Young People’s Mental Health

Debate between Wes Streeting and Huw Merriman

Thursday 27th October 2016 Commons Chamber

[Wes Streeting]

It really does. One of the things that concerns me most about young people’s poor experience of mental health services—this was reflected at the discussion by the all-party group—is that it is not just GPs and headteachers who recognise that young people are being failed and turned away; young people themselves recognise that. I cannot imagine what it must be like to be a young person who is suffering from anxiety, depression or another form of mental ill health, who knows they have a problem, seeks help and is left to feel ignored, dismissed and unsupported. I have mentioned the proportion of lesbian, gay and bisexual young people who are affected, and it is even higher for trans young people.

I represent a constituency that is highly diverse ethnically and religiously. It worries me that Asian communities seem to be far less likely to seek access to mental health services. There is a job to do there to tackle stigma and to make the services more accessible. People from African-Caribbean communities face inequality. The failures of public policy on African-Caribbean people should shame our country. It is a further indictment that the majority of African-Caribbean people who come into contact with the mental health system seem to do so through the criminal justice system. That is a terrible state of affairs. Therefore, the issue of access and support is crucial if we are to deal with the problem.

This is partly about funding. We have had a good-natured debate this afternoon, so I do not say this to be objectionable or churlish, but on Wednesday, three or four Members on both sides of the House raised the issue of mental health with the Prime Minister, and her response was, to put it politely, inadequate. Beyond general statements about parity of esteem, she seemed unable to point to any meaningful actions her Government were taking on the issue of mental health.

I am sure that the Minister has come better briefed this afternoon, but the Prime Minister also needs to make this a priority. Much of this is about joined-up government—this will be a theme of mine this afternoon—and that requires leadership from the centre. It is not good enough for the Prime Minister to be sure-footed, although wrong-headed, when it comes to home affairs issues, but completely blind-sided on issues outside her comfort zone. We need stronger leadership on mental health from her and I was genuinely disappointed with what we saw during Prime Minister’s questions this week.

Parity of esteem is not about sentiment—it is about resources. About 11% of the NHS budget is spent on mental health and just 6.36% of that 11% is spent on children’s mental health. I recognise that the Government have made a commitment to invest £1.4 billion in child mental health in the next five years, and I welcome that, but I urge the Government to ensure that that funding is delivered sooner rather than later. Locally—other Members have referred to this—budgets are being cut or frozen in three in four mental health trusts. Seven in 10 CCGs and local authorities are freezing their budgets because of pressures from central Government reductions. My hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) has, through written parliamentary questions, highlighted that decisions coming down the track will make that picture even worse.

In the London Borough of Redbridge, the council is doing fantastic work with limited resources. However, I can say from first-hand experience—I declare an interest as an elected member of the council—that local government cuts are biting. The picture is compounded by the state of our local health economy. Both our NHS trusts are in special measures, although I hope one of them will be leaving special measures sooner rather than later. I hope that they will both leave, but I suspect one is nearer to the end of that journey than the other. Primary care is creaking, it is fair to say that our clinical commissioning group is struggling, and our community health trust has a rating that requires improvement. The challenge for Redbridge is not simply the funding reductions that affect my borough, but the fact that the funding formula does not lead to a settlement for Redbridge—for the local authority and for the wider health economy—that genuinely reflects the needs of our population. I urge the Minister to look carefully at how Redbridge has been disadvantaged through the funding formula, particularly in public health funding, and at what can be done.

[Huw Merriman]

I do not wish to get into a skirmish on funding, but does the hon. Gentleman agree that, as in my area of East Sussex, the way to find the efficiency savings that the NHS is required to make, in addition to the £10 billion that this Government have put in, is to have a “better together” organisation so that hospitals and all the other healthcare providers—at county level and so on—can talk together? That would not only save money, but mean that everyone is joined up, which is the way forward on such issues, as he has rightly said.

[Wes Streeting]

I very much welcome the hon. Gentleman’s intervention. He has anticipated some of my closing remarks about looking to the future. I will have some positive words to say about the direction of Government policy in that respect.

