Child and Adolescent Mental Health Services

Glenda Jackson Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

I think my right hon. Friend is referring to the children and young people’s taskforce that I established last summer. He is right that this provides us with an incredibly valuable opportunity to modernise the way in which we organise and commission children’s mental health services. There are many fantastic professionals working in children’s mental health services, but in my view they are let down by a dysfunctional system with horribly fragmented commissioning, which is a long-standing problem. Because we are involving experts and campaigners from outside and, critically, children and young people, we have a great opportunity to get services modernised and effective and focusing particularly on prevention.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

The Minister seems to be arguing that the solution to the problem is further evidence. For all the years that I have been in this House—almost 23 now—the issue of underfunding for mental health has been constant. The underfunding of services for children and adults who are suffering from mental health problems is an issue I raised in this House less than six weeks ago. It is unacceptable to claim that if there had been more information, measures would have been put in place to prevent children being sent hundreds of miles from their homes or being placed in adult wards. The Minister’s contribution has clarified the total lack of co-ordinated services for these young people. What kind of care would be afforded to someone in their home when, as in my constituency, their home may well be bed and breakfast, a hostel or some form of temporary accommodation? This is an urgent question; it requires urgent action. [Interruption.]

[Mr Speaker]

Somebody said that was very wrong. It was a Shakespearian performance. In fact, somebody once said to me, “That person could have been on the stage”!

UK Ebola Preparedness

Glenda Jackson Excerpts

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is right. The most important thing we can do is to eliminate this disease at source, and that is why we can be extremely proud of the efforts of DFID and my right hon. Friend the Secretary of State. As I have said, we are the country that is doing the second most in the entire world to combat the disease in west Africa. There is no better example of the link between proper development policy abroad and security at home.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

May I thank the Secretary of State for his statement, affording as it does an opportunity for the House to pay tribute not only to Nurse Cafferkey and all the other NHS volunteers, but the staff of the Royal Free hospital in my constituency who day in, day out demonstrate all that is best in our NHS? When the Secretary of State meets the World Health Organisation tomorrow, will he highlight a most recent report that states that, although it is possible there has been a diminution in urban areas in west Africa, rural areas in west Africa are still giving great cause for concern? There seems to be no overarching co-ordinated work in those particularly difficult areas. Will he also, as the United Kingdom was the first off the blocks to offer services to sufferers of Ebola, act as some kind of needle to the other countries in the international community that are still failing to help in the fight against this potential catastrophe?

[Mr Hunt]

The hon. Lady is absolutely right that we need all countries to play their part. We have been very involved in international efforts to try to ensure that other countries, particularly in Europe, play their part as we in the UK have been doing. I commend her constituents who work at the Royal Free for their remarkable work, which really is world beating and incredibly impressive. It is also very challenging. The situation that Pauline is in is very difficult for them to cope with, but they are doing so with the highest levels of professionalism. On rural areas, DFID has been focused from the start on how to ramp up community care in rural areas. She is right to say that that is a very important priority.

NHS (Five Year Forward View)

Glenda Jackson Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

The hon. Gentleman is absolutely right. It is totally unacceptable for someone with severe mental health problems to be placed in a police cell. We are making very good progress in reducing the use of police cells for that purpose, with the active support of the care services Minister, my right hon. Friend the Member for North Norfolk (Norman Lamb). In the specific case to which the hon. Gentleman has referred, a bed was available but there was poor communication on the ground, which is why we were not able to solve the problem as quickly as we would have liked. As soon as NHS England was informed of the problem, it was able to find a bed within, I think, about three hours. However, as he says, this is a problem that we must eliminate.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

If that amount of new money is indeed going into the NHS, will the Secretary of State tell us how much of it will be dedicated to—perhaps even exclusively used for—better delivery of mental health services, not least services for child and adolescent mental health patients?

