Mental Health First Aid in the Workplace

Peter Aldous Excerpts

Thursday 17th January 2019 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I congratulate the hon. Member for Liverpool, Wavertree (Luciana Berger), the right hon. Member for North Norfolk (Norman Lamb) and my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) on securing this debate, and the Backbench Business Committee on granting it.

For many, first aid in the workplace has too often in the past been a green box that is kept in the corner and which, if we are lucky, is opened very occasionally when someone cuts a finger or scalds themselves when making a cup of tea. However, it is much more than that: not only can there be more serious physical illnesses to which we have to attend, such as a broken limb or a heart attack, but there are mental health challenges of which we need to be increasingly aware.

Very often, workplaces are highly stressful settings, which can accentuate mental health challenges. It is important that we put in place measures to reduce stress, to help pick up those first signs of mental illness and to ensure that people needing treatment and support receive it as quickly as possible. This is not only vital for those who are feeling unwell, but good for their employers.

I chair the all-party group on first aid, the secretariat for which is provided by St John Ambulance. I was on its management board in Suffolk before I came to this place. Mental health first aid training is increasingly being provided by St John Ambulance, which by the end of 2018 had provided 5,000 people with the skills to become mental health first aiders in their workplace, and this figure is due to rise to 10,000 this year. This is a good start, but it needs to be put in the context of 1 million physical first aiders in the workplace, requalifying on a three-year cycle. There is clearly a lot of work still to do.

I shall first highlight the research carried out by St John Ambulance, which shows clearly why we need to step up our game, and then I will move on to outline some cases that illustrate the benefits of embedding mental health support in the workplace. St John Ambulance carried out two surveys in 2018—one of 1,000 employees responsible for booking general first aid courses, and the other of 800 people who attended general first aid courses. The findings of the first survey prompted a variety of conclusions.

First, one in four people in work have left a job due to mental health problems. A further 43% of people considered leaving a job due to stress or mental ill health, yet fewer than one fifth of the organisations in which they worked had mental health policies in place. Conditions including depression and stress had caused nearly a quarter of respondents to miss work for a day or longer, and six out of 10 people asserted that their employer should do more to address mental health issues.

Individual responses from employees who took part in the research included a variety of comments:

“The company I work for are pretty archaic;”

“I believe my manager would mock me;”

“They recognise it as a valid condition but see it as an inconvenience.”

Nearly two thirds of people said that they would feel uncomfortable asking for a mental health sick day. On a more positive note, more than a third of people said that their employer recognised stress as a valid condition and worked to help, but more than a quarter said that bosses did little or nothing to help. In the second survey, more than half the respondents were unaware that employees have rights if treated unfairly by their bosses on mental health grounds, and nine out of 10 felt that organisations should have a mental health policy.

Both items of research indicate why the recent initiative by the Health and Safety Executive is so important. It has long been assumed that an employer’s responsibility for supporting mental health is covered by a standard risk assessment that takes into account all health and safety needs. In practice, however, due to the stigma attached to mental health, that simply has not been happening, and 44% of people do not feel able to tell their employer when they are feeling anxious or depressed at work, with most citing “embarrassment” as the main barrier.

There is overwhelming evidence of the need to embed a culture of mental health aid and support in the workplace. Last month St John Ambulance hosted a national conference with speakers and delegates drawn from such diverse sectors as construction, banking, retail, education, local government and the armed forces. Case studies included wellness programmes, a universal approach to mental health first-aid training, sleep training, talking groups for people as they tackled changing life circumstances, and the development of positive mental health champions. In one organisation, referrals to counselling by health professionals have fallen by 48% as a result of its initiatives, while another cited a 75% drop in absence due to work-related illness. The obvious impact on the bottom line has enabled senior leadership to buy into those programmes, which are now regarded as crucial to its success.

Having provided physical first-aid training for employers over many years, it is the experience of St John Ambulance that mandatory regulation will be necessary if every organisation is to give mental ill health the attention it deserves. It believes that further work is needed, especially among SMEs, to establish the right framework for such regulation. Extensive consultation will be required, and progress must be made in recognising the necessary impact on employees and employers. The Government must set out a firm timetable through which to consider proposals from experts, employees and employers, and they must consult on proposals for regulations to deliver parity of esteem, as called for by the Health and Social Care Act 2012, and implied by the Stevenson and Farmer report, “Thriving at Work”.

