Defending Public Services
James Morris Excerpts(8 years, 2 months ago)
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Mr Hunt
It is a pleasure to sit on the Treasury Bench with my hon. Friend the Minister for Culture and the Digital Economy for the first time in several years. I will leave him to respond to that point, but I will make a broader point in response to the question from my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) which is that the change we need to make in the NHS is to prevention rather than cure. If we can stop people becoming addicted in the first place, whether to drugs, alcohol or gambling, we will reduce costs for the NHS in the long term. That is the purpose of many of our plans.
Thirdly, a seven-day NHS requires a big improvement in access to 24/7 mental health crisis care, so that whenever a problem arises we are there promptly for some of our most vulnerable people. We will deliver that alongside our broader plans to enable 1 million more people with mental health problems to access support each year by 2020.
James Morris (Halesowen and Rowley Regis) (Con)
May I commend the Government for accepting the majority of the recommendations from the independent mental health taskforce and allocating £1 billion to implement them? The Secretary of State has been talking about system change within the NHS. To deliver on the taskforce’s recommendations, we need system change to make sure that we have the sort of mental health services that the people of this country deserve.
Mr Hunt
My hon. Friend speaks with great knowledge and as chairman of the all-party group on mental health. He is absolutely right to say that we need system change. The system change we need is to stop putting mental health in a silo, but instead to understand that it needs to be part of the whole picture of treatment when a person is in hospital or with their GP; it needs to be integrated with people’s physical health needs. We need to look at the whole person. We will not get all the way there in this Parliament, but I think the taskforce gives us a good and healthy ambition for this Parliament and I am confident we will realise it.
Mental Health Taskforce Report
James Morris Excerpts(8 years, 3 months ago)
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James Morris (Halesowen and Rowley Regis) (Con)
I beg to move,
That this House has considered the report from the independent mental health taskforce to the NHS in England.
It is a pleasure to serve under your chairmanship, Mr Wilson. This is a very important debate on the “Five Year Forward View for Mental Health” report, published in February. I pay tribute to the chair of the taskforce, Paul Farmer, who is the chief executive of the mental health charity Mind, and the vice-chair, Jacqui Dyer, for all their work. I also thank all the other members of the taskforce and the people throughout the country who contributed to its work. It is an excellent study that contains more than 50 concrete recommendations about how we need to go about improving mental healthcare in our country.
The report represents an historic opportunity. There are three reasons why I believe it is pivotal to the whole history of our approach to mental healthcare in Britain. First, both the public debate in Britain about mental health and our social attitudes towards it have been transformed over the past 10 years. The quality of the debate in Parliament, the media and the public square is at a completely different level from where it was for many years. We are addressing issues of stigma and are open to discussing mental health problems in society.
Secondly, there is a general recognition in the Government and across parties that for too long, mental health care has been underfunded in the national health service. There is now a mature debate about how we should fund mental health services over the next decade.
Thirdly, I strongly believe that, as a result of the work of many people from all political parties over a long period of time, mental health is now at the top of the list of public policy priorities. We now have the political will, which is manifested in the Minister himself, who is absolutely committed to delivering on the plan formulated by the independent taskforce. Those are the reasons why I believe the report represents an historic opportunity.
The report provides a route map for change so that we can give hope to those throughout the country who are currently suffering from mental health problems and who may not be getting, or feel that they are getting, the level of service that they should from the NHS. I shall concentrate on the implementation issues highlighted in the report. There have been many reports over the past 20 years, and many strategies have been determined by Governments of both main political parties. I think we would all agree that over that period we have not made sufficient or fast enough progress, given that mental health issues are becoming more visible in society and given the prevalence of the mental health issues we are seeing across the age range and across the social and economic landscape of the country. There is a real urgency that we get this right, and now.
What do we need to do to drive the change that we all want to see in the quality and availability of mental health care in Britain today? The report focuses on four areas that are critical to implementation—commissioning; the importance of research and data; the incentives, levers and payments for services in today’s NHS; and leadership in the NHS and across Government. The truth is that, to achieve our goal of transforming mental health services in Britain, we need urgent action in all four areas.
