Oral Answers to Questions

Jackie Doyle-Price Excerpts

Tuesday 8th May 2018 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

2. What role his Department has in supporting people with mental health problems to access help in relation to housing, debt and employment. [R]

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

The Department is working with the NHS and across the Government to increase the support available for people with mental illness and on related issues. This includes investing £39 million to double the number of employment advisers in IAPT—increasing access to psychological therapy—as well as reviewing the practice of GPs charging for evidence of patients in debt crisis and the introduction of a duty under the Homelessness Reduction Act 2017 for the NHS to refer people at risk of homelessness to the local authority.

[Dr Cameron]

A quarter of people experiencing mental health problems are also in problem debt, and eight out of 10 mental health practitioners surveyed have said that they have less time to deliver clinical care because they are being asked to assist with the task of writing up debt management plans. Does the Minister agree that to ensure the best chance of recovery, commissioning groups require to integrate advice alongside mental health care, particularly for those in problem debt?

[Jackie Doyle-Price]

The hon. Lady makes a sensible point. Of course it is true that people’s personal circumstances are a symptom and a cause of mental ill health. We are doing more to enable those delivering mental health services to signpost people with problem debt to appropriate services. Clearly, that becomes easier where those services are co-located with citizens advice bureaux. In addition, the Breathing Space programme aims to provide a break for people with debt. I recognise, however, that this is a serious problem and that debt problems will cause mental illness.

[Andrew Bridgen (North West Leicestershire) (Con)]

Will the Minister explain to the House how the Thriving at Work programme will play a role in improving public mental health as well as benefiting our working lives?

[Jackie Doyle-Price]

I thank my hon. Friend for his question. It is very much this Government’s view that work is good for people’s health, and the more we can encourage people to live independently and feel in control of their lives, the better their health outcomes will be. We absolutely stand by the Thriving at Work programme.

[Sir Vince Cable (Twickenham) (LD)]

Is the Minister aware of the growing incidence of mental illness associated with gambling addiction and of the rapid rise in suicides as a consequence? Will she try to ensure that there is adequate psychiatric capacity within the NHS, and will she liaise with her colleagues in the Department for Digital, Culture Media and Sport on preventive action?

[Jackie Doyle-Price]

The right hon. Gentleman rightly identifies problem gambling as another important contributory factor to mental ill health. When it gets out of hand, it can lead to considerable stress. We will of course work with the Department for Digital, Culture Media and Sport to ensure that we have the right regulatory processes in place, as well as ensuring that we are giving support to those who need it.

[Fiona Bruce (Congleton) (Con)]

Does the Minister agree that, when children and young people have mental health challenges, it is important wherever possible to engage with their families to help them to overcome them?

[Jackie Doyle-Price]

What my hon. Friend says is self-evidently true. We are putting in more help in schools through the Green Paper, but we also need to ensure that we are engaged with families much earlier than that. We have the health visitor programme, and those visits help to build relationships with parents. We have also taken action on specific issues, including the initiative relating to the children of alcoholics. We will continue to focus support where it is needed.

[Several hon. Members rose—]

[Keith Vaz (Leicester East) (Lab)]

3. Whether he plans to include information on mental health in the national diabetes audit.

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

People with long-term health conditions such as diabetes are at a higher risk of mental health disorders, and we are determined to improve co-ordination between services. That is why the national diabetes audit has started collecting information from GP practices on people who have both diabetes and severe mental ill health.

[Keith Vaz]

I should like to declare my interest. As the Minister knows, three out of five people with diabetes suffer from emotional and psychological problems, including depression and anxiety. A survey recently showed that 76% of diabetics were offered no emotional or mental health support. Will she look at the excellent work that is being done by the NHS in Grampian in Scotland, to see whether its programme could be rolled out for the rest of the country?

[Jackie Doyle-Price]

I would be delighted to look at the progress being made in Grampian, and we are always keen to learn from the experiences of other nations. The right hon. Gentleman makes an excellent point: people with long-term physical conditions are more likely to suffer from mental ill health. As for NHS spending, at least £1 in every eight that is spent on long-term conditions is linked to poor mental health and wellbeing spend. We have also produced a pathway for people with long-term physical health conditions to deliver more effective IAPT—increasing access to psychological therapy—services for them. However, we can always continue to learn about this subject.

