NHS: Mental Health Services

Debate between Lord Bradley and Lord Prior of Brampton

Monday 14th March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, our strategy for this area was set out in Transforming Care, a paper produced by NHS England some six weeks ago. It shows that we are absolutely committed to treating more and more of these people outside institutional settings and back in the community.

[Lord Bradley (Lab)]

My Lords, I declare my health interests. As we have heard, the collection of financial data on the investment in mental health services is crucial. I am grateful to the Minister for writing to me recently to confirm the Government’s support for the Mental Health Task Force’s priority recommendations at an additional cost of £1 billion a year by 2021, with investment beginning in 2016-17. How much additional investment will be expected each year between 2016 and 2021? What financial reports will be available for each quarter over these four years to ensure that clinical commissioning groups make the additional investment in local mental health services?

[Lord Prior of Brampton]

My Lords, the noble Lord is right: we have committed to support the request of the task force to spend an extra £1 billion by 2021. Perhaps I may write to him about the phasing of that money over the next five years; I have seen it but I cannot recall the exact figures at the moment.

Health: Adult Psychiatric Care

Debate between Lord Bradley and Lord Prior of Brampton

Monday 22nd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, reading the noble Lord’s report, I was struck that he said in the foreword that he went through times when he was very depressed and times when he was deeply impressed. In a way, that sums up the mental health system—it is fragmented, and there is a high level of variation. We provide fantastic care in one place but terrible care for somebody else, and very often it is not related to cost. I do not know about the particular instances that the noble Baroness has referred to, but I can fully understand that in certain areas it is much worse than in others.

[Lord Bradley (Lab)]

My Lords, I declare my health interests. I, too, welcome the excellent report and recommendations by the noble Lord, Lord Crisp, and his commission, and also the report and recommendations of the Mental Health Taskforce published last week. I would be grateful for clarification from the Minister on the financial commitments that the Government have made on the crucial implementation of the recommendations of both reports. In particular, can he confirm that the announcement of £1 billion each year for mental health services begins in financial year 2016-17; that, for the next four years, that £1 billion will be additional to the £1.5 billion investment in child mental health services which has already been announced; and, finally, whether this £1 billion annually is additional money or part of the £8 billion which has already been announced and allocated to NHS England for all health services?

[Lord Prior of Brampton]

My Lords, that is a complicated question, or number of questions.

Health: Parity of Esteem

Debate between Lord Bradley and Lord Prior of Brampton

Tuesday 20th October 2015 Lords Chamber

[Lord Prior of Brampton]

That is a very interesting point. We have three principal targets for mental health: two relate to IAPT and the other to access for those who have their first psychotic episode. Clearly, we do not yet have the range of targets for mental health that we have for physical health, although the introduction of those three targets this year is a big step forward. It is important that the targets should be based around outcomes rather than funding.

[Lord Bradley (Lab)]

My Lords, the five-year investment in child and adolescent mental health services is welcome, but the scale of the problem of achieving parity of esteem is huge, as a recent NSPCC report clearly showed. It stated that out of over 186,000 cases referred by doctors from 35 mental health trusts, nearly 40,000 children received no help at all. The investment equates to barely over £1 million per clinical commissioning group each year. Does the Minister believe this is sufficient not only to tackle the chronic bed shortage and the distribution of such beds across the country, but to develop comprehensive prevention and early intervention programmes?

[Lord Prior of Brampton]

The noble Lord makes a good point. I may get these figures wrong, but I think the total spend on mental health across the country is about £11 billion a year, and spending on children and young adolescents is under £1 billion—around £700 million. Therefore, under 10% of the total spend goes on young people. On the face of it, that looks to me to be far too low. That is why the last Government committed to increase that spending by £1.25 billion over the course of this Government and put another £150 million into tackling eating disorders.

Mental Health Services

Debate between Lord Bradley and Lord Prior of Brampton

Monday 19th October 2015 Lords Chamber

[Lord Prior of Brampton]

I am not aware of the report being prepared by the BMA but I will certainly be very interested in seeing it, reading it and discussing it with it.

[Lord Bradley (Lab)]

My Lords, I declare my health interests. Although I welcome the ban on the use of police cells as places of safety for children under Section 136 of the Mental Health Act by July 2016, barely nine months away, does the Minister believe that the £50 million investment in health-based places of safety will be sufficient to achieve a similar ban on the use of police cells for adults and significantly reduce the thousands of adults who end up in accident and emergency departments each year under Section 136 at a time of severe mental crisis?

