Cyber-bullying: Young People’s Mental Health

Julian Lewis Excerpts

Monday 16th April 2018 Commons Chamber

[Alex Chalk]

The hon. Gentleman rightly raises a really important point. It is only recently of course that revenge porn has become a criminal offence, but I dare say there is more that could be done. It is just one aspect of the hinterland of cyber-bullying but an extremely important one to raise.

[Dr Julian Lewis (New Forest East) (Con)]

My hon. Friend is doing us tremendous service by bringing this topic to the House. To what extent is anonymous bullying a factor? We all know from before the age of the internet the devastating effect of poison pen letters, even on a small scale; here one can have anonymised poison pen electronic letters that are accessible worldwide. Is it people who are known to victims mainly or is it people sheltering behind anonymity?

[Alex Chalk]

That is an extremely good point. In truth, it is both, and not only is it the nature of the bullying but the volume. Social media provides the opportunity, whether through sham accounts, spoof accounts or whatever, to multiply the torment, so my right hon. Friend raises such an important issue.

The most striking thing of all perhaps was that 83% of the young people told our inquiry that they thought the social media companies should do more to tackle this scourge. They felt that the onus was on the victim to act—to block or delete—and that reporting all too often felt like shouting into an empty room. There is a perceived lack of consequences for those who engage in bullying behaviour online in a way that is different from real life. There is some evidence from some platforms of temporary sanctions for cyber-bullies to nudge them back to good behaviour, but they remain the exception.

In fairness, the message is starting to get through. In his new year 2018 message, Facebook founder, Mark Zuckerberg, vowed to “fix Facebook”. One of the priorities he highlighted was “protecting our community from abuse and hate”, and he admitted that enforcement of house policies was failing. I am afraid we concluded that he was right. It is particularly impactful and devastating when the people who are being affected are under the age of 18. They are just children.

While we were grateful for the constructive engagement of social media companies—and it is true to say that the larger companies tended to take the issue more seriously—the unavoidable overall impression was that announcements and measures were largely tokenistic: slow and inadequate. Because there was so little transparency about the number of reports and the nature of the response, it was, in effect, impossible to determine whether the resources allocated bore any relation to the scale of the problem. The companies essentially continue to mark their own homework. As one witness put it, companies faced with growing alarm about the implications for young people’s mental health are “walking backwards slowly”. That is not acceptable, because our evidence showed that those failures have an impact on children and young people, and that the effect is particularly profound, concerning and long-lasting.

It is important to emphasise that tackling cyber-bullying must be a joint endeavour. Parents, guardians and teachers all have a role to play, but it is equally true that when it comes to minors, social media companies bear responsibility as well. It is simply not enough to sign children up and then just let them get on with it. It is important for the companies to be age-appropriate, and to do more to identify under-13s and, when appropriate, gain explicit consent from parents or guardians. They should provide timely, effective and consistent responses to online bullying, and they must become more accountable. What do I mean by that? I mean that they must publish data about their responses to reports of online bullying. Only then—if we know the number of reports, and the nature and timeliness of the responses—will any sensible assessment of the efficacy of those responses be possible.

As for the Government, I think that they ought to do what they reasonably can to improve our understanding of the role of social media in adolescent mental health. We are very much in the scientific foothills of our understanding of these issues, and the firmest possible evidence base will help to tailor the best solutions. I recognise, however, that the Government have gone a long way with the digital charter to increase the tempo, and I urge them to continue that important work.

My final comments are thanks. I thank the young people—more than 1,000 of them—who responded to the inquiry and gave evidence, and without whom the report would have had no currency. It was their evidence that gave its conclusions their heft, and it was their experience that left such a marked impression on all who took part in the inquiry.

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

I thank my hon. Friend the Member for Cheltenham (Alex Chalk) for securing this timely debate on the important issue of the effects of cyber-bullying on young people’s mental health. He articulated extremely well the challenges that we need to tackle, and I agreed with much of what he had to say about them.

