(4 years, 8 months ago)
Commons ChamberI would like to put one or two points on the record before the Bill goes through. The first thing that strikes me is that this is an ambitious and aggressive virus, which intends to infect every single one of us, both here in the UK and across the entire globe, unless we do something quite dramatic to stop it. It does not discriminate between rich and poor, old and young, black and white, gay and straight, and it does not discriminate on the grounds of nationality. It does not respect borders, and the pace at which it is covering the globe is something to behold. That is why I very much welcome the legislation, because the pace at which we are delivering these important measures that the Government need to be able to take under Executive action is equally as impressive.
I have a couple of questions for Ministers. Clearly, I am going to support the measure, as it is necessary that these types of measures go through quickly so that we can respond as a nation. First—I asked this question last week, but did not receive a full answer—why was it felt necessary to introduce a brand-new piece of legislation, as we have the Civil Contingencies Act 2004 on the books? Looking at the Bill, it seems that the measures and powers in it would fit within that Act quite comfortably. I raise that because some of the questions that have been asked today—I am glad that we have seen some compromises—were about accountability and about the timeframe in which the measures will be in force. The Civil Contingencies Act says that if a measure is introduced by a Minister, within seven days Parliament can say something about it. If Parliament is in recess, it can be recalled to within five days deal with any urgent matters.
I am only flagging that up—I suspect that there are good reasons why a separate piece of legislation outwith the scope of the Civil Contingencies Act was introduced. This is a dynamic and fluid situation, and things are changing, literally day by day. Some of the actions that the Government may rightly need to take may have consequences, some intended, some unintended. For example, last week, we heard about measures that, I suspect, will be incorporated in powers in the Bill relating to pubs, restaurants and clubs being told to close their doors. Without an immediate adjustment, perhaps 1 million to 3 million people would have had no money within a week or so. Thankfully, the Government were able to introduce measures that dealt with that for the majority of those people. I suspect that there will be situations in the weeks ahead where the numbers begin to escalate and we all begin to worry about our sanity, let alone our health. There will be moments when it may be necessary for the military or police services to be on the street, committed to take actions that will surprise us.
Does my hon. Friend agree that all these measures need to be unwound one day, and that Ministers must keep an eye on how they are going to do so?
I certainly do, and my hon. Friend has made the point very well. That is the central thrust of what I am saying.
One of the key aspects of the virus, and a key reason why it is so aggressive, intrusive, ambitious and quick to move around is that it may well have the ability to mutate. If that were to happen, I should like confirmation from the Government that they have in the Bill the powers necessary to ramp up the actions that they have taken in the wording of the Bill.
Overall, I very much welcome this piece of legislation, but I should like clarification about why the Civil Contingencies Act was not used, as it was carefully thought through and includes a lot of checks and balances. Secondly, I should also like reassurance that if some of the powers under the Act were deployed on the streets of our country, Parliament would in some way—I know that Ministers are responsive, and the Prime Minister has shown great leadership and is seeking to do the absolute best for the nation—be able to express, even in recess, concerns to which Government Ministers and the Executive could respond quickly, rather than at the end of a six or three-month period, or a two-year period.
(4 years, 9 months ago)
Commons ChamberI welcome, as I am sure we all do, the huge advances in HIV/AIDS care and treatment in recent years. The hon. Member and her trust came to see me recently to discuss this case. Following that meeting, I understand that NHS England, the clinical commissioning group and others met the trust to discuss the issue and the way forward. That is the right forum in which to find the right way forward—a way forward driven by the clinical evidence of the right approach.
In Windsor we have an ageing but distinguished population, and we recognise that adult social care is one of the biggest challenges facing the country and local authorities. I thank the Secretary of State for his dedication to resolving these issues, with the better care fund allocation and his call for input from MPs, among others. In those discussions, will he have an open mind to the concept of a precept for adult social care for local authorities?
My hon. Friend will be aware that already some of the funding that adult social care receives is through a council tax precept, but I would be delighted to meet him as part of the cross-party talks we have initiated to address the challenges in social care.
(6 years, 1 month ago)
Commons ChamberThis month, we hosted the world’s first ever global ministerial mental health summit. Over 60 countries were represented, and they were united in the ambition to achieve equality for mental and physical health. The legacy of the summit will continue, with the baton now passed to the Netherlands, which has committed to host next year.