[Andrew Selous (South West Bedfordshire) (Con)]

Obese adults are seven times more likely to have type 2 diabetes and the associated mental health problems that go with it. Is my hon. Friend that 140,000 obese children would qualify for adult tier 4 bariatric surgery, but there is little available? Should the NHS be fortunate enough to get some well-deserved extra money for its 70th anniversary, may I put in a bid for that area to be considered?

[Jackie Doyle-Price]

My hon. Friend is right that once children become obese they are going to become obese adults, with all the health problems that come with that. I do not want to steal the thunder of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), but rest assured that we will examine what more we can do to tackle obesity in children.

[Jim Shannon (Strangford) (DUP)]

I declare an interest as a type 2 diabetic. Bearing in mind that three out of five people with diabetes have mental health issues, will the Minister outline what support services GPs should be able to offer at the first diagnosis of diabetes? Early diagnosis is key.

[Jackie Doyle-Price]

I could not agree more. We need GPs to understand that they must consider a patient’s needs as a whole, not just the condition that is presented at the time, and that message has been sitting behind the guidance that we have been issuing to GPs on how they manage patients with long-term health conditions.

[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

4. What assessment he has made of the effect of the withdrawal of NHS bursaries on applications for nursing degrees.

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[Jenny Chapman (Darlington) (Lab)]

7. What support GPs provide to mothers experiencing perinatal mental health problems.

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

We are committed to improving mental health support for expectant and new mothers, and GPs are crucial to that. We recognise that specialist services are also required, and I am proud to announce today that NHS England will be spending £23 million on rolling out the second wave of community perinatal services to underserved parts of the country and is on course to achieve full geographic coverage by 2020-21.

[Jenny Chapman (Darlington) (Lab)]

Given that 95% of mums surveyed by the NCT said that they had experienced mental health problems, that only 22% said they were even asked about this by their GP and that only 24% of the country has any specialist provision, what more does the Minister think she ought to be doing?

[Jackie Doyle-Price]

The second wave roll-out will cover the entire geographical spread of the country. This is a transformational programme, so, by definition, it will take time to roll out, but I agree with the hon. Lady that GPs do have a role to play in this. The National Institute for Health and Care Excellence recommends postnatal checks for mothers, and NHS England expects commissioners to undertake that those guidelines are being met. As for any further support by GPs, she will be aware that there is a renegotiation of the GP contract and it will be covered there.

[Several hon. Members rose—]

[Wera Hobhouse (Bath) (LD)]

Given that children of mothers with perinatal health problems are at much higher risk of developing mental health problems themselves, why does the Government’s Green Paper on mental health not address prevention in respect of perinatal health?

[Jackie Doyle-Price]

As I have said before, the proposals in the Green Paper on children and young people’s mental health were very much focused on what we were going to be delivering through schools. Alongside that, we have a very ambitious programme on perinatal mental health, where we are spending an extra £365 million on delivering both acute care and more support in the community. Today, I have just announced the second wave of that funding.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Back in 2010, we had 19 mother and baby units across this country, but cuts to those beds resulted in our then having 15 mother and baby units. Back in November 2016, the Government said we were going to see more beds opened. I listened closely to the statement the Minister has just made, but we are still waiting for beds that were announced back in November 2016. What are her Government going to do to ensure that mothers and babies will be kept together and can access the beds they desperately need?

[Jackie Doyle-Price]

I do not accept what the hon. Lady is saying. We are investing in new mother and baby units and making sure we have sufficiently good provision geographically so that mothers and babies can access them. We are also investing in more support in the community. I am pleased that the programme we are delivering, which is £365 million of additional support, will deliver early intervention for young mothers and babies.

[Anne Marie Morris (Newton Abbot) (Con)]

8. Whether he has made a comparative assessment of the health and social care needs of rural and urban communities.

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

The diverse health and social care needs of local communities are considered in this Government’s policy and implementation. We are actively supporting local areas, including through Public Health England’s joint work with the Local Government Association, providing evidence-based recommendations to tackle the different needs of rural communities.

