Mental Health and Wellbeing in Schools

Debate between Dan Poulter and Layla Moran

Tuesday 4th December 2018 Westminster Hall

[Dr Poulter]

Certainly, eating disorders are an area of great challenge. One of the difficulties is that very often young people present in great distress after their illness has taken hold for quite some time, and the prognosis can be less good in those situations. A lot of young people may have to travel many miles or even out of area to get the specialist care they need, and that does need to be addressed as a matter of urgency. I know that my right hon. Friend the Minister will be raising such issues with his counterparts in the Department of Health and Social Care, because a number of the answers to the challenges raised in this debate have greater priority, and there is greater understanding of what the challenges are in that Department rather than in his.

[Layla Moran]

Does the hon. Gentleman agree that it is not just about talking; it is active co-ordination between the two Departments that will solve this? If they end up working in silos, as we know Government Departments often do, none of this is going to work.

[Dr Poulter]

I completely agree, but it is also about breaking down the silos on the ground. It is all very well Government Departments coming together to work together and the silos being broken down—that did help between the Department of Health and the Department for Education on special educational needs under the coalition Government, but in reality the levers or mechanisms do not exist on the ground to deliver meaningful change for young people in the timely manner that was envisaged by the legislation passed in this House. We must make sure that whatever legislation is passed and whatever co-operation there is at Whitehall level translates into the right levers on the ground to deliver the co-ordinated and joined-up approach to more integrated care that young people need, across health, education, social services and other statutory services as may be required.

On the broader issue of child and adolescent mental health, a key challenge is the lack of workforce to deliver the care needed for young people. We know that the number of full-time mental health nurses has fallen by more than 6,000 between 2010 and March 2018, with a reduction of 1,832 learning disability nurses alone during that period. The number of CAMHS and learning disability consultant psychiatrists has slightly declined over the past decade. Many parts of the country, particularly outside London, are struggling to fill higher registrar training posts in CAMHS and learning disability psychiatry. That is a real problem, because without the workforce to deliver care we will not have the bodies on the ground to make a difference for young people.

Perhaps more concerning is the fact that the recent rhetoric on child and adolescent mental health still bears little resemblance to the reality facing many children and their families. Given the shrinking CAMHS and learning disability workforce, it is difficult to see how current levels of care can be maintained, let alone how the step change in mental healthcare provision for young people, which the hon. Member for Oxford West and Abingdon and I—and everybody taking part in this debate—would like to see, can take place.

The focus on healthcare apps and the talk of fines for social media companies are no substitute for having enough trained professionals on the ground to deliver frontline care to young people and their families. The NHS is far too often viewed through the prism of A&E. As a result, acute hospitals often receive a disproportionate level of funding compared with primary care and community services. In child and adolescent mental health services, as in other parts of the NHS, community services are often understaffed and poorly resourced. In fact, we are hearing about reductions in staff levels and not about the increase that the Government talk about as being desirable. My message to the Minister today is that we need more staff in child and adolescent mental health services, whether they are working in schools or in the community. Without those staff, all the media announcements and well-wishing announcements to improve in this area will come largely to nothing, and young people will still be struggling.

On the issue of fragmented commissioning, which the hon. Member for Oxford West and Abingdon raised, we see silos not just in Whitehall but on the ground. CAMHS, social services and education providers do not always work in a joined-up way. Although there can be some good initiatives at local level, and there are examples of good, co-operative working, there is nothing to compel the providers of different services to work in a joined-up way for the benefit of young people. Unless we get the commissioning of services right in providing better mental healthcare for young people, and actually compel joint working rather than just encourage it, we will not make a meaningful difference.

I know that the Minister will want to pick up some of these issues with his colleagues in the Department of Health and Social Care. Unless we have a joined-up approach that we can compel at local level, all the announcements on improvements in tackling young people’s mental health will come to very little. We will still be having these debates in this place in 10 years’ time—those young people will have lost 10 years of their life and will still be struggling.

I know that the Minister has a great commitment to all he has done on schools and in education. He has been a very good Minister, and I hope that he will redouble his efforts to get joined-up working and collaboration with the Department of Health and Social Care in addressing some of these problems.

Social Inequality (Children’s Centres)

Debate between Dan Poulter and Layla Moran

Tuesday 11th July 2017 Westminster Hall

[Layla Moran]

These stories demonstrate why it was a big mistake to remove the ring fence from the Sure Start budget. What we have seen across the country is that the seemingly more urgent issues of older children, such as behaviour management and preventing teenage pregnancy and drug use, win out. The older a child gets, the harder it is to intervene, and the more expensive the interventions become. Given the difficult choices and the reality of cuts, it is no wonder that measures provided by children’s centres have not been given the prominence that they deserve. After all, those children have yet to impact others.

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

I congratulate the hon. Lady on securing this important debate. Clearly, there is a lot of evidence that investment in the early years is good for children’s future life chances, but does she also agree that the issues are not entirely mutually exclusive? Unwanted pregnancies and the issues facing single-parent families can be dealt with through effective interventions linked to children’s centres. They work well. That is an important point for investment.

[Layla Moran]

I agree entirely. Joined-up thinking in early intervention is important.

Parents tell me that children’s centres are a lifeline. The services that they provide, such as parenting support and breastfeeding and baby health advice, are valued by many, but almost as important is the sense of community that they create. Families who would never normally interact bond over the common challenge of making it through the day with a delightful but occasionally demanding toddler. How many parents have met friends for life at Stay and Play? It takes a whole community to achieve such aims, and there should be no stigma in asking for help.

In the past, the Government have accused those who raise the issue of being obsessed with the number of buildings. I am not, but I am obsessed with outcomes and access, and I can tell the Minister that we have a problem, especially with access. The impact on access comes from a double whammy: the remaining centres are far apart, and local transport links have been reduced. The convenience of getting to a site is a key factor for the families who need the services the most. I believe that we are at risk of leaving behind the same families that the Government purport to want to target.

I met a lovely woman a few weeks ago in Kidlington who explained that the new centre there has reopened but on a different site, and that it offers fewer services than the original centre. She had recently given birth to her seventh child, in a family that already included two sets of twins—I told her I thought she was a saint. Both she and her partner work full-time to support them all, but they are just getting by. Because the centre has moved out of walking distance and there is no direct bus link, she feels she can no longer get there. She said, “I can’t face the journey, and also when I get there, they can’t cater for everyone. I used to be able to go and there was something for all of us as a family to do. I really love to go, but it’s just too much hassle.”