NHS Eating Disorder Services
Debate between Lord Harlech and Lord Mott
Lord Mott (Con) (Maiden Speech)
My Lords, I thank the noble Baroness, Lady Parminter, for bringing forward a debate on this important topic. I know she has been a long-standing champion of those living with eating disorders. I also thank the noble Baroness, Lady Merron, for her kind welcome today and for her reassuring words in the Lobby earlier this week.
As this is my maiden speech, I believe it is customary to start with a few personal remarks, and I beg the indulgence of your Lordships to do this before I respond to the debate. I thank my fellow Peers, particularly those who do not sit on the Government Benches, who have been generous with their welcome and advice. I thank Black Rod and the officers and staff who have made me feel so welcome. In particular, I thank the doorkeepers, who have helped guide me so far; I am sure that will be required for some time to come. On a personal note, I have a supportive family who proudly watched my introduction last week. My parents and my sister gave me the most loving home life growing up and continue to support me, together with my two daughters, Olivia and Phoebe.
My hometown of Chatteris in Cambridgeshire is situated in the Fens, between Huntingdon, March and Ely. As a youngster, I enjoyed playing cricket with my local team—although not that well—and I was a member of our local swimming club. I would like to mention two businesses which still exist in my hometown: Stainless Metalcraft, which runs an incredibly successful apprenticeship scheme and has existed for many years; and Petrou Brothers, which is our local fish and chip shop. I mention it because growing up, my mum and my nan often worked there. It was always a good way to see them on a Friday evening.
I attended my local comprehensive school, Cromwell Community College, in Chatteris, then studied A-levels at Neale-Wade Community College, in March. My journey through school was a challenging one as I have dyslexia, but the challenges I faced, the determination and resilience that I needed to get through those school years, set me up incredibly well for a future career in politics.
I am humbled that a lad from the Fens who wanted to follow his father and become a bricklayer is now here in this historic Chamber. It was an accident that I started my career in politics. I began working as an apprentice in the Conservative Party over three decades ago. I am immensely proud to have started in that role and to have gone on to become the director of campaigning and then CEO, my last role. After deciding against the building site, my ambition was to become a pastry chef but, as you can tell from today, that failed as well. I ended up working in politics, being inspired, guided and motivated by my first boss, Geoffrey Harper, and later in my career by Alan Mabbutt.
On my political journey I had the pleasure of working with several of your Lordships, including my noble friend Lord Patten of Barnes, who was the candidate in my first election campaign, and my noble friend Lord Clarke of Nottingham, in 2001. While working in Rushcliffe I witnessed how politicians can debate robustly in the council chamber, as it was then; I now look forward to sitting opposite and listening once again to the noble Lord, Lord Coaker.
The next generation is so important to politics and democracy. I am immensely proud to have worked closely with the Patchwork Foundation, a UK-based charity committed to strengthening democracy. It focuses on communities and individuals who are traditionally under-represented and seeks to engage young people from those communities. It is our responsibility to support the next generation in order for our democracy to thrive.
Turning to the debate, I assure noble Lords that improving eating disorder services is a key priority for this Government and a vital part of our work to improve mental health services. Having an eating disorder can often be utterly devastating, and not just for those suffering with the condition but for family and friends, as has been mentioned in this debate. That is why we want to ensure that people have access to the right support at the right time.
I thank the noble Baronesses, Lady Parminter and Lady Wheatcroft, for giving us their very personal stories; I am very grateful. My noble friend Lord Markham, the Health Minister, is committed to continuing to make progress, and we had extensive conversations on the steps being taken when preparing for this debate. On the audit point that was raised very early on, not only when I first met the noble Baroness but again today, financial arrangements and timescales for delivery of the audit are being discussed. NHS England is awaiting details and expects to have clarity this summer. The noble Baroness asked me for a response when we met, and while it might not be quite what she was looking for, hopefully we can continue to monitor this and work together.