Oral Answers to Questions

Peter Aldous Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Matt Hancock]

I am afraid that the hon. Gentleman has it slightly muddled up, because technology does involve capital investment, but it also includes revenue investment to ensure that the service element of any technology can continue to be delivered. Maybe he should have another look at how technology is delivered these days. Alongside the capital budget, we have record spending on the NHS to ensure that it is there for the long term. Of course public health is an important element of that, and there has been £16 billion for public health over this spending review period because it really matters.

[Peter Aldous (Waveney) (Con)]

2. What steps he is taking to reduce rates of childhood obesity.

[Mary Robinson (Cheadle) (Con)]

8. What steps he is taking to reduce rates of childhood obesity.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

This June we published chapter 2 of the childhood obesity plan, which built on the world-leading measures we introduced in 2016 and included bold plans to halve childhood obesity by 2030. Our consultations on banning energy drinks and on calorie labelling are now open. Later this year we will be consulting on promotion and marketing restrictions, including suggestions of a 9 pm watershed.

[Peter Aldous]

The feedback that I receive locally in Waveney is that childhood obesity needs to be tackled by Government Departments, clinical commissioning groups, medical centres and councils working together, whether in schools or by encouraging breastfeeding and the preparation of weaning foods. Can the Minister confirm that he is pursuing such a multi-agency approach?

[Steve Brine]

I can, and the plan covers many Departments, which was why I recently announced the trailblazer programme to support innovative local action with local authorities. That has the commitment of key policy teams across many Departments to support participating councils to harness the potential of what they can do and learn from others.

Phenylketonuria: Treatment and Support

Peter Aldous Excerpts

Tuesday 26th June 2018 Westminster Hall

[Peter Aldous (Waveney) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Blaydon (Liz Twist) on securing the debate and on championing so well the cause of PKU patients and their families and carers.

It is also appropriate to highlight the pioneering work of my hon. Friend the Member for Spelthorne (Kwasi Kwarteng). In an Adjournment debate on 1 December 2011, he highlighted his constituent’s problems in obtaining a Kuvan prescription. He successfully secured a prescription for his constituent, but it is most unfortunate, as we have heard, that six and a half years later we are no further forward in making this drug, which has the proven potential to change many people’s lives, more widely available.

Finley Walsh lives in Lowestoft with his parents, Michelle and David. He is two and a half years old and he was born with PKU—a genetic condition that will be with him for his whole life. All Finley’s foods have to be weighed, using a calculation that takes account of the amount of protein in the food. His parents have to take weekly heel-prick blood tests, which are sent to Addenbrooke’s hospital in Cambridge for analysis. The results are then sent to the Norfolk and Norwich Hospital, where dieticians phone through the results that enable Michelle and David to prepare Finley’s food intake for the coming week. That is a critical, delicate and often worrying process for them. It is vital to get Finley’s protein levels right; if they go too high, there is a real risk of brain damage.

The challenges that the family face daily are immense and place a real strain on them. Quite often, the blood test results do not come through on time and must be chased up. At present, they have had no feedback for two weeks. Food must be ordered on prescription to enhance Finley’s diet. Products such as those from Violife and Hooba are not only expensive but, quite often, not immediately and readily available. At present, there is also the worry that Finley was due to have a review with his specialist in May and that appointment has yet to take place.

Children with PKU suffer patchy care and support, which depends on where they live. That could be addressed by setting up specialised metabolic centres with an experienced metabolic physician and dietician. Psychological support should also be available in the centres to assist children if they experience learning difficulties and to ensure that they receive an education that enables them to realise their full potential. The centres could also administer prescriptions for PKU foods and dietary supplements so as to provide a more efficient service and to overcome the problems that the Walshes are experiencing.

On Thursday I, too, will take part in the PKU diet for a day challenge. In no way does that replicate the real experiences of people such as Finley, but I hope that together, we in this Chamber and around the House can highlight the need for modern treatments and better care for those who face such an enormous challenge daily.

