Changes to Health Services in London

Jeremy Corbyn Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. When the dust settles on these decisions—there is rightly so much local passion, concern and uncertainty relating to hospitals, such as Charing Cross, which has a great tradition—what people will notice is whether their local NHS services are getting better. I am afraid that one of the legacies from the previous Government was the abolition of named GPs in 2004 and a sense that it has become more difficult to access one’s local GP. The proposals mean that her constituents will be some of the first in the country to have seven-day GP services, a big step forward that her constituents will welcome.

[Jeremy Corbyn (Islington North) (Lab)]

Will the Secretary of State give me an assurance, following the huge debate that took place over the future of the A and E department of the Whittington hospital—and, by extension, the neighbouring Royal Free hospital—that its future is secure and that he will not try to reconfigure services once again in north London? Does he recognise that during that debate, my right hon. Friend the Member for Leigh (Andy Burnham), who was then Secretary of State, intervened to assure the future of the Whittington A and E department? I would like the same assurance from the Secretary of State, if that is possible.

Mental Health

Jeremy Corbyn Excerpts

Thursday 16th May 2013 Commons Chamber

[Paul Burstow]

I am grateful to the hon. Gentleman for that question. He is absolutely right that access to talking therapies—begun as a result of Lord Layard’s initiatives before the general election, which the coalition Government continued to support and which is being rolled out—is very important in enabling people to recover socially, get back into work and get on with their life. At the best performance rates, as many as half the people that go through talking therapy services recover, and that can make a huge difference to them, their families and the figures I was talking about earlier. I shall return to the subject of talking therapies in a moment.

Last year I took part in the debate from a slightly different position—I spoke from the Dispatch Box. I was able to report some important progress. We had a new mental health strategy. We had the continued roll-out of talking therapies, which the hon. Member for Harrow West (Mr Thomas) just asked about. Groundbreaking work was being done to reinvent child and adolescent mental health services from the inside out, to offer access to talking therapies for children and young people. We had the flowering of a new movement to establish social recovery as a goal for mental health, with the establishment of recovery colleges channelling the lived experience of mental illness into practical learning and skills, and resilience to enable people to get on with their lives.

There was the good news that the Government had backed financially the task of Time to Change, the charity sponsored by Rethink and Mind, really motoring to tackle issues of social stigma in our country. Reports since then show that the first phase of that programme has materially altered public views about mental health in this country, but the programme needs to be sustained.

[Jeremy Corbyn (Islington North) (Lab)]

The right hon. Gentleman makes a good case for supporting Mind and other mental health charities, which do a very good job in changing attitudes to mental health. Is he not concerned, however, that many health authorities throughout the country are cutting funding to non-governmental organisations—voluntary organisations that do very good mental health therapy work, often on a contract basis? They are being cut, and therefore the opportunities for support for people going through crisis are reducing, not increasing.

[Paul Burstow]

Yes, I am concerned. The picture is complex. The figures show that spending on adult mental health services over the past couple of years overall has reduced by about 1%, which is not good, but deeper analysis of those figures shows that about half of commissioners have increased their investment and the other half have reduced their investment, so the picture is more complex than it first appears. None the less, it is concerning that services are being withdrawn where they involve providing peer support or reaching into harder-to-reach communities, particularly black and minority ethnic communities, which often get left behind and often are most prone to being subject to the most coercive parts of our mental health system. So I agree with what the hon. Gentleman said.

In the debate last year I was delighted to be able to signal the Government’s support for the Mental Health (Discrimination) (No. 2) Bill, which was introduced by my hon. Friend the Member for Croydon Central (Gavin Barwell). It is a rare thing—as we heard earlier in the business statement, only about 10 Bills last year which were introduced as private Members’ Bills made it on to the statute book. It was great that that Bill made it on to the statute book, and I congratulate my hon. Friend and all those involved in taking it forward.

I have referred to the mental health strategy for which I had some responsibility. At its heart is the radical—I might even say revolutionary—idea that there should be parity of esteem between physical and mental health. That idea is gathering momentum. We have seen the Government place that notion in the mandate for NHS England as a driving force for the way the Commissioning Board takes its responsibilities forward. It is increasingly on the lips of policy makers and service commissioners. But the recognition that there are critical interdependencies between physical and mental health still has a long way to go.

There are more than 4.6 million people in this country living with long-term physical and mental health problems, and far too often their experience of the NHS is that they are broken down into their constituent diseases, rather than being treated as a whole person. As a result, their physical health needs are treated in one place—in many cases, in many places—and their mental health needs, if they are identified at all, are dealt with in another.

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[Mrs Madeleine Moon (Bridgend) (Lab)]

It is a privilege to follow the right hon. Member for Sutton and Cheam (Paul Burstow). The House will recognise the work that he has done in bringing this issue not just to our attention, but to that of the wider public. I also pay tribute to the hon. Member for Broxbourne (Mr Walker), who has done fantastic work in this area, and to my hon. Friend the Member for North Durham (Mr Jones). [Interruption.] My hon. Friend moves away from me just as I am commending him.

I want to consider mental health issues in the armed forces, because there is an urgent need to address some myths and problems. The armed forces also have wonderful examples of best practice that are not generally appreciated and have not been dispersed throughout wider mental health services.

Looking back in time, there were 80,000 cases of shell shock or battle fatigue during the first world war. The British Government, realising that they had to do something because of problems in getting troops to the front line, started looking at mental health. Changes in mental health treatment started because the military needed to deal with mental health problems.

[Jeremy Corbyn]

My hon. Friend is making an important point about the experience of the first world war. Does she recognise that there was a great deal of discrimination against and abuse of ordinary soldiers who suffered mental health trauma as a result of the first world war, whereas some of the officers who suffered it got therapeutic treatment in special homes around the country? There was an enormous difference between the approach taken to soldiers and to officers.

[Mrs Moon]

My hon. Friend is correct. Craiglockhart hospital and the work of Dr Rivers are a prime example of the excellent treatment that was given to some officers. Many people continued to cope with post-traumatic stress disorder, which we now recognise. It was not identified as a condition at the time, although it is detailed in some post-war journals. We have, however, moved forward.

To return to my original point, the military is often at the cutting edge—it needs to be—of looking at mental health problems. Post-traumatic stress disorder has risen up the mental health agenda in the armed forces, mainly because of statistics from the United States. The US Department of Veterans Affairs estimates that post-traumatic stress disorder affects 11% of veterans of the war in Afghanistan and 20% of Iraq war veterans. By contrast, the figure for the UK—these statistics are taken from a 2010 edition of The Lancet—is 4%, while 19.7% reported more common mental health disorders and 13% reported alcohol abuse.

I want to consider the issue of alcohol abuse in the armed forces and its impact on mental health problems. The Ministry of Defence has spent a lot of time providing services, raising awareness and developing programmes such as TRiM—trauma risk management—which I will look at later, and there is far greater understanding of mental health problems among the military. Much of that is thanks to the excellent work of and collaboration between the MOD and King’s college London. I draw Members’ attention to “King’s Centre for Military Health Research: A fifteen year report”, which was published in 2010 and sets out the stunning work that has been carried out. It talks about the roll-out of TRiM. The unit has helped to raise the awareness of most common mental health problems among military personnel, including depression, alcohol misuse and post-traumatic stress disorder, although that is not the most prevalent. The unit found that pre-deployment screening was not effective in picking up problems and that mental health problems did not necessarily apply only to those whose problems had been indentified before they were deployed. Who will be affected by deployment cannot be predicted.

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[Mr Walker]

I know that the hon. Lady is an expert on these matters. I was going to say in response to the hon. Member for Bridgend that there are experts in this place. I did not want to identify the hon. Member for Ashfield (Gloria De Piero), but, to her enormous credit, she has identified herself. She is a fantastic representative of her constituents, and it is a delight to have her here today.

We have to make progress on drug therapies. Lord Stevenson of Coddenham, who is known to me and the hon. Member for North Durham (Mr Jones) very well, is doing enormously good things in this area. He has established a charity with a significant budget to look into new treatments, pathways and the brain. The charity is called MQ, its chief executive is Cynthia Joyce and I commend its work to the Minister. I would also like to thank my hon. Friend the Member for Loughborough (Nicky Morgan), who cannot speak today because, according to some bizarre convention, Whips cannot speak in the Chamber, which is a great sadness, because I wish she could. I also thank my hon. Friend the Member for Halesowen and Rowley Regis (James Morris), who has done much in this area, and of course the hon. Member for North Durham, who has become a great friend over the past year and is a fellow musketeer in these areas.

I said that I would touch on suicide. We need to build mental health resilience in our schools. That should start at a very young age. It is a great tragedy that many young men and girls decide to end their lives in their teens and early 20s. It is a public health issue, and we need to address it.