Let me point out to the Secretary of State that this is not the first occasion on which the House has raised with the Government the total failure to provide adequate services for people with mental health issues. The matter was most recently highlighted at the weekend, but it has been highlighted in the Chamber more than once in the recent past. What the Secretary of State has said today certainly does not calm my fear that if my constituents need a mental health bed, they will not find one in London, and heaven only knows how many hundreds of miles they may have to travel before they do find that security.

Health Care (London)

Glenda Jackson Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mark Field]

That is right to an extent. I know that the hon. Lady spoke in a debate that I led in the House almost a decade ago on Barts, which is located in my constituency and has a special place in the hearts of many millions of Londoners—and, indeed, of people throughout the United Kingdom. The truth is that at that juncture, the private finance initiative was the only funding game in town and we all went along with it, but that £1 billion PFI has now caused major financial issues that, I am afraid, affect not just Barts but hospitals throughout the north-east of London, as the hon. Lady is well aware. We all feel a bit depressed about that knock-on effect.

We have to accept that in London, broadly speaking, we do pretty well as far as hospital care is concerned. Being absolutely candid with everyone, because I know what it is like, in central London we have a very good service, and it is partly outer London that suffers as a result. That is because of the strength of the links to which the hon. Lady rightly referred—the passion that we have for our historic hospitals—and the amount of resource that is pushed into central London because the hospitals there are teaching hospitals with consultants, former consultants and alumni who are willing to make a strong case for the existence of those hospitals. Dare I say it, that makes it easier to make the case for Barts than for a hospital out in Romford or Whipps Cross, or one in the hon. Lady’s constituency.

We all have to face those issues. They have not arisen as a result of the reorganisation of the past three and a half years; this has been the situation in the capital for probably 40 or 50 years. I am aware that even in the latest reconfiguration there has been a sense that central London has got off slightly better than the middle portion of outer western London.

I turn to finance. There was a good outcome before Christmas for north-west London on commissioning allocations, as all of our CCGs received an uplift to offset inflation. However, I want to raise concerns about the funding formula used to determine allocation. The formula fails to take into account the needs of the large homeless population in Westminster, which places massive pressure on acute services. Rough sleepers are far more likely to attend accident and emergency; they attend six times more often than any normal member of the population. They are admitted to hospital four times more often and stay in hospital three times as long.

The formula also ignores the fact that CCGs are responsible for all attendances at urgent care centres or walk-in centres and for the costs of patients covered by reciprocal funding arrangements with other countries. Westminster welcomes more than 1 million commuters and visitors each and every day, many of whom will need health advice and care while they are here. It is important that a future funding formula recognises the impact of that on local health care services.

The proposed formula will exclude spending on community care. That cannot be correct considering the important move to provide more high-quality care at home and in the community rather than simply in hospitals. I welcome the Government’s assurances that the Advisory Council of Resource Allocation formula will not be accepted in its current state and that changes to the funding of CCGs will be fully consulted on in future.

I turn to public health spending. A draft formula for local authorities was set out in the “Healthy Lives, Healthy People” consultation, which was published on 14 June 2012 and recognised that further work was needed on adjustments for age, fixed costs and non-resident populations. However, initial modelling by London councils suggests that Westminster would have a drop of 57% in public health funding. Central London and Westminster have unique population characteristics that make it more difficult to make public health improvements. They include the age structure, with a greater focus on working age and children, and levels of mental health problems and homelessness. Those are not properly reflected in the current formula.

The formula also fails to take account of substance misuse services, many of which fall outside the pooled treatment budget, which focuses on opiates and crack treatment. It also ignores the wider health and local authority investment needed to manage the individual family and community impact of drugs and alcohol on health and well-being.

Westminster experiences a high level of population churn—I accept that many other London boroughs are in that boat—and that leads to additional demands for services, including NHS checks and other screening programmes.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

Will the hon. Gentleman give way?

[Mark Field]

Other hon. Members want to speak so, if the hon. Lady will forgive me, I will finish with a request to the Minister. I would welcome an indication from the Government of when we can expect more clarity on how future public health allocations will be determined. I would also appreciate confirmation that the formula consulted on in June 2012 will not be used to determine public health funding allocation in future.

