Eating Disorders

Debate between John Howell and Wera Hobhouse

Tuesday 16th October 2018 Westminster Hall

[Wera Hobhouse]

Across the board, and particularly when it comes to public health, prevention is so much better than picking up the pieces afterwards. We can save so much money if we do something early rather than only intervening when somebody is already in crisis. That is particularly true for mental health, and the challenge here is that eating disorders are still not very well understood.

[John Howell (Henley) (Con)]

I have a personal interest in this subject. A close member of my family suffered from bulimia. What we found most important was the support provided by the family network. That, above anything else that could be provided, was what carried the family member through to a positive conclusion.

[Wera Hobhouse]

Anybody who has had a close family member in such a situation will understand the hon. Gentleman’s point, but families are often pretty helpless too, if they do not really understand what can be done and how they can help their family member to get out of the problem. It is a form of addiction, and like with any other addiction, family members are co-sufferers. They want to help but do not really understand the deep-seated problems. Family members are important, but we need the professionals and their understanding to help families get through together. The hon. Gentleman is absolutely right that families are incredibly important.

Eating disorders define large periods of people’s lives. How can we shorten that time? We need people to be okay with saying, “I’m not okay.” We need to tackle the stigma around eating disorders, and the message needs to get through to a lot of people. More than 1 million people in the UK have an eating disorder; three quarters are women and one quarter are men. That is a very large number, plus there are the friends and family who suffer with them. So many people with conditions such as anorexia and bulimia blame themselves. It is not their fault and we need to make sure that they know that.

When I announced on Twitter that I was holding this debate, I received a wave of emotional responses and personal stories. Yesterday, a local doctor dropped into my office a book that she had written, which described her fight with eating disorders since the age of 13. That shows how early it can start.

I also got an email from a young woman called Lorna, who experienced serious anorexia while studying in my constituency in Bath. This is what she told me:

“I ended up with an initial diagnosis of anxiety and depression, and was started on antidepressants. I suspended my studies and worked as a carer in my local village, living at home with my mum and brother. People I’d known all my life began commenting on the weight I’d lost, and telling me how good I looked. This is when my anorexia began to take full hold.

I stopped eating completely, lying to my mum and saying I’d eaten at work, began over-exercising compulsively, and remember pacing the corridors at work to burn extra calories. I became obsessed. I weighed myself up to 12 times a day.

My mum was terrified, and didn’t know what to do. Eventually she came with me to my GP and I told him everything. I told him I was petrified of putting on weight, exercising excessively and skipping nearly every meal. His response was ‘Oh, that’ll be your antidepressants.’ He took me off a high dose, there and then. Cold turkey.

Each time...I told him how out of control I felt with my eating. He’d force me onto the scales, shaking and crying, and then tell me my BMI was ‘healthy’ and I didn’t meet the diagnostic criteria. I was devastated. I had opened up and was denied help. I never got diagnosed with anorexia, despite going from a size 16 to a size 8 in less than a year.

I went through the monthly humiliation of being dragged onto scales and told I wasn’t thin enough to be helped yet. And not having that formal diagnosis is hard. When I tell people I was anorexic, they never quite believe me, as even doctors didn’t. I think they always assume I was being dramatic, or ‘it wasn’t that bad then’. Today, I am weight-restored, although struggle with now being overweight.

It took me 3 years to recover. 3 years of misery and obsession. I was dangerously unwell, but not sick enough to get an ounce of support.”

When I read that story, I am amazed by how brave Lorna is. She was brave to ask for treatment and even braver to put her trust into the medical system a second time, even after she did not receive the treatment that she really needed. She was very brave to tell her story. Lorna has gone on to campaign for proper treatment for eating disorders. She is here in the Chamber, and I want to thank her personally for letting me share her story—Lorna, thank you. I am so sorry that you had to go through such an awful experience. I know your words will help others, and I desperately hope that together we can improve the treatment and care of those with eating disorders and end the stigma for good.

We cannot ignore the medical failings in Lorna’s story. We need to use them and the figures that prove that Lorna’s experience is not an isolated case. First, we need to break the stereotype that all people with eating disorders are underweight. Hope Virgo’s campaign to “Dump the Scales” was also a response to being told that she was not thin enough to receive support. She is calling on the Government properly to implement the eating disorder guidance delivered by clinicians, a call that I strongly echo along with over 60,000 signatories to her petition. To judge an eating disorder simply by BMI is not good enough; rather, we need to look at the trend and rapidity of weight loss and the story that sufferers tell.

We know that the Department of Health and Social Care knows this is an issue. We know that if we fail to take action, people not only suffer but, in some cases, lose their lives. When questioned on waiting times, the Minister often says that the Government do have targets, but he ignores the fact—or he does not tell us—that there is none for adult services. On average, adults wait twice as long as people under the age of 19. The Government must do everything to remove barriers to treatment. In particular, young adults are incredibly vulnerable. At our autumn conference, the Lib Dems called for the Government to ensure that all young people can access young people’s mental health services up to the age of 25, because from the age of 18 many young adults move out of home, go into further education or start their first job, all of which can be stressful when they no longer have support from home. We must also introduce waiting times for adults to ensure that they receive help as quickly as possible.

