Mental Health Act 1983

Debate between Jackie Doyle-Price and Kerry McCarthy

Thursday 25th July 2019 Westminster Hall

[Jackie Doyle-Price]

That is an excellent point, and it plays into a general prejudice that people who are in detention are just an inconvenience to be managed. In the context of Sir Simon’s review, the whole ethos that any reform we make should be about empowering patients brings with it obligations to challenge other aspects of the system, not just the care providers. The hon. Lady is right to say that I need to take that up with the Policing Minister, which I will do as part of rolling out our preparations for the White Paper. I understand the hon. Lady’s lack of confidence when I say that the White Paper can be expected before the end of the year, but that is certainly my ambition, notwithstanding the fact that I know she has been waiting rather a long time for another paper that she was promised.

I can reassure the hon. Lady on the extent of the work that Sir Simon has done and the engagement we have had, especially with service users. Rather like the hon. Member for Bermondsey and Old Southwark, those service users shared with us their personal experiences, often reliving significant distress. Given that they have participated and that we have raised their expectations, we would, to be frank, be letting them down if we did not address that. I do not think that would be in any way forgivable, so, as long as it is on my watch, we will be pushing ahead.

As the hon. Member for Bermondsey and Old Southwark said, we are dealing with legislation passed in 1983, so although this appears to be a once-in-a-generation opportunity to reform this legislation, I hope that that is not the case. The situation is probably more symptomatic of the fact that we have not given this matter as much attention as it deserves, but clearly that has changed. The world has changed in terms of how we debate mental health, and that is welcome. Chiming in with the discussion we have had today, I am keen that we take this matter forward with consensus.

I pay tribute to the leadership that Sir Simon has shown in this review. As well as not ducking the controversial aspects of examining the legislation, he has engaged in dialogue and dealt with them in such a way that it is accepted that Members, peers, service users and professionals need to consider them. I am incredibly grateful for what he has done.

We talk more about mental ill health now, but when it comes to severe mental illness—the hon. Member for Bermondsey and Old Southwark spoke about schizophrenia —that is something that reveals incredible prejudice in people. As we have heard, if someone is able to manage their condition, they can live a full and independent life, but the key is being able to manage the condition with the appropriate support. We still have a lot to do in educating the public and society about the real impact of severe mental illness.

There are so many issues, but I will try to address them all in the time I have. The hon. Member for Bristol East (Kerry McCarthy) asked about out-of-area placements for people with autism and learning disabilities. I must say that this is something that really bothers me. Far too many people remain in institutional care and in out-of-area placements, and nowhere is that more true than in the field of learning disabilities and autism.

It is interesting, once we dig under the issue, to see that we have been very successful in getting people with learning disabilities out of in-patient care and into the community. However, that has been matched by a bigger increase in the number of people with autism finding their way into in-patient care. That tells me—I do not think this will be a surprise to anyone in the Chamber—that we are not doing enough to diagnose autism early enough, and as a consequence we are not equipping people with the skills to be able to live independently.

The ultimate result is that we end up putting people in in-patient care. Quite often, those people are forgotten about and it becomes very expensive to keep them there, so not only are we failing people by not having services for them early enough, but we are adding significant cost to the taxpayer and, frankly, doing harm, because the longer those people stay in in-patient care, the more their ability to live independently diminishes. As far as I am concerned, that is a major failing that we need to address.

[Kerry McCarthy]

I thank the Minister for that. There are two aspects that I have come across. First, it is often when a child reaches their teenage years, which we know are difficult for any child with all the turmoil that is going on physically and mentally, that the anxiety takes over and they eventually go into crisis, and things that perhaps should have been picked up sooner are only picked up then. Secondly, that seems to be particularly true for girls. We know that it is more difficult to diagnose girls with autism than to diagnose boys. I was told yesterday, although I do not know whether this figure is true, that one in four girls in mental health units with anorexia is diagnosed with autism. There is a lot of work to be done in the early years, before they reach that crisis point in their teens.

[Jackie Doyle-Price]

I agree with every word that the hon. Lady says. One of our expectations of the new mental health support teams that we are rolling out into schools is that they will be able to work with schools and to spot people who might be in trouble. She is right that, with girls particularly, autism is under-diagnosed, and by the time the challenges start to have an impact on mental health, it is much more difficult to give people appropriate support. Early diagnosis is key.

I am pleased that we are now setting up a unit within the Department of Health and Social Care to look at neurodiverse conditions and what more we can do to improve service provision for them. I am also pleased that NHS England shares my concern about this and that we can expect more work on it, but there remains a lot to do and I do not shirk from admitting that.

--- Later in debate ---

[Jackie Doyle-Price]

I cannot commit to delivering that, but I can commit to looking at it. I hope that is good enough for the hon. Gentleman.

[Kerry McCarthy]

In the case that I was talking about, the problem was not just that the treatment was so specialised that it was that far away, but that that was when the bed became available. It is a bit of a lottery. The one closest to home was not taking in new patients because it was in special measures. There would have been other places closer. If the person does not accept a bed when one becomes available, they may have to look after a distressed child for an awful lot longer.

