Mental Health and NHS Performance

Karen Buck Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

I am happy, on my hon. Friend’s behalf, to ask the Minister responsible to meet him to discuss that psychiatric unit. Of course the proof of the pudding is in the eating, but this is the first time that I can remember that a Prime Minister has made her first major speech on the NHS about mental health and indeed talked, on the steps of Downing Street as she arrived, about the importance of sorting out mental health. That is a sign of the commitment coming right from the top.

[Ms Karen Buck (Westminster North) (Lab)]

The fabulous team at Imperial, St Mary’s in west London are featuring in a television programme this week, and the chief of service for emergency care is reported as saying:

“We’ve just had our worst 10 days on record. There’s nowhere in the hospital to move anybody. What’s happened in the last two years is the whole system, countrywide, has ground to a halt.”

That is partly because there is more than the equivalent of a ward of patients at any time who cannot move out of the hospital because there is nowhere for them to go. Does the Secretary of State accept that his Government have gone too far in the destruction of local government finance, including for social care, and does he accept that next year, despite all the rhetoric, local government finance will go down, not up?

[Mr Hunt]

First, I would like to thank the staff at Imperial, who, alongside other NHS staff, have done a fantastic job over a very difficult period. I would say to the hon. Lady that 50% of councils have no delayed discharges of care. It is a problem in many hospitals, but there are many areas that are managing to deal with it. I suggest that the local authorities that serve her constituency should look at the other parts of the country that are dealing with this problem.

Young People’s Mental Health

Karen Buck Excerpts

Thursday 27th October 2016 Commons Chamber

[Helen Hayes]

My hon. Friend is absolutely right to say that, although today we are debating young people’s mental health, many of the same issues apply to mental health services across the board for all members of our communities.

The Government published a response to the Youth Select Committee report in January 2016. That response was, on the whole, disappointing. It referred mainly to work that the Government were already doing rather than the additional work that they and other agencies clearly need to do. Most disappointing of all, the response rejected the key recommendation that statutory levels of attainment in mental health education should be introduced for all young people. I welcome the fact that the Government have subsequently announced some additional funding for young people’s mental health, but I remain very concerned about the current state of mental health services for our young people and the resourcing of those services.

I will focus, therefore, on the current state of services, and what I believe to be evidence of a crisis that is growing, not diminishing, and demands a response far bolder and more comprehensive than that which the Government are currently offering. I will also return to the conclusions of the Youth Select Committee report.

One in four of us will experience mental ill health in any given year. That means that mental health is something that affects every one of us. All of us have a friend or family member who has mental ill health, and many of us will experience mental ill health ourselves. I have known close friends and family members who have suffered from severe anxiety that impacted on their daily lives, clinical depression and eating disorders. There are few worse feelings than the worry for a loved one who seems unreachable in the pit of depression, except perhaps the worry when that loved one is a child. All any of us wants for our own children and the young people we represent is that they grow up happy, healthy and resilient to the stresses and strains of our world. Watching a precious child struggle with clinical depression, severe anxiety or an eating disorder is absolutely devastating.

According to NHS statistics, around one in 10 children and young people has a diagnosable mental health condition; that is around three students in a typical classroom. Many more young people do not have a diagnosable condition but experience a period of mental ill health or emotional distress during their childhood or adolescence. The Government’s own measures of children’s wellbeing found that almost one in four children showed some evidence of mental ill health. Half of mental health problems are established by the age of 14 and three quarters by the age of 24.

Shockingly, suicide is the most common cause of death for boys aged between five and 19, and the second-most common for girls of that age, after traffic accidents. A recent survey by Girlguiding found that 69% of girls aged seven to 21 feel that they are not good enough. It is thought that around one in eight young people self-harm between the ages of 11 and 16.