[Lord Prior of Brampton]

The noble Lord makes a very good point. Treating people in the right place is fundamental to any notion that we have of parity of esteem. He recognises the successful work that has been done with children, which we are hoping to replicate with adults. As part of the increased spending on mental health, we are also investing £30 million in liaison services in A&E departments, which is very important. A&E departments are not an appropriate place for people with a severe mental health crisis. Certainly, the evidence from Right Here, Right Now, by the CQC, indicates that people with such a condition are often treated extremely badly in A&E departments.

Health: Skin Cancer

Debate between Lord Bradley and Lord Prior of Brampton

Wednesday 22nd July 2015 Lords Chamber

[Lord Prior of Brampton]

My noble friend makes a very sound point. Harpal Kumar’s task force produced a report entitled Achieving World-Class Cancer Outcomes. If anyone wants a little bit of holiday reading, it is well worth reading at least the three-page letter at the front of the report. He recommends in the report that if a GP has a 3% or greater suspicion of cancer, the person in question should be referred for further investigations.

[Lord Bradley (Lab)]

My Lords, there is a clinical trial known as Matilda at the world-renowned Christie Hospital in Manchester, funded by the Medical Research Council and the National Institute for Health Research. This aims to treat patients with melanoma using their own white cells, which can recognise and destroy cancer cells. It was approved in 2014 but then halted because excess treatment costs, which should be funded by the NHS, were not forthcoming. I understand that the Secretary of State for Health has said that this issue will be sorted by early 2015. Can the Minister advise the House when this crucial clinical trial for the treatment of skin cancer will be progressed?

[Lord Prior of Brampton]

I am not aware of the trial at the Christie called Matilda; I will take this issue away and write to the noble Lord.

Health: Multiple Pregnancy

Debate between Lord Bradley and Lord Prior of Brampton

Monday 13th July 2015 Lords Chamber

[Lord Bradley (Lab)]

My Lords, does the Minister accept that multiple births can sometimes require additional emotional support for mothers? Will he therefore ensure that some of the extra resources allocated to child mental health services are targeted at perinatal healthcare to ensure that all maternity services have access to a perinatal mental health professional as recommended by NICE guidelines?

[Lord Prior of Brampton]

The NICE guidelines for mothers expecting twins or more have an enhanced pathway as well, in which there will be a specialist named obstetrician and a mental health specialist. The Government have committed an extra £75 million over the next five years to increase the availability of mental health expertise to women who have multiple births.

Prisons: Mental Health

Debate between Lord Bradley and Lord Prior of Brampton

Wednesday 24th June 2015 Lords Chamber

[Lord Bradley (Lab)]

My Lords, it is vital that a prison has all relevant information about an offender’s health needs when they arrive at prison reception. Does the Minister agree that an evaluation of the current health screen should be undertaken to improve the identification of mental health problems at prison reception and that the identification of learning disabilities should be part of that screen?

[Lord Prior of Brampton]

The noble Lord raised this in his report five years ago and in the follow-up report that was published more recently. A very early assessment of a prisoner when he arrives in prison is of course extremely important.

Mental Health Services: Young People

Debate between Lord Bradley and Lord Prior of Brampton

Tuesday 23rd June 2015 Lords Chamber

[Lord Prior of Brampton]

I do not have the numbers to hand, but I can tell the noble Baroness that the number of beds that have been commissioned has increased significantly over the last three years and I think 1,250 tier-1 beds are now available. The noble Baroness puts her finger on it: the way we provide treatment for people suffering from mental health conditions—and have done for many years—falls far short of what we would expect for people suffering from equivalent physical conditions. We often talk about parity of esteem quite glibly, without putting the necessary resources behind it. The Government are determined to do so.

[Lord Bradley (Lab)]

My Lords, it is welcome that the Government have decided to ban the use of police cells for children detained under Section 136 of the Mental Health Act. However, what action is being taken to ensure that there are appropriate places of safety in every locality? Will the Minister confirm that adult psychiatric wards will not be used as places of safety for children?

[Lord Prior of Brampton]

The use of police cells for anybody suffering a mental health crisis, but particularly for children, is wholly unacceptable. Last year, the number of children who were held in a police cell was 160. That has come down from a much higher number. The Government and my right honourable friend the Home Secretary are determined to stop this happening—indeed, legislation is about to go through the other place to ensure that it does not happen. But that leads to the question of where, if not to a police cell, they should go. I have been told that there is a risk that young people going through a mental health crisis might actually be arrested to make them eligible to come into a police cell, which would of course be equally unacceptable. The number is getting much smaller and I hope that if I am here in a year’s time it will be down to zero.