Children’s Wellbeing and Mental Health: Schools

David Nuttall Excerpts

Tuesday 10th January 2017 Westminster Hall

[Norman Lamb]

I thank the hon. Lady for that intervention. Given that I was responsible for that report, I feel very strongly about its absolute importance. I chaired a commission for the Education Policy Institute that reported last November, and we were pleased that the Secretary of State for Health came to speak at the launch, which I thought was important in itself. We looked at what has happened since “Future in mind” and in some parts of the country they are doing great work, but in others very little is happening. Very little has changed, with the bulk of the money still going to the acute end of the spectrum and not being reinvested in preventive care.

Critically, in many areas of the country, as the YoungMinds survey showed, 50% of clinical commissioning groups are not spending all the money—the additional investment secured in the coalition Government’s last Budget. They are not spending the full allocation on children’s mental health. I think that is scandalous. It amounts to theft of money solemnly pledged by the Government for children’s mental health, yet in many areas it is being diverted to prop up local acute hospitals. We cannot tolerate that. The Government have to find ways of ensuring that all that money is spent as intended. I know that the Government plan to have greater transparency, with Ofsted-style ratings for CCGs, but frankly there needs to be more than that. When a CCG is under financial stress, it is just too easy to shave a bit off children’s mental health to spend it where the public are clamouring for action, because ambulances are stacked up outside the A&E department.

In the first year after “Future in mind”, the system that we designed meant that local areas would get the money only if they produced a transformation plan to show how the money would be spent on changing the system to focus more on prevention. My proposition to the Government—the EPI commission report said this—is that every year the money should be tied to a commitment from the CCG that every penny of it is spent on children’s mental health. The CCG must also demonstrate that it has stuck with the plan from the previous year and that it has a plan to continue the change in the subsequent year. Unless we use the money to drive change in local areas, it will not happen because the system is under so much strain.

The other point argued for by the Education Policy Institute commission was that the Prime Minister should launch her own Prime Minister’s challenge on children’s mental health, as the former Prime Minister did on dementia, because that sort of prime ministerial stamp of importance for this subject would be incredibly valuable. Yesterday was a start, but I challenge the Prime Minister to go further and launch a formal challenge of that sort.

My final point—I am conscious that other Members wish to contribute to the debate—relates to the importance of ensuring that when a child needs specialist treatment, they get it on time. This goes to what I regard as a discrimination within the NHS, because anyone who has a physical health problem benefits from a maximum waiting time. Whatever their issue is, they know that a standard maximum waiting time applies nationally. It is accepted that those standards are under strain, but at least they exist, and I know that they drive the system, from the Secretary of State’s office downwards, in looking at every individual hospital’s performance across the country.

On mental health, however, apart from the two maximum waiting time standards that we introduced in the last two years, there are no other maximum waiting time standards. There is no standard for children. Families across the country can be left waiting, sometimes for months, to get any treatment at all, and when they get referred too often they have to clear high thresholds. In other words, someone has to prove that they are really sick before they get any help at all. That dysfunctional and irrational approach completely contradicts the principle of early intervention.

When you have a child aged 15—as I did, a girl—who had an eating disorder and was turned away from treatment because her body mass index was not low enough, and who then got admitted as a crisis case two months later because the problem had been neglected, you are left in a state of despair. We need to ensure that children with mental health problems have the same right to timely, evidence-based treatment as anyone with a physical health problem does, and that they should be treated close to home rather than being shunted sometimes hundreds of miles away.

These are the burning injustices that exist for many families across the country who cannot pay to opt out of the system. We have a duty and a responsibility—the Government, in particular, have a duty—to ensure that those children get the treatment they need on a timely basis.

[Mr David Nuttall (in the Chair)]

Five Members wish to speak in the debate and I intend to call the Front-Bench spokesmen at 10.30 am, so if Members could keep their remarks, including interventions, to about seven minutes each, I calculate that we should get everyone in and share the time equally.

--- Later in debate ---

[David Rutley (Macclesfield) (Con)]

It is a pleasure to serve under your chairmanship, Mr Nuttall; it is the first time I have done so. I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing the debate. During his time in office he really helped to highlight the challenges in mental health and he continues, quite rightly, to put the spotlight on mental health now. We are all grateful to him for the work that he has done in this area.

