Dental Healthcare: East Anglia

Peter Dowd Excerpts

Wednesday 11th December 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Jerome Mayhew to move the motion and the Minister to respond. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

I beg to move,

That this House has considered dental healthcare provision in East Anglia.

It is lovely to see you in the Chair, Mr Dowd. I am grateful to colleagues from East Anglia for supporting this debate and, I hope, making some interventions. I am also grateful to the Minister for Care for coming yet again to Westminster Hall, because this is not the first time that we have had a debate on dentistry in the east of England, and in East Anglia in particular. The reason for those numerous debates is the significant problem of access to NHS dentists in particular, but also to private dentists.

Peter Aldous, who I am sorry to say lost his seat at the recent election, was a doughty campaigner on the issue. I pay tribute to him for the numerous debates he brought forward. Most recently, in September, the hon. Member for Norwich South (Clive Lewis), who is not here today, held a debate on the topic. Time is short, so I will not focus on the need as much as I normally would, but the Minister has been here before and knows very well how significant the need is for increased access to NHS dentistry in East Anglia.

I will give highlights, however, because the Secretary of State for Health and Social Care has described Norfolk not only as a dental desert, but as the “Sahara of dental deserts”. The Minister—the noble Baroness, Lady Merron—confirmed in the other place on 25 November that the Norfolk and Waveney area has

“the worst ratio of NHS dentists to patients in England”.—[Official Report, House of Lords, 25 November 2024; Vol. 841, c. 479.]

In my last debate in this forum, I was shocked to report that in Norfolk and Waveney the ratio of dentists per 100,000 population was 39, when the national average was 52. Now I have to update those figures, because the Secretary of State has recently confirmed that the figure of 39 has dropped to 36 per 100,000 of population, while the national average has increased to 53. It is getting worse, not better.

The data from this month is even more concerning. The British Dental Association confirms that there are 3,194 NHS dentists in the east of England, which are the statistics we previously used. BDA’s further analysis last month reveals that that equates to just 1,096 full-time equivalent dentists in NHS roles. If those figures are run through the population, there are 17 full-time equivalent NHS dentists per 100,000 population in the east of England. Those are truly shocking figures.

The issue can be sliced and diced in another way. The amount of money that the Government spend on people’s mouths in the east of England makes for sobering reading. The national average is £66 per mouth spent on dental treatment by the NHS. In the east of England, that figure is just £39. What is it? Is it that our fillings and dental work are cheaper in the east of England, or are we doing less? It is not due to less demand; we have the greatest demand. We had more than 1,000 people presenting in the past year at NHS A&E with significant dental problems. I believe I am right in saying that dental concerns are the single biggest reason why primary school children present at hospitals.

Rare Autoimmune Rheumatic Diseases

Peter Dowd Excerpts

Tuesday 10th December 2024 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

It is a pleasure to see you in the Chair, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing this issue before us today, because it is one of those subjects that does not get the attention that it needs. It is really important to tease out some of the issues, because there is a danger that they could be forgotten if we do not. The hon. Gentleman pushes this matter time and again.

The whole question of rare autoimmune rheumatic disease needs to be set in the context of the wider issue of rare diseases, which are conditions that affect less than one in 2,000 people. There are 7,000 rare diseases, affecting one in 17 people, which is 3.5 million people. They can be of a genetic or non-genetic origin and they affect adults and children. Some 75% of rare diseases affect children and more than 30% of children with a rare disease die before their fifth birthday. That is a sobering statistic.

We have to put the issue into that context: it affects the lives of so many people, not just those who are directly affected by the particular disease, but their family members and friends. A disease can also have an impact on someone’s work-life balance and their job, as well as more broadly. There are challenges, but I thank the Rare Autoimmune Rheumatic Disease Alliance for bringing those groups together to push for this issue. It believes, as we all do, that getting together gives us more strength. I support that, and I have no doubt that the Minister supports that too.

