Access to Medical Treatments (Innovation) Bill

James Morris Excerpts

Friday 29th January 2016 Commons Chamber

[George Freeman]

I shall deal with amendments 8 and 9, tabled by the hon. Member for Lewisham East (Heidi Alexander), and amendment 15, which I tabled on behalf of the Government. I shall also deal with some of the important points that Members have raised.

I have to say that I am not here every Friday, but I think that today’s debate is setting a high standard, both in terms of the issues that are being raised and the way in which it is being conducted. I hope that those who take a close interest in the Bill and are watching the debate are observing the cross-party nature of our discussion of some very important issues.

I thank the hon. Member for Lewisham East for her support for the spirit of cross-party working. The sector needs to be confident in the knowledge that the House is paying close attention to the issues that underlie the Bill—issues relating to data, informatics, genomics, drug trials and research—in a cross-party spirit. As the hon. Lady knows, in the course of my work I have paid tribute to the last Labour Government’s pioneers, Lord Drayson and David Sainsbury, who did so much to create the Office for Life Sciences. I think the debate reflects that spirit, and I welcome the hon. Lady’s restatement of her support for it.

I also welcome amendments 8 and 9, which specify and flag the importance of a wide group of consultees. I entirely agree with the principle of the amendments. Indeed, I would go further and include a range of patients’ groups, charities and others. I give the hon. Lady—and the House—a commitment, which I am happy to put in writing, that I will seek to involve all the organisations on her list, and indeed others, in the consultation that will take place following the Bill’s enactment.

As an experienced parliamentary operator, the hon. Lady knows that including lists of organisations in a Bill is always a mistake, because in the end it creates more problems than it seeks to resolve. However, I will happily write to all the bodies that she has mentioned, and to all Members as well, with a list of those who I think should be involved in the consultation.

[James Morris (Halesowen and Rowley Regis) (Con)]

I know that the Bill is specifically about access to medical treatments, but, as chair of the all-party parliamentary group on mental health, I know that there is a growing need for the ability to share information about both drug-based and non-drug-based interventions in mental health care. Has any consideration been given to the sharing of information about mental health care in particular, and how would that fit into the framework of the Bill?

[George Freeman]

My hon. Friend has made a typically interesting and important point. I pay tribute to his work on mental health.

In no area of pharmacology and pharmaceuticals is drug discovery, drug use and prescribing more complex than in mental health. One of the projects on which I worked before entering the House was at the Institute of Psychiatry at King’s College London, where Professor Simon Lovestone has pioneered the use of informatics and data to integrate research into mental health conditions and the compiling of patient records information, MRI scans and, latterly, genomic information, to assist understanding of both the causes of disease and the way in which different patients respond to different drugs. As my hon. Friend will know, mental health care involves a wide range of very complex and, in some cases, very powerful drugs, and information about how those drugs work and how different patients respond is therefore crucial. I certainly want to ensure that we do not exclude mental health from the Bill’s provisions.

I tabled amendment 15 in connection with clinical research, an issue that received much attention during the Bill’s earlier stages. When—before these amendments were tabled—the Bill made provision for medical negligence, the Government were determined to ensure that none of its provisions would in any way undermine the United Kingdom’s world-class and world-rated landscape for the regulation of clinical trials. So the previous Bill contained a provision stating that nothing in it applied to clinical research. Now that my hon. Friend the Member for Daventry (Chris Heaton-Harris) has tabled amendments to remove the clauses dealing with medical negligence so as to create instead a Bill focused purely on the provision of data on innovative medicines to clinicians, I suggest that we remove that exclusion of clinical research and make sure that the database—now that it has nothing to do with negligence—actually covers drugs in research. That would make sure that we do not preclude the inclusion of drugs in clinical trials that clinicians may want to recommend to their patients or investigate their patients’ eligibility for.

Mental Health

James Morris Excerpts

Wednesday 9th December 2015 Commons Chamber

[Luciana Berger]

The Labour Government created the services in the first place. In order to introduce a waiting time standard those services have to exist, which was not the case previously. We had to address the chronic underfunding of mental health that existed pre-1997, and we introduced the improving access to psychological therapies programme, of which we are incredibly proud. As things develop, it is right that those waiting time standards come forward. The Labour party had waiting time standards in place for all consultant-led services, which included physical and mental health. I am proud of that fact but disappointed that in too many cases the same equality is not also applied to mental health. If the Government are serious about fair access to cost-effective mental health treatment, they must address that fundamental disparity. That is why we are calling on the Government to commit to ensuring that all patients, regardless of whether they need a drug, a physical health treatment or a psychological therapy, have the same rights.

[James Morris (Halesowen and Rowley Regis) (Con)]

rose—

[Luciana Berger]

I hope the hon. Gentleman will forgive me but I will make some progress as I am conscious of time.

Ensuring that people have access to help early on is critical to preventing people from becoming ill, but in recent years, short-sighted cuts to key prevention, early intervention, and community services have been having a devastating impact. When the number of children with a mental health problem who turn up at A and E has doubled in recent years, when one person in prison takes their own life every four days, when a young person who is self-harming is told that because they are not suicidal they do not meet the threshold for help, and when a woman with an eating disorder is turned away from specialist services because her body mass index is not low enough, it is clear that people are not getting the right help early enough.

Too often, mental health problems are ignored, and it is only when they reach crisis point that they receive attention. More and more I hear from mental health professionals across the country that their middle-tier community services, psychologists and counsellors are being stripped out. Apart from the obvious devastating human cost, which impacts on people’s ability to hold down a job, keep a tenancy, pay the mortgage and maintain relationships with partners, friends and family, those decisions will cost our NHS and local authorities more as they struggle to deal with the consequences of serious ill health that could have been prevented. That cost is not insignificant. Recent studies have put the cost of mental ill health to our society at a staggering £105 billion a year. How can the Secretary of State and this Tory Government justify that? Ensuring that people can access support when they need it is an urgent priority, but if we are to ensure that our services are sustainable into the future, we must do much more to prevent people from becoming ill in the first place.

The right hon. Member for North Norfolk (Norman Lamb) mentioned perinatal mental health problems, which affect up to 20% of women at some point during pregnancy and/or the year after the birth of their baby. Left untreated, perinatal mental health problems cost our economy £8 billion a year. Is it not appalling that even if those women seek help, they are not always guaranteed the specialist support they need? The number of mother and baby units has dropped since 2010. The Government’s pledge to spend £15 million on perinatal mental health this year was welcome, but as of this month— according to an answer I received to a parliamentary question—the Government have spent just one fifteenth of what they promised. That is a bitter disappointment because intervening early in perinatal mental health does not just help to improve the health and wellbeing of the mothers affected, but it also improves that of their children.

