National Marriage and Mental Health Awareness Weeks

Debate between Jackie Doyle-Price and Fiona Bruce

Thursday 16th May 2019 Westminster Hall

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

Thank you, Sir David. I am sure you do not want to listen to me until 4.30 pm; in fact, I know very well that you do not. It is a pleasure to be here with you this afternoon.

I have really enjoyed listening to this debate. There have been some compelling arguments on a subject that we do not really discuss very often, yet it is the foundation of our society. This debate is a welcome opportunity to do that. Certainly, listening to all hon. Members’ remarks, I was given considerable food for thought, so I shall do my best to address the points that were made. I congratulate my hon. Friend the Member for Congleton (Fiona Bruce) on securing the debate and on having the imagination to bring together National Marriage and Mental Health Awareness Weeks.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) talked about who might have responded to the debate were it not for the reference to mental health, which is an interesting question. Various Departments have an interest, including the Department for Work and Pensions, the Department for Education where the issue affects children, my Department where it impacts on mental health, the Ministry of Justice where it might lead to offending behaviour and the Ministry of Housing, Communities and Local Government in so far as it might lead to addiction.

This all comes back to the state delivery of services and how it tends to rely on a uniform process, yet we are dealing with human beings. If they require support, a one-size-fits-all, tick-box approach will not necessarily be effective in all cases. To be honest, when we see people whose adverse childhood experiences have led them to harm either themselves or others, I view that as a state failure. Perhaps we ought to look at the drivers of child poverty and see whether we can ensure a more effective Government response. When I sit on various cross-departmental working parties looking at domestic violence, mental health or knife crime, I often think they could all be brought together to look more holistically at the children who need early intervention. We need to get much better at that.

Obviously, how we raise our children and family relationships are crucial to how they turn out. We know that for some people, particularly those living in poverty or with an addiction or those who suffer stress, life can be hard. It ought to be available to us to give people extra help. My hon. Friend the Member for Congleton referred to the troubled families programme in her opening remarks. The ethos behind the programme was to support the families that needed extra help. We need to learn from that programme to see what works best so that we can do things better. That is very much in our thinking.

My hon. Friend also talked about some of the initiatives that we are already taking with respect to mental health and highlighted the new mental health teams that we are creating. She suggested that the teams need to work not only in schools but in families. Sir David, you heard me speak about the Charles Dickens primary school in Southwark in another meeting. I visited it as we were developing our thinking on the new support teams, and it had taken a very imaginative approach to embedding mental wellbeing throughout the school and the curriculum. Instead of having teaching assistants in the classroom assisting, the teaching assistants were doing one-to-one interventions with children. As well as one-to-one tuition, some of them were involved in reaching out and building relationships with the parents. Our school network is exactly where we ought to be able to identify the people who need a little more help.

[Fiona Bruce]

I am delighted to hear that. I do not know whether the Minister has heard of a similar approach taken by Middlewich High School in my constituency, but what is excellent about that is that the school is now reporting improved GCSE results because it works not only with the pupil, but with the whole family.

[Jackie Doyle-Price]

As my hon. Friend says, it is not rocket science. If someone is physically, mentally and socially fit, they will have a feeling of wellbeing overall. If any of those pillars falls down, it drags down the rest. If people have a happy environment at home, they will be happier in school and more disciplined and focused. If they live in a dysfunctional environment, they will want to escape, and that will not be good for their GCSEs or anything to do with their long-term development.

[Fiona Bruce]

Will the Minister allow me to intervene again? I do not want to interrupt too many times.

[Jackie Doyle-Price]

We have plenty of time.

[Fiona Bruce]

Yes, so we have heard from Sir David. Corporates are also realising how important this is to the bottom line: productivity. If people arrive at work having left a happier home, they will be more productive, which is an interesting factor to consider if we multiply it across the nation. It is fascinating that we have one of the highest levels of family breakdown in the world, but also low productivity compared with many of our competitor countries. The Minister touches on that when she talks about the flourishing of a human being in terms of relationships and productivity, which are not disconnected.

