Mental Health Taskforce Report

Huw Merriman Excerpts

Wednesday 13th April 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to speak under your chairmanship, Mr Wilson. I congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) on securing the debate. It was a pleasure to listen to the right hon. Member for North Norfolk (Norman Lamb) and the Minister speaking at the launch of the mental health taskforce report last month.

Since I was elected, constituents’ concerns about mental health provision have caused me to immerse myself in the issue and further my education on this most harrowing of subjects. I want to focus on concerns about early-stage treatment for young people. At Prime Minister’s questions recently, I mentioned visiting three families in one day in my constituency, each of whom had a child who they felt had not been given the early-stage intervention that they expected by child and adolescent mental health services. I asked the Prime Minister for more focus on early-stage treatment, so that young people do not find their condition becoming more acute. I work closely with my local CAMHS team, and I have the highest regard for the many excellent specialists who do their best. However, it is of concern to me that constituents face lengthy waiting times and that some have been moved from pillar to post when receiving treatment.

Building up trust is a key ingredient in successful diagnosis and treatment. I hear stories about young people finding the courage and trust to open up about their condition only to find that there is a new practitioner at the subsequent session, and it disappoints me to find that the young person has then regressed because of the change in personnel. I would like a commitment to treatment being given on a fixed one-to-one basis. If we can do that for maternity provision, surely we can do it for mental health treatment.

At the mental health taskforce launch, I was buoyed by the commitment by the Minister and the chief executive of NHS England to implement the excellent report. I pay tribute to the chief executive of Mind, Paul Farmer, and his team for the review. An aspect of it that cheered me was the commitment to funds to ensure that our non-mental health NHS hospitals have adequate mental health expertise on site to deal with those who are hospitalised as a result of mental health issues or who have such a condition in addition to a physical illness. What drove my concern about that was the experience of a family in my constituency following a suicide attempt. The NHS staff did not have the ability to deal with the mental health condition and my constituent, a young man, was forced to wait until CAMHS staff could make their way over from another town miles away. I understand the need for specialist treatment, but it strikes me that there is a need for a culture change across the NHS, and that all staff should be trained to understand mental health and provide a basic level of treatment in the area. Specialisation in health is important, but if the NHS becomes overly specialised it can lead to a lack of general involvement in care for patients in such areas.

I welcome the news that the Government will fund 24/7 mental health provision in our hospitals, but I was somewhat alarmed at the suggestion by my local trust that the funding may not stretch far enough. I also want to ensure that that specific coverage will not mean that other NHS staff with the necessary levels of technical understanding and empathy feel that they are not empowered to help the many patients in hospital who need help with their mental health care in addition to their physical wellbeing.

Getting early-stage intervention right is a key part of getting proper diagnosis for people with a mental health condition and lessening the chances of acute difficulties. It is the most important investment not only for people’s welfare and wellbeing but to enable young people to fulfil their hopes and dreams in their careers and make something for themselves and their country. We should not misdiagnose young people who are suffering growing pains, and who need families’ and friends’ coaching and guidance to overcome the problems of adolescence. However, I have met too many young children who face a difficult future because their mental health condition was not treated at an early stage. I applaud the report and the Government’s response. They are leading the charge to ensure that we can support all who are affected by this terrible condition. I look forward to a better mental health service in the years to come.

Community Pharmacies

Huw Merriman Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on introducing this important debate.

Some 28% of my constituents, across our 200 square miles of East Sussex, are over the age of 65. Losing our pharmacies would affect all my constituents, but I am particularly concerned about the impact on the elderly and vulnerable. I spoke today with a pharmacist in the village of Ticehurst in my constituency, who told me about his concerns. First, he is concerned that the Government might cut 6% from his dispensing fees. Secondly, he is concerned that they might withdraw the £2,500 that all pharmacists are paid annually. Thirdly, he is concerned that the Government might impose a clawback, meaning that if a budget is overspent, pharmacists might be required to reimburse their fees. Fourthly, he is concerned that the pharmacy will have to cover the welcome introduction of the national living wage and the cost of new pension arrangements.