[James Morris]

May I take the hon. Lady back to her point about the IAPT programme that was introduced by the previous Labour Government and is an illustration of where both parties have delivered success? It may be good to enshrine psychological therapies in the NHS constitution, but we need to build more capacity in the system to deliver on access standards. This is not something that we can just write into the constitution; we need to increase choice and access to psychological therapies across the country.

[Luciana Berger]

I do not think it is an either/or situation; it is about how we do both, and I will come on to that in the rest of my remarks.

We know that 75% of people who have mental health problems in working life first experienced symptoms in childhood or adolescence, yet only about 6% of the mental health budget is spent on child and adolescent mental health services. We need to do more to focus attention on children, young people and, crucially, prevention, and here we must look to our places of learning, our workplaces and our communities. We need schools and colleges that promote good mental health. We need to ensure that all children have access to high-quality social and emotional learning so that they acquire the skills to express how they feel and develop an understanding and awareness of good mental health. We were concerned to read the 2013 Ofsted report on personal, social, health and economic education, which stated that mental health education was often omitted from the curriculum owing to a lack of teacher training. The Government have funded the PSHE Association to publish guidance and lesson plans to support teaching about mental health, but how are the Government ensuring that schools are actually using it?

We need communities that promote good health and wellbeing. Poor housing, fuel poverty and neighbourhood factors, such as overcrowding, feeling unsafe and a lack of access to community facilities, can have a harmful impact on mental health. These, along with abuse, bullying, trauma, deprivation and isolation, are just some of the levers of mental distress in our communities that we must address.

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[Mr Hunt]

I accept that we need to improve the provision of mental health services for children, but I do not accept the hon. Lady’s characterisation. She will know that in the final Budget before the general election, the previous coalition Government committed £1.25 billion over this Parliament to improving child mental health provision and perinatal mental health support. That has been honoured by this Government, and we are in the process of working out how to roll that out. It is something that the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), spends a lot of time thinking about.

Before we discuss precisely what things need to happen—I think they should be done in a bipartisan spirit—we should recognise that really important progress has been made in recent years. I want to start with some of the achievements made by the previous Labour Government, who increased funding for the NHS and, within that, for mental health services. They oversaw a significant expansion of the mental health workforce and big improvements in in-patient care, with 70% of mental health patients being seen in private rooms. They increased the use of new drugs and therapies, including psychotherapy. Those were important steps forward.

Under the coalition Government in the previous Parliament, we saw a record investment of £11.7 billion in mental health services at a time of huge pressure on public finances. We passed the parity of esteem clause in the Health and Social Care Act 2012, something we Conservative Members are incredibly proud of. The first access targets were set for talking therapies for psychosis. We are starting to end the distortion that the right hon. Member for North Norfolk talked about, which saw targets for physical health access sucking resources away from local mental health provision over a sustained period.

We have seen particular progress in two areas. It is important to mention them; it provides encouragement that when we decide to focus on improving specific areas of mental health provision, we can make real progress. First, on talking therapies, the NHS is now recognised as a world leader. The number of people getting help from talking therapies quadrupled from 182,000 people starting treatment in 2009-10, to 800,000 starting treatment last year. The total number of people helped in the previous Parliament was 3 million, compared with just 226,000 people helped in the Parliament before that—a thirteenfold increase.

We are hitting the new access target to reach 15% of those needing it, although we are not quite hitting the recovery target; I hope we can put that right soon. That model is being looked at very closely by Scandinavian countries, and a pilot, based on what we have done here, is starting in Stockholm. We can be very proud of that important progress.

The last Parliament saw a 50% increase in dementia diagnosis rates, up from 41% at the start of the Parliament to 67% at the end of the Parliament—the highest dementia diagnosis rate in the world. We have 1.3 million dementia friends and 120 dementia-friendly communities. We have seen a doubling in funding for dementia research, with a new ambition to find a cure or disease-modifying therapy by 2025. In the spending round, the Prime Minister announced funding for a new dementia research institute; that will be another important step forward.

[James Morris]

The Secretary of State talks about the amount of money put into dementia research for very good reasons, but is there not a strong argument for building a research and evidence base around mental health? We need a commensurate investment in research on mental health, so that we can understand more about prevalence.

[Mr Hunt]

My hon. Friend is absolutely right, and I commend him for the work he does on the all-party group. The truth is that it is still early days when it comes to a proper understanding of mental illness. According to the latest Times Higher Education league table, this country has five of the top 10 health research universities worldwide, so we have a huge contribution to make to that research; he is absolutely right to make that point.

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[James Morris (Halesowen and Rowley Regis) (Con)]

It is important to reflect on whom this debate is about. It is about the thousands of people across the country who may have woken up this morning feeling that they might not be able to get through the day. It is for the young boy, perhaps aged 14, feeling confused and depressed at school and not knowing where to get help, and the young girl prepared to starve herself potentially to death because of issues to do with body image. This debate is for the middle-aged man of 40 who may be contemplating suicide because of a sense of a loss of his identity. It is about the older person, perhaps the 75-year-old woman who has just suffered a bereavement and feels isolated and depressed, not knowing where to go for help. Those are the people whom we are speaking about today.

In my role as the chair of the all-party parliamentary group on mental health, I am aware that the public debate about mental health has changed radically over the past decade. Celebrities and Members of Parliament talk about their mental health. That has created a unique context in which we can talk about mental health policy. This Government have an historic opportunity to make a genuine difference to the direction of mental health policy in Britain.

As part of the £14 billion that we spend on mental health services in Britain, it makes sense to move resources to tackle the issue at its source, whether through the Government’s commitment in respect of perinatal mental health, or by radically transforming our child and adolescent mental health services so that we get rid of the tiering system that is more suited to the commissioners than to service users. We need radical change in that area. We need a crisis care system in which, if an individual rings up and says, “I am having a crisis”, they get compassionate help. Overall, we need a vision for mental health policy that achieves a situation in which talking about mental health—about an individual’s mind and their place in their family and in their community—is thought to be entirely normal in society. We have that opportunity and we as a Government need to take it.

Health and Social Care

James Morris Excerpts

Tuesday 2nd June 2015 Commons Chamber

[The Secretary of State for Health (Mr Jeremy Hunt)]

It is an honour to speak about health and social care in our debates on the Gracious Speech, because nothing matters more to this Government than providing security for all of us at every stage of our life, and nothing is more critical to achieving that than our NHS.

I start by welcoming the right hon. Member for Leigh (Andy Burnham) and his colleagues back to their positions. I will not take it personally that two of them want to break from debating with me to go elsewhere. However, it is a topsy-turvy world when the shadow Health Secretary who was the scourge of private sector involvement in the NHS now wants to be the entrepreneurs’ champion. As one entrepreneur to another, may I put our differences to one side and on behalf of the whole Conservative party wish him every success in his left-wing leadership bid? This is perhaps the only occasion in history when my party’s interests and those of Len McCluskey are totally aligned.