[Anne Marie Morris]

Would the Minister find it helpful to ask the national centre for rural health and care, shortly to be launched, to identify the specific challenges facing the providers of health and care in rural areas?

[Jackie Doyle-Price]

The centre has already engaged with stakeholders to identify the issues and responses to the challenge of providing health and care in rural settings. The centre will focus on four areas—data; research; technology; and workforce and learning—and will work with partners to identify, scale up and promote the adoption of its activities across the public and private health sector to reduce health inequalities and improve the quality of life for all rural people.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

If the ministerial team want to learn about the comparison of health outcomes in urban and rural communities, they should come to Huddersfield, as we have both there. But what we want in Huddersfield is a great hospital, great GPs and a supportive community pharmacy network. When are we going to get them?

[Jackie Doyle-Price]

I will address the point the hon. Gentleman makes about urban and rural health, as my constituency has the same situation. Obviously, there are specific challenges with regard to sparsity of population, which have to be tackled through the funding formula. The new national centre for rural health and care will address that.

[Matt Warman (Boston and Skegness) (Con)]

For people in my rural constituency, the value of services at Boston’s paediatric unit could not be higher. Does the Minister agree with me—and with what the Prime Minister said last Wednesday—that we should leave no stone unturned when it comes to making sure that we can recruit the paediatricians we need and sustain the services at Pilgrim Hospital?

[Jackie Doyle-Price]

I am happy to associate myself with the comments of my hon. Friend and those of the Prime Minister. We should leave no stone unturned in making sure that we recruit enough paediatricians to support the service. I reiterate that every effort will be made to ensure that that happens.

[Carol Monaghan (Glasgow North West) (SNP)]

22. Scotland recruits many health professionals from overseas, and that is particularly important for the delivery of healthcare in rural areas. Does the Minister agree that Scotland needs overseas doctors and nurses? What representations has she made to the Minister for Immigration regarding the lifting of the tier 2 visa cap?

[Jackie Doyle-Price]

The hon. Lady will understand that the impact on the workforce is of as much interest to us south of the border as it is to her. We continue to engage in representations with colleagues to address such matters.

[Mr Philip Hollobone (Kettering) (Con)]

Northamptonshire has both rural and urban communities, but our biggest pressures are a rapid population increase because of house building and a big increase in the number of people who are, thank goodness, living to more than 80 years of age. Will the Minister ensure that those two issues are addressed in any future funding formula?

[Jackie Doyle-Price]

My hon. Friend is quite right that when we allocate funds we have to make sure that we keep pace with population growth among both the early years and the older years, which is where the demand comes from.

[Several hon. Members rose—]

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[Jackie Doyle-Price]

I can add no more to what I have already said in answer to my hon. Friend the Member for Boston and Skegness (Matt Warman). We will do everything we can to make sure that we can recruit sufficient paediatricians for that hospital.

[Julie Cooper (Burnley) (Lab)]

What plans does the Minister have to increase the role of community pharmacies in meeting the health needs of rural and urban communities? In 2016, the Government promised to develop an extended role for community pharmacies. In particular, they committed in the House that the national roll-out of a minor ailments scheme would be implemented by April 2018. Given that it is now May 2018 and that has not happened, and that there has been an overall reduction in services commissioned via community pharmacies in both rural and urban communities, will the Minister tell the House when exactly the Government intend to honour their commitment?

[Jackie Doyle-Price]

The provision of community pharmacies is an important part of integrated primary care. We will continue to make sure that we direct sufficient resource to address the particular challenges caused by rural sparsity. I remind the hon. Lady of what we have already done: we spent £175 million from the Prime Minister’s challenge fund to transform GP access, and that is increasing access in areas such as North Yorkshire, Devon and Cornwall. We will continue to look into the particular challenges that rural communities face and make resources available.

[Imran Hussain (Bradford East) (Lab)]

9. What guidance his Department provides to NHS England on the redistribution to other healthcare areas of funding clawed back from dentists who have not met their contracted units of dental activity.