[Jackie Doyle-Price]

This comes back to housing. One challenge is getting access to a bed, and another is when the person comes to leave, because we need to discharge people into safe living environments. Are there enough supported housing solutions? No, not always, so the bed remains full. I am having conversations with colleagues in local government to see what more we can do to deliver more supported housing so we can get the pathway going. We could fix it by making more beds available, but that is not really the answer. I am concerned that the longer we leave people in in-patient care, the more harm we do. We have to get that movement through the system. Hopefully, if we do that, people will be less likely to grab the first bed because they can be confident that more will become available more frequently. That is where we need to get to. I appreciate that right now it feels desperate.

There is an issue with quality. The Care Quality Commission has a challenge in deciding whether more harm will be done by taking enforcement action on a place rather than working with it to improve. We see that writ large in TV programmes such as “Panorama”. There is a massive disparity in the quality of care. I challenge the CQC to be a lot more aggressive when we see poor standards of care.

The hon. Member for Bristol East mentioned private providers. People have heard of The Priory. They hear that celebrities go there and they think it is a centre of excellence. The truth is that the care there is less than optimal, but someone with a loved one who needs hospital treatment will not know that. We need the CQC to have a lot more teeth in terms of improving what comes out of its inspections. The system generally needs to support it in doing that.

Oral Answers to Questions

Debate between Jackie Doyle-Price and Kerry McCarthy

Tuesday 18th June 2019 Commons Chamber

[Jackie Doyle-Price]

I am pleased that my hon. Friend has declared his interest in this matter. He is right that mental wellbeing is about not only clinical interventions but very much the kind of things that he describes—wider social prescribing. We cannot overstate the role of the third sector in giving wraparound support to people going through periods of mental ill health. I am giving clinical commissioning groups the clear message that they need to look at what else they commission in this space, alongside clinical interventions.

[Kerry McCarthy (Bristol East) (Lab)]

In Manchester on Saturday, people were giving away free “Unknown Pleasures” t-shirts, partly to mark the 40th anniversary of one of the greatest albums ever made. But, as anyone who knows the history of Joy Division will know, there is also the important related issue of male suicide and people were being encouraged to donate to charities, particularly those that work with young men at risk of suicide. I was sent one of the t-shirts, Mr Speaker, but I thought you might rule it out of order if I wore it. These charities obviously do great work, but they are trying to fill real gaps in the system. How can we ensure, when we consider long-term health plans and long-term mental health services, that there are not gaps that people fall between?

[Jackie Doyle-Price]

The hon. Lady articulates the issue extremely well. The purpose of local suicide prevention plans is very much to make sure that we have a joined-up approach to combating male suicide and to identify exactly where the gaps in the services are. The £600,000 that we announced yesterday for the sector-led improvement package is to enable local authorities to share expertise and to make sure that, holistically, they provide the leadership to make sure that the gaps are plugged. I am grateful for the hon. Lady’s interest in this matter.

Oral Answers to Questions

Debate between Jackie Doyle-Price and Kerry McCarthy

Tuesday 7th May 2019 Commons Chamber

[Jackie Doyle-Price]

I thank my hon. Friend for his question. Of course I will be happy to meet him. He is right to identify the fact that people with long-term conditions are more likely to suffer from mental ill health. It is very important that we achieve good care co-ordination so that all those issues can be tackled in the round. We will continue to work to ensure that professionals are made aware of these conditions.

[Kerry McCarthy (Bristol East) (Lab)]

I have spent much of the past week supporting the parents of a child who has a very, very rare genetic condition and who now needs the support of child and adolescent mental health services. It has become very clear to me that CAMHS is set up only to deal with mainstream children who can go through perhaps its anxiety counselling courses and who can process information in a certain way. It does not seem at all geared up to help children who have very complex needs and perhaps learning disabilities. What can we do to make sure that those children who are more vulnerable are not left behind?

[Jackie Doyle-Price]

The hon. Lady is entirely right. I am particularly concerned about the impact on young people going through a period of mental ill health who have neurodiverse conditions and other conditions. It is very important that we tackle the entirety of the individual’s need. Clearly, we need to do more to make sure that all children with whatever conditions can access help when they need it.

Contaminated Blood

Debate between Jackie Doyle-Price and Kerry McCarthy

Thursday 20th July 2017 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend makes a good point. That is exactly the sort of thing we need to hear from this consultation when we are setting the scope, and clearly access to treatment is very important. I encourage him to ask his constituent to write in and make those points.

[Kerry McCarthy (Bristol East) (Lab)]

I think there is a consensus across the House, because everyone has made the point very clearly that they do not have confidence in the Department of Health running the inquiry. I expect an announcement from the Minister soon. If the Cabinet Office is appointed, it does have a track record of taking rather a long time with inquiries, so quite often that is used to kick things into the long grass. Can she assure us that it will be a speedy but thorough inquiry?

[Jackie Doyle-Price]

The speed at which the inquiry reports will be determined by the chairman, because it will be independent—that is the point. At the moment the Department of Health is leading on conversations, but the inquiry will be independent; it will not be run by the Department of Health.