[Jackie Doyle-Price]

That is a very good point. We can expect employers to start doing things when they can see a return for themselves. It is interesting also that, as we reach higher levels of employment and as an appropriately skilled workforce is harder to come by, employers see the advantage of giving more help and support to their staff in order to retain them and keep them productive. We look forward to seeing more of that. Certainly our work through “Thriving at Work” with Mind, Paul Farmer and Lord Stevenson is designed to share best practice and encourage more.

My hon. Friend also talked about the long waits for children’s mental health services, which the hon. Member for Worsley and Eccles South (Barbara Keeley) also talked about. We have to concede that, historically, children’s mental health services have been very poorly funded and supplied, and we are dealing with the aftermath of that now. Everyone knows the extent of our ambition to deliver much improved mental health services to children and young people. However, we still have to properly address the situation that we have inherited. We are playing catch-up, but we will push forward and make sure that children have access to services. The mental health support teams are the first point of contact for children, helping them look after their own wellbeing.

Early Parenthood: Supporting Fathers

Debate between Jackie Doyle-Price and Fiona Bruce

Wednesday 30th January 2019 Westminster Hall

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

I have enjoyed listening to everyone’s contributions this morning. It is often said that MPs do not live in the real world, but we have heard some frank accounts this morning that very much prove that we do; we do share those experiences. I am proud of my hon. Friends who have been raw in their accounts of fatherhood. I hope that my hon. Friend the Member for Moray (Douglas Ross) has not been put off by any of the things he has heard today.

The tone for the honest and frank accounts was set by the opening comments by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who was characteristically honest in her expositions. I am grateful to her for obtaining this debate. It is time that we gave a big shout-out to dads.

The hon. Member for Ealing Central and Acton (Dr Huq), who is no longer in her place, mentioned the 400,000 single-parent families headed by dads. My partner was one of those 400,000; he raised his son alone for the first 10 years of his son’s life. It is often challenging for single dads, as things are focused on the mums. When he first started taking George to primary school, he was viewed as a bit of a curiosity by the mums and the teachers. A lot of low-level discrimination takes place towards dads in those circumstances, which we ought to be more alive to. That is probably symptomatic of discrimination towards dads. We have heard frankly today that it is all about the mum and the baby, and that the dad is a spare part. My hon. Friend the Member for East Renfrewshire (Paul Masterton) described driving home, having gone through the trauma of childbirth, and asking, “What happens now?”, then not being able to visit mum the next morning. Collectively, society needs to be a lot more understanding and welcoming of the father’s role in those early days, weeks and months, not least because it gives children the best possible start in life if dad is fully engaged.

We know that now, more than ever. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) is my conscience on these issues. He constantly emphasises to me that good-quality relationships are critical for every member of the family. He is absolutely right. Where society can bolster that, obviously we should take those steps. He has highlighted some things for me to look at, and I assure him that I will.

Childbirth and parenthood is life-changing and my hon. Friends have shared their experiences to illuminate that. Having support from a father as well as a mother is extremely important. We know that there are very real barriers to that involvement, including the pressures of work, which a number of colleagues have alluded to, particularly where employers in particular fields of employment are less than understanding about the fact that family is dad’s work as well as mum’s. That is something that we need to tackle. We have mentioned that services are not always tailored to dad’s needs as well as those of mums.

There is a general lack of information. A life-changing thing happens, and people are kind of expected just to suck it up and go along with it. It can be extremely challenging and scary, so we need to be more understanding of that. We also need to be cognisant of the fact that it is the time of most acute stress and strain on relationships. It is probably the riskiest time for relationship breakdown. We need to make sure that wraparound support is available to dads who need it.

