Drugs Policy

Debate between Diane Abbott and Norman Lamb

Tuesday 18th July 2017 Commons Chamber

[Ms Abbott]

It is unfortunate that many authorities, including many Labour authorities, privatised these services. Privatising them necessarily makes it harder to achieve the co-ordination and co-operation that was the whole point of having these services sit in the local authorities.

Local councils face unprecedented cuts to their funding—anything from 25% to 40% of their entire budget. Is it any wonder that drug-related deaths are increasing when local authorities do not have the funds necessary for comprehensive treatment programmes?

[Norman Lamb]

The right hon. Lady has talked about the war on drugs, and how it has been undermined by a lack of resources, but does she favour simply increasing the resources in that war, or a more enlightened approach that involves decriminalisation and, potentially, the regulation of cannabis markets so that we take the criminals out of the market altogether?

[Ms Abbott]

I am grateful to the right hon. Gentleman for his intervention. We cannot have a meaningful strategy on drug abuse without looking at the question of resources, but I would be the first to say that it is more complex than simply providing more money.

To give an overview of what local authorities are facing, Barnsley cut its drug and alcohol service by more than a third between 2015-16 and 2016-17. Some services will be unavailable and key drugs practitioners will be made redundant. Staffordshire County Council was forced to make cuts of 45% to its drug and alcohol treatment budget over the past two years, due to its local commissioning group pulling the expected £15 million of NHS funding. Middlesbrough Council, which sadly has one of the highest rates of death from heroin overdoses in the country, cut its budget by £1 million last year.

When the Home Office announced those policies, it correctly said that for every £1 spent on public health, £2.50 is saved. However, instead of helping local authorities to follow that logic, the Government have obliged them to pursue short-term cuts. Some local authorities have tried, and some have been particularly innovative in seeking efficiencies in their public health budgets, but the reality is that too many are looking at significant reductions in services, and some are even privatising services. When it comes to public health, the Government talk a good talk but do not follow through with the resources. I note with dismay that the strategy includes no mention of providing more resources to local authorities, which after all are on the frontline of any strategy against drug use.

NHS Sustainability and Transformation Plans

Debate between Diane Abbott and Norman Lamb

Wednesday 14th September 2016 Commons Chamber

[Ms Abbott]

That is the reason for the secrecy thus far. The Government know that if the public understood what STPs meant, there would be an outcry.

[Norman Lamb (North Norfolk) (LD)]

Does the hon. Lady agree that unless the local community are fully engaged in the process of considering how the health and care system needs to change their area, the process is destined to fail and simply will not work?

[Ms Abbott]

I am grateful to the right hon. Gentleman. For nearly the whole time I have been in Parliament, there have been attempts to reconfigure hospitals and close A&Es and make other changes in London. We have found that when the local community does not take ownership of the plans, it is impossible to take them forward. That secrecy runs counter to making the reorganisations we might have to make.

Psychosis: Early Intervention

Debate between Diane Abbott and Norman Lamb

Wednesday 7th September 2016 Westminster Hall

[Ms Abbott]

It is true of many communities, and in particular the black and minority ethnic community, as the statistics prove, that they are reluctant to take family members into the national health system. When they finally have to engage with the national health service, their symptoms are much worse and it is far harder to get positive outcomes. I tell the Minister that it is really important to look at this issue of black and minority ethnic people and the mental health system, because it is causing real misery and problems within the community. We are less likely to be offered talking therapies and more likely to be offered electroconvulsive therapy. Again, mental health facilities within the prison service, such as Rampton, have disproportionate levels of black and minority ethnic persons inside those institutions.

[Norman Lamb]

I am grateful to the hon. Lady for giving way. She is making an incredibly important point about the over-representation of black and minority ethnic people in the system. Does she agree that they are also more likely to be subject to coercion—to sectioning under the Mental Health Acts—and more likely to suffer restraint and physical force within mental health settings?

[Ms Abbott]

I am grateful to the right hon. Gentleman for that important point. It is absolutely true that, partly because they are presenting late and often have quite advanced psychotic symptoms, they are more likely to experience coercion and restraint. We know that some of those incidents of restraint have had very unhappy outcomes, and families continue to campaign against the misuse of restraint on mental health patients. All these decades after people first started to look at issues relating to black and minority ethnic communities and the mental health service, we have made little progress. Is the Minister willing to meet me to discuss this issue, which I have looked at for many years? One of the basic problems is statistics. It took years to get the health service to keep statistics broken down by ethnicity within the mental health service, and I am not sure what is happening to those data.

As we have heard, it is vital that psychosis is treated early as that prevents complications, improves outcomes and is more cost-effective. We know that psychosis costs £11.8 billion a year and we also know that mental health problems are on the rise. It is very disturbing to find that the research shows that a quarter of CCGs seem to be ignoring the access waiting time standard for psychosis, and the National Audit Office reports that there are insufficient funds available for the strategy to achieve parity of esteem to have any reality. We know, because we have heard, that too many CCGs cannot even specify how much money is devoted to early intervention; that gives rise to the suspicion that not enough is devoted to it.

The right hon. Member for North Norfolk made the fundamental point that this issue is still not being treated with the same seriousness as cancer standards are. This goes back to the issue that many Members have raised of stigma, shame and an unwillingness of the families of psychosis sufferers to speak out in the way that the families of people who suffer from cancer are willing to go into the public space and to the media to speak out.