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[Anna Turley (Redcar) (Lab/Co-op)]

17. What assessment he has made of the potential merits of flour fortified with folic acid for children and pregnant women.

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

The Government are looking at existing pre and post-conception health advice, including the use of folic acid supplements, which are recommended to help reduce the risks of neural tube defects in unborn children. We are carefully considering the recommendations in the Scientific Advisory Committee on Nutrition report on folic acid, and the Government will set out their position in due course.

[Anna Turley]

I thank the Minister for that answer, but the UK female diet leaves blood folate levels below World Health Organisation targets, and it was recommended back in 1991 that folic acid should be put into supplements and that flour should be fortified. There are 80 countries around the world where that is happening, and it is reducing cases of spina bifida and other serious illnesses by up to 50%. Will the Minister work with the Department for Environment, Food and Rural Affairs to look once again at the opportunities for fortifying flour with folic acid?

[Jackie Doyle-Price]

I can confirm that we will continue to look at that. The hon. Lady is right that a large number of countries fortify flour with folic acid, but the UK and other EU countries do not. We have advice that if the intake of folic acid exceeds given levels, that can also bring health problems, but we will continue to look at it.

[Ian Murray (Edinburgh South) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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

I am very grateful to my hon. Friend for raising this matter, and I very much welcome the contribution made by the charity to support teenagers in his constituency with psychological therapies and to help to address their mental health conditions. I join him in extending my congratulations to the mayor for choosing this very important cause and for endeavouring to raise so much money for it.

[Faisal Rashid (Warrington South) (Lab)]

T3. Chapelford medical centre in my constituency has been operating out of a portakabin on waste land for many years, due to excessive delays and the failings of various NHS bodies involved in this project. What action will Ministers take to resolve these shocking delays, and will they meet me to give assurances to my constituents?

[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the Green Paper on mental health in schools, which was published earlier this year, but it does prompt a question about the mental health of students in further and higher education. Does my right hon. Friend have any plans to look into that issue? If he does not, may I urge him to do so?

[Jackie Doyle-Price]

I thank my hon. Friend for her question and her continued industry on these matters. As she mentioned, the Green Paper outlined plans to set up a new national strategic partnership focused on improving the mental health of 16 to 25-year-olds. That partnership is likely to support and build on sector-led initiatives in higher education, such as Universities UK’s #stepchange project, whose launch I attended in September. The strategy calls on higher education leaders to adopt mental health as a strategic priority, to take a whole-university approach to mental health and to embed it across policies, courses and practices. [Interruption.]

[Mr Speaker]

Order. The hon. Member for Wigan (Lisa Nandy) need not worry; her Zebedee-like qualities will always make her visible. I am saving her for later. We will hear from her shortly.

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[Paul Masterton (East Renfrewshire) (Con)]

My constituent Susan is desperately waiting for the Government to bring forward the remedial order for single parent surrogates. The Joint Committee on Human Rights published its response to the original draft in March. Is there any update on when we will get the next version?

[Jackie Doyle-Price]

I can reassure my hon. Friend that the Government are giving careful consideration to the implications of the JCHR’s recommendations and what changes may be necessary to address them. It is our current intention that a revised order be laid for JCHR scrutiny before the summer recess.

[Several hon. Members rose—]

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[Lisa Nandy (Wigan) (Lab)]

This week marks two and a half months since the independent inquiry into child sexual abuse recommended that compensation be paid urgently to children sent abroad by their Government and subjected to the most appalling child abuse. In that time, the Secretary of State’s Department, despite repeated requests for action, has made not a single statement. Many former child migrants have died and others are dying. How many more will have to wait, and die waiting, for justice before this Government get their act together and pay them the compensation that is owed?

[Jackie Doyle-Price]

We have been quite frank about the fact that the child migration policy should never have happened and this Government have apologised repeatedly for it. I can assure the hon. Lady that I am currently working with officials to come up with a formal response to the committee of inquiry.

[Leo Docherty (Aldershot) (Con)]

Will the Minister update me on the FIT—faecal immunochemical test—for bowel cancer? It has long been promised and we know it saves lives. When will it materialise?