I would like to say that I was satisfied with progress. It is true that progress is being made, but the debate, and the research that has been mentioned, show that we need to do more. Among the things that we are putting in place and expect to deliver, our first steps clearly need to be in maternity services. We believe that they should do more to maximise fathers’ involvement, at a time that clearly offers the most important opportunity to engage them in the care of their partner and the upbringing of their children. I can tell my hon. Friends who did not have that experience that we have invested £37 million to support the involvement of fathers in labour and post-natal units, including en suite rooms and double beds adjacent to maternity wards. Clearly, that would be a much better experience for new fathers, and we will make sure that that arrangement is rolled out more and more. National Institute for Health and Care Excellence guidance states that women, their partners and their families should always be treated with kindness, respect and dignity. We need to make sure that that is done properly. Scrutiny will be through Care Quality Commission inspections, which will be designed to ensure that maternity services deliver what we expect.

Interestingly, according to CQC’s survey of women’s experience of maternity care, 96% of women said that their partner was able to be involved as much as they wanted during labour and birth. Clearly that is not consistent with the figures that we heard today, but the explanation is probably that the question was asked of mums rather than dads. It illustrates what has been said about feeling like a spare part. My hon. Friends have been honest about their emotions at the time in question, and we know that men are not always frank in exposing their emotions. What the survey tells me is that a mum does not always know that the dad feels completely useless and like a spare part. That tells us that we have an issue to tackle. Seventy-one per cent. of women said that their partner or companion was able to stay in hospital with them as much as they wanted, but that is not borne out by the feedback today. My message going out to the health services is that in addition to inspections and standards there needs to be much more sensitivity and leadership, to make sure that dads are properly considered during such an important period.

I constantly challenge the instinctive prejudice within the system to spend the considerable amount of resource that the Government make available to the NHS on clinicians and clinical support, when we know that wraparound services, as often provided by the voluntary sector, are complementary to the services given by health professionals. When we are talking about supporting families and giving children the best start in life, the voluntary sector can obviously play a part. We have heard good examples of that today.

To move the subject on from birth to early parenthood, children clearly do better when both their parents are involved in their life. Where relationships are less strong, there is a risk of poorer outcomes in the long run, as we have heard today. The quality of fathers’ involvement matters more than the quantity of time they spend with their children and partner. We need to champion those who support their partners, which is facilitated by a father’s bonding with their baby or young child. When a father is an active parent, the secure attachment that is built as a consequence makes a big difference to the child as they develop their own relationships and resilience; it leads to better outcomes in life. For fathers it can be a positive experience, often helping them to re-engage with education, employment or training, and altering their outlook on life. My hon. Friend the Member for Chatham and Aylesford shared the experience of her partner’s doing exactly that.

How can we best support fathers in doing what I have described and exploring how to have the most satisfactory parenting experience? I see health visitors as our army in doing that. We have clear expectations about their work with new families. They keep an eye on them, with a view to getting the best outcomes for children and making sure that the family environment is secure. I see health visitors in that way because they often build a less formal and deferential, and more trusting, relationship with the new family. Often they are the only person who interacts with the dad. We shall be expecting health visitors to do much more to support fathers in the early months and years of a child’s life. We expect them to work to ensure that fathers are part of the holistic assessment of family fitness.

Where possible, both parents should be included in health reviews. I have heard the messages from various Members who said that that was not their experience, and we shall give a clear set of messages to the system about addressing that. Such an approach can only boost the chances of intervening early and getting proper support for the mother, the child and the father when it is needed. In doing my job I have been moved by health visitors’ accounts. We know that post-birth is a challenging time for mums, when they are most at risk of poor mental health. The feelings of isolation and helplessness on dads’ part in those circumstances are extremely difficult, and health visitors are incredibly well placed to provide support then, and steer them towards additional help.

[Fiona Bruce]

Will that encouragement of fathers include the time before the birth? As I understand matters—this is from CSJ—only about a third of fathers with a household income below £20,000 attend antenatal classes, compared with two thirds of those who are better off. One inhibiting factor is that if people cannot get a free antenatal class, a three-day course costs about £350. That is a lot of money for those who are already financially stretched.