[Jeremy Corbyn]

I compliment the hon. Gentleman on his speech and on his work on this subject. I am glad that he has raised the issue of suicide. Like me, he must be shocked by the number of suicides and attempted suicides within our prison service and by the number of prisoners clearly suffering mental health problems but not receiving the care and support they need. Does he agree that we need a much better regime of training and support on mental health issues for all prisoners?

[Mr Walker]

I absolutely agree with the hon. Gentleman. It is a great sadness that we shut down and cleared out the asylums only to put too many of those people in our prisons. They go in ill and they come out even more ill and more addicted. It is a disgrace and something we need to address.

I thank colleagues for being here today. I know that the call of their constituencies is hard to resist, but they will be congratulated by their constituents for taking part in this debate. I commend the work of the all-party group on mental health. We have done a lot of work on mental health, schizophrenia and ethnic minority mental health. I see that my hon. Friend for Taunton is here—no, it is not Taunton, but? [Hon. Members: “Totnes.”] Well, it begins with a T for crying out loud. What’s a T among friends? I thank my hon. Friend the Member for Totnes (Dr Wollaston) for her great work. I thank you, Madam Deputy Speaker, and the Backbench Business Committee for allowing the debate to take place, and I thank the Minister and his predecessor, the right hon. Member for Sutton and Cheam (Paul Burstow), who was also a fabulous Minister, for giving the matter such attention and focus. They are to be lauded and applauded.

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[Mr Jones]

I have spoken at a few events with the Minister, and I want to thank him for his interest in, and understanding of, this subject. Getting Government Departments signed up to Time to Change would be a very good move, and he should please ask if he requires any assistance from me.

I want to talk about an issue that affects many of our constituents—namely, the work capability test and the ongoing issue with the company Atos. Is work good for people’s mental health? Yes, it is. Should people be in work if they can work? Yes, they should, with the right support. The problem with the work capability test, however, is that it is still not looking at people with mental illness with any sympathy or understanding.

I believe that individuals with long-term mental illnesses should be taken out of the current work stream, and that there should be a dedicated system for dealing with such people. I am not saying that we should write them all off and leave them at home without making any assessment, but we cannot continue with the present ludicrous system in which they are assessed by the same people who assess claimants with bad backs and other injuries. There are assessors with no expertise at all in mental illness. The assessment process is leading to some people’s conditions being made worse, and, in some cases, to people taking their own lives. One of my constituents has taken an overdose because of the trauma of being asked to attend an interview.

[Jeremy Corbyn]

My hon. Friend is making an excellent point. Does he think it would be better if, instead of calling people with mental health conditions in for an interview, Atos simply sought medical reports on them and then considered setting up an interview with a suitably qualified examiner? Would that not be better than the production line that Atos operates at the moment?

[Mr Jones]

My hon. Friend makes a good point. The starting point should be the medical history of those individuals. Someone at the Department for Work and Pensions has said that it is not possible to identify such individuals, but that is complete nonsense. The process my hon. Friend has just suggested should be the starting point.

Professor Harrington’s review of the process put forward the idea of mental function champions. The Government spun that idea out a bit, as though it was the big answer to the problem, and I actually fell for it at the beginning, thinking that those people would be the ones who would carry out the assessments. That was not the case, however; they are there to give advice to the Atos assessors. We still have assessors with no mental health qualifications.

Representatives of the charity Mental Health Matters, a good advocacy charity in the north-east, have just met Atos to ask about the champions, and a number of questions have been raised. Atos would not tell them how the champions were recruited, and there is no indication that they need any formal qualifications. I understand that they are given a two-day Atos in-service training course, but they do not interact with any of the royal colleges or other outside bodies. Remarkably, they are also not accountable to the DWP. I put it to the Minister that he needs to tell the DWP that this must be looked at again. The process is not only causing a lot of heartache and difficulty for many of our constituents; it is actually not a good use of public money. People are failing the tests and going to appeal. At least one of my constituents has been affected in that way. They sometimes go through the process and end up in a residential hospital for a month, which must cost more than the amount of benefit that might have been saved.

We also need tailor-made programmes for people with mental illness. We should consider a separate work stream that could include voluntary work, given that many people with mental illness find the transition back into work through voluntary work easier than being thrown straight back in. We also need a pool of employers who understand and are sympathetic towards people with mental illness. There is an idea that such people can just join the normal job market and that employers will just accept that they might not turn up for work for a day or a week because they are not feeling well, but that is not the case. Those people will not keep their jobs for very long.

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[Jeremy Corbyn (Islington North) (Lab)]

Like all the other Members who have spoken, I welcome the debate. It is important for us to have it, and I hope that it will become an annual event. It is a way of reducing the stigma that is attached to mental illness, increasing understanding of it, and also, quite correctly, holding the Government to account on how their policies develop.

There is still an enormous amount of discrimination against people who have suffered from some kind of mental illness or breakdown, or have spent time in a long-stay institution. Like all discrimination, it is incredibly wasteful of resources, because it means that those people cannot contribute to society in the way that we want, and as a result we all lose out.

I want to raise two points. The first relates to local experiences, and the second to national policies. My borough has an image as being relatively wealthy and high-achieving, and there are certainly some wealthy and high-achieving people in it. Islington council, however, undertook an interesting exercise: it set up a fairness commission to examine the quality of the delivery of public services to everyone in the borough, with the aim of ensuring that the purpose of the council’s policies, including health policies, was to reduce inequality.

According to a briefing that the council gave me before the debate, it is estimated that in my borough

“30,000 adults experience depression or anxiety disorders in any one week…. Mental ill health among 5 to 17 year olds is estimated to be 36% higher…than the national average”.

The briefing states that more than one in eight children are

“experiencing mental health problems at any one time.”

It also states:

“The suicide rate is… 8 per 100,000…second highest in London”,

and broadly

“similar to the national average”.

Physical ill health is often related to mental health problems. According to the briefing,

“Poor mental health was found in 43% of all Islington patients who died of cardiovascular disease before the age of 75. As people live longer, there are an increasing number of people with dementia, although Islington has a relatively smaller number of older people”—

only 9% of the population. Islington has a 70%—higher than average—rate of diagnosis of dementia. Increasingly, as others have pointed out, people who care for adults with mental health problems are much older people who find it extremely difficult to cope. Those carers need more support, so that they are better able to look after people who are becoming more and more dependent.

Both my local council, in its study, and the Mental Health Trust draw attention to the enormous over-representation of people from black and minority ethnic communities in the context of diagnosis and, in particular, the context of long-stay institutions. We should ask whether there is, in fact, a higher level of prevalence, or whether there is a perception that it is somehow OK to put black and minority ethnic people into long-stay institutions, whereas it would not be OK in the case of other people.

Indeed, I urge Members to visit long-stay institutions and talk to people resident in them. I get the impression some of them have had very difficult lives and very little support, and that they have led very isolated existences. I also get the impression that many of them have very few friends and very little representation, and whereas those who come from a fairly stable family background with a series of understanding relatives are able to get representation and often win their cases where there has been a section order, others do not get the same quality of representation and consequently do not win any tribunal cases.

In an earlier speech, I made an intervention about the role of the voluntary sector in dealing with mental health conditions. As I have pointed out, my borough has considerable problems in dealing with mental health, but we have a number of very good local organisations that often deal with mental health issues in an innovative and supportive way, and are often very successful. Nafsiyat, an intercultural therapy centre based in Finsbury Park which was founded by the late Jafar Kareem, was groundbreaking in its ideas of looking at the cultural background and ensuring culturally appropriate treatment of people with mental illness, for example by making sure there are people who speak the necessary languages and understand something of the specific cultural background. The Maya Centre, which particularly relates to women, does much of the same work, as does ICAP or Immigrant Counselling and Psychotherapy, a counselling and psychotherapy centre originally founded by people in the Irish community that now deals with a much wider community.

We also have a considerable refugee population. A very good group called Room to Heal deals with people who have achieved asylum status in this country. They have often been through the most dreadful experiences of torture, which are frequently dealt with in a community way. People meet regularly and do things together, such as gardening and taking trips. Many of them improve a great deal and get through the terrible traumas they have suffered. I find it very interesting talking to people from different countries all around the world who have all experienced torture in one form or another and who have benefited from these activities. We also have the Refugee Therapy Centre and the Women’s Therapy Centre, which also provide therapy on a culturally sensitive basis. Finally, we have the Holloway Neighbourhood Group stress project.

These are all valuable groups, and they all depend on contracts obtained either from the local health authority or neighbouring health authorities. All of them spend a great deal of time filling in forms in order to gain what are often relatively small sums of money for relatively short-term contracts. Health authorities must value these organisations and look to use them. We should give out the message that we recognise that the voluntary sector has a very important complementary role to play in supporting statutory services in the treatment of mental illness. I do not see them as competitors or rivals; I see them as complementary.