Noble Lords asked about progress on NHS eating disorder services, and about the report by the Parliamentary and Health Service Ombudsman, which described the service failings that led to the avoidable and tragic death in 2012 of 19 year-old Averil Hart. I express my sincerest sympathies to Averil’s family and thank her father, Nic Hart, for his campaign to help prevent those with eating disorders and their families suffering a similar tragedy.
In response to the report, NHS England has convened a working group with the department and other partners to address the recommendations. Progress is reported to the NHS England board throughout the year. The report highlighted a number of areas of focus to improve services. The first was improvements to workforce and training, informed by research conducted by the Faculty of Eating Disorders Psychiatry at the Royal College of Psychiatrists. The PHSO delivery group has worked to procure training courses that will increase the capacity of the existing workforce. The NHS England long-term workforce plan is due to be published very soon. It will set out the NHS’s workforce demand and supply requirements over the next 15 years and the actions to address, support and grow the workforce accordingly. The Royal College of Psychiatrists has also published comprehensive guidance on the management and identification of medical emergencies in eating disorders. This provides an overview of the latest evidence associated with eating disorders, including highlighting the important role of healthcare professionals.
Secondly, the PHSO report recommended that the department and NHS England work together to ensure that adult eating disorder services achieve parity with child and young people services. The noble Baroness, Lady Parminter, talked about FREED. In 2019-20, the NHS piloted specialised early intervention and treatment for young adults, referred to as the FREED model. This model, which has been shown to reduce waiting times and lead to better outcomes, is now being adopted more widely. We are working to increase capacity for eating disorder services through increased funding. Under the NHS long-term plan, we will invest almost £1 billion extra in expanding community mental health care by 2023-24. This will give an additional 370,000 adults with severe mental illnesses, including eating disorders, greater choice and control over their care, and support allowing them to live well in their communities. Since 2016, investment in children and young people’s community eating disorder services has risen every year, with an extra £54 million per year from 2022-23. This extra funding will increase capacity across the country, although I have made a note to take back to the department the point that the noble Baroness, Lady Janke, raised about whether funding is getting through to make a difference. I will discuss that with my noble friend Lord Markham.
As a number of noble Lords mentioned, we know that the pandemic has resulted in a large increase in demand for eating disorder services. The number of children and young people requiring urgent eating disorder treatment more than doubled from 2019-20 to 2021-22. As part of the £500 million Covid funding for the mental health recovery action plan provided in 2021-22, we invested an extra £79 million to significantly expand young people’s mental health services, including allowing 2,000 more children and young people to access eating disorder services. I am pleased to say that this target was achieved, with more than 4,000 additional young people entering treatment compared to the previous year.
We have set up the first waiting times standard to improve access to eating disorder services for children and young people, with the aim that 95% of children with an eating disorder will receive treatment within one week for urgent cases and within four weeks for routine cases. Prior to the pandemic, significant progress had been made towards achieving this ambitious target. While the increase in demand since the pandemic, as mentioned by the noble Baroness, Lady Wheatcroft, has affected performance against the waiting time standard, we remain committed to delivering it, with local areas asked to prioritise service delivery and investment to meet the needs of these vulnerable young people. We are also working with NHS England on the potential introduction of a four-week waiting time standard for adults presenting to community-based mental health services, including eating disorder services. This was something that the noble Baroness, Lady Merron, raised in her contribution to this debate.
In closing, I extend my thanks once again to the noble Baroness, Lady Parminter, for securing this debate, and to all noble Lords for their thoughtful comments and questions. I will go back to the department and raise all the issues that they have brought to my attention. The department, NHS England and other partners will continue to work to implement the recommendations from the PHSO report with the aim of preventing further tragedies. We are well aware that eating disorders are serious, life-threatening conditions. That is why we remain committed to improving services to support those affected and their families.
Lord Harlech (Con)
My Lords, I am aware that some noble Lords wishing to speak in the next debate might not have been able to enter the Chamber due to my noble friend’s maiden speech—a very fine one it was too, and I welcome him to his place. Therefore, I suggest we adjourn for two minutes.