[Jackie Doyle-Price]

The package of support that we are putting together, in terms of the continuity of carer, starts before birth and is designed to involve both parents. We are aware that there will be constraints on individuals’ ability to participate, and we need to make sure that the system is cognisant and respectful of that, and that it can make the relevant changes. My hon. Friend’s point is well made.

We need to promote initiatives such as Offload—a Warrington project for men aged 18 and over, in collaboration with rugby league. It helps men to learn the mental fitness techniques of professional sports players, to understand their own needs and help them cope. Such initiatives will enable new dads—because there is an issue with men facing up to mental health challenges—to reach out and get support from their peers.

The hon. Member for Ogmore (Chris Elmore), who is no longer in his place, raised the issue of loneliness, and my hon. Friend the Member for Chatham and Aylesford has done a great deal of work on that. Every father and family will have their own individual story. There is nothing like a life-changing experience to make one feel lonely, because all the familiar support networks are thrown in the air. We will expand social prescribing across healthcare services, so that all GPs can refer lonely patients to voluntary and community organisations. I reiterate that there is a role for the commissioning of the voluntary sector to do important work leading to better health outcomes. We will support spaces for community use, working with local groups to pilot ways to use space, to test how that can improve social connections. We need to make sure that we are keeping our eyes open for signs of loneliness, so that trusted support is given early.

In the short time I have left, I want to go further into the topic of mental health. Colleagues mentioned that 10% of fathers suffer mental ill health at the time of a child’s birth. We need to do more to support them. The “DadPack” used in Cornwall to help young fathers is a great development, and I want to champion all such models. I thank colleagues for the examples they have given.

We have had an excellent debate. It is only the start of our trying to do better at supporting dads and young families. I look forward to engaging with hon. Members on this important issue.

Question put and agreed to.

Resolved,

That this House has considered supporting fathers in early parenthood.

Oral Answers to Questions

Debate between Jackie Doyle-Price and Fiona Bruce

Tuesday 8th May 2018 Commons Chamber

[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.

Abortion Act 1967: 50th Anniversary

Debate between Jackie Doyle-Price and Fiona Bruce

Monday 6th November 2017 Commons Chamber

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

I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) on securing this debate to mark an historic occasion: the fiftieth anniversary of the passing of the Abortion Act 1967. As the hon. Lady explained, the Act was introduced as a private Member’s Bill by the then hon. Member for Roxburgh, Selkirk and Peebles—now the right hon. the Lord Steel of Aikwood—and clearly defines the grounds under which an abortion may be carried out in England.

With the exception of emergencies, when it is necessary to perform an abortion to save the life of the woman, two doctors must certify that, in their opinion, which must be formed in good faith, a request for an abortion meets at least one ground set out in the Act, and they should be in agreement as to which ground this is. The hon. Lady asked whether it should remain the case that the opinions of two doctors are required. Well, as long as that remains the law—clearly it is—my emphasis, from a Minister’s perspective, is on delivering the safest possible treatment for women in accordance with that law. The hon. Lady also raised some important issues regarding waiting times, which I would like to go away and reflect on. I am sure that everyone in this House agrees that no woman undertakes a termination lightly. For many, it is extremely traumatic, so it is incumbent on all of us to make that experience the least painful and least traumatic it can be, and as safe as possible. Central to being as safe as possible is that it takes place as early as possible.

[Fiona Bruce]

The Minister is talking about the requirement for two medical practitioners to give their agreement. A ComRes poll of 2,000 adults last week showed that 72% of the public think that abortions should continue to be subject to that legal requirement, because it ensures protection for women, particularly for those in an abusive relationship. It might be the opportunity they have to talk to someone in a safe environment about the pressure that they might be being put under to have an abortion.