill runs the risk of preventing such sensitivity and flexibility.

In many areas, work is already under way to help to identify and support carers, without there being a specific legal duty in place. For example, NHS Surrey is developing a health care pathway to trigger the identification of carers, enabling them, where appropriate, to be pointed towards information and local authority carer assessments. The key issue—this is the point we have just debated—is not about labelling people as carers; it is about raising awareness and understanding of what a caring role can entail among those working in education, health and social care. We need to equip them with the knowledge to direct people to relevant sources of information, advice and support.

GPs and those working in the NHS have a vital role to play. Last year, the Department of Health funded a range of initiatives by the Royal College of General Practitioners, Carers UK and the Carers Trust to increase awareness in primary health care of the needs of carers and how to access support. GP carers champions and voluntary carer ambassadors have been appointed and much good practice in the early recognition of carers has already been identified. We will build on that programme and are considering how it can be extended to the acute health sector and community nursing services.

Awareness is already being raised in many areas. I know that in my constituency of North Norfolk, a new service to support carers has recently been piloted at GP surgeries. The initiative was developed by the North Norfolk clinical commissioning group and is being delivered by the Norwich and District Carers Forum in 20 GP surgeries in the north of the county. Two part-time support workers are available every month at each surgery to give support to anyone in an unpaid caring role and they have been able to refer carers for a carers’ assessment to help to meet their emotional and practical needs. They have also referred carers to other agencies for support as appropriate. Those are the sort of things that the hon. Lady’s Bill seeks to encourage and I am sure that she will welcome them as they emerge around the country.

The service was designed by North Norfolk’s CCG patient partnership, which was formed to give patients at the practices in North Norfolk the chance to influence and help to design local health services. That is exactly what we should be doing—involving patients. Subject to evaluation of the pilot, it is hoped that the service will be rolled out to other GP surgeries across the county.

Let me deal with young carers, as many hon. Members have mentioned the situation that they face. Local authorities already have a duty under the Children Act 1989 to safeguard and promote the welfare of children in need in their area. The Government are funding the Children’s Society and the Carers Trust to work with local authorities and voluntary organisations to encourage children’s and adult services to work more closely together and to adopt a “whole family” approach to identifying and supporting young carers.

Young carers involved in a recent series of whole family regional conferences, facilitated by the Children’s Society, were determined that they want to be seen as just like other children and young people. At the same time, they were very clear that timely and effective support for young carers and their families can make a real difference to their lives in a range of different ways. Their views have informed the development of a template for a memorandum of understanding between directors of children’s services and adult social services published last month by the Association of Directors of Adult Social Services, the Association of Directors of Children’s Services and the Children’s Society.

Let me say a word about students, whose situation was specifically raised by the hon. Lady and others. For students at university who are also carers, colleges and universities often have systems in place to identify specific needs through student unions and personal tutors. They provide a range of services, including the flexible provision of further and higher education, which can be very important in ensuring that students are not held in a straitjacket, and enabling learning on a part-time or distance learning basis, with students able to choose the best mode of study for them.

The Department has also has funded the National Institute of Adult Continuing Education to undertake a project to improve the lives of young adult carers and young adult carers with learning disabilities and, in particular, to support them in pursuing education and employment opportunities.

[Diana Johnson]

To return to the point about universities, can the Minister tell us how many have mechanisms in place to assist students with caring responsibilities?

[Norman Lamb]

I am grateful for that intervention. I do not have a specific figure but I am sure that the position varies around the country, with some universities being exemplars of good practice and others not. We must do everything we can. This debate is about whether to impose a specific legal duty or to use other, softer means, but I think we are agreed on the ambition that we must ensure that students with caring responsibilities get access to help and support through the institution where they are learning. We are completely agreed on that.

NIACE has produced the “Really Useful Book of Learning and Earning for Young Adult Carers”—RUBLE—that they can use to plan their time and plan ahead both in respect of their caring responsibilities and in pursuing education and employment opportunities. It also provides information about budgeting and money management. Young adult carers often manage finances on behalf of the whole family, which can be an incredibly onerous responsibility.

The national institute has also produced a resource pack for further education colleges about ways in which they can support young adult carers to engage effectively in learning. That has positive outcomes for young adult carers because it enables colleges and other support services to work together to ensure that the individual carer’s needs are met and that they do not fall through the gap in services at important times, such as the move from school to college, because those transitions are often the most difficult. The national institute is building on that work with the Carers Trust and Barnardo’s, especially so that its excellent resources are disseminated more widely.

One young adult carer who has used RUBLE said:

“The RUBLE has helped me to feel positive about myself. Last year I was really depressed. The RUBLE has reminded me that caring for my mum is really important. It’s also helped me to realise I have lots of positive attributes. I feel good about myself, what I do and my future. The RUBLE has improved my relationship with my mum and helped me to ask for help. Now I know what I’m doing and have plans for the future.”

Those are powerful words.

Some colleges, of course, are already supportive of young adult carers. For example, Loughborough has a transition mentor who engages with young adult carers, their families and staff to provide support that is tailored to individuals’ needs. Such support includes flexible timetabling and allowing the carers to keep their mobile phones switched on during classes so that they can keep in touch with what is happening at home. Although legislating to place a requirement on further and higher education establishments is seductive in many ways, it might override such emerging welcome, impressive and flexible arrangements.