The report is clear about the challenge we currently face on commissioning. It states:
“The quality of local mental health commissioning is variable. We found a twofold difference in apparent per-capita spend by CCGs, a more than threefold difference in excess premature mortality in people with mental health problems in England and a fourfold variation in mortality across local authorities.”
The reality is that we need better and more effective commissioning at a local level.
The report discusses the model of commissioning set out by the “Future in mind” taskforce, which looked into child and adolescent mental health services and came up with recommendations for improving commissioning. Those recommendations, which are picked up in the “Five Year Forward View” report, speak to the need to improve commissioning across mental health services and across the age range.
Rehman Chishti (Gillingham and Rainham) (Con)
I pay tribute to my hon. Friend for securing this debate and for all he has done for mental health in his time in Parliament. He has been an absolute champion of it. Does he share my concern, which is shared by the Royal College of Psychiatrists, that there is currently no proper accountability for local clinical commissioning groups? The Bill on accountability in commissioning that I presented to Parliament last year would have required every CCG in the country to report back to the Secretary of State every year on the resources and spend in the local area. That way we would know exactly what was going on and could ensure parity of esteem in resources and allocation.
James Morris
My hon. Friend makes a very important point. He is right, and I will come to the need for greater accountability later in my speech.
On commissioning, the “Five Year Forward View” report states:
“The transformation we envisage will take a number of years and without clear information about what the best care pathways look like and good data on current levels of spending, access, quality and outcomes, it will be hard to assess the impact of organisational change and ensure mental health services are not disadvantaged.”
Its very first recommendation is:
“NHS England should continue to work with Health Education England…Public Health England…Government and other key partners to resource and implement Future in Mind, building on the 2015/16 Local Transformation Plans”—
which I know are in the process of being implemented—
“and going further to drive system-wide transformation of the local offer to children and young people so that we secure measurable improvements in their mental health within the next four years.”
I dwell on those recommendations because—this speaks to my hon. Friend’s point—we need more transparency on what clinical commissioning groups are spending and where. The report is clear that there is currently simply too much variability across the country. I have long been an advocate of the importance of local, decentralised decision making. It is important that clinical commissioning groups have the freedom to commission services that they think are appropriate to their local population. The report is clear that we need a more consistent approach on mental health services that focuses on collaboration and more integrated commissioning across the spectrum.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
Will my hon. Friend reflect, in the context of the devolved settlement for services, on the importance of substance misuse services and on the impact that the fragmentation of those services away from other mental health services may have had on patient care?
James Morris
My hon. Friend makes a powerful point. We need to deal with some of the issues to do with fragmentation in the system—he refers to substance misuse. The thrust of the recommendations in the report is about making sure we have a more integrated approach to commissioning mental health services across the piece.
The second important facet of the implementation challenges that the report throws up is research into mental health services. It mentions the need to have a proper, coherent 10-year plan for research into mental health to fill what are, as many of us would agree, big gaps in the evidence base.
Norman Lamb (North Norfolk) (LD)
I congratulate the hon. Gentleman on securing the debate. Does he share my horror at the fact that the Medical Research Council spent 3% of its budget on mental health research in 2014-15? That bears no relation to the degree of disease burden in our country, yet it chose to spend just that much on research.
James Morris
I thank the right hon. Gentleman for that intervention and pay tribute to him for all the work that he has done, particularly when he was Minister with responsibility for this area. I agree that we need to spend much more on mental health research, and we need to know what we want to research. For example, there is much talk about the power of peer support in mental health. There is an assumption that it is a good thing and that it works, but we do not have a particularly rich evidence base about whether it does.