It is clear—obviously partly because of the Prime Minister’s speech—to all of us who have tried to make some efforts on young people’s mental health over the last year that it has become a major issue. For me, it became absolutely clear that it was a critical issue around 18 months ago, when I had a group of about 10 young people come to Parliament for an induction day. In a gap in the Q and A session, I decided to ask them what they thought was the most pressing challenge that their generation faced. In unison, those 10 young people, who were studying for their A-levels and had great prospects ahead of them, did not talk about tuition fees or debt; they talked about mental health. They said that mental health is the challenge we need to deal with.

As I started to explore this area in more detail, I went to an event at a school—it was a Christmas party, I think—and spoke to one of the parents who happened to be involved in dealing with pupils with pastoral issues in another neighbourhood. She talked about the increased incidence of self-harm, particularly among young women, which the hon. Member for Bridgend (Mrs Moon) mentioned. I then had the chance to speak to a number of children who were not actually dealing with mental health challenges in their own life but who were really worried about how they could help their friends who were. They were coming home and asking, “How do you deal with a friend who is involved with self-harm, or who is considering it?” Trying to come up with those solutions is a heavy burden for a 12 or 13-year-old, so these issues need to be tackled urgently.

I am grateful to YoungMinds for the work it is doing. As I have spoken with its chief executive, Sarah Brennan, and her team, it has become clear that mental health is now not just a challenge for the one in 10 children who we have heard about, or the one in 12 to one in 15 children who are dealing with self-harm; the latter figure could even be higher, according to the hon. Member for Bridgend. It is clear that young people’s mental health is a growing challenge. It is not just static; it is growing. Therefore, because of the increase in the number of referrals and because of the challenges that exist—from talking to my local mental health service provider, Cheshire and Wirral Partnership, I know that they exist—we must tackle the issue. As I have said in previous debates, the issue is amplified by social media. Feelings of low self-esteem and low self-worth need to be tackled and we need to help build resilience.

Although, obviously, not everything has been done yet, the Government took an important step forward with the “Future in mind” report, and credit needs to be given to the Prime Minister for her efforts and for the initiatives she put forward yesterday: mental health first aid training for teachers and staff; a thematic review by the Care Quality Commission, with Ofsted support; a new Green Paper on children and young people’s mental health; and the absolutely key aim—it has not been mentioned in this debate but we must ensure that it is delivered—that by 2021 no child will be sent away from their local area to be treated for general mental health disorders. My hon. Friend the Member for Bury St Edmunds (Jo Churchill) highlighted that concern. The Prime Minister was honest enough to highlight that treatment is only part of the answer. What we need to do now is prevent mental health challenges and build resilience.

Something else that has not been mentioned today is the important investment of nearly £68 million in digital mental health services to provide online therapies. It is absolutely critical that we can multiply the expertise out to as many people as possible, making it easily accessible through digital technology.

In the couple of minutes I have remaining, I want to highlight what else we need to do next. We need to learn from best practice. Peer-to-peer support does not cost a huge amount and we need to ensure that we do it. The Emotionally Healthy Schools programme in Cheshire East has been particularly helpful. We must also ensure that there is counselling support and space available at school.

I know that you are keen for me to wind up, Mr Nuttall, but let me just say one thing in conclusion. We need to ensure that the digital funding that is available pushes forward recognition for greater support from social media themselves. Often social media are a cause or an amplifier of mental health challenges. We must ensure that easily accessible apps are in place to support these young children.

Finally, given what the Prime Minister has said, it is time for our various third sector charities to come together with a clear set of asks for the Government and a clear plan of action that they would like to see us take forward; YoungMinds, the National Society for the Prevention of Cruelty to Children, Barnardo’s and all organisations that have clear expertise bringing to bear a clear plan of action that will deliver for those young people who are suffering and those we do not want to see suffer in the years ahead.

[Mr David Nuttall (in the Chair)]

I ask the Front-Bench spokespersons to restrict their comments to nine minutes, so that we can leave a couple of minutes for the mover of the motion to wind up at the end.