Eating Disorders Awareness Week

Abena Oppong-Asare Excerpts

Thursday 29th February 2024 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Hollobone. I want to start by praising the hon. Member for Bath (Wera Hobhouse) and my hon. Friend the Member for Sheffield, Hallam (Olivia Blake). They are true champions of those suffering from eating disorders or mental health issues, especially our children and young people. I congratulate them on securing the debate and on their excellent contributions, as well as their continued work through the APPG on eating disorders to help champion this issue. They have put this issue on the national radar and have worked effectively cross-party to try to eradicate the epidemic of eating disorders.

I also thank my right hon. Friend the Member for Hayes and Harlington (John McDonnell), who talked passionately about the impact that eating disorders have on individuals and highlighted the fact that we need to understand the impact they have on people’s lives, including at work. He also talked about the huge spike in hospitalisation figures.

I want to touch on some of the points mentioned by the hon. Member for Bath, who used powerful statistics to make the growing problem of eating disorders hit home. She highlighted the disparity between areas in how high up the agenda the issue is—it is not always high up the agenda—and talked about the importance of carers and parents knowing more about the condition so they can help to address it. That was echoed by my hon. Friend the Member for Sheffield, Hallam, who talked passionately about her constituent, who said she was “reduced to numbers” before receiving help. She also highlighted something that hit home with me when she spoke about how her constituent had said that no one should be “left to a medical emergency” before getting help, and that there should be standardised treatment for this particular matter.

I am pleased to speak on behalf of the Opposition to mark Eating Disorders Awareness Week. As many people in the room will be aware, eating disorders are serious mental illnesses that can have severe consequences. It is estimated that over 1 million people in the UK live with an eating disorder, and the reality is that for far too long, those suffering have been ignored. Eating disorders are responsible for more loss of life than any other mental health condition, as has been said. Unfortunately, as we have seen with the statistics raised in the debate, it is increasingly becoming quite common. The sooner someone receives treatment, the better their chances for making a full and sustained recovery, yet that is often not the case. It is a credit to the many campaigners and parliamentary colleagues in this room who have been working on this, along with vital charities, such as Beat, that we can say progress has been made in awareness and support. However, as we continue to face the severe consequences of the pandemic, we see a mental health crisis across our country. We all know that so much more urgently needs to be done.

The NHS figures suggest that the proportion of those aged 17 to 19 with an eating disorder stands at 12%, which is up from just 0.8% six years ago. Hospital admissions are double what they were a decade ago, and last year the awareness week focused on the specific challenges for men.

I also want to quickly echo the point made my hon. Friend the Member for Sheffield, Hallam, as well as other Members, on the importance of recognising that eating disorders do not discriminate. They affect any age, ethnicity, gender or socioeconomic background. It is important to highlight those facts when continuing to break down the stigmas and stereotypes that prevent so many people from reaching out and receiving much needed help.

This year, Beat has focused its attention on another important issue that has often been overlooked—avoidant/restrictive food intake disorder. It can affect anyone of any age, and Beat has estimated that the number of people with that disorder in the UK could be over 200,000. It can be very difficult to diagnose, and as Beat has highlighted, the information available to those seeking help can be very limited, which echoes what has been said by hon. Members today about parents and carers not having sufficient information on how to address these issues. For example, it has been highlighted that eight in 10 eating disorder service providers do not state on their website whether they offer ARFID care.

The data clearly shows that such cases, like all eating disorders, have surged in recent years across the UK. However, as cases have risen, services have struggled to match the demand, which means more waiting in anguish for longer. In 2015, the Government introduced new waiting times and access standards for community-based eating disorder services for children and young people. That included targets for one-week urgent treatment and four-week routine treatment, but those targets have never been met. I would be grateful if the Minister could tell us what will be done to address that failure. Meeting those targets is much needed. Instead of meeting those targets last year, one in five patients with non-urgent referrals were not seen within four weeks, and one in three patients with urgent referrals were not seen within a week. When children and young people with urgent cases of eating disorders wait more than 12 weeks to start treatment, the severity of the current crisis cannot be overlooked.

I also want to raise the important issue of providing adequate care to adults. As highlighted by the HSJ report last year, the deaths of 19 eating disorder patients, with at least 15 of those being deemed avoidable, demonstrated an urgent need to improve eating disorder provision. What more are the Government doing to address those concerns and ensure that all those patients receive the quality of care that they deserve?

I also want to touch on some of the points mentioned by my right hon. Friend the Member for Hayes and Harlington, my hon. Friend the Member for Sheffield, Hallam, and the hon. Member for Bath. They mentioned the lack of monitoring of the effectiveness of treatment being provided. Is the Minister aware that the Royal College of Psychiatrists has published guidance for healthcare professionals to support the development of specialist skills and knowledge to assess and treat people with eating disorders? What are the Government doing to ensure that that guidance is embedded in primary care and emergency departments? The Opposition recognise that, when it comes to eating disorders and all mental health issues, prevention is so important, and early prevention provides the best chance of recovery. Too many people, especially our children and young people, are stuck on mental health waiting lists for months or years instead of receiving the urgent care that they need.