This issue is not simply about funding, but about leadership and accountability. I must say that the damning CQC report on the Brookside unit in the constituency of my hon. Friend the Member for Ilford South (Mike Gapes) has more than raised eyebrows. Some of its judgments about this facility for children’s mental health provision were:

“The ward environments were not safe, clean or suited to the care of children and young people… The wards were not adequately staffed… There was a high usage of restraint and rapid tranquilisation at the unit… The ethos of the unit was containment rather than therapy… Care plans reviewed were not recovery orientated and more behaviour orientated… During the inspection we saw staff refuse to facilitate the requests of young people… Young people stated the food was of poor quality and cultural and religious foods were not available”—

and those who know the London Borough of Redbridge will know how totally inappropriate that is. My question for the North East London NHS Foundation Trust is very simple: why did it take a damning inspection by the Care Quality Commission for sufficient action to be taken? From what I can see and from my conversations with colleagues in the local authority, there is clearly a road to improvement. It should not take inspectors coming in to highlight the fact that we have failed some of our most vulnerable young people in such a gross and unforgivable way.

Among my worst experiences as a constituency MP—these are universally my worst experiences—are in my surgeries on Friday afternoons when I see absolutely awful cases of people who have been very badly failed by public services. One case I will never forget was that of Simon Harris, a young man—he was 30 years old—who was failed by Goodmayes hospital because he was insufficiently cared for. While under the care of the NHS, he was allowed to take his own life, although he was in the very place that his family thought would keep him safe. I never again want to have a conversation with a constituent like the one I had with his incredibly stoic and courageous grandmother, Brenda. That is the consequence of mental health failure: it is simply the difference between life and death. I do not think that young people like Simon should ever be failed in such a way by the services that are there to keep them safe and well.

This subject is not just about public service provision, but about celebrating the work done by the voluntary sector. In the past year, I have visited a number of programmes in my constituency. I have visited Audacious Veg, a social enterprise that involves helping people suffering from mental ill health to set up their own social enterprise, growing and selling vegetables. This wonderful project runs in conjunction with the Forest Farm Peace Garden, another environmental and sustainability project, which gets people with mental ill health outside, interacting with others and active.

I cannot commend strongly enough to the Minister the importance of social prescribing. Here, public policy has a role to play. When Redbridge Youth Council, for example, commissioned the Redbridge Drama Centre to design and deliver a play on mental health to reach young people, 5,000 young people and counting across the London Borough of Redbridge were reached by that fantastic way of engaging young people in conversations about mental health.

Music can play a powerful role in therapy, as can sport. One of the most impressive projects I have visited in the past 12 months was Coping With Football, sponsored by the London Playing Fields Foundation and run in conjunction with the North East London Foundation Trust. Again, that project got young people outside, interacting and developing their skills and, most importantly, their self-esteem.

That brings me on to looking to the future, and I will press the Minister to take policy in a few directions. I have asked her to look at Redbridge’s funding formula, on public health in particular, and I hope she will undertake to do so. I also ask her to work with her colleagues in Government to think about funding nationally. The hon. Member for Bexhill and Battle talked about the value of joining up services locally, in particular local government and the NHS. I commend the approach being taken by the Government through the introduction of the accountable care organisations. In the pilot with Redbridge, the London Borough of Barking and Dagenham and the London Borough of Havering, that approach is bringing the local authority together with stakeholders from across the local health economy to join up public service provision. That will bear fruit.

We also need joined-up Government nationally, however. Other Members have made a compelling case for the Minister to fight her corner in public health, because investment in public health and early intervention is a money saver—and not just across Government; within her own Department we can reduce A&E admissions and the pressure on urgent and primary care if we get public health funding right.

The Minister also needs to make the case, along with the Secretary of State, across Government. For example, it is no good the Treasury making cuts to local government if that leads to cuts in public health funding and undermines the work of the Department of Health. It is no use cutting mental health provision if that leads to a spike in crime, an increase in the prison population and greater demand on the criminal justice system.

In education, it is no good asking Ofsted to inspect schools on mental health provision if school referrals to CAMHS are going unheard. We need to make sure the services are there to support schools. We also cannot continue with the postcode lottery on sex and relationships education and personal, social and health education. I hope we can revisit the issue of compulsory SRE and PSHE.

Finally, and most importantly—it is the reason we are here this afternoon—I urge the Minister and her colleagues in Government to listen to young people. That she is here this afternoon shows the importance the Government place on this report and the views of young people. My hon. Friend the Member for Dulwich and West Norwood talked about the importance of co-production and involving young people in the design of public services, and that is absolutely critical. But the Youth Select Committee has made a whole series of other recommendations that deserve not just the serious attention of this House but the response of Government. If that happens, we will get better public policy, and, I hope, we will have a generation of young people whose voices have not just been heard but, most importantly, listened to.

