Mental Health Care (Hampshire)

Andrew Griffiths Excerpts

Wednesday 18th April 2012 Westminster Hall

[Andrew Griffiths (Burton) (Con)]

I will speak briefly in support of my hon. Friend the Member for New Forest East (Dr Lewis). We have joined together on many occasions to campaign on the provision of acute mental health facilities, and today I shall express my concerns about how these processes are being undertaken by primary care trusts across the country. If anybody wants to see why the health care reforms that the Minister has fought so valiantly to introduce are needed, PCTs’ actions and decisions to close mental health facilities are the perfect example and demonstrate how they are out of touch, need reform and need to change.

Sadly, three weeks ago South Staffordshire PCT took the decision to close Margaret Stanhope Centre, a unit of 18 acute mental health beds in my constituency. It took that decision not only in the face of huge opposition from local people—8,200 people signed a petition as part of a campaign run by my local newspaper the Burton Mail and the Friends of Margaret Stanhope campaign group—but in the face of the evidence. I am a new Member of Parliament, elected for the first time at the last general election, and I had always assumed that such decisions were based on fact and on evidence—that the PCTs that took such important and often life-threatening decisions would be able to stand up to defend their decisions by proving their case. However, in the closure of the Margaret Stanhope Centre the PCT acted irresponsibly, recklessly and had no factual evidence to back up its decisions.

We conducted some research and found an Audit Commission report: 46 PCTs across the country had taken part in a benchmarking exercise, and the report showed that the average provision of acute mental health beds in those 46 PCTs was 27.5 beds per 100,000. In my trust, however, provision was 14.5 beds—almost half that average. The PCT then prayed in aid the following report, produced during the consultation process. It claimed that, miraculously, its provision had shot up to 31 per 100,000, and that there was nothing to fear.

I tried to get the facts. I tried to get the information. I asked and I asked and I asked for independent data. When the data came, they showed that the PCT had got its figure wrong: provision was not 31 beds per 100,000, but 22. However, when analysing the raw data, the PCT had included such things as mother and baby post-natal depression beds, beds for eating disorders, and drug and alcohol rehabilitation, so actually the figure for provision came out at 13.2. The PCT then prayed in aid an independent report that it had commissioned from Staffordshire university. We asked for that report. When we received it—it took two and a half months to come—we found that the person who had conducted the independent report, Dr Eleanor Bradley, was being paid not only by Staffordshire university, but by the NHS trust. The independent report that it claimed demonstrated how safe it was to close the Margaret Stanhope Centre was actually conducted by somebody on its payroll.

One claim made in the report was that the PCT had been able, through a pilot scheme, to reduce the in-patient stay by a third, but when we managed to drag the report out from the PCT, we discovered a number of things. First, we discovered that for stays in Margaret Stanhope of more than 91 days, it had managed to reduce average stays beyond 91 days by more than a third, from 39 days to 23—a reduction of 41%. However, the vast majority of admissions—88%—were between two and 90 days, and there the reduction was just 1.1%. The PCT claimed to have reduced in-patient stay by a third, but had actually reduced it by just 1.1%. I could go on about how flawed was the evidence used by my PCT to justify the closing of a much loved and much valued unit that serves the most vulnerable in my community. The process began some four years ago, so this is not a party political point, but a point about the actions of the PCT.

We met three weeks ago to discuss the passionate campaign for the continued existence of the unit. The process used to make that decision—

[Dr William McCrea (in the Chair)]

Order. May I draw the hon. Member’s attention to the fact that we are having a debate on the closure of acute adult mental health beds in Hampshire? I am sure that he is building his case from his experience, but it must be linked directly with the situation in Hampshire.

[Andrew Griffiths]

Forgive me, Dr McCrea. I will do exactly that and draw my speech to a close.

What I have seen is that the processes are flawed. What I have seen is that PCTs cannot be trusted to make the decision in Staffordshire and they cannot be trusted to make the decision in Hampshire. It is essential that we reassure the most vulnerable in our communities and in society. It is essential that the Minister understands their concerns properly and reassures himself that the decisions being made in Hampshire, and the decisions made in Staffordshire, are correct and are based on fact and evidence. I urge the Minister to train his laser-like vision on this important issue and to reassure himself, so that he, we and our constituents can be confident that mental health provision in Hampshire and in the rest of the country is not being jeopardised by false decisions made by people who are unaccountable, unelected and are not making those decisions in the best interests of our constituents.

--- Later in debate ---

[Mr Burns]

I know that nothing would give my hon. Friend greater pleasure, but I must warn him that I have been here too long to fall into that pit. It would completely compromise the independence of local government. I am sure he agrees that all too often, Governments of different political parties have been criticised for interfering too much in local government, and that local councillors are elected to local authorities to make decisions about matters that they, because of their representation of their constituents, are most familiar with. It would not be the way forward for a heavy-handed Minister at 79 Whitehall to issue messages of welcome for things. It would compromise the ethos and independence of local democracy, and the way in which local people elect local councillors to represent their views. Therefore, I must disappoint my hon. Friend.

[Andrew Griffiths]

I am a fan of localism, and I completely support what the Minister says, but does he not recognise that there is a massive lack of democratic accountability in how PCTs operate? No one elects them. They make decisions, and they are accountable only to themselves and ultimately to the Minister.

[Mr Burns]

My hon. Friend makes a valid point, and I have total sympathy with it. It is precisely why we are abolishing PCTs on 1 April next year, and why we are creating the clinical commissioning groups under the Health and Social Care Act 2012. Those groups will consist of GPs, who are most familiar with their patients’ needs and requirements, and will commission care for their patients, and create the health and wellbeing boards which will, for the first time in a generation, have democratic accountability because they will include locally elected councillors and will have responsibility under the Act and the reforms to look out for and to ensure that the needs of the local health economy are being met in local communities. That is a positive and straightforward step in addressing the very problem that my hon. Friend raised.

In response to my hon. Friend the Member for New Forest East, decisions on reconfiguration of services will be made by the local health economy, not Ministers in Whitehall. He will be aware that planned changes to in-patient mental health beds in Hampshire have been the subject of local discussions since 2009-10. However, to reiterate the clinical case for change, it will allow investment in better alternatives to in-patient care by increasing home treatment, and developing other measures to support people outside hospital in Hampshire. The number of in-patient beds will decrease by 58, from the current total of 165, to 107. That addresses the question asked by my hon. Friend the Member for Romsey and Southampton North about how many beds were involved from the start to the finish of the process. The change will also enable growth in community reablement services in the New Forest to help and support people with longer-term mental health needs, allowing them to live a more independent and fulfilling life when that is clinically appropriate.

Doctors and other professionals, the public and service users have all been involved in this process in Hampshire from the outset, and their views have always been taken into account, even when they were not supportive of the proposals and the proposals were not radically changed or abandoned.