[Ms Karen Buck (Westminster North) (Lab)]

I know that my hon. Friend also has concerns, which a number of us share, about serious youth violence. Does she agree with me that mental ill health is now understood to be a key trigger in gang and serious youth violence, and that this deserves a serious and concentrated focus from within the health service and the Government? There is some very good practice out there. It is, sadly, nothing like widely available enough to help us deal with this problem.

[Helen Hayes]

My hon. Friend makes a very powerful and important point. This is an issue that affects both our constituencies to a significant degree.

Only 0.7% of NHS funding is spent on young people’s mental health and only 16% of that funding is spent on early intervention. The Royal College of Psychiatrists also reports that additional funding the Government have committed to young people’s mental health is not getting to the frontline. Responses to a recent freedom of information request from my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) revealed that although the Secretary of State made a commitment that the proportion of funding for mental health services should be increasing everywhere this year, and this is desperately needed, 57 of the country’s clinical commissioning groups are actually reducing the proportion of funding for mental health services.

The charity YoungMinds reports that three quarters of young people with mental health problems may not get access to the treatment they need. Child and adolescent mental health services, on average, turn away nearly a quarter of children referred to them for treatment by concerned parents, GPs, teachers and others. That finding is supported by evidence from the Association of Colleges, which reports that, of 127 colleges responding to a survey, many reported real difficulties referring students on to health services in times of crisis, with 61% of respondents reporting that their relationship as a college with local mental health services is only “fair” or “not very good/non-existent”. The thresholds for support are going up at precisely a time at which demand for services is increasing. This has the potential to create a ticking time bomb of mental ill health for the future.

The average waiting times for all CAMHS providers was six months for a first appointment and almost 10 months for the start of treatment; and an investigation by Pulse recently found that three in five referrals from GPs to CAMHS are being batted back to primary care without any access to specialist support. When early intervention is not available, it is very often schools and colleges that end up dealing with the consequences, and they are woefully under-resourced to do so. A recent survey by the National Association of Head Teachers found that only a third of primary schools have access to a school-based counsellor, and that of those who do have access, 59% have a counsellor on the school site for one day a week or less.

World Autism Awareness Week

Karen Buck Excerpts

Thursday 28th April 2016 Commons Chamber

[Matthew Pennycook (Greenwich and Woolwich) (Lab)]

It is an absolute pleasure to follow that speech by the hon. Member for Berwick-upon-Tweed (Mrs Trevelyan), and I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing this debate and on her contribution over the years.

We have touched on autism awareness and autism understanding, but I would like to focus on something not explicitly mentioned so far—autism acceptance. As hon. Members have noted, public awareness of autism has grown dramatically in recent years, aided by a proliferation of books, media articles and not always accurate portrayals of people with autism on television and in film. This explosion of information on autistic spectrum disorders and the incorporation of individuals with autism into everyday culture has helped to familiarise people with the condition, and it is right that we celebrate that achievement.

Essential as it is, however, awareness alone has not necessarily led to greater understanding of ASDs, and it has not prevented the perpetuation of stereotypes and clichés, as even a cursory Google search would attest. Awareness alone has not keep people with autism from being abused, has not helped them find jobs and has not supported them to live independently. In short, we will not overcome ignorance and help those with autism— young and old—to live independent and fulfilling lives simply by increasing awareness alone.

I am lucky enough to have in my constituency a fantastic organisation called Greenwich Parent Voice. It is a group of exceptional parents, some of whom are in the Public Gallery today, who came together to support each other and to fight for a better deal for their children, all of whom have special educational needs or disabilities ranging from the mild to the most profound and complex. They have not only helped to deepen my understanding of ASDs and the challenges faced by those with autism and their parents, but have made it clear to me, over the course of many meetings, that what is really required is acceptance of autism.

Anyone who has sat and listened to parents or carers of children with autism or adults with autism for even a short time will know that the system in place at the moment, despite some improvements, still does not work. Whether it be through the problems in transferring from a statement to education, health and care plans, the difficulties trying to secure specialist support in the care system, or the strain of supporting children with autism into adulthood, the system causes families unimaginable levels of stress and exhaustion.