We do not want rare diseases, particularly this type of disease, to be left at the back of the queue. The Government acknowledge that, so I am not pointing the finger at them, or at health professionals. Many people with this type of disease say that they do not get the support they need, but they do not blame individual clinicians, practitioners or healthcare workers; they blame the system in so far as it does not bring those professionals together in, for example, the clinical networks that the hon. Member for Strangford referred to. This is not a finger-pointing exercise, but it is important that where we can identify, and have identified, problems in the system, it is our responsibility to try to fix those problems.

The hon. Gentleman also touched on the need for defined, measurable and identified standards to reduce inequalities in healthcare provision. RAIRDA is working with others to set out key statements that it believes will form the quality standards for the future. It has set out the challenges, such as the challenge of focusing on this issue and the points that the hon. Gentleman raised that the time from symptoms to diagnosis can be from two and a half years to as much as five years, and potentially beyond.

There is also a challenge with access to specialist knowledge and expertise, and the hon. Gentleman’s valid point, which I repeat, about the need for those specialist networks. There is the challenge of getting support out to the people—the professionals—dealing with our constituents in one way fashion or another. I know the UK rare diseases framework, and the England rare diseases action plan in my case, has been trying to help patients to get a diagnosis faster but we need to do more.

There has been a push to raise awareness among professionals, but we need to do more there. We need better co-ordination of care and improved access to specialist care, treatment and drugs. We also need to focus on the needs of the various nations. Although they all face similar problems, it is important to have a focus at a national and potentially regional level.

I support the hon. Gentleman, who made important points. We will no doubt come back to this issue. I know that the Minister will respond, as he always does, constructively and positively, so I look forward to hearing what he and Members from other parties have to say. I will finish by saying to the hon. Gentleman that at no point during my contribution did I mention either Shakespeare or Sophocles.

Suicide and Mental Health of Young People: Tatton

Peter Dowd Excerpts

Tuesday 26th November 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Esther McVey to move the motion. I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Esther McVey (Tatton) (Con)]

I beg to move,

That this House has considered the matter of suicide and mental health of young people in Tatton constituency.

It is a pleasure to speak under your chairmanship, Mr Dowd. I would like to convey my appreciation to the Minister for replying to this extremely important and sensitive debate on the management of withdrawal from antidepressant medication, specifically selective serotonin reuptake inhibitors, and the profound impact that that process can have on the mental health and suicide risk of young people.

I would like to begin by conveying my sincere thanks to my constituent, Gina Russell, who met me and bravely shared the experience of her daughter, Olivia, who tragically took her life in September 2021, following withdrawal from SSRI medication. Olivia’s mum is unable to be with us in Westminster Hall today. However, I know that she and her family are watching this debate at home, as they are determined to help prevent others having to suffer the same fate as Olivia.

I would also like to place on record my thanks to the charities Mind, Rethink Mental Illness, PAPYRUS Prevention of Young Suicide, as well as to The Children and Young People’s Mental Health Coalition and the House of Commons Library for the information provided to me before this debate. While the information was insightful, it was deeply disturbing, as it revealed that Olivia’s experience of declining mental health as medication was withdrawn was far from unique and was a known risk, which made me determined to pursue this debate on behalf of her family and thus bring Olivia’s story and her family’s suffering to a wider audience.

Let me start by painting a picture of Olivia, who was an intelligent, creative and hard-working 25-year-old who had just left Tatton to live in London. Her parents remember her as wonderful and vibrant—a loving daughter and a loving younger sister to her brother, Luke; a cherished and adored granddaughter; and a loyal, kind and supportive friend. She lit up a room and was admired by all who knew and loved her.

In November 2020, during the pandemic, Olivia became anxious. She began taking an SSRI—citalopram—to manage her anxiety. Initially, Olivia responded well to treatment. However, when the time came to discontinue the medication in June 2021, she experienced a rapid decline in her mental health, which was far worse than what she had previously faced. She then resumed SSRI treatment in August 2021, finally taking her life in September 2021. When she first came off her medication it was without consulting her GP, because she was feeling better. She should have been warned about stopping taking the antidepressant. The family was later to discover that citalopram is one of the most difficult antidepressants to come off.