That is not to mention the hon. Member for Leicester West (Liz Kendall), who is, in her own way, a kind of insurgent entrepreneur, taking on the might of the Labour establishment, in the mould of Richard Branson or Anita Roddick. Sadly, I fear that she will demonstrate that pro-business, reform-minded, centre-ground policies are as crushed inside today’s Labour party as they would have been in the country if Labour had won the election.

The shadow Health Secretary said countless times during the election campaign that the NHS would be on the ballot paper. He was right—the NHS was indeed the top issue on voters’ minds—but not with the result he had intended. So, just as he has now done significant U-turns on Labour’s EU referendum policy, economic policy and welfare policies, I gently encourage him to do one on Labour’s health policies too.

The Queen’s Speech committed the Government to the NHS’s Five Year Forward View and the £8 billion that the NHS says it needs to fund it. The shadow Health Secretary refused to put such a commitment in Labour’s manifesto, and I hope today he will change that policy so that we can have cross-party consensus on this important blueprint for the NHS.

[James Morris (Halesowen and Rowley Regis) (Con)]

Does the Secretary of State agree that one of the biggest challenges we face is to achieve parity of esteem between mental health and physical health in the NHS, and that the way to achieve that parity is by ensuring that mental health services are properly funded and that we have a culture change in the NHS that means that physical health and mental health are treated as the same?

[Mr Hunt]

My hon. Friend is absolutely right, and I want to thank him for his tireless campaigning on parity of esteem for mental health in the last Parliament. One in 10 children aged five to 16 has a mental health problem, and it is a false economy if we do not tackle those problems early, before they end up becoming much more expensive to the NHS as well as being extremely challenging for the individual involved. We are absolutely determined to make progress in that area.

Oral Answers to Questions

James Morris Excerpts

Tuesday 24th February 2015 Commons Chamber

[Norman Lamb]

I am tempted to say that that is a bit rich coming from an Opposition Member. I am sure that he would agree that whatever commitments are made, we need to understand their cost. That work is under way and I hope that as soon as we achieve a full understanding we can proceed.

[James Morris (Halesowen and Rowley Regis) (Con)]

8. What assessment he has made of the potential of the genomics programme to improve cancer treatment.

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman)]

The Government’s £300 million genomics England programme, led and announced by the Prime Minister as part of our life science strategy, has the potential to improve dramatically cancer diagnosis and treatment. By sequencing the entire genetic code of 100,000 NHS patients and volunteers and combining the data with their clinical records, and launching a genomic medicine service—a world first for the NHS—we will be able to understand the genetic triggers of disease, unlock new diagnostics and identify better treatments from existing drugs.

[James Morris]

The number of people being treated for cancer successfully and getting appropriate diagnostic treatment in Dudley and Sandwell has increased substantially in the past five years, but does the Minister agree that harnessing genomic medicine is key to the future, and that we need to drive innovation in this field over the next 10, 20 and 30 years?

[George Freeman]

My hon. Friend makes an excellent point. He is absolutely right: cancer is a genetic disease, and the more we know about genetics, the more we discover about different patients’ predisposition to different diseases and drugs. That is absolutely key, and nowhere more clearly so than in breast cancer, where the HER2-Herceptin breakthrough and the BRCA2 gene are allowing us better to screen, predict and target treatment of breast cancer, freeing women from the choice of mastectomy, which has been far too dominant, and enabling us to treat breast cancer as a preventable disease.

Child and Adolescent Mental Health Services

James Morris Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

I totally agree. However, I caution the Opposition about going around declaring a crisis every second day, because the picture is very varied around the country. I agree with the hon. Gentleman about any unacceptable things that are happening. He makes a very good point about co-ordinating services much better. Indeed, a central focus of the children’s mental health taskforce is to try to ensure that we get much better, co-ordinated commissioning of care.

[James Morris (Halesowen and Rowley Regis) (Con)]

In my capacity as chair of the all-party group on mental health, I recently visited the Elms centre in Dudley, which is providing an excellent CAMHS service for the people of the borough. It is important to recognise that there are very high-quality CAMHS services in certain areas of the country, although we accept that there is variability. Does the Minister agree that the challenge is not just about the order of magnitude of resources but about ensuring that commissioners are prioritising CAMHS at a local level so that they make the right decisions about the sort of provision that is required in their area?

[Norman Lamb]

I pay tribute to my hon. Friend for the work that he does on mental health. He is another champion of mental health in this House. I also pay tribute to the people in the service in Dudley that he mentioned. I have visited a fantastic children and young people’s mental health service in Accrington in Lancashire—one of the six pilots on using psychological therapies for people with severe and enduring mental ill-health. He makes a very good point. We need to celebrate great care where we find it, and also ensure that commissioners, in local authorities and in clinical commissioning groups, take this seriously. The trouble is that when there are no standards at all in mental health, it is very easy for people quietly to cut back, thinking that they can get away with it. That is why I want to ensure that people suffering mental ill-health have exactly the same right to access treatment as anyone else.

NHS (Government Spending)

James Morris Excerpts

Wednesday 28th January 2015 Commons Chamber

[Dr Poulter]

I am going to make some progress and I am sure I will give way to the hon. Lady later on.

The investment we are making in the NHS also means that our NHS is caring for more patients than it has ever done before. Last year, compared with Labour’s last year in office, there were 1.2 million more episodes of in-patient care, including 850,000 more operations, 6.1 million more out-patient appointments, 3.6 million more diagnostic tests and almost 460,000 more GP referrals seen by a specialist for suspected cancer, meaning that under this Government more patients are receiving early referral for important care. We have also reduced the number of administrators in our NHS by 20,000. That is freeing up more cash to be reinvested in the front line of patient care.

[James Morris (Halesowen and Rowley Regis) (Con)]

While we are talking about future resources for the NHS, may I commend the Government for what they have done to move towards parity of esteem in mental health and investment in talking therapies? Is it not important, when we consider future NHS resources, to consider the balance of the £14 billion that we currently spend on mental health services and how we can further invest in mental health services over the next Parliament?

[Dr Poulter]

My hon. Friend makes an important point. We have made considerable progress under this Government in improving the funding in the past year—£302 million more for mental health services—and in making sure that from this year, for the first time, there will be genuine parity between mental and physical health when we introduce access targets. They will ensure that patients are seen in a more timely manner when they suffer from mental illness and need specialist care and referral. Our record in office on mental health is something I think we can be very proud of. We have for the first time in many years reset the debate. There is now becoming a genuine parity of esteem between mental and physical health.

