Deafness and Hearing Loss

Karen Buck Excerpts

Thursday 30th November 2017 Westminster Hall

[Jim Fitzpatrick]

I am grateful for the opportunity to sum up, Ms Buck. Invariably, the Member who sums up such debates says, “We have had a good discussion.” Not only is that the case today, but this has been an exceptional debate, and I thank everybody who has contributed. There has been a personal theme, but even those who did not raise a personal experience clearly have a grasp of the importance of the subject to their constituents. If any hon. Members are not on the all-party group mailing list, they are now, but I suspect everybody already is.

The hon. Member for Milton Keynes South (Iain Stewart) put his finger on the big issue. As others mentioned, this is a cross-departmental matter, so we need a champion. I will return to that in due course. My right hon. Friend the Member for Wolverhampton South East (Mr McFadden) spoke about cochlear implants and NICE. The Minister says that the work is now back in hand; it will be nine months late, but hopefully it is coming.

The hon. Member for Rochester and Strood (Kelly Tolhurst), as the Minister said, covered her mum’s story powerfully, bringing a tear to my eye. If she saw me wiping it, it is because it was such a great explanation of an individual’s difficulty, told with clear personal commitment. She made a point about how important it is for organisations such as Auditory Verbal to get to children born deaf within the first three and a half years, when their brains can still learn to speak; after that, it is far too late. That is why the pathway is so important.

The hon. Member for Eastbourne (Stephen Lloyd) also spoke powerfully about his personal experience. I was not sure whether he was making a bid to come back as the chair of the all-party parliamentary group; he will need to wait for the annual general meeting, but he is a great vice-chairman, and I will be pleased to see him there. The hon. Member for Waveney (Peter Aldous) and the right hon. Member for Hemel Hempstead (Sir Mike Penning) both called me their hon. Friend; that does not do me any favours on this side of the House, but I know what it means. We have done a lot of good work on a number of Committees, especially on fire, and we are friends. That tells people outside the House that although we might not often be in the same Division Lobby, we have friends across the Chamber and we work together when there is a common purpose. That is really important.

My hon. Friend the Member for Bristol East (Kerry McCarthy) spoke about IQIPS and accreditation. The right hon. Member for Hemel Hempstead, with his experience as Minister of State on Access to Work, is a powerful ally. The hon. Member for Edinburgh East (Tommy Sheppard), who just left to catch his train, talked about money being available for BSL lessons here. That ought to be the case, and I am sure that it is the case; we just need to explore it. He made a point by signing, reminding me that so much of sign language is common sense, such as “book”. He used the sign for “Scotland”, which is bagpipes. That tickles me every time I see it. He made a clear point about the power of legislation.

My hon. Friend the Member for Erith and Thamesmead (Teresa Pearce) told a story about Jacob and crowdfunding. It was powerful, as was the personal story told by my hon. Friend the Member for Blaydon (Liz Twist). My hon. Friend the Member for West Lancashire (Rosie Cooper) told her stories about having BSL as her first language, and the Access to Work issues. She spoke about Liverpool minicoms, and her dad, of whom she is clearly and rightly very proud. I am sure that it touched everybody in the room.

The politics came from the three Front-Bench speakers; the place went back to normal when they started talking. I mean no disrespect at all; they deal with things from a political point of view. Judging by their speeches, the hon. Member for Linlithgow and East Falkirk (Martyn Day), my hon. Friend the Member for Burnley (Julie Cooper) and the Minister clearly understand the issues, and we are grateful for that.

Finally, we need a champion in Government. BSL needs a champion in Government. At some point, a Department or a Secretary of State will have to say to a Minister, “You’re the person for the job.” Then we can all go support that person and get a better hearing in Government. This has been a powerful debate. I am grateful to both signers for being here—[Hon. Members: “Hear, hear!”]—and to the House authorities for facilitating that. I hope that this is the first of many opportunities and becomes the norm. I am grateful for the opportunity to say these few words in closing.

[Ms Karen Buck (in the Chair)]

On behalf of us all, I thank the two signers, Sally Macreavy and Richard Law. We greatly appreciate their work.

Question put and agreed to.

Resolved,

That this House has considered deafness and hearing loss.

Mental Health and NHS Performance

Karen Buck Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

I am happy, on my hon. Friend’s behalf, to ask the Minister responsible to meet him to discuss that psychiatric unit. Of course the proof of the pudding is in the eating, but this is the first time that I can remember that a Prime Minister has made her first major speech on the NHS about mental health and indeed talked, on the steps of Downing Street as she arrived, about the importance of sorting out mental health. That is a sign of the commitment coming right from the top.

[Ms Karen Buck (Westminster North) (Lab)]

The fabulous team at Imperial, St Mary’s in west London are featuring in a television programme this week, and the chief of service for emergency care is reported as saying:

“We’ve just had our worst 10 days on record. There’s nowhere in the hospital to move anybody. What’s happened in the last two years is the whole system, countrywide, has ground to a halt.”

That is partly because there is more than the equivalent of a ward of patients at any time who cannot move out of the hospital because there is nowhere for them to go. Does the Secretary of State accept that his Government have gone too far in the destruction of local government finance, including for social care, and does he accept that next year, despite all the rhetoric, local government finance will go down, not up?

