Children and Mental Health Services

Debate between Andrew Griffiths and Dan Poulter

Tuesday 16th July 2019 Westminster Hall

[Andrew Griffiths]

I point my hon. Friend to some of the work done in my area by Matthew Ellis, the Staffordshire police and crime commissioner, and the work done by the Prime Minister when she was Home Secretary on how we treat mental health in our police stations. That is very important, but it is even more important for vulnerable young children. She makes a valid point. I will canter through some more points before taking more interventions.

The Government’s own survey shows that one in four children with a mental health disorder are seen by a mental health specialist and over 400,000 children are receiving no assistance at all. The NHS is managing to see only a fraction of the young people who have problems. My hon. Friend talks about cross-departmental working. I am delighted that the Minister is here, because she has done a huge deal to bang heads together and make this a priority. It involves the NHS, local government, the police and so many different areas, which we need to bring together.

The Children’s Commissioner’s analysis of NHS figures from 2017-18 shows that 325,000 children were treated by community services, while another 5,000 are in hospital—less than 3% of the population. Around £700 million is spent on child and adolescent mental health services and eating disorder support. By comparison, services for adults received 15 times more, despite the fact that children represent 20% of the population. While it is important that we are putting money into mental health services, we are turning it on its head. We need to put more money into children’s services, not only because there is such a great demand, but because if we can nip problems in the bud by making that early intervention, we can avoid those services being needed later in life.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend on securing the debate; he is making some very good points. As he recognises, CAMHS are the Cinderella services of the Cinderella service—mental health is still woefully underfunded in comparison with many other parts of the NHS. Does he also recognise that CAMHS recruitment is a real challenge? The August 2019 fill rates for higher trainees in the UK stand at only 63% for those entering CAMHS specialist training and at only 23% for learning disabilities, which means that almost 80% of new posts in learning disabilities for new trainees will be unfilled. Does he agree that that is a key issue for the Government to address if they want to improve CAMHS provision?

[Andrew Griffiths]

I absolutely agree with my hon. Friend, whom I congratulate on his work in our NHS; I am grateful that he does such a great job on mental health work in the community. He raises the very important point that it is all very well wanting to deliver these services and putting the money in place, but if we do not have the staff to deliver on the ground, we will always be running to catch up.

--- Later in debate ---

[Andrew Griffiths]

My hon. Friend, who is always a champion for rural communities, makes an important point about rural isolation. We have known for a long time about the mental health challenges of farmers and rural communities, but it is all the more difficult for young people who are isolated from their friends. We talk about the social media pressure on young people with Facebook, Twitter and so on, but it is even more difficult for kids in isolated rural communities, because they are even more separated. That social media connection is often their only chance to talk to their friends.

[Dr Poulter]

My hon. Friend is making one of the best speeches that I have heard in this Chamber for some time, and is going into granular detail to make his case. In the medical workforce, the numbers of mental health nurses have fallen nationally over the past decade, and we know that there are challenges with CAMHS and LD recruitment. We cannot deliver mental health care without bodies on the ground. Unless we get the workforce challenge right, it will just be rhetoric. We need to start turning rhetoric into reality by recruiting the right number of staff on the ground to deliver high-quality mental health care.

[Andrew Griffiths]

My hon. Friend is absolutely right. It is about not just the psychiatrists and the doctors, but the mental health nurses out in the community. I have witnessed their great work at first hand, so I know just how important they are.

The extensive roll-out—as the Government rightly claim it to be—over the five-year pilot is great, but it will address just 20% to 25% of the country’s need. So many young people will miss out on support until at least 2023 or perhaps even later. The mental health training for schools and colleges announced in the past week is fantastic, but under the NHS long-term plan, an extra £2.3 billion is due to be put into mental health services by 2023-24. That is a lot of money, and I want us to make sure that as much of it goes into children’s mental health services as is humanly possible. If we spend it wisely, it can have a double-whammy effect.

Sir Robert Peel Hospital

Debate between Andrew Griffiths and Dan Poulter

Tuesday 1st April 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I congratulate my hon. Friend the Member for Tamworth (Christopher Pincher) on securing the debate. I am well aware of his long-standing interest in matters affecting his constituency, including his well-documented support for the Sharon Fox cancer centre. I fully understand why he has raised the matter of the Sir Robert Peel hospital today. I hope that the discussion about the future of services in Tamworth and the surrounding area will move forward constructively following this debate—certainly more constructively than it might have done recently.