Tragically, the Royal College of Psychiatrists suggests that between a third and half of people who take antidepressant medications experience withdrawal symptoms to some extent. The severity and duration of these symptoms, and whom they affect, is not certain. In Olivia’s case, the withdrawal symptoms were severe and the resulting deterioration in her mental state ultimately led to her taking her own life. Members should bear in mind that suicide remains the leading cause of death among young people under 35 in the UK, and the mental health of young people has declined alarmingly in recent years.

Mental Health Support

Peter Dowd Excerpts

Thursday 10th October 2024 Westminster Hall

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

Order. This is clearly a popular subject. Lots of people had indicated previously that they wished to speak; there are obviously people who wish to speak who had not indicated beforehand, and others will want to intervene. The Minister and Opposition spokespersons have 10 minutes each. Having done the calculations, we will regrettably introduce a formal three-minute time limit on Back Benchers. You will be able to see the time on the screen, and regrettably I will have to cut you off in your prime if you go over three minutes. Just bear that in mind, please. I am sorry for the tutorial, but it is worth having, I suppose. Please bob if you do want to speak.

[Helen Maguire (Epsom and Ewell) (LD)]

It is an absolute pleasure to serve under your chairmanship, Mr Dowd, as I speak for the first time in Westminster Hall. I thank the hon. Member for Ashford (Sojan Joseph) for securing this important and timely debate on World Mental Health Day, and for speaking so well.

Mental health can affect any of us at any time, young or old. Unfortunately, too many people simply do not get the support they need and some go on to take their own life. Speaking personally, husbands of two friends of mine, a friend’s brother and a friend have taken their life, destroying families who are left behind figuring out how to cope.

Since becoming the MP for Epsom and Ewell, I have been shocked by the lack of mental health support, but also amazed at the ingenuity of local residents to provide it in its absence. I had the pleasure of meeting Charley Moore the other day—a Surrey female firefighter and founder of an all-female support group in Epsom and Ewell called Grow and Glow. She had a mental health crisis last year and found it very difficult to access support. She found many mental health groups for men, but she could not find any specifically for women, so she set one up.

I was also proud to meet two mental health charities the other day that were recognised at the BBC Surrey and Sussex Make a Difference Awards last week in my constituency. One was We Power On, which is a men’s mental health “walk and talk” support group set up by Chris Waller after he and his friend reconnected during lockdown and discovered that they were both struggling with their mental health. He won the bravery award. He takes people out at the weekend, walking on the lovely Epsom downs and sharing their experiences.

The other charity, Joe’s Buddy Line, was set up by Ivan Lyons, who won the community award and is one of my constituents. Ivan’s son was an award-winning radio producer on Capital Radio. Sadly, in 2020, Joe took his own life. Through Joe’s Buddy Line, Joe’s family advocate for mental health to be treated equally and with the same seriousness as physical health. The charity provides mental health support, advice and resources for schools. It is encouraging schools to put a mental health policy in place in every single school, giving teachers the support that they need to support the young people of today. The charity has highlighted to me that currently it is not a statutory requirement for a school to have a mental health policy. Such a policy would foster a whole-school approach, so today I am calling for a statutory requirement for all schools to have a specific mental health policy.

Too many people are simply suffering and too many lives are being lost, yet some of that is preventable. Early intervention and prevention are absolutely key. First, to ensure that our young people get the support they need before they reach crisis point, we need to equip them with the tools they need to build resilience to cope with modern life. We must ensure that no one feels alone in their mental health journey, and we need to normalise conversations about how we are feeling mentally. I am absolutely proud that in my constituency, individuals such as Ivan, Chris and Charley are taking the initiative to champion mental health support for everyone and fill in the gaps that they have identified in the services. Let us not forget—

[Peter Dowd (in the Chair)]

Order. Please sit down. May I reiterate that this is a very sensitive subject, and I do not want to have to stop people in mid-flow when they are talking? This is a very sensitive issue and it would sound rude, so I exhort hon. Members to keep to the three-minute limit. It is regrettable, as this is a very important subject, but please keep to the limit, because— I reiterate—this is such a sensitive subject, and I do not want to cut people off at a sensitive point.

--- Later in debate ---

[Dr Opher]

Absolutely; I fully agree with that.