I pay tribute to my hon. Friend for the report that was published recently. As he said, 1,000 young people participated in the inquiry and produced a useful body of evidence from which to draw conclusions. I also thank the Children’s Society and YoungMinds for their role in the inquiry. I met representatives of YoungMinds today, and I have regular dialogues with them on the broader issues relating to the mental health of children and young people. They are very important partners for us in this context.

As my hon. Friend recognised, a number of Departments have an interest in this matter. I have often said that silo culture is the enemy of good policy making, and I am pleased to say that the Department of Health and Social Care, the Department for Education and the Department for Digital, Culture, Media and Sport are all approaching the issue from their own unique perspectives, and attacking it from different angles. We are all committed to tackling the scourge of cyber-bullying, although, as my hon. Friend pointed out, it is an emerging issue that requires careful consideration of the evidence and joint working to enable us to start stemming the flow. He was right to say that we need to draw conclusions in a timely way to ensure that we have the appropriate tactics for prevention.

It is important to recognise that the term “cyber-bullying” is often misleading. We are talking about two separate elements. Bullying is a kind of behaviour that can take many forms, and social and other cyber-media are tools for that bullying. As my hon. Friend and my right hon. Friend the Member for New Forest East (Dr Lewis) have said, this has become a particularly acute problem to tackle as those tools can be anonymous. That dehumanises both the bully and the victim, and if we do not get it under control more effectively it will become the epidemic my hon. Friend has warned of.

Turning to what the Government are doing, the Department of Health and Social Care is focusing on improving services for children and young people’s mental health. We know that children and young people’s mental health services need to improve, and we have a programme of work under way, supported by more than £1.4 billion of additional funding, to achieve just that. As my hon. Friend the Member for Cheltenham will know, the Department of Health and Social Care and the Department for Education recently published a joint Green Paper on children and young people’s mental health, which was supported by a further £300 million.

Through that Green Paper, we acknowledged the potential impact of social media and the internet on children and young people’s mental health, but, most significantly, we identified that effective mental health care for young people does not have to take place in a clinical setting. That reinforces the importance of getting the right support in schools, which underlines my hon. Friend’s priority of preventive measures. That is why we are placing much more support in and around schools, where young people spend so much of their time.

We are also taking action to use the digital world to our advantage, using positive digital interventions for mental health. For example, NHS Digital is producing an apps library that brings together a number of digital tools to help improve health, including mental health and wellbeing, for all ages. Over time, many more tools will be added to the library to support more health needs and drive up quality.

Turning to the online world, where I think my hon. Friend is more interested in holding other agencies to account, the Department for Digital, Culture, Media and Sport last year published our internet safety strategy Green Paper. A response to the consultation process will be published imminently, and I am sure my hon. Friend will be first in the queue to read its conclusions. It will include a number of preventive initiatives to tackle cyber-bullying so that all users of all ages feel confident in being online. For example, during the consultation we proposed a voluntary social media code of practice. The intention is for the code to provide guidance to platforms about how they should tackle abusive behaviour and content and support all users, because adults can be bullied just as much as children on social media platforms.

I personally think the providers can do a great deal more. My hon. Friend referred specifically to Facebook. While Mark Zuckerberg’s comments to which he referred are welcome, I think a lot more can be done. Given that reporting to social media companies is low among those who recognise that they have been cyber-bullied, and that children have little confidence in social media companies to resolve cyber-bullying, the internet safety strategy Green Paper also involved consultation on annual online safety transparency reporting by companies. That reporting is intended to both develop better understanding of the extent of bullying behaviours and encourage those who are being bullied to make referrals to those companies. Social media companies must do more to raise awareness and improve the clarity of their reporting mechanisms in relation to cyber-bullying, and we hope that improving transparency reporting will help improve the likelihood of young people reporting these issues in the future.

As I have said, however, this is not an online-only issue, and the Department for Education is taking action to prevent bullying in general as well as cyber-bullying. All schools are legally required to have a behaviour policy with measures to prevent all forms of bullying. The Government have already put in place a number of powers and a range of support to enable schools to prevent and tackle cyber-bullying. For example, headteachers have the power to regulate pupils’ conduct when they are not on school premises. Where bullying outside school is reported to teachers, it must be investigated and acted on. We have also ensured that schools have the power to ban, limit the use of, or search mobile phones in school, and the Government Equalities Office funded the UK Safer Internet Centre to develop cyber-bullying guidance for schools and an online safety toolkit to help schools deliver sessions about cyber-bullying, peer pressure and sexting. I can advise the House that the Department for Education is also providing £1.75 million of funding over two years to support schools in tackling bullying, with cyber-bullying being an integral element of that.