We face a mental health crisis in this country, and we must have a Government that acknowledge that and will take urgent action. That is why Labour have committed to a child health action plan, with a bold ambition for this to be the healthiest generation of children ever. We will recruit thousands more mental health staff to cut waiting lists and ensure that more people can access treatment. We will focus on prevention, early diagnosis, early intervention and timely treatment near where people live.

To do that, we will put an open-access mental health hub for children and young people in every community, and a mental health specialist in every school. That will be paid for by abolishing tax loopholes for private equity fund managers and tax breaks for private schools. We cannot continue to lurch from crisis to crisis, which is what is currently happening. We must look at how we can build a new, solid, long-term foundation for a resilient health and care system, with an NHS that is truly fit for the future.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Hollobone. I start by paying tribute to the hon. Member for Bath (Wera Hobhouse) for securing an important debate on an important topic. I know that both as an MP and as the chair of the all-party parliamentary group she has long been a champion for those living with eating disorders. She has worked with the hon. Member for Sheffield, Hallam (Olivia Blake) and others on the APPG to ensure that eating disorders are kept high on the political agenda.

I share the passion for this issue expressed by all the hon. and right hon. Members who have spoken in this debate. As the right hon. Member for Hayes and Harlington (John McDonnell) said, one thing that unites everybody in the Chamber today is that we have all tried to help a constituent, or the family of a constituent, who is suffering from an eating disorder. I have certainly done so in my 13 years as the MP for Pendle, and those cases that I have dealt with are some of the most difficult and emotional to have come across my desk in my surgery.

Improving eating disorder services is a key priority for the Government and a vital part of our work to improve mental health services. As we have heard, this week is national Eating Disorders Awareness Week, and raising awareness is essential to making progress on this important issue. I am grateful for the work of Beat and other charities across the whole sector; they have shone a light on eating disorders and they support people who are struggling.

We know that having an eating disorder can so often be utterly devastating for those with the condition, as well as for those around them. As I think has been said by pretty much every hon. Member who spoke today, we know that eating disorders can affect people of any age, gender, ethnicity or background. However, we do know that recovery is possible, and that access to the right treatment and support can be life changing. Early intervention is vital, and we want to ensure that children and young people with eating disorders get swift access to support.

Since 2016, investment in children and young people’s eating disorder community services has risen every year; £53 million was invested per year in 2021-22, and that figure rose to £54 million in 2023-24. As part of the £500 million covid-19 mental health recovery action plan, we invested an extra £79 million to significantly expand young people’s mental health services—enabling 2,000 more children and young people to access eating disorder services. We have also introduced a waiting time standard for children and young people with eating disorders. Our aim is for 95% of children to receive treatment within one week for urgent cases, and within four weeks for routine cases.

[Abena Oppong-Asare]

On the Minister’s point about getting waiting time targets down to one week, those targets were implemented in 2015, and they are yet to be met. Could the Minister explain what work is being done to address that, because he just mentioned those same targets again?

[Andrew Stephenson]

I completely recognise the shadow Minister’s challenge on that point and the concern that she has—I will set out what we are doing to address it. She also mentioned the Royal College of Psychiatrists, which published a report on this today. It is worth putting on record that we very much welcome that and that we look forward to working with it and other stakeholders. Waits are not as short as we would like, and the Government are determined to meet our waiting-time standards for children and young people with eating disorders. Extra investment is going into the services to meet increased demands and reduce waits, so hopefully we will start to see progress made towards meeting those targets. However, we acknowledge that, while there has been record investment and progress in improving access to eating disorder services and improving quality, there has also been a significant increase in demand for those services over the past few years. That was especially true during the pandemic, with increased demand outstripping the planned growth in capacity.

Children and young people’s eating disorder services are treating 47% more children and young people than before the pandemic, with almost 12,000 children and young people starting routine or urgent treatment in 2022-23, compared with just over 8,000 in 2019-20. That surge in demand has made meeting our waiting-time targets more challenging, and waits are not as short as we would like them to be. However, I am proud that our services and clinicians, backed by new funding, are supporting more children and young people than ever before. Those services are changing and saving lives.

We also know that even earlier intervention is critical to prevent eating disorders from developing. Community-based early mental health and wellbeing support hubs for children and young people aged 11 to 25 can play a key role in providing that support. In October 2023, we announced that £4.92 million from the Treasury’s shared outcomes fund would be available to support hubs, and an evaluation to build the evidence base underpinning those services.

