Child and Adolescent Mental Health Services

Barry Sheerman Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

My hon. Friend raises an incredibly important point. There is a lot of co-ordination between the two Departments. Indeed, he may be aware of a new taskforce set up by the Deputy Prime Minister to co-ordinate Departments’ work on mental health. There is a plan to roll out the liaison and diversion service nationally by 2017. No other country in the world is doing this on such an industrial scale, in order to ensure that someone who turns up at a police station or a court with an identifiable mental health problem gets referred for treatment. That is really exciting.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister is right about this. In the 10 years for which I chaired the Education Committee, I knew that child mental health services were not as good as they could have been. We now have a crisis. In the past, we patched things together with a partnership among children’s services, the local authority, mental health services in hospitals, and GPs. That partnership has been broken, mainly by the reforms that the coalition Government have introduced in commissioning and the fragmentation of so much else. The earlier a child is diagnosed and treated with therapeutic help, the better. At the moment, that is not happening. This is not just about beds; it is also about early intervention.

[Norman Lamb]

I totally agree. However, I caution the Opposition about going around declaring a crisis every second day, because the picture is very varied around the country. I agree with the hon. Gentleman about any unacceptable things that are happening. He makes a very good point about co-ordinating services much better. Indeed, a central focus of the children’s mental health taskforce is to try to ensure that we get much better, co-ordinated commissioning of care.

NHS Major Incidents

Barry Sheerman Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

Indeed, across the country we have put in £700 million, which has paid for 6,400 additional beds in the system. All that is possible because we have a strong economy and we can put extra funding into the NHS. What those people in my hon. Friend’s hospital want most of all is support from Members in all parts of the House, and not to see their efforts turned into a political football.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Does the Secretary of State agree that Calderdale and Huddersfield trust was, until 2010, one of the most successful trusts in the country? I have a letter embargoed, ironically until 1 pm today, telling me of serious financial problems—not a major incident—caused by the reforms that his Government have introduced in the NHS. I remind him that it is my job as a member of the Opposition to weaponise—to use as a weapon—the disgraceful policies that his Government have introduced that are destabilising and destroying the national health service in my town and constituency, and up and down the country. I am a member of the Opposition, I will use this as a political weapon, and I will do so until the election, which we will win.

[Mr Hunt]

I am afraid that the trouble is that there are just too many people on the Labour side who think exactly like that. I suggest that the hon. Gentleman go and talk to people working in Calderdale and Huddersfield NHS Foundation Trust and ask them whether they want him to use the NHS as a political weapon in that way. They have improved their performance over the past few years and are seeing more people within four hours—every year, 4,000 more people within four hours than when Labour was in office—and MRSA cases are down. There are 79 fewer clostridium difficile cases; 525 more people are treated for cancer every year; and there are 6,200 more operations every year. Those are real improvements making a real difference to his constituents. He should celebrate them, not try to run them down.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 13th January 2015 Commons Chamber

[Dr Poulter]

My hon. Friend is absolutely right to highlight the challenges posed by perinatal mental illness. The damage it does to women’s lives, and indeed to the wider family, was highlighted in the recent independent inquiry into maternal deaths. It is therefore important for the Government to invest, as we are doing, in improved care for the perinatal mental health of women. That is why we have made it a priority for each and every maternity unit to have staff specially trained in perinatal mental health skills by 2017.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister will know that I have been part of an all-party group campaigning on post-natal depression, which is the most likely thing to kill a healthy young woman. Is he aware that this area of mental health is under-resourced, and that mental health facilities for children and young people are desperately under-resourced? That is partly because clinical commissioning groups have been commissioning in the wrong way, which has disturbed existing arrangements and demoralised staff.

A and E (Major Incidents)

Barry Sheerman Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I agree with the hon. Lady. It is critical that we look at the data carefully. I will see whether the data on mortality rates are available on a monthly basis. I will be as interested as she is to see it.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I have just been visiting a much-loved elderly relative in hospital and I have seen what a wonderful job our nurses are doing and the pressure that they are under, but may I tell the Secretary of State that Huddersfield and Calderdale used to have an amazingly good partnership of people in the health service working together. The antagonism now between trusts and commissioning services has destroyed that partnership. All we have now is tension and stress. We no longer have a partnership delivering health care in our country.

[Mr Hunt]

I agree with the hon. Gentleman about the hard work of the doctors and nurses at his local trust, but the feedback I get from the front line is of closer partnership working than has ever happened before, with the local authorities and the local NHS sitting down together planning what they will do for the most vulnerable older people through the better care fund. I want to encourage that everywhere I can.