On the efficacy of certain psychotherapies, the evidence base shows that cognitive behavioural therapy can be effective for people with mild depression and anxiety, but we do not really know about the effectiveness of other psychotherapies that we may want to promote and develop in the national health service. We clearly do not know very much about a lot of emerging areas that have an impact on mental health. For example, using technology and mobile phone and other apps to help people with mental health problems is a big emerging area, but we do not know much about its effectiveness. We certainly do not know in any coherent sense about the implications of genomic medicine on mental health care. A coherent strategy on mental health research is required over the next decade so that we can extend and expand the evidence base, because the truth is that we are often flying blind.
Oliver Colvile (Plymouth, Sutton and Devonport) (Con)
I congratulate my hon. Friend on securing the debate. It is a pleasure to serve under your chairmanship, Mr Wilson.
Does my hon. Friend recognise that one of the key issues in constituencies such as mine, which is a low-wage, low-skill economy, is tackling depression? That is helping us get everybody into work. If we want growth, it is important that we deal with people who suffer from depression, which is, of course, another mental health problem.
James Morris
My hon. Friend is absolutely right. We need to support people with depression back into work. The report makes a number of recommendations, which he may be aware of, on the use of strategies such as individual placement and support to get people with mental health problems back into work.
The report also talks a lot about data, which underpin our decisions about where we should focus our efforts on mental health. It refers to a “black hole” of data and calls for a “transparency revolution” in mental health. As I said earlier, for a long time—probably 20 years or more—we have not been collecting sufficiently robust data about what is actually going on in mental health services. We need better data on what is going on to have a firm basis on which to understand what is working, what is not working and what is going on at local and national level. Recommendation 50 in the report—this pertains to what my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) said about accountability—is at the heart of the implementation challenges that we face. It states:
“The Department of Health and NHS England should require CCGs to publish data on levels of mental health spend in their Annual Report and Accounts, by condition and per capita, including for children and Adolescent Mental Health Services, from 2017/18 onwards. They should require CCGs to report on investment in mental health to demonstrate the commitment that commissioners must continue to increase investment in mental health services each year at a level which at least matches their overall allocation”
of funding. That goes to the heart of our data challenge.
For too long, mental health services have not been properly resourced because we do not have an effective data set on what is actually happening in the NHS or, as the report highlights, an effective model in the NHS for paying for mental health services. They tend to be commissioned on what is called a block contract basis, which often has the effect of focusing on the delivery of a low-cost service, rather than on quality outcomes. We certainly do not have a model of care that focuses on an individual care pathway or a cure for an individual patient.
We need a different model of payment for mental health services in the NHS that focuses on quality and outcomes and reflects our aspiration, which is written into the NHS’s operating mandate, for parity of esteem—the integration of physical and mental health. How can we express that aspiration? To give an example, if I suffer from diabetes and a serious mental health problem, my treatment in the national health service is effectively split in two: there is a physical health pathway, which is paid for in one way, and a mental health pathway, which is paid for in another way. I believe that we need to move towards a payment-by-activity model in the NHS that does not discriminate between physical and mental health. That will certainly not happen overnight, but the report goes some way towards arguing for it in recommendation 47, which states:
“NHS England and NHS Improvement should together lead on costing, developing and introducing a revised payment system by 2017/18 to drive the whole system to improve outcomes”.
Heidi Allen (South Cambridgeshire) (Con)
Does my hon. Friend think it is right that we have a separate payment model for mental health, or should physical and mental health be treated together? Separating them could cause the very division that we are trying to lose.
James Morris
That is precisely what I am arguing for. Over time, we need to move to a model that does not discriminate between mental and physical health, with integrated payment reflecting the fact that there are a lot of conditions and a lot of comorbidity. Getting the payment system right in the NHS is fundamental to everything about the aspiration for parity of esteem. “Parity of esteem” is an interesting set of words, which can be interpreted to mean that we want a culture change or a system change—all of which is right—but to achieve it we need to change the payment model for how services are commissioned and purchased in the NHS.
Rehman Chishti
I agree with the model that my hon. Friend is proposing. From my discussions with the Royal College of Psychiatrists, which has backed a Bill on accountability, I believe that such a model would achieve a more holistic approach for patients, which can only be a good thing for outcomes.