Mental Health

Debate between Diane Abbott and Norman Lamb

Thursday 16th May 2013 Commons Chamber

[Norman Lamb]

My right hon. Friend makes a very good point and I completely agree.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke again about eating disorders—I took part in a debate that she secured in Westminster Hall. She talked about the role of parents, the nightmare of a child—I will call them a child—over the age of 16 deciding to refuse treatment and the horror that parents sometimes go through when they are not listened to sufficiently by clinicians dealing with their loved one’s condition. She also mentioned type 1 diabetes sufferers, and I would be interested to hear more about that.

My hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) is no longer here. Oh, yes he is! He has moved to a different place, just to confuse me. He talked about the low diagnosis rate for Alzheimer’s and dementia in his area. He also stressed the importance of the recognition of mental health by the Government, which I think he welcomed.

The hon. Member for Bolton South East (Yasmin Qureshi) talked about the importance of accessing appropriate and culturally sensitive care and treatment. That is incredibly important, as is getting the approach right for each individual and giving them the power to determine their priorities. She made those points well. She also stressed that the picture round the country was very variable. That is more the case in mental health than in physical health. Some areas have great services, some of which I have witnessed, but in others they are simply not good enough.

[Ms Abbott]

On the question of culturally appropriate care, does the Minister agree that it can extend to quite mundane matters? There are mental health wards in this country with large numbers of BME people in them. Those people sometimes do not have the right hair care or the right music, or they might not have their culinary needs addressed. Those things can be really disturbing for someone who is already in a mentally fragile condition.

[Norman Lamb]

Yes, I completely agree. This is about treating people as individuals, and with dignity and respect. Those things are important to people and they should be treated as such.

Oral Answers to Questions

Debate between Diane Abbott and Norman Lamb

Tuesday 15th January 2013 Commons Chamber

[Norman Lamb]

From April, local authorities will be responsible for commissioning services. Because we have seen this really impressive increase in funding for public health, local authorities will have the ability to maintain and indeed improve sexual health services for their local communities. That is something of which we should be proud.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

On the sexual health strategy, the Minister will be aware that nearly half of the national incidence of HIV is in London, so what steps will be taken from April to co-ordinate the prevention of HIV London-wide?

[Norman Lamb]

I am very much aware of the situation in London, and I acknowledge that some good work has already been undertaken there. Local authorities are very much aware of their responsibility that will apply from April and are already working with clinical commissioning groups in London to ensure that comprehensive services are in place for the London community.

Mental Health (Approval Functions) Bill

Debate between Diane Abbott and Norman Lamb

Tuesday 30th October 2012 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I want to raise two specific points. Opposition Members are concerned that the concept of “Any person” in clause 1 is too broad, because it appears to legalise approvals by anybody. Why does the clause not refer specifically to North-East, Yorkshire and the Humber, West Midlands and East Midlands?

Secondly, where is the provision for the doctors who have been approved by a trust according to what we now understand was a defective process to be re-approved by the correct process? As the clause stands, it seems—I am happy to be put right on this—that doctors approved previously by the trust will be able to continue to section patients without re-approval under the correct process.

[The Minister of State, Department of Health (Norman Lamb)]

I will first set out what the clause seeks to do and then respond to the shadow Minister’s questions.

The clause directly addresses the issue that the Bill intends to resolve. Between 2002 and 2012, four strategic health authorities delegated to mental health trusts the function of approving doctors with responsibilities under the Mental Health Act 1983. The legal advice that we have obtained is that there are good arguments, as we have already discussed, that decisions to detain made by doctors who were approved in that irregular way are nevertheless lawful. The clause removes any doubt—that is its purpose. It clearly spells out that when mental health trusts gave approval in the past they are to be treated as having had the power to do so.

The clause has the effect of eliminating any irregularity from decisions made in complete good faith, and in the best interests of the patient, by doctors fully qualified to make them. It does so in a way that is fully consistent with the legal and clinical advice that we have received on the issue, and means that patients and their families do not have to undergo the process of assessment for detention under the Act again solely for the purpose of correcting a technical error made by a strategic health authority.

The hon. Lady asked why the clause was so broad as to refer to “Any person”. I understand her concern, but the point is that we do not yet know whether there were other issues before the establishment of the SHAs. Obviously, that is part of the work that the review will undertake, but to ensure that we resolve the problem absolutely and that all those patients have clarity the decision was made for the clause to refer to “Any person” in order to avoid any risk of our uncovering another problem that might need a separate resolution. This deals with the whole problem of the approval process for the doctors who made those decisions.

The hon. Lady then asked, correctly, whether decisions will be taken properly as we progress. I can confirm that all the doctors have already been re-approved according to a proper process, so every decision that is taken from hereon in cannot be challenged. As we have said, any patient who wants to question the clinical judgement can do so and their rights remain the same as they have always been. This simply addresses the technical issue that we have been debating today.

--- Later in debate ---

[Norman Lamb]

All that is being regularised is the power to approve a doctor, not whether a doctor is clinically sound. Any patient who challenges a judgment to section them either now or in the past will retain all their rights in law. We have acted on the advice of both lawyers and clinicians to ensure that we deal with the problem that has emerged in a way that respects patients’ clinical interests and considers them with the utmost seriousness. To go through a full reauthorisation process in every case could be incredibly damaging to individuals in potentially vulnerable situations. The Bill is based on the best clinical and legal advice that we have received on how to deal with the problem.

[Ms Abbott]

The Opposition have listened with great care to what the Minister has said. He has made a point of saying that his advice suggests that the Bill is the best way to deal with the situation. We argue that it is perhaps the most convenient way, but we know that the parliamentary draftsman has been under huge pressure to produce the Bill, and this would not be the first time that parliamentary draftsmen have come up with a form of words that is in some way defective. I repeat our concern about the broad nature of the clause, which states that “any person” who “has done anything” is to be “treated for all purposes”.