Before looking at the local situation in detail, it is important to say a few words about the importance of high-quality engagement between the NHS—in this case the trust—and local patients and commissioners. Decisions about patient care and NHS services should, where possible, be taken in as open and transparent a way as possible. It is important that patient groups and the wider public are properly consulted in decisions about local NHS services. That is clearly outlined in the tests for reconfiguration laid down by my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) when he was Health Secretary earlier in this Parliament. My hon. Friend was right to highlight the importance of public and patient engagement in the design of local NHS services, in this case for the benefit of his constituents in Tamworth.

The situation at the Sir Robert Peel hospital is of course complicated by events that have taken place with the Keogh review, to which I will return in a moment. The hospital is part of the Burton Hospitals NHS Foundation Trust. It might help the House to understand the situation better if I briefly describe the foundation trust and some of the issues relating to the way the Keogh review is affecting services. The foundation trust provides hospital-based services from four main sites: Burton Hospitals NHS Foundation Trust in Burton-on-Trent, with acute hospital services including an emergency department; the treatment centre on the Burton Hospitals site, a dedicated centre for day case surgery and treatments; the Samuel Johnson community hospital in Lichfield, with local services, including a midwifery-led maternity unit and a 24/7 minor injuries unit; and the Sir Robert Peel community hospital in Tamworth. I will say a little more about those services in a moment.

The foundation trust provides a wide range of services to a population of around 360,000 across south Staffordshire, south Derbyshire and north-west Leicestershire. Over 47,000 planned and emergency admissions, more than 70,000 A and E attendances and around 13,000 day case procedures take place each year in the foundation trust hospitals across all the hospital sites. The Samuel Johnson hospital in Lichfield, as a community hospital, provides services that are similar to those provided by the Sir Robert Peel hospital in Tamworth. Both community hospitals had previously been run by the South Staffordshire primary care trust. The issue for the foundation trust is therefore much wider than the Sir Robert Peel hospital, because it is required to look across the entire population it serves and, on the basis of the services commissioned, provide a safe and high-quality service for the benefit of patients. The trust has only comparatively recently become responsible for the two community hospitals it operates, both of which it took over in 2011.

[Andrew Griffiths]

The Minister mentioned that Queen’s hospital is a Keogh hospital. The staff there are working incredibly hard to improve standards and are taking big strides forward. The Minister will have heard about the precarious situation in relation to Queen’s and the East Staffordshire clinical commissioning group. My hon. Friend the Member for Tamworth (Christopher Pincher) requested a meeting. Will the Minister agree to meet me, other colleagues and the team from Queen’s hospital and the CCG in order to discuss our concerns and find a solution that improves services locally.

[Dr Poulter]

I will be delighted to meet my hon. Friends to talk further about local issues. There are long-standing concerns, not least the processes triggered by the Keogh review in the trust and the wider health economy.

I turn to the local reconfiguration process. To ensure that the foundation trust would continue to provide the best level of service to the local population, the trust commissioned a report from Deloitte in December 2012. The intention was to address the long-term challenges faced by the trust by refocusing community services, such as those provided at the Sir Robert Peel community hospital, and concentrating on the most vulnerable patient groups.

The Deloitte report set out a number of options. However, as we are all aware, in 2013 the trust was inspected under the Keogh review, which we took forward following the Francis report on Mid Staffordshire foundation trust. Burton was inspected because it had higher than expected mortality rates. The Keogh review was not reassured by what it found. As a result of the inspection, the foundation trust was placed in special measures by Monitor, the regulator of foundation trusts. Monitor continues to work with foundation trusts in special measures to ensure that they return to safe and efficient services as soon as possible. The Keogh review made six urgent recommendations for Burton. Those recommendations have been the drivers for the changes at Burton and at the Sir Robert Peel community hospital.

Sir Bruce Keogh challenged the foundation trust on what its long-term plans would be for the community hospitals. For example, patient activity at both sites in Lichfield and Tamworth has been decreasing across minor injuries, in-patient and out-patient services for a number of years, and is, I understand, on a steadily decreasing trend. There is a need to make changes because, as well as the higher than expected mortality rates, the trust and its local commissioners believe that the health needs of the population they serve are changing.

