In-patient Mental Health Services (Children and Adolescents)

Ben Bradshaw Excerpts

Wednesday 23rd October 2013 Commons Chamber

[Alan Johnson]

This debate is about services in England, but I confirm that part of the problem is the fact that there is a rising need for adolescent and child mental health services and a decreasing capacity to deal with that need.

I asked the Minister in a parliamentary question which other areas had been affected and which units had ceased to operate. I was told by the Minister that no units had ceased to operate as a result of this change and nor were any closures expected when the change was introduced on 1 October. As I said, the unit in Hull closed in March. The change had already happened. Will the Minister take this opportunity to correct that answer?

Not only did West End close in March, but we are beginning to hear of closures across the country, including in Devon and Somerset, where my right hon. Friend the Member for Exeter (Mr Bradshaw) has been pursuing this issue vigorously with the chief executive of NHS England, who confirmed in a letter to him that other units had closed as a result of the change to tier 4 specification well before the spurious 1 October date.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is my right hon. Friend, a former Health Secretary, aware that, in Devon, that has led to young people being admitted to adult mental health residential units, in clear breach of the Mental Health Act 2007—a scandalous position? I hope that the Minister will have something to say about that when he responds.

[Alan Johnson]

I am aware that that has happened. I feel sure that, as the debate gathers momentum, Members from other parts of the country will have similar experiences.

Let me be clear. I fully accept that for the majority of young people, a community-based approach to mental health problems will give them the best treatment, but for a number of children and their families, intensive in-patient care is necessary. Those children need an approach that spans the whole network of provision, not just health, but education and social care, which cannot be replicated in a child’s home—if they have a home; many of the children affected are in care.

West End provided such services. Its in-patient facility was judged inadequate because it was available for only five nights a week. But combined with weekends at home, this provided an excellent service, which the parents who experienced it fully supported. Their preference was to extend the unit to a seven-day service, if that was what was necessary to meet the new specification, but that alternative was never offered or discussed.

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[Norman Lamb]

. The right hon. Gentleman raises the tariff, and that is what I want to get to the bottom of. I genuinely want to understand the issue and reach a conclusion on it, and I hope that by meeting we will be able to do that.

We want to ensure excellent child and adolescent mental health services facilities across the country. That is why we are investing £54 million over four years in the children’s and young people’s IAPT—improving access to psychological therapies—programme. That will drive service transformation in CAMHS, giving children and young people improved access to the best mental health care by embedding evidence-based practice which has been absent in these services until now and making sure that they use session-by-session outcome monitoring. The IAPT programme is fundamental to the success of our mental health programme. Our children’s IAPT programme is ambitious in its objectives. Its aim is service transformation with an emphasis on evidence-based practice and a rigorous focus on frequent session-by-session outcome monitoring. It differs from the adult IAPT programme in working across existing community-based CAMHS rather than creating new services.

[Mr Bradshaw]

I am sorry to have to say this, but the Minister’s speech is just waffle. Will he accept that the Government’s reorganisation of the national health service has led to confusion as to who is responsible for the interface between tier 3 and tier 4 mental health services for young people? Will he look at the cases I have raised with the Secretary of State of young people from my constituency being sent to Newcastle—the north-east of England—and all over the country, and being sent to adult wards, in breach of the law?

[Norman Lamb]

I do not think it has been waffle at all. I have tried to answer very directly the concerns that have been expressed. I will absolutely look into the cases that the right hon. Gentleman raises. When I hear reference to children being placed in adult services, I find that as unacceptable as he does. I want to understand how it has happened and bring it to an end. NHS England is carrying out a review over a three-month period to assess the facilities for tier 4 services to ensure that sufficient services are available in all parts of the country. Because of the nature of the specialism, they cannot be in every town and city, but they must be within reasonable reach. That is exactly what the review is seeking to undertake.