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[Margot James]

I do not want to cast aspersions relating to cover-ups and the like on some of the NHS management in Wales, but I think that some members of the hon. Gentleman’s own party have some salutary tales to tell on that front.

However, as was pointed out by my hon. Friend the Member for Sherwood (Mr Spencer), this is not just about spending; it is about how we control the budget and what we get for the money that we spend. I appeal to those who rate the Labour party on the basis of its health policies to reflect on its record. They should remember how much Labour was borrowing when it was running the NHS, and that it was spending money as though it were going out of fashion.

Under the last Government, the number of managers increased three times as fast as the number of nurses, and managers’ pay increased far faster than nurses’ pay. The management pay bill more than doubled under the last Government, but we have reduced it by nearly a fifth. There was absolutely no integration of health and social care under the last Government, although they had 13 years in which to put that right. Despite severe financial constraints, our record has been so much better than theirs, and that is the position I will put to my electorate when the time comes. We have produced 13,000 more doctors and nurses, and 21,000 fewer administrators and managers. That is what the public want to see. They know that this Government have the right priorities. In my area, that has translated to 353 more nurses and 84 more doctors in my hospital since this Government came to power. I congratulate our health ministerial team on not caving in all the time to producer interests—another facet of the last Government, with their command and control culture.

I want to mention a few of the things I am proud this Government have achieved within severe spending constraints. We have ended the indignity of mixed sex-wards. We have reduced infection rates dramatically. C. difficile infection rates have come down by a staggering 63%. The last Government grappled with this issue for 13 years, leaving a disaster when they left office. They had an appalling record. Another great innovation—one of many; I have not got time to mention them all—is the Cancer Drugs Fund, which has helped many of my constituents to get the treatment they were denied under the last Government, with all their spending largesse. That has also flowed through to the hospital sector—imaging and radiodiagnostic tests have increased by 34%. All these benefits have been achieved with very small real-terms increases in spend. That is what this Government have been able to do: deliver more with less.

[James Morris]

Under the previous Government, all the in-patient wards in one of my local hospitals, Rowley Regis, were closed, but during the last four and a half years they have reopened, and there has been lots of innovation and new services coming into that hospital.

National Health Service

James Morris Excerpts

Wednesday 21st January 2015 Commons Chamber

[Paul Burstow]

I think it important for the system to learn lessons from the areas where winter planning has worked well, and for us to ensure that those lessons are transferred and replicated around the country. The NHS is not always as good as it could be at ensuring that lessons are not just stuck in one place.

[James Morris (Halesowen and Rowley Regis) (Con)]

Will the right hon. Gentleman give way?

[Paul Burstow]

I must make some progress if others are to have a chance to speak.

The NHS has grappled with a productivity challenge during the current Parliament, but it should be noted that it was first set up and signed off by the last Administration. The target was £20 billion, and it was to be delivered within a shorter period than the coalition Government set in their 2010 spending review. The Labour productivity programme was set in 2009, and it was clear then that the NHS was on notice that it faced a very tough settlement regardless of which party was in government after the 2010 general election. Reducing management overheads has been a key part of our efforts to balance the books during this Parliament. Focusing on the management overhead costs of the commissioning side of the NHS in the legislation that went through the House at the beginning of the Parliament was sensible, and increasing clinical involvement in commissioning was another important move.

NHS (Five Year Forward View)

James Morris Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

The training may have started under Labour, but if we do not have enough money in the NHS budget, we cannot pay for these doctors and nurses. We can do that because we took a decision, bitterly opposed by Labour, to disband the primary care trusts and the strategic health authorities and to lose 21,000 administrators so that we could pay for 10,000 extra doctors and nurses, including in Coventry.

[James Morris (Halesowen and Rowley Regis) (Con)]

The achievement of parity of esteem between mental and physical health in the NHS is absolutely fundamental to its future. As the Secretary of State will know, the Government have a reasonably good record on moving towards parity of esteem. Does he agree that we need not only more investment in mental health services, but, more importantly, better commissioning and a change of culture towards viewing patients as a single whole?

[Mr Hunt]

My hon. Friend has campaigned incredibly hard on this issue. I totally agree that the key aspect is a change in the approach of commissioners. People with mental health needs often have physical health needs and different needs relating to gambling and alcohol addictions, for example, that are connected to their mental health problems. Unless all these issues are tackled together, we are unlikely to make progress. We are very proud to have enshrined in legislation parity of esteem as something that we must achieve in the NHS. Today’s announcement will help this to go further.

Christina Edkins

James Morris Excerpts

Monday 17th November 2014 Commons Chamber

[James Morris (Halesowen and Rowley Regis) (Con)]

The murder of Christina Edkins on 7 March 2013 in a random knife attack on the No. 9 bus, while travelling from Birmingham to school in my constituency, was a devastating blow to her family, friends and the community where she lived in Birmingham, and where she went to school in Halesowen. Nobody could imagine the depth of pain and anguish that the Edkins family have had to suffer, and I will read an extract from their victim impact statement:

“The school have been wonderful and so have all of Christina’s friends, who have also been affected by her death. They wanted us to come to the Prom for Christina, but we couldn’t do it, it would have been too difficult…Some months after her death, we had a parcel delivered—it was Christina’s exam results, she had done really well. Also enclosed was the school year book, where Christina was included, and at the back they had done a tribute page to her. There was a poem and lots of photographs of her and a quote by her headmaster ‘if a school could choose its pupils, it would be full of Christinas’…Our family are so devastated I don’t know how we will get over what has happened. We are a big family and no one has been left untouched. Christina loved her family and her cousins—they all called her CJ. Our lives have been changed beyond all belief by that knock on the door on 7 March 2013. Our lives will never be the same and I don’t know what we will do without our precious daughter Christina.”

At first, the focus following this act was on the use of a knife in the attack by Phillip Simelane. Immediately after the incident I called on the Prime Minister in Prime Minister’s questions to tighten knife laws, and I supported an amendment to the Criminal Courts and Justice Bill, which has significantly strengthened our knife laws.

It became clear when matters were brought to court that Phillip Simelane was unable to make a plea because he was considered too mentally ill to do so. In September 2013 he appeared in court, and in October 2013 he was convicted of manslaughter on the grounds of diminished responsibility and detained in a psychiatric hospital. During court proceedings, the judge at Birmingham Crown court raised a number of issues and questions about the mental health of Simelane. Why had he not been admitted to a psychiatric hospital? Why had he been discharged from HMP Birmingham without any follow-up? Why did the services he was involved with prior to being admitted to HMP Hewell not deem him to require treatment.