Mental Health Services (Norfolk and Suffolk)

Peter Aldous Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Dr Poulter]

I thank my constituency neighbour for that intervention. I entirely agree with everything he says, although I am not sure it is quite so pioneering—I think the hospitals in London would probably disagree with that. There is a lot of good work going on in London built around exactly that sort of model of more integrated care.

One of the challenges faced by the trust in the past, and which mental health trusts in general face, is the failure of many partner organisations to properly engage on issues such as the provision of adequate social care for patients with chronic and long-term mental illness and dementia. There is also the failure of housing providers to be involved and of the police to be properly involved. There is a big overlap between some people with mental ill health and presentation to the police, when they would be better looked after by the NHS.

This project is the right way forward, with more integration of services and better integration between mental and physical health. Many patients with chronic mental health needs have physical health problems. They are sometimes a side-effect of the drugs, but are often a result of a chaotic lifestyle. Better joined-up working with the local NHS undoubtedly has to be a good thing. For that to be effective, however, as we have seen in some pilot projects in London, there needs to be the funding to deliver it. The mental health trust is not in the best financial shape—I will come on to that later—and support from the Government through funding for this innovative way of working, which I think is certainly a first in a rural area, would be very welcome. I hope the Minister may be able to provide some reassurance on that this evening.

[Peter Aldous (Waveney) (Con)]

I congratulate my hon. Friend and constituency neighbour on securing the debate. Before he goes on to talk about the money, which is very important, does he agree that it is very important that the trust promotes and endorses local, tailor-made initiatives such as the trauma-informed approach currently being promoted in Lowestoft by mental health champions Tod Sullivan and Paul Hammond?

[Dr Poulter]

Yes, that is absolutely the right way to provide integrated services and joined-up care, because we cannot necessarily have a one-size-fits-all approach across Suffolk or Norfolk. We need to look at the local healthcare need. That is partly about working not just with housing providers, social services providers, primary care and GPs, as I believe is happening in my hon. Friend’s constituency, but with the voluntary sector, other third sector providers and local charities, many of which have knowledge of the needs of patients, families and carers. When we are providing joined-up, holistic mental healthcare, it is just as important to make sure that the approach is joined up and holistic in that regard, and I believe that the project in my hon. Friend’s constituency will have a very good chance of improving services for patients.

Deafness and Hearing Loss

Peter Aldous Excerpts

Thursday 30th November 2017 Westminster Hall

[Peter Aldous (Waveney) (Con)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I congratulate my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) on securing the debate. Colleagues have spoken very movingly about their personal experiences.

It is great to see my hon. Friend the Member for Winchester (Steve Brine) in his place as the responding Minister. I am sure he will do this ably, but it is an indication of the challenges that the hard-of-hearing and deaf community face that hon. Members have mentioned five Departments that have issues that need to be addressed: the Department of Health, the Department for Education, the Department for Business, Energy and Industrial Strategy, the Department for Culture, Media and Sport and the Department for Work and Pensions. That shows that by working in departmental silos, there is perhaps a danger that some of challenges that we are hearing about today are not being properly addressed.

My hon. Friend the Member for Poplar and Limehouse is a champion for the deaf and hard-of-hearing community. I will briefly highlight the work of another such champion, Ann Jillings, from Lowestoft, who is working with passion and determination to secure the best possible education for her son, Daniel. In doing so, she is campaigning for other parents of deaf children in north Suffolk. Daniel started at Bungay High School in September. He is doing well and there is good package of support in place for him, but Ann had to fight very hard to get that and she continues to campaign for a hearing impaired unit in north Suffolk.

It is clear that not just in Suffolk but across the country, deaf children do not get the right support right from the start, so they cannot always realise their full potential at school. That can put them at a considerable disadvantage for the rest of their lives. We need to break down these barriers and create a properly funded national framework, within which local education authorities such as Suffolk County Council can provide a good education and support service locally. If they do not do that, they must be held to account.

The National Deaf Children’s Society, which does great work campaigning for deaf children to have the same opportunities as everyone else, has highlighted four issues on which Government action is needed to break down the barriers that deaf children face. First, the NHS needs to improve the quality of children’s hearing services. The National Deaf Children’s Society highlighted in its Listen Up! campaign that, across the country, many such services have significant shortcomings and are failing to meet the necessary audiology standards. The quality assurance process that was previously in place has ended, and it has not been replaced by any other mandatory process.