--- Later in debate ---

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

Thank you, Mrs Main. I congratulate my hon. Friend the Member for Westminster North (Ms Buck) on securing this very important debate. I share the concerns expressed by my colleagues earlier, including those about the Secretary of State cancelling the meeting that I and the leader of Ealing council requested. We were looking forward to expressing the views of the residents of our constituencies.

Multiple A and E departments in the capital have been under threat of closure or set for closure, from Lewisham, where a hard-fought campaign has saved the hospital from closure, to south-west London, Ilford, and the four A and Es in west London, two of which have been marked for closure and two of which are still effectively closed—they are being called A and Es when they are not. One of them is in my constituency in Ealing hospital. In a city of more than 8 million inhabitants, where the population growth is twice the national average, those closures and downgrades will have a huge impact on the lives and safety of local residents, leaving many residents miles from their local A and E.

Accident and emergency services are already under tremendous pressure and will be subject to increased strain with local closures. We know that the number of blue-light ambulance diverts increased drastically in London, by almost a quarter, proving that A and Es in London are over capacity. One of the hospitals that has regularly turned away ambulances is Northwick Park. With the closure of A and Es at Central Middlesex and Hammersmith hospitals, and with Ealing and Charing Cross hospitals seemingly unable to receive blue-light ambulances in north-west London, Northwick Park will be under even more strain as patients are sent there for emergency treatment.

Northwick Park is already overburdened and is one of the worst-performing A and Es in the country. It will simply not be able to cope with the four other local A and Es closing and will be unable to accept blue-light ambulances. Journey times for patients will be longer and they face the risk of travelling elsewhere if the ambulance is turned away. That will be the difference between life and death for emergency patients—an unacceptable situation.

Back at the end of October, the Secretary of State confirmed the closure of A and Es at Central Middlesex and Hammersmith hospitals, and announced that A and Es would remain at Charing Cross hospital and Ealing hospital, in my constituency, the shape and size of which would be subject to a review. His statement, which was supposed to remove uncertainty about the future of our local hospitals, only further increased confusion.

It has, however, been made clear, through the Keogh review and Dr Mark Spencer’s subsequent comments, that the review would in fact reduce the size of Ealing’s A and E, and that Ealing would be unable to receive blue-light ambulances. The Secretary of State, who pledged to keep the A and E services, has in fact downgraded Ealing hospital, while keeping the A and E in name only. The Secretary of State promised an A and E for Ealing, but delivered only more disappointment to local residents. There are many other concerns, not least of which is the fact that many of my constituents in Southall are the poorest and most vulnerable members of society, with specific health needs that are met by nearby Ealing hospital. They will have to travel considerable distances, putting their lives at risk.

With the population of west London growing, those decisions seem, at best, unsafe and, at worst, dangerous. The concerns that we have in my constituency and in west London will obviously be replicated across London with the threat of more closures in the midst of an A and E crisis. There needs to be more of a concerted effort from the Secretary of State and the Department of Health to help Londoners receive the best health care, rather than making this existing crisis worse.

[Glenda Jackson]

rose—

[Mrs Anne Main (in the Chair)]

Order. I call Ms Glenda Jackson—you have one and a half minutes.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

Thank you very much, Mrs Main. I had intended to talk for slightly longer than two minutes, but the central thing I wish to say is about mental health. Other contributors to this very important debate have touched on that, but it seems to me that for us, as a nation, it is essentially a Cinderella service, and certainly has been all the time that I have been in the House.

The hon. Member for Cities of London and Westminster (Mark Field) referred to the pressures on central London. That is not only to do with the churn of people moving into London and moving out, but, as he rightly said, it is most markedly about people who are dependent, or over-dependent, on drugs and alcohol, and people with mental health issues. A peripatetic patient cohort—I hate that word, but I cannot think of anything else at the moment—is virtually not being regarded, let alone something on which the multifarious bodies and boards that are now responsible for delivering health care in London are working together.