Returning to the role of social media companies, we really believe that they have a central role to play. That is why we set up a joint working group with the Department for Digital, Culture, Media and Sport to discuss how to make progress in specific areas, particularly that of age verification. My hon. Friend said that many young people are spending a great deal of time online—more than was good for their health—and we want to explore time limits. On the question of age verification, I am clear that the social media companies could do a lot more to protect young people. The reality is that if they can collaborate on developing apps that allow people to harvest data, they can use the intelligence on their platforms to identify young people and communicate with them. We recognise that some companies have existing work in place, and we congratulate them on that, but a lot more can be done. There are significant challenges to overcome, and there remains a need for further action to be taken. We are actively encouraging companies to work with us and to make tangible progress in this area.

We have heard what the Government are doing to tackle these problems as they arise, but we also need to recognise that, without further research, our efforts will not reach the level that we need and that young people deserve. We have heard the statistics already this evening. Social media and the internet are an ever-growing part of children’s and young people’s lives. As my hon. Friend has said, some individuals are spending an inordinate amount of time online. More than half of 12-year-olds have a social media profile, and those are the people who really need our protection. However, although evidence has shown links between increases in social media use and poorer mental health, it is not clear whether that increased use causes poorer mental health, or whether poorer mental health drives an increase in use of social media. We need to develop more evidence on that.

We should also recognise that there are positive impacts of social media use that can really improve the lives of children and young people suffering with mental health issues. It can build a community that they can access to increase their self-esteem and get social support. In practice, that could mean children collaborating on projects through better online communities—for example, a homework WhatsApp group for people in the same class or a Twitter hashtag for those studying for school or university exams. So let us keep a balance here: there are some positives. Young people also take advantage of being able to access supportive online networks of people with similar health conditions, which could be more difficult in the offline world.

I should also like to welcome the Science and Technology Committee’s recently launched inquiry into the effects of social media on young people’s health. I am sure that my hon. Friend will be watching that with interest too. I look forward to contributing to the inquiry and to hearing its outcomes, which will add to our evidence in this area. I can also advise the House that, in order to better understand the relationship between social media and the mental health of children and young people, the chief medical officer is leading a systematic review to examine all relevant international research in the area. For the review, existing literature will be searched extensively, which will enable Professor Davies to build a map of research activity, identify the areas for in-depth review and subsequently allow her to examine the areas in detail. This will allow her to assess the relative strengths and weaknesses of the evidence base, as well as considering the positive and negative impacts of social media.

In conclusion, across Government, we are as clear as my hon. Friend is about the need to take action to tackle and prevent the increase in cyber-bullying, as well as the need to improve the support available to those suffering as a result of it. We are incorporating such action within related work streams across the Department of Health and Social Care, the Department for Education and the Department for Digital, Culture, Media and Sport. It is clear that a cultural shift is needed to ensure that future generations do not accept cyber-bullying as the norm, and that they know when and how to access support and help. We need to make it clear what online behaviour is acceptable and what is not. We have made it clear as a Government that we are prepared to work with social media and technology companies in this area, and, like my hon. Friend, we expect them to take significant further steps. However, the buck stops with them. The ball is in their court and they need to do much more. We will continue to maintain the dialogue on that basis. I thank my hon. Friend again for raising this important issue. I have no doubt that we will come back to the subject again.

[Dr Julian Lewis (New Forest East) (Con)]

On a point of order, Mr Speaker. With the blessing of the Government Whip here present, may I ask whether any steps have been taken to reinstate the curtain-and-commode system that used to envelop the Chair, so that on occasions like today, when you have sat there continuously from when the House first met until the House adjourns this evening, you might be able to do so in a little more comfort?