The NDCS has a three-point action plan to address this particular problem. First, NHS England must ensure that the children’s audiology services that it directly commissions, such as for the under-fives, comply with the IQIPs—improving quality in physiological services—accreditation programme. Secondly, it is vital that that programme is more transparent, so that families know whether their services are good quality or whether they need to improve. Thirdly, the accreditation must be compulsory, so that all paediatric audiology services move towards running a good-quality operation.

My second point relates to access to radio waves technology for deaf children. Radio aids play a vital role in helping deaf children to hear speech; they enable them to better understand their teacher, and they have a big impact on improving parent-child communication. Despite the obvious benefits, most local authorities do not currently make radio aids available for use by families in the home. The NDCS is calling on local authorities and the Department for Education to ensure that every child who could benefit from a radio aid is given access to one at the earliest possible opportunity. To do that, the Department for Education should encourage local authorities to make use of their special provision capital fund, to provide radio aids where they are needed.

My third point relates to the need for a GCSE in British Sign Language. The Government really must listen to the right to sign campaign, to make British Sign Language available as a GCSE that can be taught in school. Ann Jillings points out that it is the first language of deaf children, so it is discriminatory that deaf children do not have the opportunity to achieve what is probably the most widely recognised qualification, and that it is given a lower status than other languages. There are other accredited qualifications in British Sign Language, but they are not widely available to children in schools and they are less likely to be recognised by employers. Daniel Jillings achieved his BSL level 1 three years ago, but it was not funded. Ann tutored him and paid for all the assessments herself. There is a compelling case for a GCSE in BSL, based on equality, the denial of choice for deaf children and the unnecessary barrier that it poses to further and higher education, and thereafter, entry to the workplace. That barrier must be removed. A GCSE has already been piloted and is largely ready to go. The Department for Education must make an exception to its blanket policy of not allowing any new GCSEs to be developed.

My fourth and final point relates to the special educational needs and disabilities framework. The Children and Families Act 2014 made significant changes to the SEND framework. One key change was replacing SEND statements with EHC—education, health and care—plans. The deadline for implementing those changes is April next year. There is a concern that many schools and local education authorities are struggling to implement the changes in time. In Suffolk, Ofsted and the CQC identified weaknesses in the county council’s practices in meeting the requirements of the Act.

Authorities such as Suffolk must be provided with sufficient funding so that they can meet their obligations. Although the high needs block, which funds SEND support, has been protected in cash terms, it has not been adjusted to reflect a variety of additional challenges: the rising number of children and young people requiring additional support; the greater local authority responsibility for young children with SEND aged between 16 and 25 and in early years; and a trend towards placing more children in special schools. More money needs to be made available and Ofsted needs to review how it can strengthen the accountability framework around SEND and how it inspects schools.

Ann Jillings has gone that extra mile and works tirelessly to ensure that Daniel gets the opportunity to have the best possible start in life and the best possible education, so that he can realise his full potential. There are many barriers that have been placed in her way in pursuit of that goal. I suggest that it is our duty, the duty of Government and of local authorities to remove those barriers as soon as possible.

Oral Answers to Questions

Peter Aldous Excerpts

Tuesday 14th November 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

The hon. Gentleman raises an issue that is of concern to many women up and down the country, and no one can fail to be moved by some of the horrendous injuries they experience. We now have 18 centres of specialist care that can treat those women. However, the advice we still receive is that, in some very narrow cases of stress incontinence, mesh remains the best possible treatment. The issue will be kept under review, and my noble Friend Lord O'Shaughnessy is due to meet the all-party group on surgical mesh implants to consider it in greater detail.

[Peter Aldous (Waveney) (Con)]

T4. The James Paget Hospital at Gorleston, which is doing great work under great pressure, has highlighted the fact that it and the clinical commissioning group have two different regulators. Does my right hon. Friend agree that it would be sensible for one body to oversee both organisations, so as to avoid duplication and redirect funds to the front line?