I hope the Minister will take that away and put it at the top of her list, because the enormous damage that is done to individuals when they are allowed to go over the cliff of their crisis is reflected in the damage inflicted on their families and their wider community. I am firmly of the opinion that the right provision, as we have had in my own constituency, is a house that is open 24/7, 365 days a year. People who felt that they were going to go over the edge of their mental health crisis could walk in through the door. There were people there all the time to care for them. Yes, such facilities are expensive to set up, but I am firmly of the opinion that the money we save by having them could be put towards the sharp end of delivering a high-quality health service to people who are not suffering from mental health problems.

Urgent and Emergency Care Review

Glenda Jackson Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely. The most senior A and E doctor in the country, Professor Keith Willett, said that he thought that between 15% and 30% of the people attending A and E could be looked after in the community. This is a root cause of pressure. I am afraid that the Labour party needs to show some humility before it starts whipping up public concern about problems that it had a very big part in making. I am in the process of discussions with the BMA, and I hope my hon. Friend will not have to wait too long for some good news.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

Will the Keogh review genuinely examine the lack of parity in respect of those who are physically ill and those who are mentally ill? We are already suffering from a crisis in emergency mental health beds in London and we are seeing an increasing use of A and E departments for those who are mentally ill. Surely we should be looking at an increase in walk-in centres for the mentally ill, which have proven to be remarkably effective in helping those on the brink of a serious fall.

[Mr Hunt]

The hon. Lady is absolutely right that the urgent emergency care we offer to people with mental health problems is not up to scratch and needs to be a great deal better. Different solutions will be appropriate in different parts of the country, but often going to a normal A and E is not the right approach. We need to consider whether, when people have such conditions, there can be better access to people who know them, their medical history and their condition and who are in a position to advise them in a way that means they do not end up doing what I have seen happening time and again in A and Es, where people end up as frequent fliers, going again and again to an A and E just because there is nowhere else to go. That is one thing that we are trying to sort out tomorrow.

Care and Support

Glenda Jackson Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

In this instance, I completely understand where the Alzheimer’s Society is coming from. We all want to achieve what Andrew Dilnot made very clear in presenting his report. Any of us or any members of our families could be subject to catastrophic care costs as a consequence of a diagnosis of dementia and several years’ need for care. We want people to be able to plan and prepare, and to protect themselves against that. From the Government’s point of view, and as I have said today, the Dilnot commission’s report is the basis for a funding model for that, but it must be paid for. As with anything else, we are not going to start promising things that we do not know we can pay for. We therefore have a job of work to do, and I am determined that we will do it as speedily as we can.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

The Secretary of State referred to deferred payments. In the time before the individual dies, who will pay for that care? Is there any estimate of how much the care will cost? It seems to be an extremely bad deal for the individual if they must also carry the interest rates of that loan. Will it be administered by local authorities? Who will fund that local authority?

[Mr Lansley]

From the care user’s point of view, it will be funded by local authorities. Central Government will back that up.

Care of the Dying

Glenda Jackson Excerpts

Tuesday 17th January 2012 Westminster Hall

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

May I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes)on obtaining this debate? I agree with the bulk of what he said. There is something drastically wrong with a society that can contemplate legalising something that is, to my mind, murder. A change in the law would inevitably define the value of a life as dependent upon physical or mental capacity.

One of the greatest regrets of my life is that I was not present when either of my parents died. They did not die at the same time: both died in hospital and there was a period between each of them dying. One of the greatest privileges that can be afforded to a caring person—to us as human beings—is to be present at that moment when the last great adventure begins, when life slips away. A great strength of the Marie Curie hospice in my constituency is not that it exclusively treats the individual who is facing that last great adventure, but that it offers care and concern for the family, so that they can be included in that process.

Surely, we all deserve dignity in our death, whether or not that happens, as I think most of us would like to experience it, in our own home. Certainly, hospices provide the most extraordinary care. I agree with the hon. Gentleman that, regrettably, neither this Government nor the previous one took on board sufficiently the importance of hospices by financing them to the degree they warrant and deserve. As the hon. Member for Loughborough (Nicky Morgan) said, we are not simply discussing those who are elderly and facing death: this also applies to children and young people. The particular approach that hospices and palliative care can provide is of paramount importance.