NHS (Five Year Forward View)

Barry Sheerman Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

I hear what my hon. Friend says, but it is also important to have a clear plan of action to take us in the right direction over the next six years, which is what the plan from NHS England and Simon Stevens provides and what the Government have said we support. She is right that the demographic trends will get worse. By 2030 the number of over-80s will have doubled to 5 million. That is the sobering reality that we all have to face up to.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Is the Secretary of State aware the some of us on the Opposition side feel a bit sorry for him? This is the third “pie in the sky” statement we have had recently—we have heard statements on rail, on roads and now on health—which basically say that things might get better in future, and of course the election is in five months. The fact of the matter is that when I go back to Huddersfield, I see a health service in which all the players, who used to work together in partnership for something they believed in, are now at each other’s throats, as a result of his reforms: not collaborating, but fighting, disagreeing and making bids against each other.

[Mr Hunt]

Let us take one example. The better care fund has meant that for the first time—this did not happen in 13 years under Labour—local authorities are sitting around a table with the local NHS, working out how to jointly commission care for the most vulnerable patients in the community. That is a huge step forward. The hon. Gentleman should talk with the people in his local authority, because he will hear about the incredible progress that is being made. This is not pie in the sky; it is £2 billion of new money for the NHS. That will make a big difference to doctors and nurses in Huddersfield, just as it will everywhere else.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 25th November 2014 Commons Chamber

[George Freeman]

My hon. Friend makes an excellent point. As with Airedale, the Marsden Grange care home initiative shows that we can improve patients’ outcomes, deliver more health for the same amount of money and make our system much more efficient. That is why we so strongly support telemedicine, why NHS England has undertaken a rapid review of the 3 million lives programme and why, last week, we launched our review to accelerate the adoption of innovative med-tech and e-health technologies into the NHS.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

What is the good of innovation if we do not use it? For the 1 million people who suffer from atrial fibrillation, the three new NICE-approved drugs are a life saver; they make life worth living. But only about 6.5% to 7% of people have been prescribed the new drugs, as they are being blocked by clinical commissioning groups and GPs. What will the Minister do about that?

[George Freeman]

The hon. Gentleman is right to raise the matter. We have all seen it coming in recent years. Extraordinary advances in science are developing a huge range of new products, which our system is having to adjust to cope with, and that is precisely why I launched the review last week with NICE and the MHRA. We must look at these transformational technologies that bring new opportunities to our services and at how we can design a system that is better able to target innovations to the patients who need them.

National Health Service (Amended Duties and Powers) Bill

Barry Sheerman Excerpts

Friday 21st November 2014 Commons Chamber

[Dr Poulter]

I will give way one more time in a moment, and then that really will, I am afraid, be the lot, because I know that Mr Deputy Speaker would like me to come to a conclusion.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

On a point of order, Mr Deputy Speaker. I do not know what is going on with this speech. I know that the Minister is a distinguished medical person, but he is presenting the speech with so much jargon and such technical terms that very few people out there will understand the main thrust of it. The only thing many people have understood in the last few minutes is the back-door privatisation.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

That is absolutely not a point of order, but we will hear from some other speakers if we can get to the end of this speech. We might then hear some other parts of the debate.

Five Year Forward View

Barry Sheerman Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

My hon. Friend, as ever, makes an important point. I do not think that we have been as good as we should have been in the NHS about explaining changes to urgent and emergency care, and people are understandably worried if they think that there is any risk that they will not be able to see a doctor in an emergency, which is what the NHS is there to do. I think that we now have a better blueprint for urgent and emergency care, but the report also recognises that it is not sustainable to say that all urgent and emergency care will always be dealt with in A and E departments. We have to find a way to improve the capacity of primary care and make it easier for people to see their GP so that we can reduce the pressure on hard-pressed A and Es.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Will the Secretary of State take on board the fact —I invite him to visit Calderdale and Huddersfield NHS Foundation Trust to have a look—that the reforms that his Government introduced have fragmented the health service? It is very difficult to find in the health service one common purpose or one common voice. The fact of the matter is that whether it is A and E closures or NICE—National Institute for Health and Care Excellence—prescriptions being handed down by GPs, everywhere I try to find an answer, instead of one voice, one team and one leadership, I find fragmentation and no real positive movement.

[Mr Hunt]

Let me try to reassure the hon. Gentleman. The reality is that those reforms, by getting rid of the huge bureaucracies of the primary care trusts and strategic health authorities—19,000 administrators—have allowed us to hire an extra 10,000 doctors and nurses. We are doing nearly 1 million more operations every year. I will write to him with the details, and I think that he will find that there are more nurses and doctors employed in his constituency now than there were before the reforms.