[Mr Speaker]

Well, I am grateful to the right hon. Gentleman for his point of order, but I am not aware that any such steps are planned. In so far as my personal comfort is a matter of interest or concern to the right hon. Gentleman, which is very touching, and might conceivably be to other colleagues, I can assure him and them that I have not felt other than comfortable, privileged and exhilarated to have been in the Chair for the past nine and a quarter hours.

Question put and agreed to.

NHS Staff Pay

Julian Lewis Excerpts

Wednesday 21st March 2018 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

rose—

[Dr Julian Lewis (New Forest East) (Con)]

rose—

--- Later in debate ---

[Mr Hunt]

I disagree that the deal will not be believed—it is a concrete deal. NHS staff still have to vote for it, but the Government have committed to significant rises in pay. I agree, however, that we will need to find the best way of getting more money into the NHS and social care system as we face the pressures of an ageing population.

[Dr Julian Lewis]

Will the Secretary of State expand a little on what he briefly said about flexibility of working hours and family bereavement among NHS staff? After this urgent question, will he kindly give a short tutorial to those of us with an interest in defence on his successful techniques for extracting £5 billion from the Treasury for a Department that urgently needs it?

Contaminated Blood

Julian Lewis Excerpts

Thursday 20th July 2017 Commons Chamber

[Jackie Doyle-Price]

As I mentioned, no firm view has been taken as to which Department will run the inquiry, but as the Minister with responsibility for this area the House would consider it amiss if I were not having meetings and discussions with those affected about the inquiry’s remit. When the Minister of State, my hon. Friend the Member for Ludlow (Mr Dunne), made the statement to the House about the inquiry, we made it clear that we wanted to progress as soon as possible. The Secretary of State called this meeting because we want to hear directly from the victims about what they want from the inquiry. We are very much in listening mode. A decision has not yet been taken as to which Department will run the inquiry but ultimately, as a Minister, I am accountable to Parliament for what happens in the Department of Health in those areas for which I have responsibility, and I want to be leading from the front, having those discussions.

[Dr Julian Lewis (New Forest East) (Con)]

I thank the Minister for saying that no decision has yet been taken about which Department will run the inquiry. Does she agree that perception is as important as reality in this matter, and therefore will she gain from this occasion a mindfulness of the weight placed by hon. Members, on both sides of the House, on the idea that the inquiry perhaps would be perceived to be more objective if some other Department took the lead?

[Jackie Doyle-Price]

I say to my right hon. Friend, and I have repeated this in other discussions as well, that the Cabinet Office is very closely involved in this, and this opportunity has given me the time to make that clear to the House. The Government are listening; we want to consult as widely as possible. No decision has yet been taken, but the Cabinet Office is closely involved in all the consultation we are currently having.

Contaminated Blood

Julian Lewis Excerpts

Tuesday 11th July 2017 Commons Chamber

[Mr Dunne]

I have just described the additional contribution to the financial scheme for England. It will be for the inquiry to decide whether it wants to make recommendations about financial arrangements. At present, I am not in a position to give the hon. Gentleman the confirmation that he is seeking. That will have to come through the inquiry.

[Dr Julian Lewis (New Forest East) (Con)]

My constituent Lesley Hughes was infected with hepatitis C in 1970, but this was discovered only about three years ago. Will any consideration be given to those long years of suffering when the compensation scheme is put into effect?

[Mr Dunne]

I offer my sympathy to my right hon. Friend’s constituent for the challenges she finds herself facing. We have to say at this point that it will be down to individuals to make their applications. We will respond to the consultation in due course. I strongly encourage my right hon. Friend to make representations on his constituent’s behalf to the inquiry when it is established.

Mental Health and NHS Performance

Julian Lewis Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

I will happily take a look at that. Obviously, when it comes to the allocation of capital, we prioritise any projects that will help us to improve the situation in A&E departments and reduce the stresses.

[Dr Julian Lewis (New Forest East) (Con)]

The Secretary of State has acknowledged that there is a shortage of acute mental health beds. That arises from the decision by many health trusts to close beds in favour of putting resources into services in the community. One effect is that people approaching a mental health crisis find it harder to know where to turn for help. Will he explain more about the crisis provision in which we are investing the extra £15 million? Is there a common way of knowing how one can easily access those vital services?