James Morris
Again, my hon. Friend is absolutely right. The model contained in recommendation 47 and discussed in the report should drive the achievement of parity by moving towards an integrated tariff or pricing model. A lot of detailed work needs to be done to achieve that—I am not saying it is something that the Minister will be able to implement in the next week—but it goes, fundamentally, to the transformation argument that is at the centre of the report.
Perhaps most importantly, the report talks about the importance of, and absolute need for, strong leadership in the NHS and across Government to drive the change and to make things happen. This is not only about the NHS, but about the whole of Government; it is about putting mental health at the heart of our thinking in many different areas. We need a cross-Government approach, with a strong grip at the centre. I say that despite being someone who believes in devolution, because in mental health policy we have reached the stage of consensus, with much agreement about what needs to be done, but we need political will and a grip at the centre of Government to make things happen. The truth is that the existing system needs to be challenged. We need a culture of challenge—if we say that we are allocating money to mental health, why is it not being spent? Why is it not delivering the outcomes that we need?
As the report highlights, successful implementation is about not only co-ordinating our healthcare response but what we need to do on mental health in education, criminal justice and, as my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) said, back to work programmes in the Home Office. Everything should be working together to achieve the goal of supporting the five-year transformation plan for mental health.
The last recommendation of the report, recommendation 58, might sound somewhat technical and bureaucratic, being a little obsessed with governance, but it is fundamental. It states:
“By no later than Summer 2016, NHS England, the Department of Health and the Cabinet Office should confirm what governance arrangements will be put in place to support the delivery of this strategy.”
That process of ensuring that the recommendations are followed through, that there is a performance and accountability framework, and that change is driven from the centre strikes me as fundamental.
The implementation challenges highlighted in the report are substantial and require action on multiple fronts. As I said earlier, the Minister has shown absolute commitment to addressing many of them. Will he give us an update on what progress has been made in the four areas that I have described today, namely commissioning, data and research, new payment mechanisms in the NHS and leadership in the NHS and across Government?
Getting this right is an historic opportunity. As I said at the beginning, to some degree the stars are aligned: we have a high-quality public debate; much more openness about mental health and its discussion; a mature debate on how we fund mental health; and political commitment at the highest level of Government, with the Prime Minister having made several speeches on and commitments about mental health in the past few months. We have the opportunity to drive forward what a 21st-century mental health care system should look like and make it deliver for all the people out there who need care and support. They are relying on the opportunity being realised and on us getting it right.
Several hon. Members rose—
James Morris
I thank all right hon. and hon. Members for taking part in this debate. We have got to the stage of knowing where the problem is and what the solutions are. We need the will in Government and across Parliament to make them happen. We owe that to all the people out there who are relying on us to get this right and I think the stars are aligned to make it happen. Let us get it right.
Question put and agreed to.
Resolved,
That this House has considered the report from the independent mental health taskforce ta the NHS in England.
Mental Health Taskforce
James Morris Excerpts(8 years, 5 months ago)
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Alistair Burt
I thank the hon. Lady for her interest and her considerable knowledge of these issues, which she has raised a number of times.
There are two things to say. First, on expenditure on children and young people’s mental health services, £1.25 billion will be spent over the next five years to improve the baseline for child and adolescent mental health services, including early prevention. I would also mention the full roll-out of IAPT—improving access to psychological therapies—services for children by 2018. That is already in place for, I think, 70% of the country, and it will be completed by 2018. It is a way of ensuring that children have early access to the psychological therapies that they need. That is an important development, which I hope the hon. Lady welcomes.
James Morris (Halesowen and Rowley Regis) (Con)
As chairman of the all-party parliamentary group on mental health, I very much welcome the report, as Members in all parts of the House should. There is a high-quality public debate about mental health, in which we are addressing stigma, and the Prime Minister has made two speeches in the past three weeks about mental health, setting out the Government’s priorities. Does the Minister agree that there is a unique opportunity for him and the Government to drive forward real, quality change in mental health?