The Minister is likely to mention that in 2015 the Government allocated £30 million of extra resources per year for five years to improve the NHS treatment of eating disorders for teenagers. However, in some cases that is not reaching the frontline, because the funding is not ring-fenced and can be diverted to other priorities.

Domestic Abuse Victims and Family Courts

Debate between John Howell and Wera Hobhouse

Wednesday 18th July 2018 Westminster Hall

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Ms Ryan. I congratulate the hon. Member for Birmingham, Yardley (Jess Phillips) on securing this important debate. I also pay my respects to organisations such as Women’s Aid, which have raised many of the issues that have been discussed—specifically, judicial attitudes.

I know some of the difficulties with judicial attitudes because I did an Industry and Parliament Trust fellowship in the law courts, during which I spent almost three weeks sitting with judges. If she has the time, I urge the hon. Lady to undertake such a fellowship in the specific courts of interest to her, so that she can participate in how they work and see how they could change to achieve some of the aims that she holds so dear.

The one aspect of this issue that I raise above all others comes from my membership of the Council of Europe: the Istanbul convention. It is very important to the debate. [Interruption.] I see the hon. Lady nodding, so she knows of it. I mention it because it sets minimum standards for how domestic abuse and violence towards women and girls are treated in the member countries. Its primary aim is to protect victims. That is a very important point to bear in mind.

The convention ensures that domestic violence and rape crisis shelters are set up and that helplines and counselling are available for victims. Although the UK has signed the Istanbul convention, it has not yet fully ratified it because we still need a legal means of bringing elements of it into our legislation. Given that we are one of the countries that helped to produce the Istanbul convention, I hope that we move quickly to ratify it. If I may, I will read a brief quote from it:

“there can be no real equality between women and men if women experience gender-based violence on a large-scale and state agencies and institutions turn a blind eye.”

That is an important point to bear in mind. I hope the Minister will take the Istanbul convention into account in her response, because it provides the necessary framework for people to be able to tackle the issue.

My second approach relates to my role as a member of the Justice Committee. That may not seem immediately relevant, but the Justice Committee is a statutory consultee of the Sentencing Council. We recently looked at draft sentencing guidelines on domestic abuse. The previous guidelines were, I am afraid, last produced in 2006 and are completely out of date, particularly with society’s attitudes to domestic abuse and the standards that we want to see. The starting point is the definition of domestic abuse. If I may quote again, the guidelines state that it is:

“any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass”—

this is the important point—

“but is not limited to: psychological...physical...sexual...financial ...emotional”

issues. That range of different abuses shows that there is a great attitude among the judiciary: to change and try to incorporate a much broader spectrum of activities.

In our response to the Sentencing Council, we said that such offences need to be seen as particularly serious and not ranked on a par with other offences; they need to be sorted out as really important offences. Overall, we said that they needed to be condemned in the strongest possible terms. One of the paragraphs in the report stated:

“We recognise that recorded offences related to domestic abuse are largely, but not exclusively, perpetrated by men and boys against women and girls.”

We understood

“the various contexts in which domestic abuse may occur and the forms that it may take...Accordingly, we recommend that comprehensive training on domestic abuse and intimidatory offences should be provided to magistrates and the judiciary to coincide with the launch of the guideline.”

I was pleased to see that the judiciary has moved some way towards doing that and has begun the training required. The need for training has been recognised.

[Wera Hobhouse]

I heard the most heart-breaking story a year ago from a Bath constituent about a CAFCASS worker. She felt that the social worker allocated to help her through the process was absolutely not sympathetic and seemed not to have had any of that training. Should the training not also include the social workers allocated to help women through the process? Should not women have the right to pick the social worker to work with them?

[John Howell]

I agree with the hon. Lady that the training can incorporate a large number of people, but we are dealing here with the courts and what we want to happen there. I am simply saying that the need for training has been recognised in the courts. It is also important to ensure that domestic abuse cases are flagged up properly as they pass through the court system so that everyone knows what is a domestic abuse case and can help to smooth it along the way.

To go back to the guidelines, they are overarching and recognise that a defining characteristic of domestic abuse is the harm caused. That harm goes to a violation of trust, which is a crucial element. Trust is a very important thing that we hold dear, and we should take that into account.

The third element that I want to touch on is the Government’s domestic violence consultation, which came out recently. I hope the Minister will provide information about how the process is going and the sorts of questions that will tackle the important issues we have raised today. I do not have a vast array of case studies of my own to share, but I have my experience of dealing with the courts; I also have experience, as has the hon. Member for Penistone and Stocksbridge (Angela Smith), of the Council of Europe and the Istanbul convention. I urge the Government to try to ratify the Istanbul convention as quickly as possible.