Oral Answers to Questions

Barry Sheerman Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

My hon. Friend is right to highlight the fact that the annual cost of PFI left by the previous Administration is £1.79 billion, which will rise to £2.7 billion. It is right that we do all we can to support hospitals to reduce the costs of PFI that have been inflicted upon them, and we will continue to do that and work with the Treasury to make sure that that specialist advice is available for the NHS to reduce the cost.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I am worried that the members of the ministerial team are living in some sort of parallel universe. At the Calderdale and Huddersfield Trust we had a PFI. A hospital that has a long history of success is now struggling because it cannot get a management that works between the clinical commissioning groups and the trust. That is the truth—it is chaos.

[Dr Poulter]

There is nothing wrong with PFI schemes in principle; the point is the way in which they were put together by the previous Government. In 2011, the right hon. Member for Leigh (Andy Burnham) said:

“We made mistakes. I’m not defending every pen stroke of the PFI deals we signed”.

Those PFI contracts have damaged local hospitals and damaged local health care provision—

Foetal Alcohol Syndrome

Barry Sheerman Excerpts

Tuesday 14th October 2014 Westminster Hall

[Bill Esterson]

I thank my hon. Friend for mentioning the excellent work done by her constituents. I, too, praise them and many others who have done such good work to raise awareness of the condition, the risks and the need for action.

On greater awareness, the Education Committee is about to start an inquiry into personal, social and health education. What better subject for children at school to learn about than the dangers of drinking in pregnancy? I hope that my comment is taken on board by my fellow Committee members when we consider what to look at during that inquiry.

Al Aynsley-Green describes sitting in a class of seven–year-olds in Canada:

“‘What do you never drink when you have a baby in your tummy?’ asks the facilitator. ‘We never drink alcohol, Miss,’ chorus the children.”

That level of awareness at that age is in stark contrast to anything that happens here. He then mentions a conference in Toronto on prenatal alcohol exposure, attended by several hundred scientists, clinicians, lawyers, parliamentarians and lay people. Emily is 16 years old and has severe learning difficulties. She stood alongside her twin sister, courageously describing what it is like to be affected by the alcohol drunk by their Russian birth mother before they were adopted by their Canadian family. Emily described social isolation, bullying, fidgeting, impulsivity, distractibility, loud noise intolerance and poor concentration, which makes learning difficult.

Canadians take the impact of alcohol before birth seriously. Federal and provincial governments are convinced that prenatal alcohol causing foetal alcohol spectrum disorder is the most important preventable cause of severe brain damage in childhood. It affects affluent families and aboriginal people. Less badly affected children exhibit poor behaviour in their schools and communities and populate the prisons. Canadians express incredulity that the economic cost, let alone the human cost of the syndrome, has not been grasped by politicians in England.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

In that Canadian classroom, the children might well, if my Canadian experience is anything to go by, have also been shouting, “And no drugs and no smoking too.” That is important. I know that the debate is not about that, but it is linked, is it not?

[Bill Esterson]

Indeed it is. Awareness of the dangers, particularly of smoking during pregnancy, is much higher. Why, when we know what we know about smoking and the damage it causes to the unborn child, would we not ensure that the same awareness is in place for alcohol?

We have known about the dangers of alcohol to the foetus for a long time. Judges 13:7 says:

“Behold, thou shalt conceive, and bear a son; and now drink no wine or strong drink”.

Aristotle wrote about the effects of women drinking during pregnancy. Sir Francis Bacon advised women not to drink during pregnancy. The gin epidemic saw a rise in birth defects in Britain in the 1700s. The infant death rate was 20% higher for alcoholic women in prison in 1899 as compared with the rest of the population. Distinct facial characteristics were noted by French researcher Dr Paul Lemoine—I apologise for the pronunciation—who studied families where mothers drank a lot in pregnancy. The term “foetal alcohol syndrome” was first used by English researchers Jones and Smith in 1973.

There has been extensive preventive and clinical work in Canada, the United States and Australia. In 2007, Lord Mitchell’s private Members’ Bill called for it to be mandatory for alcohol sellers to display warning labels. That was seven years ago, and it has not happened yet. We saw recent success when legislation on smoking in cars with children present was passed. The Minister was heavily involved, and I commend her for her work on that. Perhaps we can persuade her to do the same on the labelling of alcohol.

At the severe end of the spectrum, there are some 7,000 live births of children with foetal alcohol syndrome each year in the UK, with three or four times as many babies born with the wider foetal alcohol spectrum disorder. There is, however, a suggestion of under-diagnosis, as symptoms are similar to those resulting from such conditions as attention deficit hyperactivity disorder or autistic spectrum disorder. The neglect of children who end up in care or being adopted can also produce behaviours that are similar to those seen with foetal alcohol spectrum disorder. The combined effects of neglect and FASD can make life difficult for children in care and those around them.