[Ms Karen Buck (Westminster North) (Lab)]

In common with other speakers, my hon. Friend is making a very powerful speech about awareness and understanding. Does he agree—I thought his remarks were leading towards this—that we also need to translate such awareness into some hard practical action on service delivery, and that this applies whether it be about education or housing? My hon. Friend, like others, has been dealing with parents of autistic children who are forced to share rooms or to live in 10th or higher storeys in tower blocks because housing policy does not reflect the needs of autistic children. We need to build on greater awareness, but also to resource it and turn it into some practical action that will really assist people.

[Matthew Pennycook]

My hon. Friend makes a very good point. I have dealt with allocation cases myself, and I agree that detailed policies need to be put in place that are based on recognition of the particular needs of autistic children and their families. As I have said, having to navigate the system as it stands can cause those families unimaginable stress and anxiety.

Those who can grow the sharp elbows necessary to navigate the system often do so at great personal cost, and, as the hon. Member for Mid Derbyshire (Pauline Latham) said, not everyone has the ability to do that. The range of challenges faced by those with autism and their families is vast, and this is not the debate for delving into any particular one in great detail.

My sense is, however, that our collective will and readiness to do something to help people on the spectrum would be stronger if more of us were not only aware of autism and understood it, but were more accepting of it as a society. If we were, I suspect we would be compelled more urgently to address the lack of suitable childcare provision for autistic children and the fact that too many schools are still not autism-friendly and too many children are not getting the support they require. We would be compelled more urgently to address the prevalence of mental health conditions in those with autism, and the isolation that young people with autism too frequently face in school. We would be compelled to address the cliff edge in support—that is what it is—that still faces autistic people in too many parts of the country as they transition to adulthood. We would also be compelled to address the huge challenges that still face autistic adults in terms of diagnosis, employment and housing.

I have no doubt that these challenges will be overcome in time, not least because more and more people with autism and their families, such as those who helped establish Greenwich Parent Voice in my constituency, are advocating more strongly for themselves. I believe that each of us here in this Chamber and in the wider country can hasten the process by working towards a society in which more of us are not only aware of autism and understand it, but accept those with it and indeed celebrate them and their contribution—not only as family members and friends, but as classmates, colleagues and members of our communities.

Mental Health

Karen Buck Excerpts

Wednesday 9th December 2015 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I beg to move,

That this House believes that mental health should be treated with the same priority as physical health and recognises the importance of promoting good mental health from childhood through to adulthood; believes that not enough progress has been made in translating this House’s commitment to parity of esteem between mental and physical health into practice; notes with concern that the King’s Fund has reported widespread evidence of poor-quality care across mental health services, and the latest available figures show a rise in suicide rates and the number of detentions under the Mental Health Act 1983 increasing by 10 per cent in the past year alone; further notes the delay in the publication of NHS England’s Mental Health Taskforce report; notes the concerns that have been raised with the Scottish Government regarding the rate of inappropriate admissions of young people to non-specialist facilities for mental health treatment which have increased by 38 per cent since 2011; is concerned by the absence of data on NHS spending on mental health services since 2011-12; opposes the Government’s decision not to enshrine the right to psychological therapies in the NHS Constitution; and calls on the Government to urgently rectify this systemic inequity in entitlement to treatments, reinstate the annual survey of investment in mental health services and develop and implement in full a new strategy to improve the Government’s cross-departmental response to mental health.

It is a privilege to open this debate as the first shadow Minister for mental health. The fact that we are having this debate is testament to just how seriously the Opposition consider mental health. The issue affects one in four of us every year, yet it has been neglected for far too long. Mental health has come out of the shadows in recent years, and I know that many Members on both sides of the House feel very strongly about this issue. There have been many important steps forward, but talk to anyone with a mental health condition and they will tell you that they still face stigma, prejudice and discrimination. Sadly, there remain many areas in which there has not been the progress for which we had hoped.