I want to make a couple of comments about the state of mental health services, for which there are extraordinary waits: a patient of mine had to wait six months following a suicide attempt. That is simply not good enough. In Stroud, we have to wait four years for neurodiversity assessments because we do not have enough resource. In my opinion, we need to move the resource into the community.

I also support what my hon. Friend the Member for Ashford said about health and education. We need mental health support teams in our schools, and we must spread SEND provision evenly.

The Under-Secretary of State for Public Health and Prevention is with us, so I want to talk about the prevention of mental health issues. There is quite a lot of evidence about promoting maternal and infant mental health, and also about parenting and bullying at school. Using arts and culture is an incredibly strong way of improving mental health.

I was impressed with what my hon. Friend the Member for York Central (Rachael Maskell) said about the community basis of mental health treatment. For many lower-level conditions, there is no need for consultant-led care. Support that takes place in the community costs much less and can be really effective.

The CAMHS waiting list is appalling, and we have a crisis with SEND and delays with education, health and care plans. We do not have enough educational psychologists either. I want to stress what my hon. Friend the Member for Ashford said about care co-ordinators. Young people’s social prescribers are very effective and tend to de-medicalise things that can be supported in the community.

I am really impressed that we are going to get 8,500 more mental health workers. I am also impressed by what they will be doing in schools. We need to improve the physical health of people with serious mental illness, reduce the number of SSRI antidepressant medications, and promote social prescribing, the arts and community care in our mental health services.

[Peter Dowd (in the Chair)]

Can I just remind Members about modes of expression? I will be diplomatic about it.

[Lola McEvoy (Darlington) (Lab)]

I rise to speak about this issue on World Mental Health Day. I have championed it many times across my career and I will continue to do so in my time in this place.

My constituents—and, I am sure, those of all hon. Members—want something that we used to take for granted: a happy, decent life, with a better future for their children. For too many in Darlington, that is not the reality, and I believe that the current mental health crisis is a product of our times. I will focus my brief contribution not on those with severe mental illness, who are often in crisis, but on those who are struggling with day-to-day poor mental health.

I agree with the hon. Member for Hinckley and Bosworth (Dr Evans), who advocated a cross-departmental approach. Poor mental health is pushing people out of work, and that is a huge issue for the Treasury and the Department for Work and Pensions. A lack of child mental health support and a failure to tackle the online safety crisis for children is leading to school refusals, which is an issue not only for the Department for Education but for the economy and for future generations. Loneliness is impacting the physical health of our older people, which is an issue for the NHS. The lack of opportunity, quality work, maternal mental health services, veteran support and childcare support is driving people in my constituency to despair.

I have mentioned this before, but I will mention it again on this day: within my own network, I have lost seven men to suicide. Only one of them had a severe mental illness. In my region, we have the highest rate of male suicide and the lowest wages. I ask that we, as a Government who are committed to equality of opportunity for our regions, consider my constituency and my region for a cross-departmental pilot to tackle poor mental health before we lose any more people to avoidable deaths.

[Peter Dowd (in the Chair)]

I now come to the Opposition spokespersons.

--- Later in debate ---

[Dr Spencer]

I thank the hon. Gentleman for sharing something so personal in his intervention, and for sharing his experience of the impact of suicide. Many Members have shared personal experience in this debate. That is very important.

I am mindful that there will be people in the Gallery or watching at home who may be affected by the topics we are discussing, and I take a moment to point out that there are a variety of services to help people in their recovery, if one can call it that, after a loved one has tragically died from suicide, or to help people who are in crisis, such as local crisis services, the Samaritans or Mind. There is a variety of third sector and charity helplines that can help. Men’s Sheds is one organisation I know of that is very helpful. I am really pleased that the hon. Gentleman raised this issue.

I will finish with a few questions for the Minister. The Government do not have a mental health care and treatment strategy or a psychosis strategy and, following an answer to a written parliamentary question I tabled, I understand that there are no plans for a mental ill health strategy to be brought in. Given today’s debate, I wonder whether the Minister will reconsider that position. What are the Government’s plans on taking forward our suicide prevention strategy, or a specific psychosis or mental ill health strategy—however he wants to cut the cloth?