As a nation, we face changing challenges in health care—for example, the demographic pressures imposed by an ageing population. As the health needs of the population change, it is right that the services provided at local hospitals and in the local health economy also change and that a more integrated approach is taken between local authorities and the NHS in delivering more personalised care, particularly for the frail elderly, and more care in people’s homes and communities.

The foundation trust has already responded to the Keogh review challenge, although much is still to be done. I understand that the reconfiguration to which my hon. Friend the Member for Tamworth refers follows on from and continues the response to the Keogh review. Certainly, the aims are the same—to ensure that health care services are of high quality and meet the needs of local patients.

The Keogh review has affected the Sir Robert Peel community hospital, which currently offers local services for people living in and around Tamworth—including, for example, a 24/7 minor injuries unit, in-patient, X-ray and ultrasound department, and an out-patient service. There is one ward providing rehabilitation, care of older people, general medical care and palliative care. Consultant and nurse-led clinics accommodate consultations, investigations, minor procedures, post-treatment follow-up and health promotion.

That is not the full range of services that one would expect at larger NHS hospitals. However, having close-to-home community-based facilities is an important part of meeting the challenge of looking after older people in their own homes. Some such facilities are found at Sir Robert Peel community hospital. I am sure that the local population welcome that and believe it important in delivering high-quality health care in the months and years ahead.

There are currently discussions about the relocation of day case surgery and there is a review of endoscopy. I understand that that would affect about 30 patients a week, with services moving to local GP surgeries, Good Hope hospital at Sutton Coldfield about eight miles away, or the main trust site at Burton.

I understand that further changes are being considered in response to Keogh. However, planning is at a very early stage. I understand that the trust board will be receiving an outline paper this coming Thursday and that no decisions have yet been taken. I am sure that my hon. Friend will agree that it would be highly inappropriate for me to speculate about what option or options might be considered or chosen by the local NHS. I would certainly not want to suggest that there is a Government-preferred option that should be followed; I am not in a position to do that. Whitehall micro-management of the local NHS invariably leads to bad things happening; that is what we have tried to avoid through the health reforms that we instigated in 2012. As I said a few minutes ago, such decisions are local decisions and must be seen to be taken by the local NHS and local commissioners, in consultation with local patients.

House of Lords Reform Bill

Debate between Andrew Griffiths and Dan Poulter

Tuesday 10th July 2012 Commons Chamber

[Andrew Griffiths (Burton) (Con)]

Having sat through the whole of this debate, let me say first that I am grateful to be called, but secondly that I pay tribute to the way in which this debate has been conducted. It has been thoughtful and, on the whole, respectful. It has actually moved the debate forward.

I rise with some sorrow because I consider myself a loyal Back Bencher. I have tried my best in my two years in this place to support my Government in their legislation, but for the first time I am faced with the decision of having to vote against my Government and against my Prime Minister. I do so with no relish and with a heavy heart, but I think many of us have come to the conclusion that we simply cannot accept this Bill. It is bad for the country, it is bad for Parliament and it is bad for our constituents. For that reason, I will vote against the Government tonight. I do that not to give the Prime Minister a bloody nose, not to send a message about the coalition, not even to upset my Lib Dem coalition colleagues—I always prefer to put work before pleasure.

A number of colleagues have mentioned the e-mails they have received from their constituents—some for and some against the Bill, but all in small numbers. I received an e-mail from a constituent this morning, which said, “Dear Mr Griffiths, Yesterday I was made redundant. Why is Parliament spending its time navel gazing?” That, I think, is the heart of the matter. Parliament is looking inward rather than looking outward, at the challenges that we face in governing the country.

It is difficult for me to reconcile some of the promises that we have been given with what will actually happen. We have been promised that there will be no conflict between this House and the newly elected House of Lords, but that promise fails to take account of the nature of the beast with which we are dealing. We are dealing with politicians, and politicians have a mandate. They want power, they want to make decisions, and they want to represent their constituents.

I will say to an elected House of Lords, “This House has primacy.” The Lords will say to me, “I was elected like you, but I was elected under a more proportional system than you.” They will say, “I have a much bigger constituency than you”—which will be true—and they will say that they have been elected for a longer term than me. Most important, they will say, “We are full-time legislators.” As a constituency MP, I spend some of my time here in the Chamber debating issues and some of it dealing with constituency queries.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend is making a good speech, but I disagree with him. Does he not accept that a Chamber that is only 80% elected and 20% appointed inherently maintains the primacy of this place?