[Mr Hunt]

I am happy to supply more details. The £15 million is for places of safety—it is very specifically focused on support for the police service so that we can ensure that we live up to our legal commitment from this year not to send young people into police cells when they actually need mental health support.

More broadly, my right hon. Friend is right that there is a policy change—most people think it is the right thing—to treat more people in the community where we can. What is not working is the system that divides people up into four tiers, which means that we sometimes say to people, “We can’t treat you because you are tier 3.” People get sent away, which is not acceptable. That is why we are producing a Green Paper. We want to look at a better way forward.

Coeliac Disease and Prescriptions

Julian Lewis Excerpts

Tuesday 1st November 2016 Westminster Hall

[Mr Jones]

I will make a bit more progress.

We have a situation where, in places such as east Essex, the needs of patients are being discounted despite a complete lack of any type of research. I am concerned that more CCGs across the country will begin to use inadequate justifications as a precedent and follow a similar path. That leads me back to my earlier point about the big problem of under-diagnosis. I am afraid we will see a bigger problem if gluten-free prescriptions are not made available to those on low incomes.

[Dr Julian Lewis (New Forest East) (Con)]

On the specific point of failure to diagnose, until 20 years ago I had never heard of coeliac disease, and then I went out with a young lady who, as a teenager, had repeatedly gone to her GP knowing something was wrong. Coeliac disease was never diagnosed until she suffered something analogous to a stroke, which left her permanently all but unable to read. Although she has bravely developed coping strategies over the years, there is no doubt that her life and career have suffered, and she should never have been put in that situation.

[Mr Jones]

The right hon. Gentleman raises a serious point about the life-changing effects that coeliac disease can have. I was only diagnosed by accident, in my 30s; my mother was not diagnosed until she was over 70. Early diagnosis is important, but it is not uncommon for people to live a long time without one being made.

The Health and Social Care Act 2012 included a duty on CCGs to have regard for National Institute for Health and Care Excellence quality standards, but NICE guidance on prescribing gluten-free food for the management of coeliac disease has only recently been published. It says:

“Gluten-free products are more expensive and are usually only available from larger retailers, making access more difficult for people on low incomes or with limited mobility. As coeliac disease can affect more than one member of a family it can also be an additional burden on the family budget”—

as the hon. Member for Aldershot (Sir Gerald Howarth) said.

“To address this, healthcare professionals should help people who may need support to find suitable gluten-free food products on prescription to enable them to maintain a gluten-free diet.”

Junior Doctors: Industrial Action

Julian Lewis Excerpts

Monday 5th September 2016 Commons Chamber

[Mr Speaker]

I call Dr (post-war strategic military planning) Julian Lewis.

[Dr Julian Lewis (New Forest East) (Con)]

In other words, I am totally unqualified as a medical doctor. Therefore, may I ask a question about democratic mandates? I appreciate that, unlike a referendum, a general election does not give an entirely specific mandate on every proposal put forward, but will the Secretary of State take the opportunity to remind the House and the country of how central the proposal for a seven-day NHS was to the Conservative manifesto as far as his Department was concerned?

[Mr Hunt]

My right hon. Friend is right, as that was our only really substantive promise in terms of a commitment to the NHS at the last election. We are funding it and we have an absolute obligation to the British people to deliver on it. That is why in that short period after the last election I felt I had to be clear with the BMA that we were going to deliver on that manifesto promise. If the BMA had reflected on that, it might have perhaps behaved differently from how it did.

Southern Health NHS Foundation Trust

Julian Lewis Excerpts

Wednesday 8th June 2016 Westminster Hall

[Dr Julian Lewis (New Forest East) (Con)]

My hon. Friend the Member for Fareham (Suella Fernandes) has done the House a service by bringing this debate to the Floor. The measure of cross-party support that she has achieved is evidenced by the powerful speech of the right hon. Member for Oxford East (Mr Smith).

