Oral Answers to Questions Debate
Full Debate: Read Full DebateAlistair Burt
Main Page: Alistair Burt (Conservative - North East Bedfordshire)Department Debates - View all Alistair Burt's debates with the Department of Health and Social Care
(8 years, 10 months ago)
Commons Chamber7. How much additional investment there will be in children and young people’s mental health services in 2015-16.
We are investing an additional £173 million this year, which includes £30 million specifically for eating disorders. We are taking a targeted and phased approach to the additional investment to develop capacity and capability across health, education and children’s services, from prevention and resilience building to supporting the most vulnerable.
The Government explicitly promised £250 million for children’s mental health in 2015-16, yet the Department of Health has admitted it will be spending only £143 million by next April. Is this £170 million shortfall not further evidence that while Ministers might talk a good talk on mental health, we should judge them by their actions?
No. I take the hon. Lady’s point, but we are committed to spending £1.25 billion over the Parliament. We will not be able to spend the £250 million this year, but it will be included in future years. The reason is that we have to make sure it is effectively and properly spent and it is a phased programme. She will be delighted to know that in her constituency there will be an extra £536,000 for children’s mental health services.
The organisation YoungMinds found that one in five mental health trusts had had to freeze or cut budgets every year in the last Parliament, and at the moment 40,000 young people are being refused mental health treatment. What guarantees can the Minister give that the money promised by the Chancellor recently will actually be made available and that trusts will not continue to cut mental health budgets?
The hon. Lady makes a fair point. While we invest money nationally in services, people complain that locally clinical commissioning groups have not been funnelling the money down. Two things should help: first, for the first time the national access and working time targets, which the Government have introduced, will provide a means of monitoring what CCGs are doing; and, secondly, the new scorecard for CCGs will look explicitly to ensure that a proportion of the increase to a CCG goes into mental health services. The hon. Lady will also be pleased to know that in her own CCG area there will be an extra £521,000 for children’s mental health services.
Some 23% of the adult prison population were in care as children and many of them have poor mental health. Will the Minister ensure that mental health services are in place for children in care to make the greatest contribution possible to improving their life chances, and not least to ensure we reduce the numbers ending up in prison?
Yes, the hon. Gentleman makes a point made by successive Governments: care outcomes are terrible and the earlier the intervention the better. We are encouraging the engagement of early prevention therapies, including for those in care, and for the first time the Government have appointed a dedicated mental health Minister, in the Department for Education, further to promote resilience and work more closely with young children, including those in care.
Infection control in the community is a great way to reduce preventable illness. In November, I will launch a handwashing campaign in Parliament that I hope will have cross-party support. Will the Minister inform the House what his Department is doing to promote infection control outside the hospital setting?
I believe we are. I will check to be certain, as I know the right hon. Gentleman knows a great deal about this, but I believe we are. We have £150 million for eating disorders, and £30 million is being spent this year, with additional beds allocated. I will check that the waiting target times remain because they have made a significant difference. The right hon. Gentleman’s work has been of powerful import in what we do.
Yesterday, the National Society for the Prevention of Cruelty to Children revealed that one in five children in need of mental health treatment are being turned away. Is it not appalling that young people are being denied help, only for them to become more seriously ill later on, and that the number of children turning up at A&E because of mental illness has doubled in recent years? Does the Minister accept that children’s mental health needs more money now—this year, as he promised? I can point to many different organisations across the country that would gladly receive that support now. How is he going to put his broken promise right?
May I welcome the hon. Lady to her position, not least her Cabinet position—he said carefully—and welcome the prominence that mental health now has among all parties? Let me say rather gently in response to the tirade that I have just received that under this Government we have for the first time introduced parity of esteem for mental health on waiting times and national access targets. We are spending more money—£1.25 billion over the next five years. We have the highest number of beds for young people in emergency situations; we have the first dedicated education Minister for young people’s health; we have £75 million for perinatal health; and in her own constituency, the hon. Lady will be pleased to welcome from her shadow Cabinet position an extra £1.1 million going to Liverpool for mental health treatment for children and young people. I think that is a significant response.
I do not know who writes a lot of this screed, but sometimes a blue pencil needs to be taken to it. The Minister is immensely capable and experienced, but a distillation or an abridged version rather than a “War and Peace” version would be appreciated.
4. What progress his Department has made in introducing a cap on care costs.
We have introduced primary legislation and consulted on draft regulations to introduce the care cap. Following the decision to delay implementation until April 2020, we will use the additional time to improve the policy in the light of feedback from stakeholders.
Let me first declare an interest as a vice-president of the Local Government Association.
May I ask what assistance the Department is offering local authorities which are currently cash-strapped so that they can implement new minimum wage regulation, which is very welcome, in order to provide first-class social care?
It is not possible for me to talk about what may emerge from the spending round and settlement, but I can say to the hon. Lady that local authorities were given extra finance to implement the Care Act 2014. Some £5.3 billion is available to local authorities to work through the new integrated social care and NHS budget. So we are very conscious of the pressures on local authorities, which need the resources to provide the social care we all expect.
The coalition Government agreed a policy of a cap on care costs, and the Conservative manifesto in May said that no one would have to sell their homes to pay for care. Some £100 million has been wasted on this delay, which has betrayed our older people and has simply ducked one of the biggest crises facing this country. Will the Minister and the Department now apologise?
There was a consultation on the coalition proposals, which began at the beginning of this year and ran through the election period. The consultation included a very strong representation from the Local Government Association, which said that it did not want to implement the care cap now and wanted extra time. Therefore, the decision has been taken not to cancel, but to delay. It is of course a change from the position we set out. I fully accept that, but we listened to stakeholders and we are now going to use the extra time, at the request of the LGA and others, to find a way through to implement the policy and to use the time for extra financial products.
