Queen’s Speech

Baroness Tyler of Enfield Excerpts

Thursday 19th May 2016 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, I welcome the focus in the gracious Speech on life chances and help for the most disadvantaged. My focus today is on some of the key components of an all-encompassing life chances strategy and on mental health. As the noble Baroness, Lady Massey, has said, we had a very good debate on life chances in this Chamber only last week, and I look forward to the Government’s forthcoming life chances strategy and the associated indicators that will be developed to assess its progress. It will be important that those indicators are broadly drawn, a point on which this House has much expertise to offer. A key point emerging in our debate was that any life chances strategy worth its name must look at all life stages, but starting of course with investment in young people through measures such as high-quality early-years education and the pupil premium to ensure every child has a fair chance in life. In addition, we need to support strong family relationships, which are the bedrock of nurturing the next generation. So I will be looking closely for evidence that investment in relationship and parenting support is a key component of the life chances strategy.

We must never overlook the life chances of the majority of young people—some 53%—who do not pursue the traditional academic route of A-levels and higher education but pursue vocational routes instead. Too often they have received scant attention from Ministers and policymakers, so I join the noble Earl, Lord Kinnoull, the noble Baroness, Lady Massey, and my noble friend Lady Sharp in eagerly awaiting the Government’s response to the Lords Select Committee on Social Mobility’s report on improving the transition from school to work. It was a great honour to serve on that committee, and I very much hope that the forthcoming education for all Bill will focus on the need for coherent, properly resourced, easy to navigate and high-quality vocational routes. As well as looking at fair funding for schools, I hope the Bill will address the substantial inequalities in funding between schools and FE colleges for 16 to 18 year-olds. While I am not holding my breath, perhaps the Minister will surprise and delight me in her response.

So, yes, we must ensure that every child has the best possible start in life, but that is not the whole story. A comprehensive life chances strategy must also ensure that co-ordinated support is available to help people of all ages address the barriers that are preventing them getting on in life. It is well known that many of the problems that people face today, including homelessness, substance misuse, mental ill-health and contact with the criminal justice system, stem from trauma and abuse in childhood, long-term poverty and the repeated failure of state interventions. A staggering 40% of people with severe multiple needs ran away as children, 24% have experienced abuse and 18% were in the care system. That is why I welcome proposals set out in the Children and Social Work Bill to strengthen the support that local authorities, as the corporate parent, offer to children in care and care leavers up to 25, and to improve standards across the social work profession. We must also use this opportunity to make sure that children’s mental health is properly assessed on entry into care and throughout their time in the care system and, critically, that that assessment leads to appropriate and timely support so that children and young people do not have to reach crisis point before help is at hand. As the noble Earl, Lord Listowel, argued so compellingly, this assessment cannot just be the current paper-based method of assessing a child’s mental health. I strongly agree with the recommendation of the Education Select Committee that all children have a specialist mental health assessment. Charities such as the NSPCC have been calling for improvements to the therapeutic support received by children who have experienced abuse and neglect to help them rebuild their lives. Given their early traumatic experiences, it is hardly surprising that children in care are significantly more prone to mental ill health.

Another group crying out for better mental health support are young carers, given the distress too many of them are experiencing in looking after their loved ones. As a starting point, the Government must meet their duties to support young carers under the Children and Families Act 2014 and the Care Act 2014. Given the concerns that have been expressed in this area, a review of the impact and resourcing of these Acts is urgently needed. Mental health services must be able to identify young carers, give them the right information and provide them with support and increased access to mental health services. Schools have a very important role to play here, and am I very glad that the noble Lord, Lord Nash, is in his place to hear me say this. I strongly support the proposal for schools to act as hubs for mental health support, working in collaboration with CAMHS and the voluntary sector. When the Government’s carers strategy is published later in the year, it is essential that young carers’ mental health needs be centre stage.

Turning now to adults, my experiences as chair of the Making Every Adult Matter coalition of charities—I refer to my declared interests in the register—convince me that we must find more effective ways of supporting adults already in crisis. Too often these individuals receive a poorly co-ordinated and ineffective response from local services, resulting in poor outcomes and significant cost to the public purse.

During the recent life chances debate, I called on the Government to develop a national cross-departmental strategy to support and incentivise local areas to develop better responses for adults experiencing multiple and complex needs, or who are at significant risk of doing so. That should be an integral part of a life chances strategy, and it is a really important opportunity to say more about how entrenched and interconnected social problems can be tackled and, importantly, lives transformed. I again urge the Government to do this, and ask the Minister if she will respond on this point in winding up.

To illustrate how joined-up these problems are, the Royal College of Psychiatrists has estimated that up to 90% of prisoners experience a mental health issue. I therefore welcome the focus in the prison and court reform Bill on education, healthcare and the provision of better mental healthcare for prisoners. However, it is no exaggeration to say that mental health for all age groups and all sections of society has become one of the defining challenges of our age. Missing from the gracious Speech was a strong commitment to mental health across the piece.

I was disappointed not to see an equality for mental health Bill to deliver genuine parity of esteem between mental and physical health. There is so much to do to deliver on the commitments the Government have already made in response to the Future in Mind report on children and young people’s mental health, the Crisp report on acute psychiatric care for adults and the recent Mental Health Task Force report. The real concern here is that despite all the fine words and good intentions, which I strongly support, the money promised is not getting through to the front line where it is most needed or translating into new mental health practitioners, and that the amounts of money allocated, welcome though they are, are simply inadequate for dealing simultaneously with both historic underfunding on a grand scale and the new initiatives that have been announced, not least in relation to waiting times and access standards.

The recent report from the Mental Health Finance Faculty and NHS Providers has highlighted that parity of esteem is nowhere near being achieved consistently at local level. It makes for sobering reading. In short, commissioners and providers do not share the same understanding of parity of esteem. All CCGs signed up to the principle of parity of esteem, and underline that they have increased their real-terms investment in mental health services. In practice, though, only half the services reported that they had received it, hence the need for an equality of mental health Bill.