I hesitated to contribute to this debate because I have not been involved in the cause of the current crisis, which is about the deaths of patients being insufficiently explained. However, I have a history with Southern Health. I explained in the course of an urgent question, which the present Minister responded to on 6 May, that back in 2011 and 2012 my dealings with the trust were, in 19 years in Parliament, the only constituency issue that caused me genuinely to suffer sleepless nights. It was a question not about the way in which people were treated as inpatients in Southern Health establishments, but about a determination by the trust, in concert with a number of other trusts in other parts of the country using similarly questionable techniques, to follow what appeared to be a trend, if not a fashion, to close a significant proportion—35%—of the existing inpatient acute mental health beds.

My hon. Friend the Member for Eastleigh (Mims Davies) said in her intervention that she detected something of a “bunker mentality”. She is absolutely right. The mentality that I detected at that time was a culture of stubbornness and denial about whatever it was that Southern Health wanted to do, irrespective of what other people might wish it to do. The issue at the time hinged upon something that ought to have been straightforward: namely, what was the necessary number of acute inpatient beds to retain. I raised that subject in two debates. Although I have not yet had the chance to meet Tim Smart, the new chairman of the trust, of whom I hear good reports, I hope he will take the opportunity to look up the two debates. One was on 10 November 2011 and, most importantly, the second one was on 18 April 2012. I had information from within the trust that the bed occupancy rates were high. In fact, the bed occupancy rates on average were between 91.9% and 96.7% when I was surveying the data. So it made it rather hard to argue that one could safely close two out of the six acute inpatient units, thus reducing the number of available acute inpatient beds from a total of 165 to only 107.

Part of the reason for the reduction was given quite frankly as a cost saving. It was proposed to save £4.4 million; £2.9 million out of that total would be absolute savings and the remaining £1.5 million would be invested in something called “hospital at home”. The group that we set up in the New Forest, which continues to meet regularly—usually three or four times a year—is called Support our Mental Health Services. It has found no evidence whatever that there has been any significant increase in the amount of support or the quality or quantity of support that people get at home.

Given that, at the time, with 165 beds 53% of patients were detained and just under half the total were people who opted to go into an acute bed if they suffered some dreadful breakdown, I predicted that the figure for those detained would rise proportionately to about 82%. When I made these remarks in public, Katrina Percy took objection to them and sent a letter to Ministers, councillors and Hampshire MPs denouncing my comments as “unfounded”, “scaremongering” and with “no place in the 21st century” because I had pointed out that if someone suffered a severe breakdown, perhaps their best chance of getting a bed if they needed one under the Southern Health regime would be to cause as much mayhem as possible. But it remains a fact that today, as I understand it from sources within the trust, some 80% of the remaining beds are occupied by people who have been sectioned or detained, and that means that the opportunity for getting a bed if you need one, other than if you are sectioned, is correspondingly reduced.

The difficulty that I had at the time in trying to save the beds was that the trust’s clinical director, Dr Lesley Stevens, was determined to go on repeating figures over and over again that there were between 20 and 30 beds vacant at any one time. There were not. Exceptionally, in a short period—if I remember correctly around Christmas time—there was a figure of that sort, but even by the time she was continuing to put that bogus figure forward, that temporary departure from the norm of high bed occupancy had already been left behind and we were back to business as usual with pressure on bed numbers. Eventually, even a proposal that instead of closing both units at once the trust should close just one of the two units scheduled for closure, and see how that panned out, was rejected.

As you can imagine, Mr Hanson, the relationship between me and the trust was pretty much at rock bottom after all the controversy, but both sides decided we had better try to make the best of what was now a fait accompli. Katrina Percy, for her part, promised—and I believe she kept the promise—that no patient whom the trust judged to be really in need of a bed would be denied one, even if one had to be bought in from the private sector. In return I volunteered never to criticise the trust if it bought in such beds; and I never have, because it is most important that it should give beds to those who need them, and that it should not be deterred because of a politician saying “I told you so; look, you are now having to buy in private beds.”