[Andrew Stephenson]

We do need more information on that, and I will come to that point. The next point that I wanted to make was on an announcement that I know the hon. Lady will already be aware of, but other hon. Members may not be. Following the evaluation of some excellent commercial tenders from hubs across the country, the Government announced just this week that we are now providing an additional £3 million, which means that total of 24 hubs will receive a share of almost £8 million in 2024-25. That is more than double our original target of funding 10 hubs, and organisations across England—from Gateshead to Truro—will now benefit.

I appreciate that there is still a bit of a postcode lottery around the country, but we are looking to strengthen services, working with different partners across England, to ensure that we are improving services—enhancing existing services—or developing new services where they have not been provided in the past.

[Abena Oppong-Asare]

I just want to add to the point made by the hon. Member for Bath (Wera Hobhouse) about hubs. What work will be done to ensure that the data is captured to see how the growing problem of eating disorders can be addressed and what effective treatments could slow the increase?

[Andrew Stephenson]

We are working very closely with NHS England and partners to ensure that that data is captured. We are also working with the charities involved in this sector and with others.

I know that the Minister with responsibility for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), has been doing a lot of work on this and has met with various stakeholders. I perhaps should have said at the start of the debate that the reason my hon. Friend is not here and hon. Members have me instead is, of course, that the International Women’s Day debate in the Chamber was still going when this debate started —so, unfortunately, there was an unavoidable clash.

However, I know that this is a topic very close to my hon. Friend’s heart, and getting the data right is really important for us to ensure that the gaps that currently exist in services are being addressed. I will certainly ensure that the shadow Minister’s issue is raised with my hon. Friend; if I may, I will ask her to write to the hon. Lady on that.

We know that eating disorders can have devastating effects on adults too. Under the NHS long term plan, by 2023-24 we are investing almost £1 billion extra in community mental health care for adults with severe mental illness, including eating disorders. That extra funding will help to enhance the capacity of new or improved community eating disorder teams covering the whole of the country. As part of funding provided in 2021-22 in response to pressures created by the pandemic, we also provided £58 million to support the expansion of community mental health services for adults, including those relating to eating disorders.

Many hon. Members in their contributions raised avoidant/restrictive food intake disorder, or ARFID. I share their ambition to improve support for people living with this under-recognised condition. In 2019-20, NHS England funded seven community eating disorder teams for children and young people, one in each region of England, in a pilot programme to improve access, assessment and treatment for children presenting with ARFID. The pilots ran from September 2019 to March 2020 and included training to support the adaption of each service’s existing care pathways, assessments and treatment interventions for children and young people with ARFID. The training from those pilots is now available for local areas to commission for their community children and young people’s eating disorders services. In 2021, NHS England also commissioned ARFID training for staff delivering treatment in inpatient children and young people’s mental health services.

We recognise that more needs to be done. We know that the earlier treatment is provided, the greater the chance of recovery. NHS England continues to work with eating disorders services and local commissioners to improve access to treatment for all children and young people with a suspected eating disorder, including those presenting with ARFID.

Several hon. and right hon. Members raised the issue of BMI and the Dump the Scales campaign. NHS England continues to emphasise to systems and services that BMI should not be used as a single measure to determine access to treatment within either adult or children and young people’s eating disorders services. That is in line with NICE recommendations and is included in the national published guidance, as well as in the recent community mental health framework. NHS England is also in the process of updating the children and young person’s guidance, which will also state that BMI should not be used as a single measure.

The hon. Member for Bath asked whether we would consider appointing an eating disorder champion who could help to galvanise action and support for people living with those conditions. As she may know, the Government do not currently have plans to appoint a specific champion role, but I can assure her that the Department of Health and Social Care and NHS England already work closely with stakeholders advocating for better care, such as Beat. We are also very grateful for the work of Dr Alex George in his role as the Government’s ambassador for children and young people’s mental health, which includes championing the needs of those with eating disorders.

The right hon. Member for Hayes and Harlington raised the issue of palliative care pathways. I want to assure him and other hon. Members that people with eating disorders should not be routinely placed on palliative care pathways, including those with severe, complex or enduring eating disorders. The NHS is clear that all those with severe, complex or enduring eating disorders should have access to evidence-based treatments focused on helping people recover, including hospital-based care if appropriate. Staff involved in the care of people with complex and severe eating disorders must adhere to the legal frameworks that safeguard their best interests, and NHS England will work with patient groups and stakeholders to develop further guidance on that.

The hon. Members for Bath and for North Ayrshire and Arran (Patricia Gibson) raised the issue of suicide. It is critical that we all do all we can for those affected by eating disorders before they reach that point. That is why the Government published a suicide prevention strategy in September of last year, which aims to reduce suicide over the next five years. I want to reassure right hon. and hon. Members that people in contact with mental health services, including those with eating disorders, are a priority group for the strategy.

In closing, I extend my thanks once again to the hon. Member for Bath for securing the debate, and to all the hon. and right hon. Members here today for their thoughtful contributions and questions.