Mental Health Provision: Children and Young People

Jackie Doyle-Price Excerpts

Tuesday 12th December 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I thank the hon. Member for Liverpool, Wavertree (Luciana Berger) for bringing this debate to the House. As usual, she speaks with clear passion on this subject, and she has very clearly outlined the challenges that we face. We have brought forward this Green Paper exactly because of the sort of examples she has articulated, and we need to do a lot more for our young people.

The Green Paper is centred on the support we are going to give through schools, through which we will achieve earlier intervention. We intend to be treating 70,000 more children and young people by 2021. I appreciate the hon. Lady’s impatience, but we are none the less trying to achieve a step change in the amount of support and care we give to children and young people. We have set out proposals for consultation, and I encourage all Members of the House to get involved in responding to them. I am very heartened that, notwithstanding the late hour and the difficult set of votes we have had, so many Members are in the Chamber, which is an indication of just how important this subject is.

The hon. Lady raised a number of issues that are, indeed, all challenging, and I will pick up on a few of them before I come on to the substance of my remarks. The issue of the workforce is extremely important. She and I have had many exchanges on this, and the reality is that our ambition can be delivered only to the extent that we can achieve an increase in the workforce. We are giving a very clear indication that mental health is our priority—we want to send the very clear message that there is a future career in mental health and to attract people into it; none the less, we have had problems with recruitment and retention for many years, and this will take some time to embed. Through the pilots, which she has described, we want to learn what works, and I hope we can deliver on our ambition to deliver a real change.

The hon. Lady also asked whether we are putting too much of a burden on teachers. I would dispute that: we have found that 61% of teachers want to know how best to support children when they see evidence of mental ill health, and nobody can doubt the real commitment of teachers to the children in their care. Part of what we are proposing in the Green Paper is to give them the tools to do the job, and to give them access to more treatment. This is the first time that schools, the Department of Health and the Department for Education have come together to deliver such a policy, and this is a very important way of achieving earlier intervention to support better outcomes.

The Green Paper seeks to build on the progress that we have already made—from setting up the first ever waiting times for mental health to supporting the recommendations of “Future in Mind” through investing £1.4 billion to bring together all services working with children and young people to improve mental health services. While we have heard about some of the very considerable concerns raised about services as they stand, the hon. Lady will have heard me say previously that we are in the midst of a huge programme to achieve change for the better.

I want to take a moment to pay tribute to the incredible staff who are rising to this very significant challenge. We are naturally focused on the shortcomings of services, but we need to recognise that many staff work incredibly hard, and their work must not go unacknowledged.

We are in the midst of an improvement. Last year we saw a 20% increase in the amount of money that clinical commissioning groups spent on children and young people’s mental health, rising from £516 million in 2015-16 to £619 million in 2016-17. I recognise the issues that the hon. Lady raised in her area. As she will be aware, they are under review by NHS England through Claire Murdoch’s programme board.

We have heard concerns about money not getting through to the frontline, but we know that the additional £1.4 billion is already making a difference. Amid the huge concerns raised, we have to keep in mind the huge achievements of the NHS, with many more lives changed for the better thanks to its work.

It is also worth acknowledging where we have achieved success with early intervention. We are exceeding the early intervention in psychosis waiting time standard, with 76.7% of patients receiving treatment within two weeks of referral, and we are on track to meet the waiting time element of the eating disorder standard, with 71% of urgent eating disorder patients receiving treatment within one week and 82% of routine eating disorder patient receiving treatment within four weeks.

The hon. Lady mentioned the pilots and the extent of our ambition with regard to the four-week waiting time. The target is to achieve four weeks for access to assessment for specialist services. While she might feel frustrated by that ambition, it is worth recognising that at the moment some children can be waiting for as long as two years, which is clearly unacceptable. We need to assess what works and ensure that any services that are accessed are based on clinical need.

“Future in Mind” brought together experts from across the sector to ensure that services dealing with young people had credible plans to improve services. We also made sure that these included the voices of young people themselves, and we intend to continue our dialogue with young people. Since “Future in Mind”, we have committed to rolling out mental health first aid to every secondary school by 2019, and to all primary schools by the end of this Parliament. We are also investing £15 million, with the help of Public Health England and others, in a public mental health campaign to train 1 million people in mental health awareness. I think we all agree that the earlier the intervention, the better the outcome.

The hon. Lady quite rightly raised the issue of young people having to travel too far for care, which clearly is appalling. NHS England has committed to eliminating inappropriate out-of-area placements by 2020-21, so we are seeing investment in services and beds where there is lack of provision. In particular, we have had a significant increase in provision in the south-west.

[Jamie Stone]

I appreciate the sincerity of the Minister’s remarks. All that I can say, given my earlier intervention about my vast and remote constituency the other side of the border, is that I would be grateful if she could share her Department’s expertise with the Scottish Government, because the same issues could be tackled in the same way north of the border.

[Jackie Doyle-Price]

I thank the hon. Gentleman for his intervention. I am pleased to acknowledge that I have a very good dialogue with the Scottish Health Minister. It is fair to say that all four nations can learn from each other when it comes to delivering better health outcomes and sharing best practice.

We know that young people are sometimes still taken to police cells when they are in a mental health crisis. The hon. Member for Liverpool, Wavertree outlined the very distressing case of the young woman who had been restrained many times. The Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), and I yesterday announced new police provisions that will finally put an end to this practice. We will ensure that children will always be taken to places of safety. The issue of prone restraint for children really needs to be examined.

The Green Paper will build on these foundations to build a new approach to supporting the mental health of our children and young people. With over £300 million of funding available, we will train a senior designated mental health lead in every school and college to improve prevention work—many schools have already made that commitment—and create brand new mental health support teams working directly with schools and colleges, and we anticipate that they might be working within multi-academy trusts or through local education authorities, and some might be provided through the NHS. Through the pilots we will discover what works, and it will not necessarily be a one-size-fits-all approach.

[Luciana Berger]

I am conscious of the time and that the Minister will soon conclude her remarks, but I have two points that I would like her to respond to. Does she accept that what she is laying out is essentially replacing much of what has been lost in schools: the number of educational psychologists, peer mentors and counsellors lost from our schools because they do not have the funds to pay for them? I hope in her final remarks she can address prevention, which is a very serious point. What are she and the Government going to do to prevent mental ill health in our young people?

[Jackie Doyle-Price]

I do not accept the premise of the hon. Lady’s first point. We are trying to build a critical mass that schools will have access to. On prevention, the investment we are making in mental health first aid and training in schools will enable staff in schools to see when people are going through mental ill health issues. The earlier we can put that support in place the better. We are working with the Department for Digital, Culture, Media and Sport on what we can do through social media. We know that online bullying is causing a lot of mental health issues. As I say, this is a Green Paper. We are making money available. We want to see what works and we want to take this forward in a consultative manner. We will respond fully to any points made as a result of that consultation.

[Rachael Maskell]

What is the Minister going to do to prevent the causes of poor mental health in young people?

[Jackie Doyle-Price]

The point of the Green Paper is that we are looking to put support mechanisms in place so that children facing mental health issues have access to care. That is very much the focus of today’s debate and the Green Paper.

To conclude, as we are running very short of time, I am grateful to the hon. Member for Liverpool, Wavertree for bringing this subject forward for debate. I am sure it will not be the last time we debate it—in fact, I know for certain that it will not. We are trying to achieve a step change in the support we are giving to children and young people. We know that the situation is far from perfect at the moment, but we fully anticipate that we will meet our ambition in the five year forward view to be treating 70,000 more children by 2021.

Question put and agreed to.