Alistair Burt
I pay tribute to my hon. Friend for the work that he has done as chair of the all-party group, and indeed to all colleagues in the House who have raised these issues over a period of time and, partly as a result of their personal experiences and their bravery in talking about them, have helped in the process in which we are engaged.
Yes, we have a great opportunity. The taskforce has set out a 10-year vision, and there is a commitment from the NHS. At the top level, in all parts of the House, there is a commitment to the issue, and I hope that we will have an opportunity to develop the services that people want and for which, in all honesty, they have waited too long.
Access to Medical Treatments (Innovation) Bill
James Morris Excerpts(8 years, 5 months ago)
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George Freeman
I shall deal with amendments 8 and 9, tabled by the hon. Member for Lewisham East (Heidi Alexander), and amendment 15, which I tabled on behalf of the Government. I shall also deal with some of the important points that Members have raised.
I have to say that I am not here every Friday, but I think that today’s debate is setting a high standard, both in terms of the issues that are being raised and the way in which it is being conducted. I hope that those who take a close interest in the Bill and are watching the debate are observing the cross-party nature of our discussion of some very important issues.
I thank the hon. Member for Lewisham East for her support for the spirit of cross-party working. The sector needs to be confident in the knowledge that the House is paying close attention to the issues that underlie the Bill—issues relating to data, informatics, genomics, drug trials and research—in a cross-party spirit. As the hon. Lady knows, in the course of my work I have paid tribute to the last Labour Government’s pioneers, Lord Drayson and David Sainsbury, who did so much to create the Office for Life Sciences. I think the debate reflects that spirit, and I welcome the hon. Lady’s restatement of her support for it.
I also welcome amendments 8 and 9, which specify and flag the importance of a wide group of consultees. I entirely agree with the principle of the amendments. Indeed, I would go further and include a range of patients’ groups, charities and others. I give the hon. Lady—and the House—a commitment, which I am happy to put in writing, that I will seek to involve all the organisations on her list, and indeed others, in the consultation that will take place following the Bill’s enactment.
As an experienced parliamentary operator, the hon. Lady knows that including lists of organisations in a Bill is always a mistake, because in the end it creates more problems than it seeks to resolve. However, I will happily write to all the bodies that she has mentioned, and to all Members as well, with a list of those who I think should be involved in the consultation.
James Morris (Halesowen and Rowley Regis) (Con)
I know that the Bill is specifically about access to medical treatments, but, as chair of the all-party parliamentary group on mental health, I know that there is a growing need for the ability to share information about both drug-based and non-drug-based interventions in mental health care. Has any consideration been given to the sharing of information about mental health care in particular, and how would that fit into the framework of the Bill?
George Freeman
My hon. Friend has made a typically interesting and important point. I pay tribute to his work on mental health.
In no area of pharmacology and pharmaceuticals is drug discovery, drug use and prescribing more complex than in mental health. One of the projects on which I worked before entering the House was at the Institute of Psychiatry at King’s College London, where Professor Simon Lovestone has pioneered the use of informatics and data to integrate research into mental health conditions and the compiling of patient records information, MRI scans and, latterly, genomic information, to assist understanding of both the causes of disease and the way in which different patients respond to different drugs. As my hon. Friend will know, mental health care involves a wide range of very complex and, in some cases, very powerful drugs, and information about how those drugs work and how different patients respond is therefore crucial. I certainly want to ensure that we do not exclude mental health from the Bill’s provisions.