No, the question has been grouped. The moment is now; the chance is here—let us hear from the hon. Gentleman.
Thank you very much.
It strikes me that every person in this Chamber, every one of our constituents and every household across the country will have been affected by the issue of suicide, whether among family, friends or colleagues. The causes of suicide are multi-faceted—there are so many, including mental health—so I welcome the new ministerial responsibility. Will my right hon. Friend clarify precisely what the role will entail in government?
(8 years ago)
Commons ChamberDespite some of the obvious challenges in the healthcare service, this is a wonderful time of year when hundreds of thousands of people choose to quit smoking by putting down their cancer stick and picking up an electronic vaping device. Does the Minister share my concern, however, that we must be very cautious in any implementation of the EU tobacco products directive so that it does not act as a barrier to people quitting smoking and taking up vaping?
The Government are very clear that vaping is significantly less harmful than continuing to smoke. Under the current regulatory regime, huge numbers of smokers are successfully using these innovative products as an effective quitting tool. We have already committed to reviewing the TPD and we will fully explore the opportunities that Brexit may provide, but until exit negotiations are concluded we remain a full member of the EU.
(9 years, 9 months ago)
Commons ChamberEasington. I beg my hon. Friend’s pardon. The CAMHS budget has been cut to £716 million, which is a cut of £50 million. That is an enormous cut.
The hon. Gentleman is making a powerful case, particularly on resourcing. Clearly, we would all like to see more resources going into adolescent mental health challenges, but does he share my view that if we get this right, with proper standards, proper implementation and early intervention, there could be a net saving to the Exchequer overall?
I absolutely agree with the hon. Gentleman. I think the whole House would agree with his intervention, which was short and to the point. As in so many situations, prevention is better than cure. It is also a lot cheaper. We all know that, and there is a case for it in this context, but it will require investment up front. That is where the Government do not get it, because they usually take a short-sighted view of these matters.
I wish to make two points in closing. First, if local councils do not have the resources at the moment, we cannot look to them to provide these services and so they are likely to get overlooked. Lastly, will the Minister confirm something about the leak—I am sure he will have read about this in the press—from his taskforce, which speaks of the perverse incentives that have arisen, particularly in relation to mental health, from the Government’s reorganisation? Have they exacerbated the problem? As a result, is the real cost of that reorganisation to the mental heath services not £50 million, but possibly a much higher figure?
In any event, we all know from our constituency experience that we have had losses. Last night, I saw in a television programme that we have lost hundreds of doctors and thousands of nurses, and the prospect in the next few years is an accelerating trend on both. So the Labour party’s commitment for 20,000 new nurses and 8,000 new doctors is a bold one, but it is manageable. It is also absolutely necessary if we are to deal with any of our current problems. That is the message I would like to leave the House with. We need early intervention; a commitment to increase the number of doctors and nurses; parity of treatment—and even ahead of that— in the integration of mental health services; and the restoration of the CAMHS budget as soon as possible.
I apologise for not arriving for the first part of the debate; sadly, I was detained elsewhere. I wanted to say a few words about this excellent report. I commend the Chair of the Health Committee and its other members for producing a very well-balanced report that does not appear to be partisan in any way but does point to some of the problems that still exist in our child and adolescent mental health services, and to some of the possible solutions, if any future Government were to adopt its recommendations. The other impressive thing about the report is that it does not apportion blame. It merely observes that there are challenges, without attributing blame on a partisan basis or to a particular group or individual. It can often be hard to implement the recommendations in these reports if it is felt that a finger is pointed at a particular body.
Clearly, mental health challenges are widespread. As other Members have observed, they generally start when people are younger; it is unusual for a mental health challenge suddenly to appear out of the blue. That is why this report and looking at early intervention is very important if we want to tackle mental health services for citizens and mental health outcomes for our constituents. The mental health unit at Heatherwood hospital in my constituency has been transferred to Reading. It strikes me that that is very positive in many ways, because it enables more integrated services to be provided in a larger establishment, which has more resources and is better able to deal with the people who present themselves there.
I want to focus on a couple of positives that I very much welcome among the recommendations. One is the recommendation to develop, implement and monitor minimum standards. It seems to me that that is exactly what we do in every other area of health care. When I was shadow Minister for Science and Innovation, it was precisely what the Medicines and Healthcare Products Regulatory Agency and the then National Institute for Health and Clinical Excellence intended when it came to interventions requiring medical trials and proper evidence. Minimum standards are an absolute minimum, to put it that way, if we are absolutely serious about ensuring that care is consistent and does not fall below a well defined level in services and the way in which they are provided.