[Mr Kevan Jones]

I agree with what my hon. Friend says about the smaller contracts these organisations get and the bureaucracy they have to deal with. Does he agree that some of them could bid for larger contracts to provide services as well, but the bureaucracy and financial hurdles involved in bids for such contracts make it very difficult for them to do so?

[Jeremy Corbyn]

I agree. The bureaucracy involved and the skewing of the contract culture frequently means voluntary organisations that have a tradition of the voluntary provision of services—often in an effective and innovative way, as I have described—are debarred by the contracting process. Instead, very large private sector medical companies come in to privatise those services and run them in a profit-related way, rather than the voluntary sector, which is motivated not by profit, but by the care of the individuals. I urge Ministers to look very carefully at how services are contracted out to the private sector, which is motivated by profit, as opposed to voluntary sector organisations, which often have a very good record in looking after people who need help and support.

We must also recognise that if we are to deal with mental illness problems in any community, there must be a level of understanding that goes wider than just what GPs, hospital doctors and the statutory services do. There is the question of signposting. I pay tribute to local organisations—voluntary groups, churches, mosques —that understand the situation and help signpost people into getting help and support, because many people in our society with some degree of mental illness get no support whatever. This debate may well help us to understand that that is needed.

We must also recognise that there is a cost involved. The cost to health budgets of dealing with mental health is very high. Unfortunately, the policy of community care for the mentally ill has often resulted in lack of care, and in deep isolation and serious problems for the individuals concerned.

I recall a debate in the House in 1986. The Select Committee on Health was looking in an interesting and critical way at the closing down of large asylums and long-stay institutions, such as Friern Barnet and Napsbury, that existed all around London, and, indeed, all around the country. The Committee warned that community care should not be seen as a cheap option, saying it should instead be seen as an opportunity, but as one requiring comprehensive support, support workers and care.

I am sure all MPs have talked at their surgeries with neighbours of those with mental health problems who have come to complain about noise and inappropriate behaviour. Many of them say to me they are sympathetic to the plight of the individual, and recognise there is a lack of support. We should not see community care as the cheap option. It is an option that can be followed, but a great deal of support is also required to carry it through.

[Mr Kevan Jones]

Does my hon. Friend also agree that under the new NHS structure, local councils will have to do a lot more in terms of understanding the needs of people with mental health conditions?

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[Jeremy Corbyn]

Absolutely, which is why I referred in my opening remarks to the strategy adopted by my local authority. It has taken the issue very seriously, and has developed a strategy that involves signposting, understanding, support for care in the community and a close relationship with the mental health trust locally. I suspect many local authorities are not particularly well geared up for that role, and they need to address that quickly.

We must recognise that children and young people suffer a great deal of diagnosable mental health conditions. The Mental Health Foundation estimates that one in 10 children suffer from them. One in six young adults aged between 16 and 24 are also suffering from them at any one time. It is very hard for young adults and teenagers to admit they have mental health problems. It is very difficult for them to go to a GP and say they have a mental health problem. Peer group rivalry and peer group abuse—abuse in schools and colleges—is nasty, dangerous, damaging and very hurtful, and can ultimately lead to suicide. The old saying “Sticks and stones can break my bones, but names cannot hurt me” is wrong. Names do hurt. Name calling does hurt. It can lead to young people becoming isolated, and in extreme situations it can lead to suicide.

[Mike Crockart]

The all-party group on social mobility has looked at that issue, and we found that one of the major things holding children back from realising their full potential was not necessarily access to the right type of education—further education or higher education—or to funding for such education. Instead, it is their having the social and emotional resilience to be able to bounce back from such problems and take their careers forward.

[Jeremy Corbyn]

The hon. Gentleman is absolutely right in what he says. Bouncing back from these things and then getting on in education or any career is very important. I hope that debates such as this one and the remarks made by hon. Members who have been through mental health problems and depression begin to help give a greater understanding in the much wider community.

I wish to make only a couple more points, because I know that other colleagues wish to contribute to this debate. I intervened earlier about the number of suicides that take place in prisons and the number of people in our prisons who are suffering mental illness. Although such people may be there on the basis of a crime, they need mental health support rather than incarceration in a prison. Today’s edition of The Guardian contains a helpful reproduction of a map of suicides in British prisons. Although the number of suicides has reduced, 833 prisoners committed suicide in the decade up to 2011. When a prisoner commits suicide it is traumatic for the prison and for the prison officers concerned, and devastating for the rest of the prison population. We need to look much more seriously at how our prisons operate, the training that is given to prison officers and the mental health issues that need to be assessed much more carefully by the courts and by the prison services. We also need to examine whether it is really necessary or appropriate to put someone who has a mental health condition into a prison, at any level of security, knowing that there is a real danger of their committing suicide. They are not going to become less better because of this approach; they are probably going to get considerably worse.

My hon. Friend the Member for North Durham (Mr Jones) made an important point about people’s availability for work interviews undertaken by Atos on behalf of the Department for Work and Pensions. I am sure that every hon. Member has had people come to their constituency surgery who have been through the misery of an Atos interview when they are suffering from a mental health condition. Whether on a good day or a bad day, nearly all of them get assessed as being capable of work. They therefore start losing benefits and then go through an appeal. Usually, these people eventually win the appeal, but the trauma caused during that process has led to suicides, to deep depression and to deep fear among them.

When I intervened on my hon. Friend, I suggested that instead of automatically calling those with mental health conditions in for an interview, just as every other person with a disability is called in, medical records should be looked at first and a much more sympathetic and appropriate way forward should be taken. Where someone is able to work and an employer is able to take them on, as there is a job, that is clearly good—we want and welcome that—but we should not force them into it. We should not force people to try to hide mental health conditions. Instead, we should be supportive and sympathetic towards them. I hope that the message we can send from the debate is that that is the direction in which we want to go.

This is a valuable and timely debate on an issue that can affect any of us at any time. We all know people who are affected by mental health conditions and as a society we should stop the name calling, stop the abuse and start understanding this as a condition that we can all suffer from and that we can also, generally speaking, always get over.

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[Mr Reed]

I thank the Minister for his intervention. I am grateful for his generous offer, which I will certainly take up.

[Jeremy Corbyn]

I compliment my friend on an excellent speech. Does he agree that the problem of representation of people both in initial assessments and when they are placed in long-stay mental health institutions often means that many poorer young black men never get any representation whatever and end up being completely institutionalised as a result, leading to those ludicrously higher statistics for black and ethnic minority people, who are no more prone to mental health problems than anyone else in society?

[Mr Reed]

I thank my hon. Friend for that contribution. There are a range of concerns about the treatment of black people in the mental health system that need to be tackled to reassure that community.

I believe other Members in the House will agree that this cannot be allowed to go on. I urge Ministers to use their offices to persuade the IPCC, the CPS and the Metropolitan police to work together to obtain a quashing order against the IPCC’s original decision so that a criminal investigation into the Seni Lewis case can go ahead, followed by a full public inquest. Instead of apparently washing their hands of the concerns that this matter raises, Ministers should acknowledge the need for a national strategy on policing within mental health settings.

The organisation Inquest points out that it is an unacceptable anomaly that there is no independent body charged with investigating deaths in the mental health service, as there is for deaths in police custody. As a result of that anomaly, reviews are conducted internally, they may not involve the family affected, and there is no collation or joining up of learning across the service nationally. After this case and other cases like it, the community deserves the reassurance of an independent inquiry into the treatment of black people in the mental health service.

Two years and eight months after their son’s death, the Lewis family still do not know how or why he died. The public hearings scheduled for July 2012 and then March 2013 were both delayed without explanation. Seni Lewis deserves justice. The Lewis family deserve justice and they must not be kept waiting any longer.

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[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I apologise to the House for not being present for the debate’s opening speeches, which was due to circumstances beyond my control. I certainly meant no lack of respect for this debate; I think these Backbench Business Committee debates have been one of the more important and successful innovations of this Parliament, and mental health is a particularly important subject.

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow) on leading the debate in a detailed and informative fashion, and my hon. Friend the Member for Bridgend (Mrs Moon), who raised a number of important points, including alcohol abuse and its impact on mental health—those two issues are inextricably linked. I follow the hon. Member for Totnes (Dr Wollaston) in saying that if we are concerned about addressing alcohol abuse, one issue—although not the only issue—must be to do something about the flood of cheap alcohol that is overwhelming some of our communities, and put in place a minimum price for alcohol. I am glad to say that that is the Labour party’s policy.

I congratulate the hon. Member for Broxbourne (Mr Walker) on his speech. I remember a similar debate last year in which he made a moving speech about his experience, which resonated country-wide. Since then, he has shown great leadership in the mental health all-party group. He made a number of important points, including the fact that although the NHS can be good at managing symptoms, it is not necessarily so good at addressing their underlying causes. I will return to that issue when I mention Atos later in my remarks.