Diagnosis among some groups can be difficult. As the parent of two adopted children, I have no idea whether their birth mother drank during pregnancy. As a result, behaviours consistent with foetal alcohol spectrum disorder, which my children exhibit, could be due to neglect or alcohol consumption during pregnancy or both or neither. There is no way of knowing. The point is that we have to raise awareness, because we have to reduce risk. The education and development needs of this group of children are specialised. I refer the Minister to the research and ask her to look further at what is needed and just how demanding it is to enable children with foetal alcohol spectrum disorders to achieve their potential, given their difficulties in learning and in relating to others.

In 2009, the National Organisation for Foetal Alcohol Syndrome said:

“Teachers and teaching support staff will undoubtedly meet children with FASD in their classrooms. They need to know how to respond to their learning needs effectively, enable them to maximise their potential, improve their life chances and take their places alongside their mainstream peers as citizens…FASD now accounts for the largest, non-genetic group of children presenting with learning difficulties/disabilities. The difficulties that children face in the classroom epitomise that much-used phrase ‘complex needs’…Their unusual style of learning and their extreme challenging behaviour is out of the experience of many teachers”—

and support staff—

“and, as there is significant shortfall in guidance for teachers on how to educate children with FASD in the UK, teachers find themselves ‘pedagogically bereft’.”

We have to look at how we can reduce the number of children with FASD. Advice that says that someone may want to stop could and should be harder hitting. As my hon. Friend said, drinking while pregnant will harm the baby, just as smoking does. The private Member’s Bill introduced by Lord Mitchell in 2007 called for mandatory labelling. In 2005, the French Government made it a legal requirement for alcohol to display a warning for pregnant women on the container. The French research quoted the same dangers, research and risks as I have. Crucially, alcohol, according to the French research, can affect the brain at any stage of pregnancy. There is no safe level. The advice in France is that the safest option is no alcohol during pregnancy. That comes from the alcohol project manager at the National Institute for Prevention and Health Education. It faced a lawsuit in 2004, and later that year moved to change the law. In 2005, the law was changed. In France, it now says on bottles of alcohol that the consumption of alcoholic drinks during pregnancy, even in small amounts, may have serious consequences for the child’s health. There is also the symbol of a pregnant woman drinking in a red circle with a red line through the centre. Why do we not have that here?

The Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) was on the Health Committee in 2012. At that time, he was quoted as saying that there should be better warnings on the dangers of alcohol. He and others in the medical profession have warned of those dangers for some time, including those posed by drinking during pregnancy. He called for greater publicising of the dangers to raise awareness. As a Minister—along with his colleagues, whom he can advise—he is in a better position to act than he was in 2012.

Last week, the British Pregnancy Advisory Service raised concerns about the impact on pregnant women of the recent publicity on this issue, of which there has been a significant amount in recent months. The BPAS said that women are considering abortions because they fear they may have harmed their unborn child before they realised they were pregnant. It stated that occasional binge drinking was unlikely to cause harm to the baby. From the research I have looked at and the evidence available to us, it is true that binge drinking may not harm a baby, if it happens on occasion, but the trouble with that advice is that there is no way of knowing which babies will be harmed. The concern raised by the BPAS should not be taken lightly. It says that media coverage has caused panic among some pregnant women. That is the last thing that anyone who takes an interest in this issue wants, but, equally, there is a danger that playing down the risks of damage from foetal alcohol spectrum disorders could lead to some women continuing to drink, thinking it is safe when it is not. The BPAS points out that half of pregnancies are unplanned, so many women do not know that they are pregnant, meaning that many women will be drinking alcohol while pregnant. I agree that women should not be alarmed as there is nothing that can be done about what has already happened. However, if greater awareness of the risks can reduce the number of women drinking while pregnant in future, which is the experience in other countries, that must be a step forward.

--- Later in debate ---

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Turner, as you used to serve under my chairmanship.

I have been interested in this subject for a long time. I am a trustee of the National Children’s Centre, which is based in my constituency, and part of the initiative to form a new children’s commission. Also, for quite a long time, I was Chair of the Select Committee on Children, Schools and Families.

I have to say one slightly party political thing: I still deplore the smaller emphasis placed by the coalition Government on children’s issues. We have a junior Minister, but we should have a Secretary of State and a whole Department. I thought that the Department for Children, Schools and Families was a breakthrough Ministry, and I am sorry that it is much diminished, although I have a lot of respect for some of the ministerial team, as colleagues know. Today, however, there is relative neglect of children’s issues.