8. What assessment his Department has made of progress in implementing the success regime at Derriford hospital in Plymouth.
11. What steps he is taking to improve support for carers.
I am not quite sure what the situation is in Wales, but in England I do not think that carers’ invaluable contribution to society has ever been better recognised. We are working very hard to see the implementation of the improved rights for carers enshrined in the Care Act 2014. I am also responsible for developing a new national carers strategy to see what more we can do to support existing and new carers in England.
There are more than 6.5 million unpaid carers in the UK, with nearly 11,000 in my constituency. In total, they save the state more than £119 billion each year, which is more than this Government spend on the NHS . Research by Carers UK has found that nearly 50% of carers are struggling to make ends meet, and that is seriously affecting their health. What plans does the Minister have to work with the Department for Work and Pensions and the Treasury, and across government, to ensure that the improvement of carers’ finances will be a key part of the Government’s care strategy?
The work I am doing on developing the new strategy involves other Departments, and it will look at not only the economics, but what is happening internationally and where we can take the whole concept of caring for a different society in the future. The economics is certainly important; we could not do without the contribution that carers make, but it would be impossible to replace it with total Government finance.
Yesterday, the Public Accounts Committee heard from officials at the Department of Health about the implementation of the Care Act, which is a bold piece of legislation. They admitted that they were very concerned about the unidentified carers, who need to be found in order to be supported. What is the Minister planning to do to make sure that they are identified and supported?
In a way, the self-definition states its own problem: these are unidentified carers. I hope that the new responsibilities in the Care Act will encourage more people to come forward and that the greater work of carer support organisations, such as the one I preside over in Bedfordshire, Carers in Bedfordshire, will be able to identify more carers. We want more young people to come forward because, as the hon. Lady says, people are caring and they do not realise they are. We need a concerted effort all round to try to reveal them, so that more can be done.
I am surprised that the Minister believes he is supporting carers in any way acceptably well. The recent personal social services survey found that 38% of adult carers now care for more than 100 hours a week but only one in five of those carers is getting support to take a break from caring. Government cuts have caused a funding gap in social care, which, it is estimated, will be £4 billion by 2020, piling additional pressure on those family carers, and the better care fund and integration will not, in themselves, fix that gap. When will Health Ministers admit that they have got this wrong and argue for more funding for social care, so that carers can get the support and respite breaks they should get?
Between 2010 and 2015, £400 million extra was found in order to provide respite for those who are caring for others. Any support that goes into local government, or indeed the NHS, is predicated on a decent economy and decent economic principles in order to fund it—I believe from what happened last night that that has been abandoned by the Labour party. We have to have the resources in the first place. That is what we are seeking to ensure and that is what the work is being done for.
12. What steps his Department is taking to manage and meet demand for A&E services in Worcester.
T4. It emerged earlier this month that North East Lincolnshire CCG was operating a primary care incentive scheme intended to reduce outpatient referrals. Understandably, this has met with a hostile reception from my constituents, who fear it may affect decisions on their care. Will Ministers look into this scheme and either offer some reassurance or instruct the CCG to reconsider?
The north Lincolnshire scheme is designed to try to encourage doctors to make sure that there are no inappropriate referrals to secondary care; it is not designed to prevent appropriate ones. Over the past five years we have seen an increase of 600,000 in urgent referrals for cancer care, for example. We want to see that continue. It will not be helped if there are inappropriate referrals, and that is what the scheme is about.
Last week senior officials at Monitor reported being leaned on by the Department of Health to suppress the publication of financial figures ahead of the Conservative party conference. This week the Health Secretary has been accused of vetoing the release of impartial independent reports on measures that could reduce our consumption of sugar. Does he not understand that leadership on transparency must come from the very top? Will he now commit to practising what he preaches on NHS transparency and release this report immediately?
T5. The all- party spinal cord injury group, which I chair, recently reported that very vulnerable patients are being prejudiced by delayed discharges, taking up lots of public money in hospital expenses that should be used to treat more patients. Will the Secretary of State carry out an urgent service review to address this real problem in England, Wales, Scotland and Northern Ireland?
Delayed discharge has been a problem across the system for many years. An awful lot of work is going on to ensure that more preventive work is done so that people do not go into hospital, and to ensure that if they do go in they leave quickly. I visited Salford Royal only a couple of months ago and saw the process it has for dealing with discharges more effectively. Learning is going on throughout the system, and more money is in the system for winter in order to cover the problem.
To continue on the same theme—hopefully I am coming in at the right time, Mr Speaker—I chair the all-party group on patient safety, in collaboration with the Patients Association. We are about to look into hospital infections, and in Parliament in November I will launch a hand washing campaign. What is the Department of Health doing to promote infection control outside hospital settings?
T7. What measures is the Secretary of State putting in place to recruit and retain GPs? Given that he has indicated recruiting 5,000, where does he plan to find them?
As part of the proposal to see an increase of 5,000 in the number of doctors working in general practice by 2020, work is being done not only to recruit more, but to retain them and to bring back those who have left general practice but want to return. Health Education England is working with the Department on all these plans and proposals. The hon. Gentleman is right to identify that as a key source of those who will come into the service in future.
Delayed publication of evidence is as damaging as non-publication, which is why we rightly expect clinicians, researchers and managers to publish their evidence and data in a timely and transparent manner. It is a matter of great regret to the Health Committee that we started our inquiry today without access to the detailed and impartial review of the evidence that we need to make a contribution to this inquiry. Will the Secretary of State please set out when he will publish it?