As a result of questions raised by the trial judge, Birmingham and Solihull Mental Health NHS Foundation Trust initiated a serious incident review. Culminating in the report chaired by Dr Alison Reed, the review revealed more than a decade of contact by services with Phillip Simelane, including Birmingham and Solihull mental health trust, the Black Country Partnership mental health trust, Sandwell social services, Worcestershire Health and Care NHS Trust, Phillip Simelane’s GP, the West Midlands police, Sandwell Women’s Aid, HMP Hewell in Birmingham, the Crown Prosecution Service, and Her Majesty’s Courts and Tribunals Service. The report revealed a litany of service and system failures that led it to conclude:

“The homicide of Christina by P was directly related to his mental illness and could have been prevented if his mental health needs had been identified and met.”

The report revealed a lack of co-ordination between services over a long period, from the time that problems with Simelane were raised in school, through to his discharge from HMP Birmingham almost a decade later. It identified the complete breakdown of communication between different services that came into contact with Simelane over a 10-year period. It identified the unrealistic responsibility that was placed on Simelane and his mother—to whom he had made several violent threats and actions—to initiate and engage with health care services, including his GP, child and adolescent mental health services, and the Prison Service, when it became increasingly clear that Simelane was not in a position to judge his own mental health needs.

Paragraph 64 of the report illustrates one of the issues. On 26 March 2009, Phillip Simelane’s GP called his mother on the telephone. The report says:

“There was a further discussion about whether P was involved with drugs, but she had not discovered any illicit substances. It was reported to the GP that P had admitted to using alcohol/cannabis in the past. The GP recorded that the plan was to refer P to the BCPFT Community Mental Health Team and ask them to assess P soon. The BCPFT Oldbury & Smethwick Community Mental Health Team sent an ‘opt in’ letter to P on 1 April 2009 asking him to contact them to make a ‘mutually convenient appointment’ within the next 14 days. The letter also stated, ‘If we do not hear from you within two weeks, we will assume you do not need our service’. On the 20th April 2009 the team wrote back to the GP saying they had not had any response from P and were therefore discharging him back to the GP’s care. The case was closed. P did not receive any written confirmation that his case had been closed. On interview, the GP stated that if a GP expressed concerns to a mental health specialist about a patient, then at the very least the patient should be seen.”

My intention is to raise the serious problems with the idea that people should “opt in” to mental health care.

The next issue is the repeated failures of professionals across the agencies to determine Simelane’s future risk to himself, his family and the public, with often contradictory assessments of his mental health state over a 10-year period. Another issue is the lack of basic information sharing between agencies and within the prison and courts system, leading to bad or confused decision making about the care—or lack of care—of Phillip Simelane. As an example, attempts were made in 2012, some six months before the incident took place, by the Black Country Partnership mental health trust crisis team to raise their concerns about Phillip Simelane with HMP Hewell, but these were not followed up.

One of the most devastating indictments in the report is that in October 2012 Simelane was released from HMP Hewell on licence, with no notification to his GP of prescribed medication and no mental health follow-up. He was also discharged with only three days of anti-psychotic medication. After he had reoffended while on licence, he was released from HMP Birmingham having been rendered homeless. An injunction was at his mother’s address. Again, there was no notification to his GP from the Prison Service and no mental health follow-up.

The failures identified in the report have a depressing familiarity. The truth is that they are failings that have been identified many times in previous reviews. We now have a duty to the memory of Christina Edkins and the anguish suffered by her family to act, and to do everything that we can to stop a repeat of this tragedy.

I ask the Minister to take specific actions to address the concerns and failings highlighted in the report. First, we need to address the consistent failure of all agencies involved to share crucial information about Phillip Simelane. How do we ensure that we implement a radical culture change so that there is a presumption that relevant information will be shared across agencies? Will the Minister consider a potential role for the Care Quality Commission, as part of its inspection responsibilities, to ensure that that happens? How do we move to a more systematic and standardised assessment of risk that properly pulls together different perspectives and evaluations of individuals such as Phillip Simelane?

The interaction of Simelane with the child and adolescent mental health services reveals some well-known limitations of, and issues with, those services. How do we approach the treatment of people who, at one stage in their life, are deemed to be below the threshold? How do we overcome poor communication and lack of information sharing between GPs, schools, services and the voluntary sector? Will the Minister commit to a review of CAMHS, building on the recent Health Committee report on their functioning to take into account the particular examples in the report on Simelane?

The report reveals significant failings in HMP Hewell and HMP Birmingham while Simelane was in prison. Again, there was a lack of information sharing, of care plans, of co-ordination and of communication, including—incredibly—no notification of Simelane’s release from prison to his GP. Can the Minister commit to working with colleagues in the Ministry of Justice to address the issue of mental health in prisons and to ensure that appropriate care plans are in place on release? Will the Minister also reflect on the status of this report? It was commissioned by the Birmingham and Solihull Mental Health NHS Foundation Trust and co-ordinated by the cross-Birmingham clinical commissioning group. It was commissioned locally but has wide national applicability. How can we ensure that the lessons of this report and its recommendations are implemented nationally?

The family of Christina Edkins has written to NHS England to raise concerns and to ask whether a further independent inquiry is needed. Will the Minister commit tonight to discuss immediately with NHS England its views on the need for a further independent inquiry as a matter of urgency? In the end, nothing will diminish the pain and anguish suffered by the family of Christina Edkins, but those in positions of public responsibility should now do everything they can to ensure that the tragic circumstances of this case are not repeated.

[The Minister of State, Department of Health (Norman Lamb)]

I congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) on securing this debate on this incredibly important and difficult issue. He asked some specific questions. First, he talked about the failure of organisations to share information, and I will develop my thoughts on that in due course. He made a particular point about the role of the Care Quality Commission. Under the new inspection regime, the CQC will undertake much more detailed inspections of providers than has been the case in the past, and it will be able to take into account issues such as the importance of sharing information to ensure good care. I will make sure it receives the Hansard report of this debate, so it can take on board the specific points he makes.

My hon. Friend talked about the importance of a more systematic and standardised assessment of risk. That is one of the points the Government need to respond to in terms of the report. At the end of his speech he asked about the status of the report. It is clear that the report raises issues of both local and national significance. It is incredibly important that the Government recognise that and seek to address and respond to the concerns identified. I am happy to write to him to pursue that further, but I am intent on ensuring that we respond as soon as possible where it is clear that there are national lessons to be learned. This tragic case raises issues that have been raised before—they are not new. It is imperative for all of us to seek to address the issues identified in the report.

My hon. Friend raised a concern about individuals who do not hit the threshold for admission to secondary care. He also asked whether I would be prepared to review child and adolescent mental health services. I am pleased to say that in the summer I announced a taskforce to review the way in which CAMHS operate. I do not think that the way we commission or organise CAMHS is fit for purpose. There is a need for a fundamental review of how the services are organised and commissioned. The findings of the report can absolutely feed into that taskforce.