I have some practical experience of children: three daughters, one son and nine grandchildren under the age of 10. We are quite a tribe when we are all together. When my wife and I had children, we were aware that we should not drink too much—she said that she should not drink too much—but my generation thought that a little bit of alcohol was all right. That was wrong, but luckily we survived and had healthy children. My daughters, however, never drank during pregnancy.

My hon. Friend the Member for Sefton Central (Bill Esterson) made a brilliant speech, but the speech by the hon. Member for Chatham and Aylesford (Tracey Crouch) was also thoughtful. She mentioned the growing consumption of alcohol by women. Only the other day, I chaired a session—one of those irritating breakfast meetings—by the Parliamentary Advisory Council for Transport Safety, or PACTS, on women and alcohol, and it was explained to us that the likelihood of a man being caught for drink- driving has plateaued for some years, but the figures for women are going up fast.

A senior policewoman from one of the home counties, or perhaps Hampshire, stood up at that breakfast meeting to say, “We have done a study of all the pubs by going in and asking for a small glass of wine, and they all said, ‘No, we only do medium and large.’” Three large glasses of wine in a pub is a bottle of wine. Many of the women pulled over by the police, according to that policewoman, would say, “I have only had two glasses”, but that means that they have had two thirds of a bottle of wine. With the drinks industry trying to increase sales, many more women are drinking high levels of alcohol. Is that binge drinking? Most of the people whom we describe as binge drinkers would not think that they were binge drinkers. Yes, they have a couple of large glasses of wine, but they have learned to feel that that is relatively normal.

There is one point I will take issue with. Why not scare people? When we campaigned for seat belts, against drink-driving and on the dangers of smoking, there had to be a bit of fear. We have to change the culture. If someone went into a pub now and said, “I’m only going to have a couple of pints, and then I’m driving home—I’m a better driver when I’ve had a couple,” they would be excluded from the pub and their local community, because that is not acceptable. We have to have a little element of fear to get over the message that people who drink while pregnant are damaging their unborn child. The message has to be very strong; it has to be from the Department of Health and all the other Departments, and it has to be loud and clear.

Let us not pussyfoot about on this—you and I do not pussyfoot about, Mr Turner. Let us be honest: people from more disadvantaged backgrounds—poorer people—drink more than other people during pregnancy. That is the truth, and we have to accept it; otherwise we cannot get the message across. Of course, a lot of middle-class women drink, but more middle-class women tend to give up drinking when they are pregnant. However, a lot of people who have copied middle-class role models over the years and who are drinking are not seeing the danger signs during pregnancy.

[Bill Esterson]

The point about women from disadvantaged backgrounds is right, but is my hon. Friend aware of some of the research from the United States? In some studies, mentoring of women in at-risk groups has led to something like a 50% reduction in drinking during pregnancy in cities across America. Does he agree that that is the kind of bold action we need here?

[Mr Sheerman]

My hon. Friend is absolutely right. I love that sort of idea, because it is holistic. We have to go right across the piece—mentors, health visitors and GPs. GPs should wake up. For goodness’ sake, what are they doing if they are not telling pregnant women, “Do not drink when you are pregnant.”? I despair when I see the level and quality of advice from some GPs, who should be telling women in very firm terms about the damage they could do to a little child.

[Mr Robin Walker (Worcester) (Con)]

I apologise for missing the opening comments in this important debate. The hon. Gentleman mentioned GPs. Does he agree that it is important that there should be clinical leads on FASD in each part of the country? I met the clinical lead on FASD in Worcester, along with Richard Procter of the FASD Trust, to talk about the issue. We should build up clinical leads, so that they can make sure that best practice is shared among GPs and other health groups. That is one way we can make sure that there is a better approach to this issue.

[Mr Sheerman]

The hon. Gentleman is right, but he tempts me to make the political point that getting a message to local health people now is very complex. I used to be able to pick up the phone to one person—the trust’s chief executive—and have a conversation about health in Huddersfield. Now, I have to make about seven phone calls to get any sense of a holistic approach to anything. I admit that that is a bit of a snide reply, but we must make things as holistic as possible.

We must get the drinks industry involved. Why do we not have the sign that my hon. Friend the Member for Sefton Central mentioned—the red slash across the pregnant woman with the glass of wine? Why can we not, as we did with the tobacco industry, get industry, the pubs and the restaurants on our side? Why can we not get the schools on our side? Where are the schools in all this? We must tackle this issue across the piece, and we must have one consistent message: do not consume alcohol, drugs or tobacco when pregnant.