I tabled amendment 15 in connection with clinical research, an issue that received much attention during the Bill’s earlier stages. When—before these amendments were tabled—the Bill made provision for medical negligence, the Government were determined to ensure that none of its provisions would in any way undermine the United Kingdom’s world-class and world-rated landscape for the regulation of clinical trials. So the previous Bill contained a provision stating that nothing in it applied to clinical research. Now that my hon. Friend the Member for Daventry (Chris Heaton-Harris) has tabled amendments to remove the clauses dealing with medical negligence so as to create instead a Bill focused purely on the provision of data on innovative medicines to clinicians, I suggest that we remove that exclusion of clinical research and make sure that the database—now that it has nothing to do with negligence—actually covers drugs in research. That would make sure that we do not preclude the inclusion of drugs in clinical trials that clinicians may want to recommend to their patients or investigate their patients’ eligibility for.
Mental Health
James Morris Excerpts(8 years, 7 months ago)
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Luciana Berger
The Labour Government created the services in the first place. In order to introduce a waiting time standard those services have to exist, which was not the case previously. We had to address the chronic underfunding of mental health that existed pre-1997, and we introduced the improving access to psychological therapies programme, of which we are incredibly proud. As things develop, it is right that those waiting time standards come forward. The Labour party had waiting time standards in place for all consultant-led services, which included physical and mental health. I am proud of that fact but disappointed that in too many cases the same equality is not also applied to mental health. If the Government are serious about fair access to cost-effective mental health treatment, they must address that fundamental disparity. That is why we are calling on the Government to commit to ensuring that all patients, regardless of whether they need a drug, a physical health treatment or a psychological therapy, have the same rights.
Luciana Berger
I hope the hon. Gentleman will forgive me but I will make some progress as I am conscious of time.
Ensuring that people have access to help early on is critical to preventing people from becoming ill, but in recent years, short-sighted cuts to key prevention, early intervention, and community services have been having a devastating impact. When the number of children with a mental health problem who turn up at A and E has doubled in recent years, when one person in prison takes their own life every four days, when a young person who is self-harming is told that because they are not suicidal they do not meet the threshold for help, and when a woman with an eating disorder is turned away from specialist services because her body mass index is not low enough, it is clear that people are not getting the right help early enough.
Too often, mental health problems are ignored, and it is only when they reach crisis point that they receive attention. More and more I hear from mental health professionals across the country that their middle-tier community services, psychologists and counsellors are being stripped out. Apart from the obvious devastating human cost, which impacts on people’s ability to hold down a job, keep a tenancy, pay the mortgage and maintain relationships with partners, friends and family, those decisions will cost our NHS and local authorities more as they struggle to deal with the consequences of serious ill health that could have been prevented. That cost is not insignificant. Recent studies have put the cost of mental ill health to our society at a staggering £105 billion a year. How can the Secretary of State and this Tory Government justify that? Ensuring that people can access support when they need it is an urgent priority, but if we are to ensure that our services are sustainable into the future, we must do much more to prevent people from becoming ill in the first place.
The right hon. Member for North Norfolk (Norman Lamb) mentioned perinatal mental health problems, which affect up to 20% of women at some point during pregnancy and/or the year after the birth of their baby. Left untreated, perinatal mental health problems cost our economy £8 billion a year. Is it not appalling that even if those women seek help, they are not always guaranteed the specialist support they need? The number of mother and baby units has dropped since 2010. The Government’s pledge to spend £15 million on perinatal mental health this year was welcome, but as of this month— according to an answer I received to a parliamentary question—the Government have spent just one fifteenth of what they promised. That is a bitter disappointment because intervening early in perinatal mental health does not just help to improve the health and wellbeing of the mothers affected, but it also improves that of their children.
James Morris
May I take the hon. Lady back to her point about the IAPT programme that was introduced by the previous Labour Government and is an illustration of where both parties have delivered success? It may be good to enshrine psychological therapies in the NHS constitution, but we need to build more capacity in the system to deliver on access standards. This is not something that we can just write into the constitution; we need to increase choice and access to psychological therapies across the country.
Luciana Berger
I do not think it is an either/or situation; it is about how we do both, and I will come on to that in the rest of my remarks.