I would just like to dwell on some of the issues we need to look at in the taskforce process. At the moment, four organisations are involved in the commissioning of services for children and young people: local authorities, schools, clinical commissioning groups and NHS England. The fragmented arrangement for commissioning care does not lead to the best chance of joined-up services and that fundamentally needs to change. We recognise that it is very clear that only a minority of youngsters who have mental health problems receive access to any service at all. That has been the case for a very long time, but it does not make it right.

It is clear that many interventions deployed with youngsters have a very strong evidence base. For example, early intervention in psychosis—after the first episode of psychosis—can stop deterioration occurring. However, around the country the position is variable. In some areas there is access to good services, but in other areas there is either no service at all or people have to wait a very long time. I am therefore very pleased that the Prime Minister announced in October the introduction, for the first time, of an access waiting time standard of two weeks for early intervention in psychosis. We start with 50% of everyone who experiences an episode of psychosis. In future years, the aim would be to raise that percentage so that as many people as possible have access to support as fast as possible, and access to a service that is evidence-based, NICE-based and approved.

That is a breakthrough and a watershed moment for mental health services, but another area that the CAMHS taskforce wants to look at is how to improve access more generally. In Australia there is something called Headspace, which involves non-stigmatised access to services often provided by third sector consortia. There are local Headspace centres around the country, and a telephone service and an online service. That means that far more youngsters can receive access to some support at a much earlier stage than is the case in this country—and was the case in Australia before it introduced Headspace. We can learn lessons from the way services are commissioned and provided, and there is a lot we can do to improve access to support in those earlier years.

Moving on from the specific points my hon. Friend raised, I should put on the record my horror at Christina’s murder. I share his sentiments and wish to extend my personal sympathies to the family. What they must have been through is unimaginable, and my heart goes out to them. Christina Edkins was a happy, well-loved teenager with a bright future ahead of her. She was doing well academically, she played netball for the school team and enjoyed writing. She had ambitions to become a midwife and was already working with young children in a nursery school. Her death was tragic. We should all be able to go about our daily lives without fear of violence.

As Dr Reed’s report says, the attack was random and unprovoked. The question is whether it was preventable. As my hon. Friend made clear, Phillip Simelane’s mother tried for many years to get him the help she knew he needed. The system has let down that family as well as the victim’s family, and one’s heart goes out to his mother for what she must have gone through, having tried so hard to get help over many years. She herself suffered a number of attacks by Phillip, and she knew that his mental state was deteriorating and tried to get help. We cannot say what would have happened had she been successful, but it could hardly have been worse than what took place in March 2013. I am sure I speak for everyone here when I say that my heartfelt sympathies go out to the families of both Christina Edkins and Phillip Simelane.

Nothing we can do can return Christina to her family, but as my hon. Friend said, we can ensure that lessons are learned and that appropriate action is taken to prevent, as far as is humanly possible, any similar event from happening again. This afternoon, I met Dr Reed, who wrote the homicide report into Christina’s death, and discussed with her at length both her report and the importance of responding to the recommendations raised in it. Lessons can be learned from this tragic incident, both locally and nationally, and we are considering the national recommendations in the report. As well as explaining some of the actions today, I would be happy to write to my hon. Friend setting out in more detail what action the Government are taking to address the recommendations. I want us to be clear about the time scale for responding more fully and about what actions might follow a formal written response.

Before I turn to the specifics of the report, I would first like to touch on the importance of parity of esteem for mental health, which has long been a personal priority of mine and of my hon. Friend. The Government are clear that mental health care is as important as physical health care. It is unacceptable that in this time of modern medicine three out of four people with common mental health problems receive no treatment. If three out of four people with diabetes, for example, received no treatment, we would all be completely outraged. Mental health problems can have a huge impact on the quality of life of individuals and their families and friends and should be taken as seriously as physical health problems. I think that this simple principle of equality is starting to be accepted, but there remains a big and frustrating time lag when it comes to translating it into practice in terms of the responsiveness of services on the ground.

It is clear from the homicide investigation report that Phillip Simelane did not receive the treatment he needed for his mental health conditions. His mother repeatedly attempted to get appropriate treatment for her son from the time he was 14. The report found that there were multiple opportunities for Mr Simelane to be given access to mental health interventions or treatment, but many opportunities were missed. In some cases, Mr Simelane did not meet the provider’s criteria for specific services—a point made by my hon. Friend—such as admission to a psychiatric intensive care unit. In others, he was not able or willing to engage with services. During this time, his behaviour deteriorated and his mother became increasingly concerned and at risk. One can only begin to imagine how hard it must have been for her to see the deterioration happening before her eyes, to be at risk herself yet to have no proper response from the authorities, who ought to have been safeguarding her and ensuring that others were safeguarded from the actions of someone whose condition was deteriorating.

In total, Mr Simelane was reviewed or formally assessed for mental health conditions 17 times by four different organisations between April 2009 and December 2012. Quite a lot of effort and time were put into assessing him, but there was precious little action or support. None of this resulted in him getting the help he actually needed.

The 2014-15 mandate to the NHS sets out an explicit target for NHS England to make measurable progress to ensure that

“everyone who needs it has timely access to evidence-based services”,

whether it be for mental health or physical health. We have identified £40 million of additional spending to kick-start change in mental health services in the current year, and a further £80 million for 2015-16. As I said, this will for the first time enable the setting of access and waiting time standards in mental health services. This will include 75% of people referred to the improving access to psychological therapies programme being treated within six weeks of referral, and 95% being treated within 18 weeks of referral as a backstop. At last, people with a mental health condition—depression, anxiety or a condition such as obsessive-compulsive disorder—will have an entitlement, just like those with a physical health problem, to access treatment on a timely basis. Furthermore, at least 50% of patients experiencing a first episode of psychosis will be treated with a NICE-approved care package within two weeks of referral, while £30 million-worth of targeted investment from within the total £80 million envelope will be spent on effective models of liaison psychiatry in more acute hospitals.

Crisis care is one area where the gap between the experience of those with physical and mental health problems is at its greatest. If someone suffers a physical health crisis, they will know what will happen—an ambulance will arrive and they will be taken to A and E. The system may be under pressure, but access will be granted to a specialist who can help with the particular condition. If someone suffers a mental health crisis, however, God knows what will happen. They may have a good service, but too often it falls short. Too often still, people end up in police cells when they are in the middle of a mental health crisis.

[James Morris]

One crucial aspect of this particular report is the interaction between crisis care services and the Prison Service. One of the big gaps revealed by the report relates to what happens when someone is released from prison with known mental health problems. In this case, nothing happened and the individual was lost to services. Will the Minister reflect a little on how we might be able to join the Prison Service and health services more closely?