I am somewhat shocked at the idea that hospices are somehow irrelevant, which is argued by some who seem to believe that advances made in medical science have, during our period on Earth, ground to a halt. I remember, because I am quite old—[Hon. Members: “No!”] I am sorry, but I am. The most frightening diseases when I was a child were cancer, and consumption—tuberculosis—which was deemed an absolutely incurable illness leading inevitably to death. We hear that its incidence has increased, but we do not hear much about it being an absolute death sentence.

We should all support the advances being made in medical science and research, not only in curing illnesses but in preventing their onset. In this instance, it is paramount that our society turn its face away from what could become legalised murder, and argue and press the case for increased funding, increased support for palliative care and, most markedly, support for hospices.

Southern Cross Care Homes

Glenda Jackson Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

My hon. Friend is absolutely right, and that is indeed one of the many issues we need to consider as we proceed towards publishing a White Paper next year on social care reform. We have to ask questions about the regulatory framework that existed when that business model was established. We also need to ensure that we have the necessary tools to deal with large care home providers of this sort, where an individual local authority might be unable to cope with the consequences. Those are the issues that we are working with and that we shall continue to work with.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

The Minister gave a list of consultations and apparently daily meetings of his officials with care home providers and landlords. The one group that was markedly lacking in the process was the residents of the homes and their families. When will they be included in this process? Who will be responsible for informing them of the timeline if there have to be moves, and will they be in a position to object strongly if, for example, an elderly person does not wish to be moved from the home in which they are resident? Who is responsible for informing those people?

[Paul Burstow]

The first thing to say is that everything I have set out for the House today is about minimising the numbers of closures and moves. It is about ensuring continuity of care and continuing care in existing care homes. However, having said that, I made the point in response to her right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) that there is new guidance for local authorities on how they engage with the residents of care homes and their families, and it is the responsibility of local authorities to do just that.

Winterbourne View Care Home

Glenda Jackson Excerpts

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

My hon. Friend makes an important point. I do not know the answer to the question of how long the people were filmed before the whistle was blown again by “Panorama”. However, it is an important point that will undoubtedly become clearer as we come on to the details of the inquiry.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

I endorse the Minister’s praise for the whistleblower in this horrific case, but may I remind him that he blew the whistle three times to the Care Quality Commission, which did precisely nothing? What are the Government doing to ensure that such a situation can never arise again?

[Paul Burstow]

The local authority was notified in the same way, so there are a number of agencies at which we need to look carefully and critically, and that is what the independently chaired serious case review will do. That is what the review by the CQC is about, and we will pull all those reviews together. If there are any gaps in the information that comes from that process, we will make sure that they are filled. However, the key thing is that lessons are learned along the way and changes are made straight away.

NHS Reform

Glenda Jackson Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

I will indeed do that, and I am very grateful to my hon. Friend for her comments. She represents a Cornwall seat, and she and I know that over the years many people in Cornwall have felt they wanted a greater sense of ownership of the decisions made in the health service, not only for individuals but for the health service in Cornwall itself. That is precisely what we are going to make available through both local commissioning and local authorities.

[Glenda Jackson (Hampstead and Kilburn) (Lab)]

The Secretary of State listed in his statement concerns to which he intends to listen, but every single one of them has been raised with him before, going back to the time of the publication of his White Paper. As he did not listen to those concerns then, why should any of us believe his positive commitment to listen to them now?

[Mr Lansley]

I am afraid the hon. Lady is completely wrong about that. We have continuously listened. After the publication of the White Paper, we had a full 12-week consultation with more than 6,000 responses, and in December’s Command Paper we set out a whole series of changes that were consequent on that, including to the structure of commissioning and the timetable for the transfer of NHS trusts into foundation trusts. In Committee, we have introduced further amendments, not least to make it clear that competition in the NHS will be on the basis of quality not price, which is very important because that is a concern that people raised.