To bring the story up to date, and conclude: there was a double tragedy. The individual tragedy was the death of a young man called James Barton. He was taken on by the trust and became the director of mental health and learning disabilities. That was in about 2014, and in my opinion James was a total breath of fresh air. He reached out to us, and said, “I know we have had all these troubles in the past; I want to build a new relationship”—and he did. In the course of a number of times when James came to liaise with and participate in our group he confided to me that he believed that the bed cutting had gone too far, and he was experimenting with different configurations, in the hope that bringing perhaps about 15 or 18 beds back into the system—approaching approximately half of what had been lost—might get things back into balance. Tragically, in February 2015 James was suddenly found dead at the age of 36, from an unexplained medical condition. That was a huge personal loss to people such as myself, who knew him only slightly. I can only imagine the catastrophic loss it was to his nearest and dearest.

It was also a tragedy from the point of view of people who need acute beds, in my opinion. Although James’s successor, Mark Morgan, has maintained the contact and is a very pleasant person to deal with, the message that I am getting back from Southern Health now is exactly what it was: “Well, we were having to buy in these beds, but we are not having to do it now, and we seem to be back in balance. We don’t need any extra beds.” Incidentally, one of the two units that were closed was at Woodhaven hospital and was only eight years old. I had performed the opening ceremony. The Winsor ward in Woodhaven hospital remains empty to this day.

[Mims Davies]

I have had families coming to see me—particularly the families of people aged 19 or in their early 20s—for whom beds and in-patient availability are the biggest issue. The treatment at home is working, but they need more sustained treatment, and the closure of bed spaces is having a profound effect on the development of those young people.

[Dr Lewis]

Furthermore, the beds at Woodhaven were state of the art, with en suite facilities—which is terribly important if someone has to be an in-patient in such circumstances. Many of the remaining beds do not have those facilities. That ward has been standing empty for several years now. I believe a change of culture is needed in the trust. Certainly there is no difference of opinion between us on the point that it is desirable if possible for people to avoid going into a mental health unit as an in-patient. However, to have the confidence to be treated in the community they must know that there will be in-patient beds for the occasions when they need extra support. I hope that that lesson from the past will be borne in mind in future restructuring of the trust. I called the trust’s culture one of stubborness and denial. That may lie in the minds of individuals, rather than in its structure, but that is a matter for people other than me to decide.

--- Later in debate ---

[Alistair Burt]

Genuinely, I am unaware of that. The police may review evidence at any time. If CQC has certain evidence that it wishes to take to the police for prosecution, that is a matter for it. I understand the processes that people would want to go through. It is important for me to offer reassurance that those processes are in place, and that things that for too long have been swept under the carpet are open for examination, which I understand to be the case.

Let me deal with the question of a public inquiry. Ministers face many calls for inquiries, and it is important for public inquiries to be considered only where other available investigatory mechanisms would not be sufficient. Public inquiries are rare events. I argue that the processes now being followed by NHS Improvement and CQC are the best way to put right the safety and governance issues at Southern Health. That does not rule out the dissemination of wider learning from this case through NHS Improvement or, where appropriate, the holding to account of individuals via professional regulation or normal performance management routes.

It is right and proper that we should ask such questions. We can perhaps examine whether the system would have responded in the same way had the trust been an acute trust, as I mentioned earlier. I am passionate about improving the care and outcomes for people with mental illness or learning disabilities by ensuring that all aspects of healthcare for people, whatever the issue that has brought them into the care of the NHS and others, are given equal priority with physical health. That must include regulation.

Let me now deal with the point made by my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood). As I have indicated, what I have observed over the past year has worried me. That is to say, there seems to be greater tolerance of when things go wrong in mental health than in acute services. We need to ask ourselves why it has taken so long to resolve those difficulties and to reach the regulatory decisions that are now starting to take effect.

I will therefore be looking at the matter with NHS Improvement, to consider both the effectiveness and the timeliness of regulatory interventions in mental health and learning disability services. I am keen to bring independent leadership into that work, alongside NHS Improvement. A task-and-report group will do a piece of work specifically on that.

