Mental Health (Approval Functions) Bill

Debate between Andy Burnham and Andrew Smith

Tuesday 30th October 2012 Commons Chamber

[Andy Burnham]

The Secretary of State is nodding from a sedentary position, so I assume that is correct. Surely, therefore, a concern arises that the SHA part of the process is no more than a rubber-stamping exercise. The Department will be entirely remote from the local situation on the ground relating to the individuals involved and the clinicians and institutions making the judgments. If this process is taken up to the national level, will that not give rise to more concerns that mistakes might be made in the future, because of the distance between the process of approval and the individual cases on the ground? Has the Secretary of State had discussions with mental health organisations about whether they believe those arrangements are acceptable? I must say that I have serious concerns about them.

[Mr Andrew Smith]

That is a very important point. Following the logic of my right hon. Friend’s argument, does he agree that the Government would be well advised to ensure there is independent professional involvement in auditing and overseeing that process?

[Andy Burnham]

That is a tremendously important point. Over the years, in terms of crucial public functions such as those we are discussing—and, indeed, in wider considerations such as assessments of new treatments with the National Institute for Health and Clinical Excellence—there has been a trend towards independent decision making, so that people can feel that there is no political, or departmental, interference, such as through changing local resource decisions.

The taking of these powers, and the rubber-stamping of approvals to section people, up to the national level will give rise to concerns about whether the process is sufficiently independent and people’s rights are being properly considered. I hope Ministers have listened to the important point my right hon. Friend the Member for Oxford East has just made.

I will end by addressing a point of wider principle about mental health policy and the place of mental health within our society. I believe it is possible that this whole unfortunate episode is symptomatic of a wider cultural problem: that mental health simply does not get sufficient focus and resources in the NHS at both the local PCT level and the regional SHA level—and, indeed, within the Department of Health. Beyond that, I do not believe that mental health gets the consideration it needs in Government or in this place. We do not give sufficient consideration to the hugely important issues relating to mental health.

When I was Health Secretary, hundreds of submissions would come across my desk in the course of an average week, and it was unusual if just one of them related to mental health. It is very much seen as a fringe consideration, pushed to the edges of the system—a peripheral concern in PCTs and SHAs, and all the way up to the Department of Health. That situation must not be allowed to continue.

The culture of separateness in the way we consider mental health, as opposed to other NHS issues, has deep roots in our society. Mental health services have often been provided in buildings that are out of sight, out of mind and on the fringes of the mainstream health care system.

That has to change. In the 21st century, we demand it. In our lives, we are all now dealing with much greater levels of stress, change and upheaval, and sometimes we are all left reeling by the sheer pace of modern life. We are discussing today between 4,000 and 5,000 very vulnerable people as though they are somehow apart from the rest of us. They are not. Any family can suffer the terrible consequences of serious mental health issues. In such circumstances, we would all want to be assured that those affected are not forgotten and pushed to the fringes where proper procedures are not carried out because there is a somewhat out-of-sight, out-of-mind approach. These issues are central concerns because they go to the heart of 21st century living.

Mental health must no longer be left at the edges of our national debate about health and care policy. It has to come to the very centre of our health care system. The Health and Social Care Act 2012 includes one good measure at least: to create parity of esteem between physical and mental health. I must say that it was a Labour amendment in another place that introduced that improvement into the Act, but, to be fair to the Government, I should add that I am pleased that they accepted it.

Will the Secretary of State explain what parity of esteem means in practice? What action has the Department thus far taken to put parity of esteem into effect in the national health service, and what plans does it have for the future? We have learnt in recent days that the budget for mental health has been cut in the last financial year, which suggests to me that the NHS is reverting to its default position in tough times.