It is clear that the recommendations on intervention and recognition in schools and GP surgeries are already very well known among Members. In the 10 years that I have been here, I have heard debates in which such points have been highlighted. It is good to see a recognition in print that there needs to be more awareness in schools. I thank my hon. Friend the Member for Brigg and Goole (Andrew Percy), who was a teacher for many years before he entered this place, for his words on this subject. Without the relevant guidance, it is quite tricky to distinguish between children who, just from their background or families, one thinks are just being tricky, and children who are presenting with a diagnosable and observable emotional or clinical mental health condition.
On in-patient care for people under section 136 of the Mental Health Act 1983, times have moved on. The days when the idea was that somebody in such a unit should feel that it was akin to a prison must be well behind us. I very much welcome much of the work already done in the NHS and elsewhere to make sure that although such units are secure and can protect the vulnerable young people housed in them, they are developed not just as a location in which to keep them safe, but as a place with the services—the cognitive behavioural therapy, the psychiatrists and the psychologists—required to reintegrate them into society.
Without criticising the report, I would have liked it to go a little further on online resources and the digital world. It seems to me that we often see Twitter, social media and technology as a huge danger with all sorts of negative consequences, and that we seldom see the positive applications that could be made in the online and digital world. I very much welcome the acknowledgment of the extra stresses and burdens that social media place on young people in particular. I also welcome the allusion to how, perhaps with more resources and more proactive health care providers and more proactive people with an interest in mental health conditions, technology could be made part of the answer. When somebody is being bullied on Twitter or social media, technology could be used to create a little pop-up saying, “Hey. This looks like bullying. Would you like to analyse how you’re feeling about that?”
There could be all sorts of excellent uses of digital technology to help people through a process, through a partial process of CBT or in identifying the problems they face, and online resources could be exceptionally helpful in that regard. A lot of the process is about acknowledgment and recognition and then of leading people on to the next step, but if they do not feel that fulfilling the criteria for having a mental health challenge will be an embarrassment or that stigma will be attached to them, such technology could guide and lead them to getting additional help. When the Government look at the report, perhaps they could look even further into using the online world and digital technology as part of the cure.
As a former shadow Minister, I would like to say that if we had a pill that cured 50% of people of any illness or mental health condition that they had after six weeks, we would say that it was a miracle cure. Certainly for less acute mental health conditions among adolescents, cognitive behavioural therapy is that wonder pill. We need to see more investment in, further roll-out of and quicker access to such services.
(11 years, 6 months ago)
Commons ChamberT9. For the last decade, in the face of constant threats of closure to Heatherwood and Wexham Park, I have campaigned alongside local councillors, activists and residents to try to get the right balance of services across my constituency. The people I work with are very reasonable, as is the Secretary of State, so will he meet me and a small delegation from Windsor to discuss their options?
(12 years, 6 months ago)
Commons ChamberI thank the hon. Gentleman for his question. May I undertake to write to him about that matter in more detail? It has come up in our work on our suicide prevention strategy in relation to the nature of suicide verdicts, and narrative verdicts in particular, in coroners’ courts. I would be happy to come back to him on that issue.
In the past year, we have made progress across a broad front. We have committed £400 million to make psychological therapies available for adults of all ages, as well as for people with long-term health conditions and with severe and enduring mental illness. When it comes to our focus on recovery, the latest figures show that 44.4% of those who complete programmes recover and that more achieve lasting improvement. That puts us on track to achieve our target rate of recovery of over 50%.
Given that we know that the first signs of more than half of all lifelong mental illnesses can be detected in adolescence, we have to go further. That is why the Government are breaking new ground by investing in a new training-led approach to re-equip children and young people’s mental health services to offer a range of psychological therapies. I pay tribute to the leadership shown by YoungMinds. Without its support, we would not have come as far in this area as fast as we have.
I want to say something about the necessity of achieving the best possible outcomes for people in mental health crisis. Secondary mental health services across the country have made significant changes, both in community and hospital settings, including the provision of alternatives to psychiatric hospital admission. For example, more than 10,000 people with an early diagnosis of psychosis were engaged with early intervention services last year. That is the highest figure ever recorded. The improvements in community-based early intervention services are driving up standards of care, as well as reducing the demand for hospital admissions. I freely acknowledge that there is more to do and I take on board the point that my hon. Friend the Member for Broxbourne made about the need to look at the variability in the accessibility of mental health advocacy.