I understand that it is essential for the NHS to make savings—£22 billion over this term—and it therefore seems reasonable to expect the £2.8 billion pharmacy budget to contribute to that. The Government rightly point out that many of our pharmacies are situated in walking distance clusters, but I am concerned that the proposed funding changes, if not sensibly targeted, could affect not just pharmacies in clusters but the rural pharmacy that is miles from another one and more than just a dispensing chemist. Because a pharmacist knows his or her customers, he or she is able to advise them on solutions more cost-effectively than if they were to utilise the wider NHS, including GPs and A&E.

[Mr Steve Baker (Wycombe) (Con)]

In an unscientific Twitter survey, which I kicked off at the beginning of the debate, 62% of respondents say they would prefer to see a community pharmacist first. Does my hon. Friend agree that the Government should be clear when making their funding allocation about the extent to which people would prefer to make use of community pharmacists before they see GPs?

[Huw Merriman]

Much as I prefer to disagree with everything that is said on Twitter, I could not disagree with that particular scientific survey.

[Julian Sturdy (York Outer) (Con)]

My hon. Friend is making a powerful argument about rural pharmacies. A pharmacist in my constituency contacted me. He said that, if the proposed cuts go through, he will have to cut staff and the apprentices he is training, as well as reduce opening hours and stop the free services, such as the deliveries to housebound patients. The cuts would not just stop the important services that my constituents and many others get from rural pharmacies; it would also deeply impact on skills, and on skills going back into the services that we have to protect.

[Huw Merriman]

I very much agree with my hon. Friend’s point, and I can give another two reasons why pharmacists are so important. Like the post offices, our pharmacists also act as the eyes and ears for the welfare of certain vulnerable constituents. As a staple part of our village and town centres, pharmacies provide the footfall that allows our pubs, restaurants and shops to survive in an increasingly difficult environment.

I am not a deficit denier, and it would be hypocritical to be elected on the platform of balancing the Government books by 2020 and then to refuse to countenance savings in this area. It strikes me, however, that a better focus for efficiency is not the fees for dispensing, but the volume of drugs wasted by over-dispensing. For example, some drugs may be dispensed for a period of three months, only for the individual to change a course of treatment or stop treatment altogether. As soon as those drugs leave the pharmacy, they have to be used or destroyed. I wonder exactly how much money could be saved by dispensing for shorter periods of time.

Additionally, I find it extraordinary that pharmacists deliver NHS prescriptions free of charge to all who want that service. I understand why those who cannot collect their prescriptions should get them delivered, but to provide free delivery, effectively on the NHS, appears to be an area that is ripe for efficiency savings. I welcome the Government’s proposal for a pharmacy access scheme. That would provide more NHS funds to certain pharmacies based on factors such as location and the health needs of the population. To that end, I ask the Government to distinguish and make a special case for rural pharmacies and to focus their efficiencies on those pharmacies that are within closer proximity to each other. If difficult choices are to be made, let us ensure that our constituents can still access a pharmacy within their locality.

Care Homes: England

Huw Merriman Excerpts

Wednesday 13th January 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. I thank the hon. Member for Hove (Peter Kyle), one of my constituency neighbours, for securing the debate and permitting me to consider the role that care homes play in my constituency.

Some 27,000 of my constituents are aged over 65 years. The hon. Gentleman mentioned the ResPublica article, which states that by 2050 the proportion of people in the UK aged 65-plus will have risen to 25%. In my constituency it is already at 28%, against a national and regional average of 17%. Indeed, Bexhill and Battle has the fifth highest proportion of people over 65 years old in the UK.

As a result, many of my constituents live or work in care homes. Before and since my election, I have visited many of those care homes and been hugely impressed by the levels of care and devotion afforded to that most special group of constituents. It is therefore right today to celebrate the role that care homes play in our country and to say thank you.

There is an unfortunate perception of care homes, which regular visitors such as myself try hard to dispel. Although many people feel negatively towards hospitals, they are considered to be places where improvements in outcomes are possible. The same is not often said of care homes. The perception is of a place that people move to when their lives have deteriorated and will continue to deteriorate. That perception means that the public rarely hear about the improvements in outcomes that care homes deliver, the innovative treatment that residents are afforded and the compassionate care that owners and their staff deliver to residents. I hope that we can use this debate to celebrate what care homes do for our constituents.