[Norman Lamb]

I completely agree with my hon. Friend on that point. The first incredibly positive thing to say is that we have embarked on the national roll-out of a liaison and diversion service, the purpose of which is to ensure that when a person first appears in the criminal justice system—whether at a court or a police station—someone will be able to assess their mental health. If they have an identifiable mental health problem, they will be referred straight away for treatment and support. They may still go through the criminal justice system and may still end up in prison, but their condition will have been identified and they will have been referred for the treatment that may help them to address their offending behaviour.

So far we have spent £25 million in the current financial year. We have covered about 25% of the country, and next year we will cover more than 50%. Our aim is a national roll-out by 2017, subject to the making of a business case to the Treasury, and that in itself will make a dramatic difference. No other country in the world is pursuing this on such an industrial scale. Moreover, what we are doing is evidence-based, and as we build on the programme, we will develop the evidence and ensure that we apply it. There is also the issue of what happens to someone who is in the system and what happens when the person leaves prison, and I shall deal with that in a moment.

The Department has funded nine street triage pilots this year, in which police and mental health professionals have worked together to support people who are experiencing mental health crises. Perhaps most relevant to cases such as that of Mr Simelane is the £25 million to which I referred earlier, which constitutes the first stage of the roll-out of a national liaison and diversion service.

Before my hon. Friend intervened, I was talking about the unacceptable practice of allowing people who are in the middle of mental health crises to end up in police cells. It is good news that between the 2012-13 and 2013-14 financial years there was a 24% reduction in the use of police cells, and evidence suggests that that trend is continuing in the current year. Earlier this year we published the mental health crisis care concordat, in which more than 20 national organisations committed themselves to standards of care in mental health crisis for the first time. Our objectives were a 50% reduction in the use of police cells in the current financial year compared with two years ago, and a complete ending of the use of police cells for children. My right hon. Friend the Minister for Policing, Criminal Justice and Victims and I are currently writing to local authorities asking them to take seriously their responsibility to end that unacceptable practice. I think everyone would agree that the practice of allowing a child under the age of 18 to end up behind bars in a police station must be brought to an end.

A key finding of the homicide report was that information sharing within and between organisations involved in Mr Simelane’s case was not effective. The sharing of information between organisations that are responsible for the care of vulnerable people has many benefits, and all organisations of that kind should strive to communicate and share information effectively. Indeed, I believe that they have a duty to do so. At the heart of most of the scandals over the years when something dreadful has happened has been a failure to share information effectively, and that certainly includes the case of Mr Simelane.

I realise that, in practice, such information sharing is difficult to achieve, but it must be an absolute priority, and the organisations involved must actively seek solutions. We recently issued a simple one-page guide for practitioners working in the health system, which emphasised the importance of sharing information. We are right to focus on the importance of confidentiality, but, in doing so, we sometimes forget that need to share information to ensure that good care is provided.

Electronic patient records are becoming more prevalent and are making information sharing easier, but they are not foolproof, and there are still security and confidentiality issues that limit the sharing of some information. For the time being, such systems should be seen as adding an additional layer of patient safety, and it is important for all clinicians receiving a referred patient to satisfy themselves that they have a thorough understanding of the patient’s history. Clinicians also have the ability to request additional information from other clinicians or relevant professionals if they feel that such information would be beneficial in making an accurate assessment of the patient.

The Ministry of Justice is responsible for the management of offenders in the community. Care and supervision may be delivered by a number of agencies working together to share information, including health, social care, probation and other authorities. This enables appropriate action to be taken if an offender’s behaviour escalates to present a risk to the public, and that may include intervention by professionals or even recall to prison or to another appropriate facility.

We come back to the need for appropriate sharing of information among organisations. As I have said, this can in practice be complex and difficult to implement. However, organisations with a responsibility to care for vulnerable people and to protect the public must be able to work effectively together. Dr Reed’s report was only published in September and there will be no quick fixes for the organisations involved in this case. We expect NHS England to work with all the NHS providers involved to ensure that they address the recommendations in the report. This will require NHS providers to work with non-NHS organisations, including the Prison Service, to ensure that the lessons that need to be learned from this report are implemented across the board.

The issues identified in the report as essentially local will probably be common to many other organisations around the country, and we owe it to the families who have been devastated by this tragedy to ensure that those local lessons with wider applications and the issues identified as of national importance are all properly addressed, and I am happy to work with my hon. Friend to try to achieve that.

[James Morris]

On the specific point about the status of this report, I know that the Edkins family have written to NHS England expressing concerns about some of the findings in the report and asking whether there needs to be a further independent review. I think NHS England has promised to get back to them. Could the Minister use his good offices to communicate with NHS England to get back to the family?

[Norman Lamb]

I absolutely will communicate with NHS England and seek to ensure that the family get a response to that request.

As I said earlier, I shall write to my hon. Friend on all the issues that emanate from the report, and in doing so I will summarise the work being undertaken by the Government in response to this report. Work on this has already begun. The health care providers at HMP Hewell and HMP Birmingham have developed action plans in response to the recommendations in the report. NHS England’s Shropshire and Staffordshire area team is monitoring progress closely to make sure that all recommendations are met. The report also contained national recommendations for NHS England, and the Department of Health and the Ministry of Justice will work with partner organisation to address these recommendations.

Black Country Partnership NHS Foundation Trust has already implemented some changes in response to Christina’s death. It has phased out the use of “opt-in” letters, which my hon. Friend specifically referred to. Their use was an extraordinary practice when one thinks about it, given the nature of the condition that individuals such as Mr Simelane suffer from. Opt-in letters were previously used to invite patients to make an appointment, but they allowed someone to be discharged from secondary care if they did not respond. This practice has to end. The trust now proactively assesses all patients referred to it. That issue has wide application across the country.

The trust is working to improve the way its services join up with others, particularly those provided by external agencies, in the care of someone with severe mental illness. The trust will shortly be introducing electronic patient records which will enable teams across different parts of the service to access relevant patient information more quickly.

Birmingham and Solihull Mental Health NHS Foundation Trust has also implemented changes, including putting in place a robust escalation process for all cases in which disputes or concerns are raised about the outcome of a prison assessment, and ensuring that a full check is made on the HMP health care patient information recording system to identify any previous significant physical and/or mental health history.

The trust also has work under way. This includes changing psychiatric intensive care unit induction and training for doctors and nurses to include training on how to undertake prison assessments; introducing a review of all new prisoners by a nurse specialist within 24 hours when mental health concerns have been raised and, if recommended, by a psychiatrist within a maximum of five working days; and including in health screening on discharge cross-checking and reference between the health and prison records systems. The trust aims to have these and other changes in place by March 2015.