The development of recovery-focused services is a critical part of the Government’s strategy. That work is being led by the NHS Confederation’s mental health network and the Centre for Mental Health. They are supporting pilot sites that cover almost half of England and are making the kind of changes that service users have sought for years. The programme has identified 10 key changes to the way in which staff work, the types of services that are provided and the culture of organisations to embed recovery principles into routine practice.
When I visited the South West London recovery college, I heard powerful personal testimonies from people who were living purposeful and fulfilling lives, and who were living with their illness rather than having to be cured of symptoms or illnesses. It is important that recovery is not just seen in medical terms, but is self-defined. Students at the college learn not only how to manage their condition, but skills to help them back to work and to form new relationships. Some become lecturers at the college themselves. I was told that being called a student, rather than a patient, helped people take control of their recovery, gave them more confidence and, crucially, made them feel normal, as opposed to being treated as a helpless, passive recipient of care.
Part of a good recovery is the ability to exercise more control over one’s life. In health care, that means that there must be more shared decision making and choice. In opening the debate, my hon. Friend the Member for Loughborough mentioned the principle of “no decision about me without me”. Undoubtedly, the any qualified provider policy and tariff reform have a part to play in that.
Many of us recognise that many people who come to our constituency surgeries, perhaps with a housing benefit inquiry or other benefit inquiry, are actually struggling with mental health challenges. It seems to me that the lack of control that results from the way in which Government services are designed can be a great contributing factor to stress and, therefore, to depression. The Minister is speaking about control. Can the design of public services, such as housing benefit and other benefits, be taken into account as a way of relieving the stress on a great number of our constituents?
That intervention rather helpfully moves me on to the point that has been made by several hon. Members about Atos. Although it is not my ministerial responsibility, a number of important points have been made about how it operates in particular cases. I will ensure that those points are taken into account by my ministerial colleagues at the Department for Work and Pensions. I will gladly pass them on.
(13 years, 2 months ago)
Commons ChamberThat was a good example of bluster—perhaps that is what we will see from the Opposition under the right hon. Gentleman’s stewardship.
The right hon. Gentleman ought to be aware, because it happened on his watch, that primary care trusts and strategic health authorities have seen their management costs increase by more than £1 billion. There was a 120% increase from 2002 to when this Government took office. That is why we are determined to cut overhead costs in the NHS, so that we can reinvest every penny in the front line.
7. What recent representations he has received from Berkshire East primary care trust on the future of Heatherwood hospital in Ascot.
I have received no such representations.
My constituents are shocked to discover that yet again, the future of Heatherwood is under threat. I have had sight of a major petition, and I am actively campaigning with hard-working local councillors, activists and residents to uncover why Heatherwood’s future is under threat when the funding from the Government to the region has increased. Does my right hon. Friend agree that the Berkshire East PCT must cut its bureaucracy costs and introduce efficiencies before threatening the money to Heatherwood hospital and other local services?
I am grateful to my hon. Friend and completely understand what he is saying. In this financial year compared to the previous one, revenue available to Berkshire East PCT increased by £16.3 million. That is just one part of the £3.8 billion increase in revenue resources available to the NHS this year compared with last year.
Although I very much welcome the shadow Secretary of State to his new position, we will miss his predecessor. We welcome the new shadow Secretary of State not least because he might begin to explain to the NHS why he thought it was irresponsible to increase resources to the NHS in real terms by about £3.8 billion—
(14 years, 2 months ago)
Commons ChamberMy constituent Sarah Vergopoulos came to see me when her brother died because of infected blood just last year. She was most concerned to ensure that something would actually happen as a result of this debate. It seems to me that this debate—I commend the Backbench Business Committee on it—has already been a success, because something has already happened. The review has been announced and a timeline has been given to ensure that something will come forward this side of Christmas. I can thus report back to my constituent that just by holding this debate, something has already moved, which might not have moved without it.
The hon. Gentleman is correct. This debate on the Floor of the House is something for which many of those affected have called for a number of years. For them, it is important that that has been recognised and that Ministers are now listening to Members of all parties expressing their views.