Health: Mental Health Strategy

Earl of Listowel Excerpts

Monday 14th February 2011 Lords Chamber

[The Earl of Listowel]

My Lords, it is a privilege to follow the noble Lord, Lord Alderdice, given his career as a practitioner in mental health services. I second his desire to encourage the Minister and his colleagues the honourable Paul Burstow and the right honourable Andrew Lansley to take every opportunity to go out and visit services, schools, young offender institutions and the wider services catering for young people with mental health problems. There is tremendous anxiety out there about the impact of the cuts. It might be difficult to experience that but people need to see Ministers and Members of Parliament on the front line and know that there is interest in the issue and support for it.

I welcome this very timely and important debate initiated by my noble friend Lady Murphy. I am grateful that the noble Earl, Lord Howe, will reply to the debate, given his long experience in this area. We are grateful for that, given the challenges that lie ahead of us. I welcome the Government’s No Health without Mental Health strategy. I was particularly struck by the evidence that many smokers have a mental health disorder. I also welcome the fact that early intervention is emphasised. The work that the Government have commissioned from Frank Field MP, Graham Allen MP, Dame Clare Tickell and Professor Eileen Munro to look at how we can intervene early to improve outcomes for children is all very welcome and I am sure will be an important part of the strategy. Tim Loughton MP is a great example of someone who has got out there and found out what is happening on the front line. Practitioners have immense respect for him as he has done that. At a recent meeting on children’s centres, he spoke about the need to share best practice in Sure Start centres. I hope that there may soon be a means to do so. I understand that the Government are considering making a grant to organisations to hold a conference on that, which I welcome.

Unfortunately, I have a number of concerns. On a quick reading of the document, I saw no reference to the mental health of looked-after children and specialist looked-after children mental health teams. The statistics for the mental health of children, especially in children’s homes, point to a high degree of unfairness in this area. It needs constant thought and attention. CAMHS concerns me very much. A huge amount of CAMHS funding comes from local authorities. In the London Borough of Barnet, five-sixths of the funding for CAMHS comes from the local authority. That funding has been hit by the current cuts. Lots of thought needs to be given to how to support CAMHS at this time.

The report refers to targeted mental health services in schools—TAMHS. Very successful pilots have been run in schools but I understand that if there is no will or funding to sustain them, this early intervention, which is so effective, may be lost. The Minister is kindly giving careful thought to the future of the Cassel Hospital and the possibility of providing national funding. I know that he has been concerned about the vacancy rates in the family assessment unit. I understand that they have been rising for a number of years following a 2005 ruling in the High Court which forbade judges insisting that local authorities fund assessments at the Cassel Hospital. In short, the Cassel Hospital has not been funded adequately. It provides specialist services for families with very complex needs. I am grateful to the Minister for the attention that he is giving it. I should be interested to hear what other options he may be considering for these families. That interesting information would inform our further discussions on this matter.

There is concern that the Sure Start centres in the most impoverished areas are the ones most at risk of closing. I hope that the Government will listen to their adviser, Frank Field MP, and will consider ring-fenced funding if it seems to be necessary, or other means to incentivise local authorities to fund these fundamental early intervention services.

I have here a note about the number of commissioners who have already been lost, with all their experience in local authorities and the health service. There is a shortage of psychiatrists, as I have said. Clinical psychologists are more in abundance, but future generations may be put off by the fact that it is difficult for the current generation to find work. This profession is crucial. For example, Hackney’s social services have in the past three years experienced a reduction from 500 to 270 in the number of children taken into care, and it is astounding that a quarter of young people leaving care in Hackney have gone on to university—the highest proportion across the country. Hackney’s teams have included clinical psychologists with additional training to become systemic psychotherapists. Support from that sort of professional can make a huge difference, and I know that the noble Earl is considering a review of NHS professions. I hope that that consideration will be given priority.

To conclude, I welcome this strategy and hope that the Minister will take every opportunity to visit the services I have described.