We know that 75% of people who have mental health problems in working life first experienced symptoms in childhood or adolescence, yet only about 6% of the mental health budget is spent on child and adolescent mental health services. We need to do more to focus attention on children, young people and, crucially, prevention, and here we must look to our places of learning, our workplaces and our communities. We need schools and colleges that promote good mental health. We need to ensure that all children have access to high-quality social and emotional learning so that they acquire the skills to express how they feel and develop an understanding and awareness of good mental health. We were concerned to read the 2013 Ofsted report on personal, social, health and economic education, which stated that mental health education was often omitted from the curriculum owing to a lack of teacher training. The Government have funded the PSHE Association to publish guidance and lesson plans to support teaching about mental health, but how are the Government ensuring that schools are actually using it?
We need communities that promote good health and wellbeing. Poor housing, fuel poverty and neighbourhood factors, such as overcrowding, feeling unsafe and a lack of access to community facilities, can have a harmful impact on mental health. These, along with abuse, bullying, trauma, deprivation and isolation, are just some of the levers of mental distress in our communities that we must address.
Mr Hunt
I accept that we need to improve the provision of mental health services for children, but I do not accept the hon. Lady’s characterisation. She will know that in the final Budget before the general election, the previous coalition Government committed £1.25 billion over this Parliament to improving child mental health provision and perinatal mental health support. That has been honoured by this Government, and we are in the process of working out how to roll that out. It is something that the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), spends a lot of time thinking about.
Before we discuss precisely what things need to happen—I think they should be done in a bipartisan spirit—we should recognise that really important progress has been made in recent years. I want to start with some of the achievements made by the previous Labour Government, who increased funding for the NHS and, within that, for mental health services. They oversaw a significant expansion of the mental health workforce and big improvements in in-patient care, with 70% of mental health patients being seen in private rooms. They increased the use of new drugs and therapies, including psychotherapy. Those were important steps forward.
Under the coalition Government in the previous Parliament, we saw a record investment of £11.7 billion in mental health services at a time of huge pressure on public finances. We passed the parity of esteem clause in the Health and Social Care Act 2012, something we Conservative Members are incredibly proud of. The first access targets were set for talking therapies for psychosis. We are starting to end the distortion that the right hon. Member for North Norfolk talked about, which saw targets for physical health access sucking resources away from local mental health provision over a sustained period.
We have seen particular progress in two areas. It is important to mention them; it provides encouragement that when we decide to focus on improving specific areas of mental health provision, we can make real progress. First, on talking therapies, the NHS is now recognised as a world leader. The number of people getting help from talking therapies quadrupled from 182,000 people starting treatment in 2009-10, to 800,000 starting treatment last year. The total number of people helped in the previous Parliament was 3 million, compared with just 226,000 people helped in the Parliament before that—a thirteenfold increase.
We are hitting the new access target to reach 15% of those needing it, although we are not quite hitting the recovery target; I hope we can put that right soon. That model is being looked at very closely by Scandinavian countries, and a pilot, based on what we have done here, is starting in Stockholm. We can be very proud of that important progress.
The last Parliament saw a 50% increase in dementia diagnosis rates, up from 41% at the start of the Parliament to 67% at the end of the Parliament—the highest dementia diagnosis rate in the world. We have 1.3 million dementia friends and 120 dementia-friendly communities. We have seen a doubling in funding for dementia research, with a new ambition to find a cure or disease-modifying therapy by 2025. In the spending round, the Prime Minister announced funding for a new dementia research institute; that will be another important step forward.
James Morris
The Secretary of State talks about the amount of money put into dementia research for very good reasons, but is there not a strong argument for building a research and evidence base around mental health? We need a commensurate investment in research on mental health, so that we can understand more about prevalence.
Mr Hunt
My hon. Friend is absolutely right, and I commend him for the work he does on the all-party group. The truth is that it is still early days when it comes to a proper understanding of mental illness. According to the latest Times Higher Education league table, this country has five of the top 10 health research universities worldwide, so we have a huge contribution to make to that research; he is absolutely right to make that point.