I am sorry to have missed the remarks of my hon. Friend the Member for North Durham (Mr Jones). He is always well worth listening to, and he too received country-wide respect for his contribution to last year’s debate on mental health when he spoke about his personal circumstances for the first time on the Floor of the House. He made a number of important points, including that mental illness and depression are equal opportunity conditions. They do not discriminate; they affect all social classes and backgrounds.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke about a number of issues, including borderline personality disorders and the way that eating disorders affect women and girls. She made the important point that, although we sometimes associate mental disorders with socially marginalised communities and persons, eating disorders can affect the most high-achieving, educationally focused girls. That issue should not be trivialised because it is harming the life chances, health and well-being of many young women up and down the country.

My good Friend the hon. Member for Islington North (Jeremy Corbyn) made an important speech about mentally ill people in prison. When getting caught up with the “prison works” narrative, it is worth remembering how many people in prison are either illiterate or simply mentally ill, and if we want to contain the number of people in the prison estate, we must address the mentally ill. My hon. Friend also mentioned black and minority ethnic communities and mental health, and I will return to that point later.

The hon. Member for Totnes made an important speech and mentioned social exclusion and BME mental health. My hon. Friend the Member for Croydon North (Mr Reed) made an important speech about Olaseni Lewis and the issue of black and minority ethnic persons detained under the Mental Health Act 1983. I am glad that the Minister has agreed to meet my hon. Friend and engage with him and the family on that issue. The hon. Member for Harrogate and Knaresborough (Andrew Jones) also made an important speech.

My hon. Friend the Member for Bolton South East (Yasmin Qureshi) made a speech about—among other things—the importance of a holistic treatment for mental health issues and taking account of people’s different cultural backgrounds, which I thought was important. There was, as always, an interesting and provocative speech from the hon. Member for Southport (John Pugh), and I was interested to listen to the hon. Member for Battersea (Jane Ellison) who spoke about mental health and female genital mutilation—if it had been my choice, her speech could have gone on longer. I thought she raised important issues, and the House should respect the lead that she has shown in addressing the issue, which is difficult for people outside the affected communities to address. If in future some young girls are not subjected to that child abuse because of her work, she will deserve the congratulations of this House. The hon. Member for Finchley and Golders Green (Mike Freer) also made an important contribution.

We have heard figures for the incidence and prevalence of mental health problems, and because it is a Cinderella service and a Cinderella issue it is always worth reminding people that one in six people in Britain is affected by mental illness at any one time. In other words, almost every family will have experience of mental health. It is not something that happens to other people, but something that happens in our own families. One in four of us will suffer from mental illness at some point, and by 2030 depression will be the leading cause of disease around the world, costing the NHS a further £10 billion a year. The criminal justice system will also pick up the bill because 70% of those in our prisons have a mental illness. Mental health problems cost British business almost £26 billion a year.

The subject has been addressed by my right hon. Friend the Member for Doncaster North (Edward Miliband) who made an important speech to the Royal College of Psychiatrists in October last year. The key points he made are worth reporting and concern the importance of breaking down stigma—something that the House dwelt on at length in last year’s debate—and the importance of parity of esteem for mental health within the NHS. My mother was a mental health nurse in Huddersfield, and her hospital was a former Victorian workhouse on the fringes of Huddersfield. Having an old workhouse outside the city for mental health issues, and mainstream health services in the centre, illustrates the lack of parity of esteem for mental health in relation to the services we offer, and also to practitioners at every level within mental health services.

Finally, my right hon. Friend the Member for Doncaster North mentioned the importance of mental health in our society, and argued that good mental health does not start in hospitals but in workplaces, schools and communities. He took the opportunity last October to announce the formation of a taskforce on mental health in society, which will look in particular at employers and the role they play.

[Jeremy Corbyn]

Perhaps my hon. Friend can help me. I hope that the taskforce will also look at issues surrounding the voluntary sector and its excellent work within the mental health service, as well as the dangerous tendency of franchising out mental health services to the private sector by some mental health trusts that do it for profit rather than care.

[Ms Abbott]

My hon. Friend’s points are well made.

Let me consider the future for mental health and set out for the House how important the role of local authorities can be in addressing the social determinants of mental ill health. Public health has become the responsibility of local authorities. They have a ring-fenced public health budget, and despite all their pressures and difficulties—which I do not seek to minimise—there is an opportunity for local authorities to do important and interesting work, bringing together education and housing with health care to address mental health problems and intervene in them early.

I was shocked to hear of a social housing project near King’s Cross that, presumably to make its tenants more manageable, did not want to give tenancies either to people who had a history of rent arrears or to people who had a history of mental health problems. Such things need to be highlighted and addressed. Sitting responsibility for public health with local authorities could address mental health, particularly in respect of early intervention and preventive work with children in schools.

I gave a speech this morning on the crisis in masculinity. We need to focus on the mental health challenges that face men. Whether it is because they are unwilling to come forward or because of stress in society, we know that, during a recession or economic downturn, suicide rates among men increase. Suicide is currently the biggest cause of death among under 35s. In planning services nationally and locally, we need to pay particular attention to that issue among others.

The hon. Member for Totnes made an important point. She said that, in our desire to reduce health tourism—a desire supported by the Opposition—there is a notion that people will need their passport when they turn up to see their GP. That runs the risk of making it harder for the socially excluded to access health care—many simply do not have a passport or such documentation.

I will not speak at this point about the merits or otherwise of the welfare reforms, but there is a lot of anecdotal evidence that they are having an effect on the mental health of some who are caught up in the system. There is a lot of anecdotal evidence that Atos, as it is currently configured and as it currently operates, does not meet the needs or seem to understand the problems of people with mental health challenges.

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[Norman Lamb]

Yes, I completely agree. This is about treating people as individuals, and with dignity and respect. Those things are important to people and they should be treated as such.

[Jeremy Corbyn]

My hon. Friend the Member for North Durham (Mr Jones) and I raised the question of the work capability interviews being undertaken by the Department for Work and Pensions with people with mental health conditions. I do not think that the Minister was in the Chamber at the time, but we suggested that it would be better for the DWP to have access to those people’s medical reports rather than conducting rather bald interviews. Would the Minister be prepared to undertake discussions with the DWP about the treatment during those interviews of people who suffer from mental health conditions?

Oral Answers to Questions

Jeremy Corbyn Excerpts

Tuesday 26th February 2013 Commons Chamber

[Anna Soubry]

Is it not remarkable to have criticism of a reorganisation from someone who supported a Government who had nine reorganisations in nine years? The sexual health strategy document is very important, which is why we are working hard to ensure that it is absolutely right. I re-wrote a large section to ensure that it will deliver—[Interruption.] I do not know why the hon. Member for Hackney North and Stoke Newington (Ms Abbott), from a sedentary position, says “Ah.” It is an important document and we want to get it right, and I am sure she will welcome it when it is published. However, let me make it clear: any delay in the document is not preventing rightful commissioning at a local level. I saw that yesterday when I went to Bedford and met the Brook organisation and the Terrence Higgins Trust, which have long been engaged, certainly in that county, in a tendering process from the local authority to continue to deliver excellent services.

[Jeremy Corbyn (Islington North) (Lab)]

5. What recent discussions he has had with the Whittington hospital on the proposed disposal of its assets and reductions in medical and non-medical staff.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

This is a matter for the local NHS, in particular the Whittington Hospital NHS Trust. Neither the Secretary of State nor the ministerial team have met with the trust recently on this subject.

[Jeremy Corbyn]

That is a disappointing reply from the Minister. Is he aware that the Whittington is a successful, popular, local district general hospital, yet, as part of its application to become a foundation trust, it is proposing to: sell off a quarter of its land; make 500 of its staff, including many nurses, redundant; and reduce the number of beds to 177, roughly half the current figure? This is, apparently, to provide a better service to the community, a point totally lost on the thousands of local people who are angry at the reduction in their hospital services. They see it as a prelude to its ultimate closure as a district general hospital with an A and E department. Will the Minister take an interest and perhaps intervene to protect a very good local hospital from this not very sensible plan?

[Dr Poulter]

The hon. Gentleman is right to highlight the fact that the trust has handled this issue badly at a local level, but, as he will know, decisions about local health care reside with local trusts. The point is this: if we look at the plans, the trust is talking about selling off land that is mostly not used for clinical purposes and reinvesting that money in front-line patient care: investing £10 million in improving the maternity department, which has already benefited from £750,000 from the Government only this year; £2.9 million in the same-day treatment centre to support A and E and treat patients faster; and £1.9 million for a new undergraduate education centre and library. Those assets are being sold off to directly influence and improve patient care, which has to be a good thing.