Let me name the other places that have upset me during the course of the year. In Hull, there has been a problem with in-patient beds and an inability on the part of the NHS to make decisions about it for more than three years. There was the case of Matthew Garnett, the young man with autism in the wrong place; I could not get information on him for weeks, because of the failure of the NHS to provide what I needed. There are the problems in Tottenham with new mental health facilities, similar to what happened in York, at Bootham Park—how that was closed, and the inability of people to handle it correctly. That is a whole series of cases in which I think things could have been done better. The response has not been good enough. An inquiry into one thing is not sufficient, and the processes are in place to deal with that. Looking at the whole range of why such things happen is really important, and that work is now underway.

[Dr Julian Lewis]

Will the Minister give way?

[Alistair Burt]

No, I cannot, because my hon. Friend the Member for Fareham has to have her two minutes.

A further review of the investigation of deaths is being done. It was announced by my right hon. Friend the Secretary of State for Health, but it will not be completed until the end of the year, when the Department will give its response. This has been a hugely important debate, but it is not the end of the matter. It is a staging post, and people will be able to see things following it. I commend my hon. Friend for raising it.

Southern Health NHS Foundation Trust

Julian Lewis Excerpts

Tuesday 3rd May 2016 Commons Chamber

[Alistair Burt]

The frustration in the NHS is that although what the right hon. Lady says is not true in some places, it is in others; the special measures process in effect at the moment has effected change and has done so more quickly. There are other places where that does not happen. I am concerned that in mental health the sense of defensiveness which we know has characterised parts of the NHS for too long has probably had too great a grip, and we have not always got things done more quickly or demanded that things are done with the degree of urgency that we would expect, on behalf of constituents. I am very determined that any difficulties in getting things done locally in trusts when they need to be done will not be aided or abetted by any lack of urgency in the Department or the upper reaches of the NHS with which we have contact. The concern to make sure that urgency is there is rightfully expressed by the House, and we have to see that that is delivered.

[Dr Julian Lewis (New Forest East) (Con)]

In 2011 and 2012, I was locked in a bitter confrontation with Southern Health Foundation Trust over the determination of its top management to close no fewer than 58 out of its 165 acute in-patient beds for people suffering from mental health illnesses and breakdowns. It is the only constituency issue over which I have ever suffered sleepless nights, and I failed to stop the trust closing the Winsor ward in the relatively new Woodhaven hospital in my constituency. Today, apart from this terrible issue about the deaths, the system remains overfull, the beds remain too few and I understand that at least 80% of the in-patients are people who have been sectioned, leaving people a very low chance of getting an elective bed from Southern Health unless they are prepared to wait a long time. Can the CQC look into this wider issue, given that it has so many other serious concerns about the trust?

[Alistair Burt]

The CQC’s powers are extensive and I know that it will absolutely know what my right hon. Friend says. The debate comparing the provision of beds for treatment with community treatment has been going on for some time in mental health, and different pathways are taken by different trusts. Some trusts put more people into beds, while others are doing more in the community. The general sense is that more should be available in the community, but that must not preclude the availability of emergency beds when they are needed. I will ensure that the CQC is aware of my right hon. Friend’s concerns about that particular trust.

Junior Doctors Contracts

Julian Lewis Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

We have had eight studies in the past six years—those were independent studies, not commissioned by the Government, and they covered areas such as paediatric and cancer care, emergency surgery and a whole range of other areas. Six of those eight studies mentioned staffing levels at weekends as something that seriously needs to be investigated. Today there are higher mortality rates for weekend admissions, and the Government have a responsibility to do something, not to commission further studies. That is why we are determined to press ahead.

[Dr Julian Lewis (New Forest East) (Con)]

May I reiterate my concern that there appears to have been no ballot of junior doctors specifically on the question of withdrawal of emergency care? Does the Secretary of State share my fear that if, despite his best efforts, people die as a result of this withdrawal of emergency cover, public demand for a legislative change to ensure that that can never happen again will become irresistible?

[Mr Hunt]

My right hon. Friend is right to say that the public will be extremely disappointed that professionals are putting patients at risk in such a way, and it is extremely tragic that they are doing so. I am afraid that I think this is a crossing of the Rubicon—crossing a line in a way that has not happened before. I think it is totally tragic, and I support the concern of my right hon. Friend.