UK Economy

Debate between Wes Streeting and Huw Merriman

Wednesday 29th June 2016 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to follow the powerful and eloquent speech of the hon. Member for Ilford North (Wes Streeting); I feel somewhat like a dull bank manager following on from his act.

Perhaps unusually, may I welcome not just the subject of the motion, but also the wording of it? I congratulate those on the Opposition Front Bench on bringing this motion forward today.

I must confess that the decision made by the voters of the UK to leave the European Union came as both a surprise and a shock to me. I spent my time holding debates across my Bexhill and Battle constituency so that constituents could hear both sides of the argument and then come to their own conclusion. I never sought to influence their votes one way or the other. This position of balance also permitted me to speak to 25 schools—both secondary and primary—over the last week of the referendum campaign. It troubled me greatly that young children whose parents were originally from the EU were asking if their parents would have to leave the UK or whether Britain would go to war if we left. At least it gave me the opportunity, with balance, to do my best to reassure them.

I would contend that the campaign themes and sometimes extreme scenarios that were being asserted were causing these concerns to be raised and it is little wonder to me that some votes appear to have been irrationally cast. Had the remain side recognised, perhaps in more balanced tones, that there were positive reasons for the UK to leave the EU but even more positive reasons to remain, I wonder whether the UK population would have so readily lined up to give the establishment opinion-makers the thumbs-down.

All this is for historians to deal with in due course. We are where we are and it is my belief that we in this place have to lead from the front and get the best deal for the UK in order to preserve the rights that our population has enjoyed from the EU while delivering the semblance of democratic control which the public have demanded of us through this result.

While I have concerns about the economic implications in the short term, I believe that, with the right civil service negotiation team in place, we can get a good deal from our European partners. I do, however, believe that this will take determination, good grace, hard work, focus and an ability to work with our European counterparts. Thumbing our noses, as Nigel Farage did so disgracefully in the European Parliament this week, not only demonstrates that he should not be let anywhere near this process, but also demonstrates that vitriol and triumphalism rarely bring out the best in negotiation counterparts.

My rationale for this is borne of my experience working at Lehman Brothers over a 15-year period, for seven years with the small team that was unwinding what became the world’s largest bankruptcy. I was running a legal department the day Lehman Brothers went bankrupt. During the speech of the hon. Member for Ilford North, there was a time when I wanted to come over and give him a cuddle, because there was great fear in 2008 just like the fear for his generation that he was describing. There is great fear right now, but I remember that fear back in 2008, from a personal perspective because I had my mortgage on that institution, and my friends and colleagues for many years worked for it. Despite what people say about investment banks, they include not only bankers, but cleaners, secretaries, and people who do not earn a great wage, and they lost not only their job, but their sense of pride and security in that institution.

[Wes Streeting]

The hon. Gentleman is right to mention the support staff and cleaners who make those businesses function, but it is also worth mentioning the fact that, although the people who work in financial services have been guilty of all sorts over the years, including bringing our economy almost to its knees, the financial services sector still generates enormous investment in this country and creates jobs. It would be foolish to allow that great industry to go by the wayside, given all the benefits that it brings and the tax receipts that we invest in public services. We should not let those people off the hook, but we should never pretend that financial services are not an asset to this country.

[Huw Merriman]

I absolutely agree with the hon. Gentleman. There were some who really needed more punishment than they got, while others took a huge amount of punishment, but those services are still a great exporter for UK plc.

The events on that day in 2008 were an enormous shock, and I remember them well. I worked with a guy from another bank—the largest international and commercial bank—who was in control of its legal department. He said he had spent that weekend dealing with Lehman Brothers as it fell over. He then spent the following week dealing with one of the other largest banks as it fell over. The week after that, his own bank fell over as well. Back then, those of us who were there remember feeling that money was just not safe in any financial institution at all. People might be fearful right now, but I ask Members to cast their minds back to 2008 when things felt even more uncertain.

I also ask the House to recognise that, in the past six years, the economy in this country has got better. We have recovered. Who would have thought we would reach a position in which 2 million new jobs could be created? Perhaps the decision on the European Union has been such a great shock because we have once again got used to a form of stability.