Accident and Emergency Departments

Jeremy Corbyn Excerpts

Thursday 7th February 2013 Commons Chamber

[Mr David Lammy (Tottenham) (Lab)]

Twelve years ago I sat where the Minister is sitting, when I was the Under-Secretary of State for Health. I had responsibility for accident and emergency services in particular, and I want to impress on her that she has power to respond to what is being said in the House today.

All Members will understand that the NHS does not stand still. Reconfigurations are necessary. Changes are necessary. I was born in a constituency that had a wonderful hospital called the Prince of Wales; it no longer exists. In the Roehampton part of London, there was a hospital; it no longer exists. Things change. In London we have seen changes to stroke services. It is possible that someone in an ambulance, having been unfortunate enough to have a stroke, will drive past a hospital to get to another hospital, a centre of excellence. That was a configuration that was carried out with great consensus across London. I pay tribute to Richard Sumray, who was chair of the primary care trust in Haringey and led the consultation on changing stroke services in London.

The Minister has heard deep concerns expressed about the changes proposed in every area of our capital city—deep concerns about King George hospital in the east and about the much loved hospital in Lewisham in the south. No one can understand why Lewisham should pay for problems in an adjoining area, as currently proposed. We raised concerns about the problems in the north. I will refer briefly to the Whittington, although my hon. Friend the Member for Islington North (Jeremy Corbyn) is in his seat and will major on that. We have heard about Chase Farm and about pressures deep in the south, in St Helier and the Croydon area, which were described by my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh). We have also heard about concerns in the west of London around Ealing. That is unprecedented.

[Jeremy Corbyn (Islington North) (Lab)]

Does my right hon. Friend accept that one problem is that London’s population is rising, health inequalities are rising, and health demands are rising among poorer people? Although I understand all the arguments about putting services in the community, if hospitals are closed, many desperately poor and ill people will not be properly served.

[Mr Lammy]

My hon. Friend makes the point beautifully. Let us look at the demographics of London. The Mayor’s London plan estimated London’s population to be 7.8 million. The census later showed us that it was 8.17 million at least. The London plan assumed that the population would break 8.5 million in 2027. We now believe that it will exceed that figure in 2016. By 2031 there will be 9.5 million people living in our capital city. The areas marked for growth are the upper Lea valley—Chase Farm; the Metropolitan line corridor, with nine A and E units now turning into five; and the south-east of London, where Lewisham is based. There will be 9.5 million people using services that the Health Secretary is seeing shut down. There are huge concerns.

I sat in the Minister’s seat. That was after the terrible winter flu epidemics in the late 1990s. At that point the Whittington hospital in north London was at the epicentre of a public storm because of the bed waits and other long waits. My job, set by the former Member for Darlington who was then Secretary of State for Health, was to ensure that that four-hour wait was a reality across our country. I would sit with chief execs and we would go through the so-called sitreps to ensure that those hospitals were meeting the four-hour waiting target. That was the key element of my job.

I decided to look at the sitrep for the past four weeks across London. There is a target, and if hospitals are doing badly they are flagged as red, while if they are doing well and meeting the target, they are marked as green. I was startled. Ealing, Hillingdon, Imperial, North West London Hospitals, West Middlesex, Barnet and Chase, Whittington, Barking, Guy’s and St Thomas’, King’s College, Lewisham, South London, Epsom and St Helier, Kingston, Croydon and St George all currently fail. Yet it is proposed that we can lose many of our A and E departments—eight across London—at this time. It does not make sense.

This is a health service in London that we look to when a helicopter falls out of the sky or when bombs go off in Canary Wharf or on the underground. This is an A and E service that we look to following riots. I remember the A and E serving our police officers on the first night of riots in my constituency. Londoners will be very concerned indeed that this debate is being framed and structured in this way at this time, with the lack of consultation described so well by my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock).

I was staggered when I found out about the proposed changes to Whittington hospital in Camden New Journal. In November, I had a meeting with the chair and the chief executive, with other Members of Parliament, and we found out that a third of the hospital was to be sold off, that it was apparently to be totally reliant on community services, that it was to lose 500 jobs, and that the people of north London would again have to fight to retain the hospital that they loved—a hospital in my constituency in which my two sons and I were born, and which has been served particularly by nurses from the Caribbean.

Londoners are concerned and Londoners will fight. The Minister has the power to act to put an end to the disarray that we are now seeing across London, and I ask her to do so.

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[Jeremy Corbyn (Islington North) (Lab)]

I will try to be as brief as possible so that the debate can be properly concluded.

This debate goes to the heart of what the NHS is about. Many Members of Parliament are deeply frustrated about health plans being hatched in their constituencies, but they have very little power to influence events. The health service is being atomised by a large number of private interests through private finance initiatives, and by a large number of trusts with competing interests. We need a properly planned health service rather than the internal market and competition, which are at the heart of so many of our problems.

If the hon. Member for Enfield North (Nick de Bois) were still in his place, I could tell him something that would make him even more depressed about the future of Chase Farm hospital. As a former member of the late Enfield and Haringey area health authority in the 1970s, I recall debates on whether Chase Farm should be closed. There are agendas—colleagues will recognise such agendas all over the country—that live on beyond past directors, trusts and reconfigurations: somebody always has an aspiration to close something and centralise something else. If hon. Members think politics in the House of Commons is robust, they should try NHS politics, which is far more robust and nastier than anything we experience here.

I congratulate my hon. Friend the Member for Ealing, Southall (Mr Sharma) on opening and securing this debate, and on the campaign he is running on behalf of the people of his constituency. Many Members are involved in that campaign in west London and the one in south London. What is going on in London is outrageous. I ask the House to consider what my right hon. Friend the Member for Tottenham (Mr Lammy) said. London has a fast growing population, great health inequalities and poverty, and a fast growing number of people in the daytime: the population of central London goes up phenomenally during the day because of people commuting to work, going to cultural or sporting events, or simply passing through the capital city. If we start closing A and E departments and saying that everything should go out into the community, and thus that hospitals can be reduced and closed, we are making the future very dangerous for our communities.

As the House is well aware, I represent Islington North. The Whittington hospital is in my constituency. Anything I say about the hospital is not a criticism of it or its wonderful staff—I absolutely support them and their work. Some three years ago, we discovered that the A and E department was due to be closed. As ever, there were denials all over the place. I tell the hon. Member for Morecambe and Lunesdale (David Morris) to be ever so sceptical when told that an A and E department is not closing, because closure is probably in a plan somewhere.

We exposed the plan to close the Whittington A and E and eventually had the most bizarre general election rally ever in 2010, when the right hon. Member for South Cambridgeshire (Mr Lansley), the hon. Members for North Norfolk (Norman Lamb) and for Hornsey and Wood Green (Lynne Featherstone), my right hon. Friends the Members for Holborn and St Pancras (Frank Dobson) and for Tottenham, and my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) and I were on a platform pledging to save the A and E department, which was duly saved. However, time moves on. The hospital wants to become a trust and has begun putting together a financial package, to which my right hon. Friend the Member for Tottenham referred. The package involves the sale of a quarter of the site—apparently, £17 million is to be made from that—the loss of 500 jobs and a reduction in the number of beds in the hospital to 177, which is about half what it was five years ago.

We asked whether an A and E department with a hospital of only 177 beds behind it was viable. Is that not a plan to remove the Whittington as an overall local district general hospital with an A and E department in future? The Camden New Journal and Islington Tribune reported on this with great alacrity last week. I congratulate Tom Foot and all those who put the story together, because I suspect the issue would not otherwise have reached the light of day. At a public meeting next Tuesday, friends, neighbouring MPs and many others from the local community will be questioning the chief executive and others from the hospital, and taking part in a big campaign to protect our hospital.

We all face issues of health care. I think there is a consensus that we all respect and value the principles of the national health service, but if we allow buildings to be sold off and A and E departments to close, we will end up with the health service becoming a service of last resort and with the promotion of private medicine at the expense of the NHS. We will end up with much poorer societies and much greater health inequalities, and that is in nobody’s interest. Let us get control of this in a democratic way, so that we can control what goes on in the health service in our name.

NHS Commissioning Board (Mandate)

Jeremy Corbyn Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

My hon. Friend, as a GP, will recognise from the mandate that a lot of the improvements that we need in the NHS are in primary care. The budget for the NHS is protected, but demand for services is going up, so we need to make these changes. I will give her one example where I think that this is particularly important. The number of hours it will save GPs if the majority of prescriptions are ordered online, which does not happen at the moment, could transform life for more than 8,000 GP surgeries up and down the country.

[Jeremy Corbyn (Islington North) (Lab)]

One of the great problems the NHS has is the millstone of private finance initiative costs that are so damaging to so many hospitals. The other millstone is the huge profit made by the private sector on contracted out and privatised services. Is it not time for the Government to give a clear directive to the NHS to employ its staff to deliver its services and borrow money in the traditional way to build new facilities, so that public money goes into a public service and the public are not lining the pockets of the banks and private health providers instead?

