Mental Health of Children and Young Adults

Lord Bradley Excerpts

Thursday 16th May 2019 Lords Chamber

[Lord Bradley (Lab)]

My Lords, I, too, congratulate my noble friend Lady Royall on her excellent opening speech to this very important debate. I also declare my interests in health and education as recorded in the register.

I will take a few moments of my time to sincerely thank both Houses of Parliament, including the Ministers—the noble Baroness, Lady Blackwood, and the noble Baroness, Lady Goldie, who has just left the Chamber—and my noble friend Lady Thornton, on behalf of my sister Janet, Gavin, Miles and both of our families for the very kind messages of sympathy following the deaths of my sister, Dr Sally Bradley, and her husband, Bill Harrop, in the Sri Lankan bombings. They were a great comfort to us all. Thank you.

Turning to the subject of the debate, I will first make a brief comment about the funding of mental health services. In a Written Answer, the Minister advised me that the cumulative increase in NHS England’s revenue funding would be £6.2 billion in 2019-20, rising to £25.4 billion in 2022-23. The NHS Long Term Plan indicates that at least £2.3 billion more will be spent on mental health care. Assuming we receive that £2.3 billion, it means that over the period, the percentage spend on mental health will actually reduce from 37% in 2019-20 to 9% in 2022-23. We also know that the proportion of that spend on children and adolescent mental health services is only about 15% of the total. If we are really to tackle the gaps in mental health services for children, a significant further shift in resource allocation from physical to mental health must be made to achieve the ambition of parity of esteem. I should be very grateful for the Minister’s views on that point.

Secondly, I will say a brief word on the workforce. The long-term plan states that,

“we will continue to increase the NHS workforce, training and recruiting more professionals—including thousands more clinical placements for undergraduate nurses”.

There is a real crisis in our current mental health workforce, given the age profile of those extremely dedicated staff and the number who will retire in the next few years. It was disappointing that the workforce plan was not published at the same time as the long-term plan. Obviously, we welcome the work that the noble Baroness, Lady Harding, is undertaking on behalf of the Government, but can the Minister confirm today when the final report will be published and what engagement the noble Baroness has had with universities undertaking high-quality nurse training, such as the University of Salford in Greater Manchester, where I am honoured to be the pro-chancellor? Without a clear, robust workforce plan, whatever the increase in funding, timely access to essential support for the spectrum of mental health needs—the key issue—will not be achieved.

Turning to mental health and well-being in the education system, I will raise two issues. First, many representations—including my own—have been made through YoungMinds and the Children and Young People’s Mental Health Coalition to Ofsted as it reviews its inspection framework to ensure that it assesses and recognises the effectiveness of schools and academies in supporting children and young people’s well-being. I hope the Minister will ensure that it becomes part of the Ofsted framework to ensure that early intervention in schools is comprehensive and consistent across the country.

Secondly, it is clear from the speeches we have already heard that mental health issues in higher education are a crucial challenge that universities need to address. Over the past five years, 94% of universities have experienced a sharp increase in the number of people trying to access support services. I therefore commend to the Minister an initiative in Greater Manchester that established a task force, following a workshop bringing together all the universities in Greater Manchester, the Greater Manchester Health and Social Care Partnership, the Mayor of Greater Manchester, mental health experts and clinicians. The task force designed an integrated single pathway and hub for all 100,000 students in Greater Manchester and included a central physical treatment hub in the area of greatest student density—on Oxford Road, near the centre of Manchester—and two further hubs in Salford and Bolton, as well as a clear pathway to enable students to be referred through existing support channels, digital consultation sessions, digital communication with students and many other initiatives. This is a two-year pilot going live at the start of the new academic year in September and co-funded by the universities and the NHS. I hope the Minister will visit Greater Manchester to review this project, with a view to it being rolled out as a model across the country.

Finally, I will make a brief comment on mental health, learning disabilities and the criminal justice system. Over the past few years, since my report was published in 2009, a core all-age liaison and diversion service has been rolled out across the country to support people who hit against or find themselves in the criminal justice system. It is anticipated that the scheme will reach 100% geographical coverage over the next year. The next stage, for the next 10 years, is to address particular health issues. I raise one today—autism—in recognition of how many people with that condition may find themselves a witness, victim or suspect in the criminal justice system. We must improve access to training for all staff working in the criminal justice system—whether in police stations, courts, probation services or prisons—on autism and other key vulnerabilities, and deliver on the commitment in the NHS Long Term Plan to,

“invest in additional support for the most vulnerable children and young people in, or at risk of being in, contact with the youth justice system”.

I hope the Minister will help drive this forward.