Labour Members have deep concerns about our nation’s mental health and the services and support that are available. Three years ago, my Labour colleagues in the House of Lords won the fight to ensure that the Government wrote parity of esteem between mental health and physical health into law. However, the gap between the rhetoric we hear from this Government and the reality for patients on the ground is growing wider.

I am sure Members on both sides of the House have many constituency cases that echo such concerns. In my first few months in this position, I have been struck by the thousands of messages I have received from people up and down the country. They are desperate to see a change in how our society approaches mental health. This strength of feeling is not surprising. On this Government’s watch, there has been an increase in the number of patients who report a poor experience of community mental health care. More patients have to travel hundreds of miles just to get a bed. The number of children being treated on adult wards, which the Mental Health Act 1983 rightly says should not happen, has risen again this year. The number of people becoming so ill that they had to be detained under the Mental Health Acts leapt by 10% in the past year. The level of suicides, particularly among men under the age of 45, has been at its highest since 2001.

[Ms Karen Buck (Westminster North) (Lab)]

Does my hon. Friend share my concern about the scale of the stress—by common agreement, often inappropriate stress—on the police as a consequence of the pressure on emergency mental health services? My local police have advised me that they sometimes spend half a shift with severely mentally ill patients who are queuing for access to acute mental health hospitals. That is bad for the police and bad for the patients, and is a reflection of the terrible pressures on the acute mental health sector.

[Luciana Berger]

I thank my hon. Friend for making that very important intervention. There are too many stories of our blue light services—not just the police, but our ambulance and fire services—being under incredible pressure in contending with such issues. I believe that the Government must do more to address that issue.

Health and Social Care

Karen Buck Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

I will tell the hon. Gentleman what I remember: I remember NHS waiting lists in 2010 being at their lowest ever level; I remember public satisfaction with the NHS being at its highest ever level; and I also remember leaving behind a financially solvent national health service. Let us look at it today: NHS waiting lists at a six-year high; cancer patients waiting longer for their treatment to start; A&E in crisis; and, as I said, a £1 billion deficit, and rising, at the heart of the NHS. That is the Secretary of State’s record, and a little more humility might not go amiss.

[Ms Karen Buck (Westminster North) (Lab)]

Is it not true that the NHS’s greatest resource, and indeed greatest cost, is its staff? Imperial College Healthcare NHS Trust overspent on staff by £24 million last year, and at the end of the financial year 12% of all its spending was going on agency and “bank” staff. While it is completely right to clamp down on the ludicrous overspend on agency staffing, does this not reflect the reality of cuts in training and of an attitude to staff pay by the Government? Does my right hon. Friend agree that we will not deal with agency staff without having a better deal for the recruitment and retention of permanent staff in the NHS?

[Andy Burnham]

My hon. Friend anticipates me, because this is precisely the issue I am coming on to. Under the Lansley reorganisation, workforce planning went out of the window, and that led to today’s huge workforce crisis and hospitals being in the grip of private staffing agencies. That is the single biggest driver of the NHS deficit that I mentioned a moment ago, and I will talk about that shortly.

The Secretary of State gave us a pious warning about temperate language, yet this is the Secretary of State who today on the front page of The Daily Telegraph is saying that the NHS has enough cash and now must deliver:

“the time for debating whether or not”

it has enough money is over, it

“now needs to deliver its side of the bargain”.

Not for the first time, that is a statement by the Secretary of State that will have caused jaws to drop across the NHS. People will not forget the time he accused hospitals of coasting when they were in the middle of an A&E crisis, but even by his standards this was a staggering piece of spin.

The simple fact is that the NHS does not have enough money. In fact it is seriously short of money. It is facing a £1 billion deficit this year, with two thirds of hospitals in the red, which marks a major deterioration from what the Conservatives inherited in 2010, when there was a surplus of over £500 million.