Secondly, when does he expect the Mental Health Bill to have its First Reading in this place? All Members are going to want to extensively debate and scrutinise that Bill. When does he expect it to come forward? What is his appraisal of the challenges that the Bill needs to answer when it comes to the interaction between the Mental Health Act 1983 and the Mental Capacity Act 2005 and the deprivation of liberty safeguards? What about the MM case on deprivation of liberty in the context of a restricted patient in the community, and the interaction with the Children’s Act 1989 on when children can choose a nominated representative? I realise he may not have the answers to that immediately, but I would be grateful if he could write to me. Community mental health teams are the core of psychiatric teams in the community and our psychiatric care and treatment service. What is his plan to support them?

Finally, what is his appraisal of integrated care systems and their commissioning of mental health services? The hon. Member for Hastings and Rye (Helena Dollimore) mentioned the challenges with her ICS. What is the Minister’s appraisal of that commissioning and how integrated care systems can be held to account to make sure that is being delivered?

[Peter Dowd (in the Chair)]

I want to give the sponsor an opportunity to wind up at the end. I call the Minister.

--- Later in debate ---

[Andrew Gwynne]

I am reluctant to commit Ministers to roundtables when I am covering another portfolio, because then they will do the same when they cover me in Westminster Hall debates, but I will say that we take this agenda incredibly seriously. When we were in opposition we gave support to the then Government, and I assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time to the people who need it.

As I was saying, the covid-19 pandemic has exacerbated the need for mental health support. Around 345,000 children and young people were on a mental health waiting list at the end of July this year, with more than 10% of them having waited for more than two years. Some groups of children and young people are disproportionately impacted by mental health problems largely driven by a complex interplay of social and environmental determinants of poor mental health, as we heard in the debate.

We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults do not receive the mental health- care that they need, and we know that waits for mental health services are far too long. We are determined to change that, which is why we will recruit 8,500 additional mental health workers across child and adolescent mental health services. We will also introduce a specialist mental health professional in every school and roll out Young Futures hubs. We are working with our colleagues at NHS England and in the Department for Education as we plan the delivery of those commitments.

Early intervention on mental health issues is vital if we want to prevent young people from reaching crisis point. Schools and colleges play an important role in early support, which is why we have committed to providing a mental health professional in every school. However, it is not enough to provide access to a mental health professional when young people are struggling; we want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact on the promotion of good mental health and wellbeing. Doing this will require a holistic approach, drawing in many aspects of the school or college’s provision. I know there are many schools that already do this work, and my Department is working alongside the DFE to understand how we can support best practice across the sector.

As I have said, our manifesto commits us to rolling out Young Futures hubs. This national network will bring local services together and deliver support for teenagers who are at risk of being drawn into crime or who face mental health challenges. The hubs will provide open-access mental health support for children and young people in every community.

On other aspects of our plans, the mental health Bill announced in the King’s Speech will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and it will ensure that everyone is treated with dignity and respect throughout their medical treatment. It is important that we get the balance right to ensure that people receive the support and treatment they need when necessary for their own protection and that of others. The Bill will make the Mental Health Act 1983 fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better and more personalised care. It will also limit the scope to detain people with a learning disability and autistic people under the 1983 Act.

Finally, Lord Darzi’s report identified circumstances in which mental health patients are being accommodated in Victorian-era cells that are infested with vermin, with 17 men sharing two showers. We will ensure that everyone is treated with dignity and respect throughout their treatment in a mental health hospital, and we will fix the broken system to ensure that we give mental health the same attention as physical health.

If I have not answered Members’ questions, those Members will be written to by the relevant Minister. I again congratulate my hon. Friend the Member for Ashford on securing the debate.

[Peter Dowd (in the Chair)]

I call Sojan Joseph to wind up very briefly.

Preventable Baby Loss

Peter Dowd Excerpts

Wednesday 4th September 2024 Westminster Hall

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

I remind Members that if they wish to speak, they should bob—as some of you have done. Thank you for that.