The investigation makes national recommendations, including the implementation of new supervision requirements for offenders who have served sentences of under 12 months, as was the case for Mr Simelane at the time of the incident. As part of the Transforming Rehabilitation programme, the National Offender Management Service is working with the NHS on through-the-prison-gate support for offenders serving sentences of under 12 months, including those offenders who are known to have mental health problems.

The Ministry of Justice is putting in place an unprecedented nationwide resettlement service, which will mean that most offenders are given continuous support by one provider from custody into the community. The Ministry will ensure that most offenders are held in a prison designated to their area for at least three months before release. This will mean better continuity of supervision and rehabilitation services, as well as better family links for those offenders and a network of prisons more specifically catering for the needs of short-term offenders. As my hon. Friend has pointed out, continuity of care and support when an individual leaves prison is of fundamental importance.

None of the changes made in response to Dr Reed’s report can bring Christina Edkins back, but we can all do our very best to ensure that no other family suffers in the way that Christina’s has done. None of the recommendations in the report is unachievable. They will require hard work on the part of many organisations, but the result will be better care, supervision and support for some of our society’s most vulnerable people.

I close by once again offering my heartfelt condolences to Christina’s family and assuring them that we will ensure that everything that can be done to prevent similar tragic events in future will be done. I shall be happy to work with my hon. Friend and to continue a dialogue with him to ensure that we maintain momentum in addressing the recommendations in the report and the concerns of the family.

Question put and agreed to.

NHS Services (Access)

James Morris Excerpts

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham]

I will not.

The Secretary of State now claims that his reorganisation is saving £1 billion a year, but the truth is that that is a fantasy figure. The reorganisation, which cost £3 billion and counting, turned the 163 NHS organisations into 440 separate administrations with their own running costs. It introduced a new competition regime that is eating up tens of millions of pounds of NHS money. Perhaps that is why Kieran Walshe, professor of health policy at Manchester business school, said:

“I haven’t found anybody who thinks that this reorganisation has made the NHS more efficient and more productive… and I don’t think you find many people who think that the new system costs any less to run.”

The Secretary of State needs to clear this up today. Either he publishes the independent analysis that he claims supports his figure of £1 billion, or he stops making a claim that is simply not credible.

[James Morris (Halesowen and Rowley Regis) (Con)]

I thought that this debate was about access to services. One thing that the right hon. Gentleman has not mentioned is mental health services. One of this Government’s achievements is that 100,000 more people are getting access to psychological therapies than under the previous Government, and last week the Government announced for the first time access standards and waiting time targets for mental health services, which were never in place in the 13 years of the Labour Government.

[Andy Burnham]

I am afraid that the hon. Gentleman is wrong, because I mentioned the cuts to mental health services earlier in answer to my hon. Friend the Member for Warrington North (Helen Jones). The talking therapies he mentioned were introduced by the previous Government —indeed by me—and in some places they are not being cut, which I am pleased about, but in others they are. The letter I referred to from the royal colleges and other organisations talked about a crisis in mental health. They say that people are being ferried hundreds of miles to find emergency beds. That is the reality on this Government’s watch. I think that a little less complacency and a little more focus on these problems would not go amiss.

--- Later in debate ---

[David Morris (Morecambe and Lunesdale) (Con)]

It is an absolute pleasure to serve under your guidance, Mr Speaker, in this debate about access to services.

I share one thing in common with the right hon. Member for Leigh (Andy Burnham), which is that I am from Leigh, as we both know. I am still under a specialist in Leigh, whom I have seen on many occasions. I have never had to wait and it has always been on time. I have seen specialists across at Tommy’s—St Thomas’s—without ever having to wait and always on time. I have also seen specialists in Lancaster without ever having to wait and always on time. I have heard all the stories about waiting lists and delays, but I personally have not experienced that. My family in the right hon. Gentleman’s constituency, where they still live, have not experienced it either. When my mother was leaving this world, shall we say, she had exemplary care from the local health trust. There was never any talk among the health professionals of cuts. They did not know who I was; I was just another person who was losing their mother.

I do not like to be tribal. The right hon. Gentleman and I have had terse words in the past, but I will say this on the record in the House: he is a good man and an honourable gentleman. I have friends who have voted for him. He is very well-regarded in his constituency. But what upsets me—I do not want to change the tone of this debate—is that in my constituency the Labour party is campaigning on the basis of an erroneous agenda of cuts, hospital closures and A and E closures that have never happened and are not going to happen. I received an e-mail today from a constituent who is absolutely terrified that the local Royal Lancaster infirmary is going to close, but it is not. There is no suggestion of it closing. In fact, I have spoken to the chief executive and she said, “I don’t know where this has come from.”

We are in the run-up to a general election and it is the silly season—that is evident to everyone inside and outside the Chamber—but it does no service to anybody in the political world, never mind the Opposition, if candidates up and down the country are going to fight about cuts and closures to the health service that are not even happening in certain areas. That will certainly not play into the hands of an incoming Government.

In my constituency of Morecambe and Lunesdale, £25 million has been spent recently on a new health centre. The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) opened a walk-in centre recently. We have been allocated £150 million to improve the local trust, most of which will be spent on the Royal Lancaster infirmary, which has four new hospital wards, and we have just received £2 million for GP access at the weekend. Two weeks ago, I opened a new mental health facility in my constituency.

Morecambe and Lunesdale has never seen so much investment in the NHS, yet the Labour party in my area says that everything is going to hell in a handcart and the hospital is closing down, but that is wrong. The RLI is not going to close, and neither was the hospital serving Corby, which the hon. Member for Corby (Andy Sawford) campaigned on.

[James Morris]

My hon. Friend is making a powerful case. In my constituency, there has been millions of pounds of new investment in the Rowley Regis hospital, which was under threat under the previous Government when all its in-patient wards were closed. The recent sign-off on a £350 million new integrated hospital in Smethwick in Sandwell, one of the most deprived areas in the country, will substantially benefit the population’s health care and also help regenerate the economy.

[David Morris]

I thank my hon. Friend and namesake for making that point.

I am passionate about the NHS and I know that the Opposition and the right hon. Member for Leigh are also passionate about it, but we should get a grip on reality. Campaigns are saying that £25 million is being cut from the local trust when £150 million has been invested in it, so the maths do not stack up. As my hon. Friend the Member for St Ives (Andrew George) has said, we have been horse-trading figures, but we have to look at the reality of the situation. Scaremongering is not the way forward, because all it does is alienate the electorate, my constituents and the people we all live with across the nation and put fear into the services that we are trying to protect.

I am facing a third erroneous campaign on health cuts in my constituency, and my mail box is always full every time there is such a campaign. All it seeks to do is frighten the electorate, but it does not frighten me, because the electorate know the truth.