[Mr Hunt]

I hope we can move beyond the debate about public good, private bad and private good, public bad that has dogged the NHS for many years. I believe there is a role for the independent sector and the voluntary sector. Of course, the primary role will be for the traditional NHS. However, when the private and voluntary sectors are used will not be a matter not for politicians or parties; but for local doctors on the ground. I think that in the vast majority of cases, they will want to use and contract with traditional NHS services, but it is important that they have the choice to do what is in the interests of the patients for whom they are responsible.

Mental Health

Jeremy Corbyn Excerpts

Thursday 14th June 2012 Commons Chamber

[Nicky Morgan]

My hon. Friend is absolutely right, and I shall talk about well-being shortly. We often talk about these subjects in very negative ways. If we all talk about our mental well-being, and are regularly asked about it when we see our GPs, that will help a lot to de-stigmatise mental health issues.

I want to touch briefly on secondary care. One of the Sunday Express campaign demands is that all hospitals should be therapeutic environments where people with mental health problems feel safe and are treated with respect and have someone to talk to. In a debate in this House last November, I mentioned patients who abscond from secondary care units, and in particular the tragic case of my constituent Kirsty Brookes, who was able to escape from a unit in Leicester and subsequently hanged herself. I am sure the Minister will remember that debate, and our discussion of the definition of absconding.

The Care Quality Commission has published its first report on absconding levels, and I welcome that, but the picture in respect of absconding and escape numbers is still unclear. The numbers provided in this first CQC report need to be broken down further, therefore, but the report showed that in the year in question—2009-10, I think—there were 4,321 incidents of absence without leave from secondary care. Some of them were, of course, far more serious than others; some will have involved a person missing a bus on the way back to the unit, while others might have ended in tragic circumstances. I make this point not to beat up on secondary care providers and health providers generally, but we must know the scale of a problem before we can begin to tackle it.

The impact of the voluntary and community sector on mental health must not be forgotten either, and I hope Members will talk about that. The sector offers vital support, and it must be part of the commissioning landscape.

[Jeremy Corbyn (Islington North) (Lab)]

I congratulate the hon. Lady on securing this important debate. Many smaller voluntary sector organisations give a very good service and understand their communities. Under the commissioning process, however, they often lose out to very large enterprises—large charities and medical companies—that have no real understanding of the local community, particularly ethnic minority communities. Does the hon. Lady agree that the Minister needs to consider that issue further?

[Nicky Morgan]

I agree; that is an issue. The commissioning structures are being changed, with local GPs now deciding what care they want to buy and where they want to buy it from. I hope that change will allow them to explore the value of smaller organisations, which tend to know particularly well the people they are treating. Although such organisations might not have the clout of large organisations, they are often more successful in terms of patient care. I am sure the Minister has heard that point.

I want to thank one of my regular correspondents, Mike Crump of My Time, a community interest company based in the west midlands. He may well be in the Public Gallery for this debate. My Time provides evidence-based, culturally sensitive professional counselling and support services. He said to me that a great deal of many people’s recoveries

“is owed to therapies based on basic common sense not the miraculous powers of a tablet or the mysterious wonders of the medical profession.”

Let me turn briefly to policing. My chief constable in Leicestershire is also the Association of Chief Police Officers mental health lead. In Leicestershire in 2011-12 there were 444 detentions under section 136 of the Mental Health Act 1983, which gives powers to take a person to a place of safety. Leicestershire police deal with serious incidents involving mental health issues on a daily basis, and it has provided me with a snapshot of what happened on the jubilee weekend. From 8 pm one night to 7 am the next morning they dealt with 10 incidents in which mental health conditions or concerns were clearly prevalent. That night, police officers spent four hours with a man in hospital after he was detained under section 136. I therefore ask this question: are the police the right people to be dealing with such incidents?

I hope Members will talk about the criminal justice system, and the fact that nine out of every 10 prisoners have a mental health problem. The Government are investing more than £19 million this year in diversion services, but it is still taking too long to get prisoners out of prison and into secure hospitals.

Finally, I want to talk about the mental well-being landscape. All of us have mental health; it is just that some people’s is better than other people’s. We need to get to a situation where it is as normal to talk about our mental well-being as about our physical well-being.

Public health policy has a role to play. Local authority public health services are key in promoting good public health. I welcome the Leicestershire joint strategic needs assessment chapter on mental health, which was published recently. It makes it clear that mental health is important and says that it cannot be seen in isolation, as many factors contribute to mental ill-health, including the economic instability at present—which I am sure we will hear about this afternoon—and the welfare reform changes, such as asking people whether they are fit enough to go back to work. I think such questions need to be asked, but I thank my constituent Jo Gibbs, who recently brought me a letter outlining her concerns about these changes and the anxiety and pressure they are causing her and others.

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[Mr Jones]

Yes, that is one of the key roles of those boards. Again, however, it will be important to ensure that we get the right people on those boards—for example, counsellors who really understand mental health. As the hon. Member for Loughborough said, people have empathy in respect of cancer, but do not quite understand mental health. I agree with the Minister that it is important that the boards are the counterweight to ensure that that happens, but I think that central Government also have to play a role in ensuring that it happens. As I say, we have some great opportunities here and the commissioned work that Chester-le-Street Mind delivers is excellent. In addition, it is cheap compared with some of the major contracts in terms of delivery, because it is delivered by well-trained professionals and by very committed and hard-working individuals in the community.

A lot of mental health charities also rely on charity funding from organisations. In the north-east this funding comes from, for example, institutions such as the Northern Rock Foundation, which has now been taken over by Virgin Money. There is real concern that as those sums contract, the money going into mental health services from those groups will also contract. We need to keep an eye on the situation to ensure that, be it through the lottery or through organisations such as the Northern Rock Foundation or the County Durham Community Foundation, where funds are limited because of the economic crisis, mental health gets its fair share of the funding available. I mean no disrespect when I say that people give happily to Guide Dogs for the Blind or to cancer charities, but it is very much more difficult to get a lot of people to recognise and give money to mental health charities, unless they have been through or had a family member who has been involved in mental health issues. We need to be wary of that, too.

I now wish to discuss the welfare benefit changes, which my hon. Friend the Member for Bolton West mentioned. I commend Mental Health North East, a very good group in the north-east that has interacted with the Department of Health. It is an umbrella group of mental health charities that not only campaigns for and raises awareness about mental health but delivers services to mental health charities and individuals. The organisation is run by a very dynamic chief executive, Lyn Boyd, and is made up of paid individuals and a large number of volunteers, many of whom have personal experience of mental health issues. They are very good advocates, not only ensuring that mental health is kept high on the political agenda but interacting very successfully with the Department of Health in consultations and so on.

One piece of work that that organisation has considered is on a matter that I have increasingly seen in my constituency surgeries. There are people with mental health issues who were on the old incapacity benefit and are now on the new employment and support allowance and who are, frankly, being treated appallingly. The way that is being done is costing the Government more money in the long term. I know that it is not the direct responsibility of the Department of Health, but some thought needs to go into how we deal with the work test for people with mental health illnesses. I am one of the first to recognise that, as most of the professionals say, working is good for people’s mental health; it is important to say that. However, we must recognise that certain people will have difficulties with that. If we are to get people with mental health problems into work, we must ensure that the pathway is a little more sympathetic than the one we have at the moment.

Another massive problem is the work needed with employers. If employers are going to take on people with mental health issues, they will have to be very understanding to cope with those individuals.

[Jeremy Corbyn]

Many of those who are taken for work-related interviews by Atos are declared fit for work, only to win an appeal to show that they are not. On many occasions, the levels of stress they have been through in going for the interview, failing it and winning an appeal are very detrimental to their health. Does my hon. Friend agree that the Department must be far more sensitive about that and think a lot more before it starts to call people in for these interviews?

[Mr Jones]

I totally agree and I shall give some examples of that in a minute.

We must try to get a system in which employers, even in these tight economic circumstances, understand the mental health issues and can make adaptations. Whether we support employers who take people with mental health issues on for a certain period or whether we do other things, we need to think it out a bit more than it is at the moment.

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[Paul Burstow]

I hope that there will be cross-party consensus on these issues today, and I shall take the hon. Gentleman’s question in that spirit. He makes a fair point. This is about building on what is working, and ensuring that it can work even better. The work done by my hon. Friend the Member for South West Wiltshire has certainly accelerated the pace.

When the Deputy Prime Minister and I launched the mental health strategy last year, we recognised the need to tackle the root causes of mental illness as well as ensuring that community and acute services provide timely treatment and care. We placed a strong emphasis on recovery from a human, rather than just a medical, perspective. We also made it clear that delivering significant improvements in people’s health and well-being requires parity of esteem between physical and mental health.