However, it is right to highlight some key challenges for care home providers, and I shall list two that require the support of the House and the Government. The first, which the hon. Gentleman mentioned, is local authority funding. The gap between local authority care home fees and the cost of care home places in real terms continues to grow. That has represented a drop of almost 5% for council-funded residents over the past five years. That situation could be exacerbated by the welcome announcement of the Government’s new living wage, which will give care home staff a wage of £9 an hour by 2020. I was glad to hear the hon. Gentleman celebrate that pay rise for hard-working care home staff, who, as he mentioned, have been underpaid for many years.

Many of my local care home providers have approached me with concerns that they may have to cease operating if margins continue to be squeezed. On their behalf I have lobbied Ministers to highlight the funding gap, and I am pleased that the Government have now given local authorities the right to add a 2% council tax surcharge for adult social care. In East Sussex, local authorities and the NHS are delivering our “Better Together” integrated healthcare programme. Although I continue to lobby for lower taxes for my constituents, I hope that they will embrace that new tax levy as a means to support the funding of care for our elderly community. I therefore hope that the gap will be plugged, at least in part. It will be interesting to hear the responses of my right hon. Friend the Minister to the other questions that the hon. Gentleman asked.

I would like to touch on staff recruitment. In the care home sector, the staff turnover rate is 32%, which is incredibly high. It is clear that the sector has issues in recruiting and retaining staff. Reliance on staff recruitment from abroad is very strong. I am delighted that the Government have added care home nurses to the shortage occupation list, albeit temporarily. Those who criticise net increases in immigration to the UK need to understand that our population is getting older and needs more care, which means more carers. I welcome the desire of the care home industry to win more contracts from our clinical commissioning funders, because I hope that that will make jobs in care homes more fulfilling, skilled and desirable. I also hope that it will allow us to rely less on staff coming from abroad—from countries that are underdeveloped and whose own residents may need care and assistance even more than people in this country do.

I will conclude, to allow other hon. Members to speak. I welcome the debate, and I celebrate the role that care homes play in this country. I have visited care homes where dementia sufferers are taken on incredible journeys back to their childhoods, where schoolchildren are invited in to go through their exercise books with residents, where residents play games and sing and where there is a great celebration of the rich lives that they have experienced and will continue to experience. I look forward to visiting more care homes and championing their owners, staff and residents in the years to come.

Junior Doctors Contract

Huw Merriman Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I do think that that is the primary concern of the vast majority of junior doctors, which is why I think it was wrong for the BMA to refuse even to sit down and discuss with the Government how we were going to implement a manifesto commitment. I now hope we can get past that, so I will not say any more other than that I think it is now possible to get a better agreement for the NHS, and I hope we will now be able to do that.

[Huw Merriman (Bexhill and Battle) (Con)]

Having been fortunate enough to hear both from junior doctors in my constituency and from the Secretary of State, it is clear to me that both parties are talking the same language but that the communication has not quite filtered through via the BMA. Once this matter is, I hope, resolved, will the Secretary of State think of ways in which dialogue can be improved directly between the Department of Health and junior doctors?

[Mr Hunt]

My hon. Friend is absolutely right: we have had some very unfortunate megaphone diplomacy over recent months, but I hope we can now put that behind us and that lessons will be learned. As he rightly says, we have never wanted to do anything other than what I think is good for doctors, as well as what is good for patients, and that is what the proposals were about.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 7th July 2015 Commons Chamber

[Jane Ellison]

We take the issue of childhood health extremely seriously. We want every child to have the best start in life. That is why, for example, we are bringing record numbers of health visitors into the health service and why health is now part of the troubled families programme. In my area of responsibility, public health, it is why we have taken measures on matters such as smoking that particularly affect children in deprived communities.

[Huw Merriman (Bexhill and Battle) (Con)]

On adolescent mental care, capacity in my constituency can require lengthy in-patient care to be undertaken from Roehampton in south London. A constituent of mine makes regular visits to her young daughter making work impractical, but is unable to qualify for travel assistance as she is deemed physically able to work and does not qualify for benefits. As transport reimbursement is normally available only to those eligible for out-of-work benefits, will my right hon. Friend consider recommending widening the parameters to include those who have to travel outside their area?

[Alistair Burt]

I will look at the issue my hon. Friend raises. Clearly, in the first place, we want to make sure that more beds are available more locally, so that the issue does not arise. Greater concentration is being given not only to that, but to the level of care that can be provided before in-patient treatment is considered. I will take the point he makes about benefits and raise it with the relevant Department.