James Morris (Halesowen and Rowley Regis) (Con)
It is important to reflect on whom this debate is about. It is about the thousands of people across the country who may have woken up this morning feeling that they might not be able to get through the day. It is for the young boy, perhaps aged 14, feeling confused and depressed at school and not knowing where to get help, and the young girl prepared to starve herself potentially to death because of issues to do with body image. This debate is for the middle-aged man of 40 who may be contemplating suicide because of a sense of a loss of his identity. It is about the older person, perhaps the 75-year-old woman who has just suffered a bereavement and feels isolated and depressed, not knowing where to go for help. Those are the people whom we are speaking about today.
In my role as the chair of the all-party parliamentary group on mental health, I am aware that the public debate about mental health has changed radically over the past decade. Celebrities and Members of Parliament talk about their mental health. That has created a unique context in which we can talk about mental health policy. This Government have an historic opportunity to make a genuine difference to the direction of mental health policy in Britain.
As part of the £14 billion that we spend on mental health services in Britain, it makes sense to move resources to tackle the issue at its source, whether through the Government’s commitment in respect of perinatal mental health, or by radically transforming our child and adolescent mental health services so that we get rid of the tiering system that is more suited to the commissioners than to service users. We need radical change in that area. We need a crisis care system in which, if an individual rings up and says, “I am having a crisis”, they get compassionate help. Overall, we need a vision for mental health policy that achieves a situation in which talking about mental health—about an individual’s mind and their place in their family and in their community—is thought to be entirely normal in society. We have that opportunity and we as a Government need to take it.
Health and Social Care
James Morris Excerpts(9 years, 1 month ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
It is an honour to speak about health and social care in our debates on the Gracious Speech, because nothing matters more to this Government than providing security for all of us at every stage of our life, and nothing is more critical to achieving that than our NHS.
I start by welcoming the right hon. Member for Leigh (Andy Burnham) and his colleagues back to their positions. I will not take it personally that two of them want to break from debating with me to go elsewhere. However, it is a topsy-turvy world when the shadow Health Secretary who was the scourge of private sector involvement in the NHS now wants to be the entrepreneurs’ champion. As one entrepreneur to another, may I put our differences to one side and on behalf of the whole Conservative party wish him every success in his left-wing leadership bid? This is perhaps the only occasion in history when my party’s interests and those of Len McCluskey are totally aligned.
That is not to mention the hon. Member for Leicester West (Liz Kendall), who is, in her own way, a kind of insurgent entrepreneur, taking on the might of the Labour establishment, in the mould of Richard Branson or Anita Roddick. Sadly, I fear that she will demonstrate that pro-business, reform-minded, centre-ground policies are as crushed inside today’s Labour party as they would have been in the country if Labour had won the election.
The shadow Health Secretary said countless times during the election campaign that the NHS would be on the ballot paper. He was right—the NHS was indeed the top issue on voters’ minds—but not with the result he had intended. So, just as he has now done significant U-turns on Labour’s EU referendum policy, economic policy and welfare policies, I gently encourage him to do one on Labour’s health policies too.
The Queen’s Speech committed the Government to the NHS’s Five Year Forward View and the £8 billion that the NHS says it needs to fund it. The shadow Health Secretary refused to put such a commitment in Labour’s manifesto, and I hope today he will change that policy so that we can have cross-party consensus on this important blueprint for the NHS.
James Morris (Halesowen and Rowley Regis) (Con)
Does the Secretary of State agree that one of the biggest challenges we face is to achieve parity of esteem between mental health and physical health in the NHS, and that the way to achieve that parity is by ensuring that mental health services are properly funded and that we have a culture change in the NHS that means that physical health and mental health are treated as the same?
Mr Hunt
My hon. Friend is absolutely right, and I want to thank him for his tireless campaigning on parity of esteem for mental health in the last Parliament. One in 10 children aged five to 16 has a mental health problem, and it is a false economy if we do not tackle those problems early, before they end up becoming much more expensive to the NHS as well as being extremely challenging for the individual involved. We are absolutely determined to make progress in that area.