I know that some hon. Members are concerned that not enough emphasis has been placed on acute and in-patient care. Let me be clear. Our plans to provide a safe, modern, effective mental health service give equal emphasis to the full range of services, from public mental health and prevention through to forensic mental health services. This is about people receiving high quality, appropriate care when they need it. If services can intervene early—the case for that has already been powerfully made—so that mental health problems can be managed in the community before more serious problems develop, that should result in acute in-patient care being made available more quickly for those who need it.

My hon. Friend the Member for Loughborough mentioned the concerns raised by the Association of Chief Police Officers about places of safety. In partnership with the Home Office and the police, we are examining how to ensure that health services are properly commissioned in custodial situations. I would be only too happy to meet her and the ACPO mental health lead to discuss those issues further.

[Jeremy Corbyn]

Will the Minister look carefully into the circumstances of people who die either in police custody or in a mental health institution as a result of a mental health issue, to determine whether adequate forms of inquest and inquiry exist, and whether adequate lessons are being learned from the experiences? In view of what is going on in one or two inquests at the moment, I feel that there are some quite serious deficiencies in that area.

[Paul Burstow]

I thank the hon. Gentleman for his question. May I undertake to write to him about that matter in more detail? It has come up in our work on our suicide prevention strategy in relation to the nature of suicide verdicts, and narrative verdicts in particular, in coroners’ courts. I would be happy to come back to him on that issue.

In the past year, we have made progress across a broad front. We have committed £400 million to make psychological therapies available for adults of all ages, as well as for people with long-term health conditions and with severe and enduring mental illness. When it comes to our focus on recovery, the latest figures show that 44.4% of those who complete programmes recover and that more achieve lasting improvement. That puts us on track to achieve our target rate of recovery of over 50%.

Given that we know that the first signs of more than half of all lifelong mental illnesses can be detected in adolescence, we have to go further. That is why the Government are breaking new ground by investing in a new training-led approach to re-equip children and young people’s mental health services to offer a range of psychological therapies. I pay tribute to the leadership shown by YoungMinds. Without its support, we would not have come as far in this area as fast as we have.

I want to say something about the necessity of achieving the best possible outcomes for people in mental health crisis. Secondary mental health services across the country have made significant changes, both in community and hospital settings, including the provision of alternatives to psychiatric hospital admission. For example, more than 10,000 people with an early diagnosis of psychosis were engaged with early intervention services last year. That is the highest figure ever recorded. The improvements in community-based early intervention services are driving up standards of care, as well as reducing the demand for hospital admissions. I freely acknowledge that there is more to do and I take on board the point that my hon. Friend the Member for Broxbourne made about the need to look at the variability in the accessibility of mental health advocacy.

The development of recovery-focused services is a critical part of the Government’s strategy. That work is being led by the NHS Confederation’s mental health network and the Centre for Mental Health. They are supporting pilot sites that cover almost half of England and are making the kind of changes that service users have sought for years. The programme has identified 10 key changes to the way in which staff work, the types of services that are provided and the culture of organisations to embed recovery principles into routine practice.

When I visited the South West London recovery college, I heard powerful personal testimonies from people who were living purposeful and fulfilling lives, and who were living with their illness rather than having to be cured of symptoms or illnesses. It is important that recovery is not just seen in medical terms, but is self-defined. Students at the college learn not only how to manage their condition, but skills to help them back to work and to form new relationships. Some become lecturers at the college themselves. I was told that being called a student, rather than a patient, helped people take control of their recovery, gave them more confidence and, crucially, made them feel normal, as opposed to being treated as a helpless, passive recipient of care.

Part of a good recovery is the ability to exercise more control over one’s life. In health care, that means that there must be more shared decision making and choice. In opening the debate, my hon. Friend the Member for Loughborough mentioned the principle of “no decision about me without me”. Undoubtedly, the any qualified provider policy and tariff reform have a part to play in that.

--- Later in debate ---

[Andy Burnham]

I completely agree, and obviously that was one of the major conclusions of the Field report, which the hon. Lady’s Government commissioned. The problem is not just the separateness of the system, although that is one of the factors; rather, it starts much earlier. We need to take that broad view.

More co-location of acute care and mental health care within the same hospital would be a good thing to encourage. We heard on the radio this morning about the RAID—rapid assessment interface and discharge—service in Birmingham, which is an excellent example of that and something we need to follow. That is part of the culture change we need in the NHS. The other part of that change is that practitioners dealing with mental health, particularly GPs, at the primary care level, should not just reach first for medical interventions, rather than social or psychological interventions. However, I am afraid that that is what we do. Let us look at these, more startling statistics. In 2009, the NHS issued 39.1 million prescriptions for antidepressants—there was a big jump during the financial crisis, towards the end of the last decade. That figure represented a 95% increase on the decade, from the 20.2 million prescriptions issued in 1998. Were all of those 40 million prescriptions necessary? Of course they were not.

Prompted by my north-west colleague, the hon. Member for Southport (John Pugh), let me pick up the point about Labour’s successes. We did address some of these issues. The improving access to psychological therapies programme is something I am very proud of taking forward as Secretary of State, because it began to give GPs an alternative to antidepressants and medication to refer people towards. That was an important development, and—credit where it is due—it was Lord Richard Layard who made such an incredible change, by pushing so determinedly for that programme.

[Jeremy Corbyn]

My right hon. Friend is making an important point. Too often GPs reach for medicine when they should be reaching for counselling. They should be offering a more supportive environment, but when we get high-speed GPs with little time to talk to patients, they tend to prescribe medicines when they ought to be doing something else. Does my right hon. Friend agree that we need to go a lot further than we already have?

[Andy Burnham]

I completely agree. I do a lot of work shadowing, and I recently shadowed a GP. What amazed me was how many of the people coming through his door were the people who also come through our doors on a Friday and Saturday. They are not necessarily looking for something to take to the chemists; they are actually just crying out for help, in one way or another, with a problem they are struggling with. That GP was very good and did not prescribe, but referred lots of people to the IAPT service, as I sat there with him. However, he said that across Coventry, where he was based, many others were not doing the same.

--- Later in debate ---

[Jeremy Corbyn (Islington North) (Lab)]

I welcome this debate, and I will do my best to stick to the eight minutes that you have suggested, Mr Deputy Speaker, to ensure that everybody gets to make a contribution. It is valuable to have this debate and to raise the whole issue of the stigma surrounding mental health. I pay a huge tribute to my hon. Friend the Member for North Durham (Mr Jones) and the hon. Member for Broxbourne (Mr Walker) for speaking out, because it is necessary to do so. The public need to understand that everyone knows somebody who has suffered from degrees of depression or many other conditions. I am sure that all of us, even if we do not believe that we have suffered from this ourselves in our own lives and in our own families, know people who have. Public attitudes have come a long way since the late Tom Eagleton was driven out of the US vice-presidential nomination in 1972 because he had had treatment for severe depression. He, to his credit, later went on to become a senator, elected with 60% of the vote, so the timidity of the political establishment in the US in 1972 was overturned by a much more generous political atmosphere some years later. We should remember people like him, who, in many respects, paved the way for it.

We have to understand that about 4,000 people a year in this country commit suicide. The figure varies a bit from year to year, but it is about 4,000. That is a very large figure indeed, which is why I intervened on the Minister on the question of deaths when people are in care or in custody, and I am looking forward to his response. As a society, we have to think a bit more carefully about the terror that some people live their lives in, which ends in a lonely suicide. These are people who were unable to seek help or support from anybody else, and were probably reading in the papers, hearing jokes on television and being the butt of comedians’ jokes about “sad nutters”, “desperate people” and so on. As a society and as a community, we need to reach out to people who are going through their own tensions and their own crises. If we cannot do that, the number of suicides will not fall and is likely to increase.

In my community, we have a good mental health service. We have a trust that operates in Camden and Islington, which is quite a small geographical area for it to operate across. It is certainly much smaller than many others in other parts of the country, and my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) and I fought very hard to ensure that it was operated on a relatively small basis because we felt that that would provide for a better service that was more in touch with the local community. I hope that it will be able to continue in that way, but I am saddened to have to report that this year the trust plans to deliver what it describes as

“£75.1m savings across the acute sector; £46.7m from acute productivity and £28.4m through changes in care setting and other demand management initiatives.”

That is quite a big cut in desperately needed services in an area that suffers from a very high level of need for mental health care and treatment.

My own local Islington borough council, to its credit, instituted the fairness commission after the 2010 elections. The council has said:

“The work of the Islington Fairness Commission highlighted the wide-ranging impacts of challenges to mental health and wellbeing for people, communities and services in Islington, particularly during a period of economic uncertainty and financial hardship.”

