Mental Health: Children and Young People

Lord Bradley Excerpts

Wednesday 30th January 2019 Lords Chamber

[Lord Bradley (Lab)]

My Lords, I also congratulate the noble Baroness, Lady Tyler of Enfield, on securing this very timely debate. I also declare my health and education interests, as in the register. In the short time available I shall touch on three issues: funding, workforce and crisis care, which GPs have raised many times with me.

First, in the NHS Five Year Forward View the NHS budget was about £120 billion but mental health received only 15% of the total. As we know, one in four people will suffer some form of mental health problem during their lives and, critically, children’s mental health services receive only about 7% of the 15%, which is totally unacceptable. There is growing evidence that there is a huge rise in the prevalence of poor mental health, particularly among young women over the last decade, and a much faster rise in help-seeking and referrals to specialist CAMHS services.

The 10-year plan pledges that funding for children and young people’s mental health will rise faster than the average for the NHS and by more than it will for adult mental health services. Can the Minister indicate today the profile of this funding escalation up to 2023? Unless it is honoured, the thresholds for access to services, which GPs are so concerned about, will continue to rise.

Further, as has been mentioned, GPs have raised concerns that funding allocations to clinical commissioning groups have not always been spent on mental health services but have sometimes been used to cover deficits elsewhere in the system. This, again, is totally unacceptable. Can the Minister give further details of the mechanisms that will be employed to deliver the 10-year plan’s commitment to ensure that local NHS commissioners are held to account for the increases in funding for mental health services?

Secondly, to deliver the ambitions of the 10-year plan for mental health it is crucial that a robust and imaginative new workforce plan is published. As we have heard, the Royal College of Psychiatrists has pointed out that one in 10 consultant psychiatrist posts is vacant and the latest training programme data shows that 60% of training places for child and adolescent psychiatrists are unfilled. The Royal College of Paediatrics and Child Health, the Royal College of General Practitioners and the Royal College of Psychiatrists have highlighted that currently under half of GPs have received mental health training, while 82% of practice nurses feel ill-equipped to deal with mental health problems. Yet 90% of people with mental health problems are served in primary care settings. Can the Minister tell us when the new workforce plan will be published? Many of us were disappointed that it was not published at the same time as the 10-year plan.

Thirdly, and quickly, from my own work on the development of liaison and diversion services, I am well aware that it is essential that children in crisis need to be assessed and supported in an appropriate setting. Police cells have now been banned for the assessment of children who find themselves in some way connected with the criminal justice system but A&E departments can be equally inappropriate and a very poor environment for proper assessment. It is obviously welcome that the 10-year plan recognises this and the importance of investment in community-based crisis response services, and commits to ensuring that children and young people experiencing crisis will be able to access crisis care 24 hours a day, seven days a week. Can the Minister indicate the timescale for the delivery of that?

Finally, it is essential that we have a spread of in-patient beds across the country for people who need them, in their localities and not some distance away.