A number of recommendations are then made, with the council going on to state:

“Levels of need are exceptionally high in Islington. There were 3,152 patients on serious mental illness primary care registers in Islington in 2010/11, representing 1 in every 65 patients. There are an estimated 31,000 adults and 3,000 children and young people…experiencing mental health problems…There are an estimated 3,500…drug users, and 10,000 problem alcohol users, with 46,000 adults in total drinking at hazardous or harmful levels. Underlying rates of mental health and substance misuse problems in prison reach in excess of 90%.”

My borough contains two prisons. We have to examine those issues seriously as a House and as a society.

The other point I wanted to make was that the economic issues associated with stress are very serious indeed. Obviously, one such issue is unemployment, but others are housing and overcrowding and, often, the domestic violence that results. My hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) and I share the Finsbury Park Homeless Families Project unit, which is based in her constituency but does wonderful work to support families in both our constituencies. The unit’s staff point out that the severe problems of the people who come to see them are usually related to serious overcrowding, housing uncertainty and lack of secure tenancy. Various levels of stress and mental health issues pertain to that. In solving these issues, we must consider the economic factors.

We should also consider very seriously the levels of stress and depression among young people. Growing up as a young person in any community is not easy. They are faced with enormous pressures from a consumerist society to achieve and to have. Many cannot fulfil those ideals and will never be able to fulfil those ambitions. The levels of stress we are forcing on to young people result in some cases—although, thankfully, only a very small number—in serious illness or even suicide.

[Yvonne Fovargue (Makerfield) (Lab)]

To return to the social pressures, does my hon. Friend agree that debt is a considerable social pressure? I ran a scheme where debt advice was provided on prescription and paid for by the PCT. Independent analysis reckoned that at least three suicides had been prevented by early access to debt advice. Does my hon. Friend share my concern that that access might well now be restricted?

[Jeremy Corbyn]

I completely endorse what my hon. Friend has said and the great work she has done in supporting advice agencies and dealing with such issues. My borough recently opened a new citizen’s advice bureau—I congratulate the council on being able to fund and reopen it—and it has been inundated with people with serious debt issues. It offers serious debt advice and a great deal of help. We have also given a lot of support to a credit union that is working very well with a large and fast-growing membership. People are accessing a limited amount of credit and support, and it is far better that it comes from that source than from the high street loan sharks who are appearing all over the country and bleeding people dry with the excessive rates of interest that they charge.

There are some things we can do, but my point is that if a young person worked hard in school, did well, studied hard and got good grades but is still unemployed and after a while becomes almost unemployable, it becomes a source of enormous stress about the future.

I want to bring up two more issues before I conclude. In my part of London and, I suspect, many other parts of urban Britain, many victims of domestic violence, usually women, seek support and therapy. The voluntary sector is often best placed to provide that support and therapy and that was why I intervened on the hon. Member for Loughborough (Nicky Morgan) when she introduced the debate to make the point that when commissioning is done by the primary care trusts or the wider trusts that deal exclusively with mental health issues, it tends to be skewed in favour of the very large and financially burgeoned organisations rather than local charities and voluntary sector groups with a specific base, which are often much more effective and provide a very good service. I would be grateful if the Minister could give us some good news on that, or if he could write to me about how those issues could be brought out.

In my community, we have a number of very effective charities that work with victims of domestic violence and racist abuse, which, fortunately, is not an enormous issue but nevertheless exists. We also have a large number of people who have experienced torture and violence and are either asylum seekers or have achieved refugee status. I thank those charities for the work they do. Nafsiyat, an intercultural therapy centre based in Finsbury Park, has done good and groundbreaking work on cultural values and dealing with stress and the victims of violence. The Maya centre deals with women who have suffered similar problems. We also have the Women’s Therapy Centre, ICAP—Immigrant Counselling and Psychotherapy—which gives enormous support to other people, and the local Refugee Therapy Centre. They all do very good work, all have difficulty coping with the demands placed on them and all have financial issues. When the Government talk about increased money for mental health, they should think very carefully about how the contracts are negotiated, as they often force very low rates of pay on the voluntary sector to undertake the kind of work that is done. The Minister needs to think quite carefully about that.

The housing issue has been referred to and the number of homeless people in this country is rising, as is the number who are suffering from stress. Locally, we have a group called the Pilion Trust which has recently been given a donation—I am grateful to the Amy Winehouse Foundation for that—to help in its work in providing a night shelter, but a night shelter is not a solution to homelessness problems. A solution to homelessness problems is having a requirement regarding re-housing and a much more aggressive housing programme in this country.

I conclude by saying that too many people commit suicide and suffer from mental health issues and stress in their lives. We cannot change all that but we can change the approach to mental health issues. We can look at the good work that is done and support people in that work. We can say to those who have gone through depression and crises, “That is not the end.” Such people are contributing to our society and will succeed later in life. We should recognise the value of everyone and not consign people to a mark that indicates they have become unemployable and have no future. That is as bad as what the asylum system did in the past. We can do better than that and learn from others and the good experience they have had.

Health and Social Care Bill

Jeremy Corbyn Excerpts

Tuesday 20th March 2012 Commons Chamber

[Mr Speaker]

We come now to the petition. Before I call the hon. Member for Hayes and Harlington (John McDonnell), may I ask Members who are leaving the Chamber to do so quickly and quietly—

[Jeremy Corbyn (Islington North) (Lab)]

Stay for the petition.

NHS Future Forum

Jeremy Corbyn Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

My hon. Friend makes an interesting point, because, as the Future Forum report acknowledges, the Bill does not extend the application of competition rules in the NHS, which were introduced under the Labour Government. The co-operation and competition panel was established under the Labour Government in 2009. The rules that we will maintain as a process of evolution, rather than revolution, are the ones that were consulted on in January 2009 and most recently published by a Labour Government in March 2010. To that extent, and despite all the hot air from the Labour party on competition in the NHS, we are adopting an evolutionary approach and starting precisely from the situation that applied under the Labour Government.

[Jeremy Corbyn (Islington North) (Lab)]

In his earlier answer to my right hon. Friend the Member for Oldham West and Royton (Mr Meacher), the Secretary of State, if I understood him correctly, said that commissioning consortia would have to do the commissioning themselves and could not franchise it out to private providers. Will he confirm that that is the case and that he has powers to limit the number of private patients who can be taken into NHS facilities under the regulations he is proposing in the Bill?

[Mr Lansley]

I reiterate that the clinical commissioning groups will be statutory bodies with a statutory responsibility for commissioning, so it would not be legal for them to delegate that to another body that was not subject to the same obligations. As far as access to private patients is concerned, we have made it clear—I do not believe that the Future Forum makes any recommendations on this—that foundation trusts, which often have arbitrary rules relating to limits on their income from private patients, should have that cap lifted, but we propose to put additional safeguards in place to make it clear that, if they do so, not only must that income be separately accounted for so that there is no subsidisation from NHS facilities, but the trusts must demonstrate how that will support their continuing primary purpose of providing services to the NHS in England.

Health and Social Care Bill

Jeremy Corbyn Excerpts

Monday 31st January 2011 Commons Chamber

[John Healey]

I accept that correction, Mr Deputy Speaker. Let me put it in these terms. The policy is not Liberal Democrat policy, but it is being done in their name, and the public will hold the Liberal Democrats responsible if they allow the Tories to do this to our NHS.

[Jeremy Corbyn (Islington North) (Lab)]

Is my right hon. Friend aware that, in the rush to establish a GP commissioning system, PCTs are being merged, and that large numbers of highly skilled staff are disappearing quickly, as is the ability of PCTs to administer anything, and all this before the Bill has even received a Second Reading? Does he not think that the Secretary of State is culpable in the rapid disintegration and disorganisation of local NHS facilities all over the country?

[John Healey]

That is one of the things that worries experts and those in the health service the most. It is also one of the things that the right hon. Member for Charnwood (Mr Dorrell) and his Health Committee were most concerned about. [Interruption.] The right hon. Gentleman is nodding. “Disruptive” was one term that the Committee used for the changes.

NHS White Paper

Jeremy Corbyn Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

Yes, I am indeed aware of precisely what my hon. Friend says and will certainly take it into account.

[Jeremy Corbyn (Islington North) (Lab)]

The Secretary of State has been asked by many Members about the accountability of GPs, and he has not answered. Some £80 billion is to be pumped through GPs, who will then buy in services. Who manages them? Who monitors them? Who checks on what they are doing? Will we get value for money or, as my right hon. Friend the Member for Oldham West and Royton (Mr Meacher) said, will the system in reality be administered by private health companies, just as GPs are private contractors in the NHS?

[Mr Lansley]

At the risk of repetition, let me say that GPs will be accountable to patients, who will exercise more control and choice. They will be accountable to the NHS commissioning board, which will hold their contracts, for financial control and for their performance, through the quality and outcomes framework. They will be accountable to their local authority for their strategy and for the co-ordination of public health services and social care.