[Mr Hunt]

First, I would like to thank the staff at Imperial, who, alongside other NHS staff, have done a fantastic job over a very difficult period. I would say to the hon. Lady that 50% of councils have no delayed discharges of care. It is a problem in many hospitals, but there are many areas that are managing to deal with it. I suggest that the local authorities that serve her constituency should look at the other parts of the country that are dealing with this problem.

Young People’s Mental Health

Karen Buck Excerpts

Thursday 27th October 2016 Commons Chamber

[Helen Hayes]

My hon. Friend is absolutely right to say that, although today we are debating young people’s mental health, many of the same issues apply to mental health services across the board for all members of our communities.

The Government published a response to the Youth Select Committee report in January 2016. That response was, on the whole, disappointing. It referred mainly to work that the Government were already doing rather than the additional work that they and other agencies clearly need to do. Most disappointing of all, the response rejected the key recommendation that statutory levels of attainment in mental health education should be introduced for all young people. I welcome the fact that the Government have subsequently announced some additional funding for young people’s mental health, but I remain very concerned about the current state of mental health services for our young people and the resourcing of those services.

I will focus, therefore, on the current state of services, and what I believe to be evidence of a crisis that is growing, not diminishing, and demands a response far bolder and more comprehensive than that which the Government are currently offering. I will also return to the conclusions of the Youth Select Committee report.

One in four of us will experience mental ill health in any given year. That means that mental health is something that affects every one of us. All of us have a friend or family member who has mental ill health, and many of us will experience mental ill health ourselves. I have known close friends and family members who have suffered from severe anxiety that impacted on their daily lives, clinical depression and eating disorders. There are few worse feelings than the worry for a loved one who seems unreachable in the pit of depression, except perhaps the worry when that loved one is a child. All any of us wants for our own children and the young people we represent is that they grow up happy, healthy and resilient to the stresses and strains of our world. Watching a precious child struggle with clinical depression, severe anxiety or an eating disorder is absolutely devastating.

According to NHS statistics, around one in 10 children and young people has a diagnosable mental health condition; that is around three students in a typical classroom. Many more young people do not have a diagnosable condition but experience a period of mental ill health or emotional distress during their childhood or adolescence. The Government’s own measures of children’s wellbeing found that almost one in four children showed some evidence of mental ill health. Half of mental health problems are established by the age of 14 and three quarters by the age of 24.

Shockingly, suicide is the most common cause of death for boys aged between five and 19, and the second-most common for girls of that age, after traffic accidents. A recent survey by Girlguiding found that 69% of girls aged seven to 21 feel that they are not good enough. It is thought that around one in eight young people self-harm between the ages of 11 and 16.

[Ms Karen Buck (Westminster North) (Lab)]

I know that my hon. Friend also has concerns, which a number of us share, about serious youth violence. Does she agree with me that mental ill health is now understood to be a key trigger in gang and serious youth violence, and that this deserves a serious and concentrated focus from within the health service and the Government? There is some very good practice out there. It is, sadly, nothing like widely available enough to help us deal with this problem.

[Helen Hayes]

My hon. Friend makes a very powerful and important point. This is an issue that affects both our constituencies to a significant degree.

Only 0.7% of NHS funding is spent on young people’s mental health and only 16% of that funding is spent on early intervention. The Royal College of Psychiatrists also reports that additional funding the Government have committed to young people’s mental health is not getting to the frontline. Responses to a recent freedom of information request from my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) revealed that although the Secretary of State made a commitment that the proportion of funding for mental health services should be increasing everywhere this year, and this is desperately needed, 57 of the country’s clinical commissioning groups are actually reducing the proportion of funding for mental health services.

The charity YoungMinds reports that three quarters of young people with mental health problems may not get access to the treatment they need. Child and adolescent mental health services, on average, turn away nearly a quarter of children referred to them for treatment by concerned parents, GPs, teachers and others. That finding is supported by evidence from the Association of Colleges, which reports that, of 127 colleges responding to a survey, many reported real difficulties referring students on to health services in times of crisis, with 61% of respondents reporting that their relationship as a college with local mental health services is only “fair” or “not very good/non-existent”. The thresholds for support are going up at precisely a time at which demand for services is increasing. This has the potential to create a ticking time bomb of mental ill health for the future.

The average waiting times for all CAMHS providers was six months for a first appointment and almost 10 months for the start of treatment; and an investigation by Pulse recently found that three in five referrals from GPs to CAMHS are being batted back to primary care without any access to specialist support. When early intervention is not available, it is very often schools and colleges that end up dealing with the consequences, and they are woefully under-resourced to do so. A recent survey by the National Association of Head Teachers found that only a third of primary schools have access to a school-based counsellor, and that of those who do have access, 59% have a counsellor on the school site for one day a week or less.

World Autism Awareness Week

Karen Buck Excerpts

Thursday 28th April 2016 Commons Chamber

[Matthew Pennycook (Greenwich and Woolwich) (Lab)]

It is an absolute pleasure to follow that speech by the hon. Member for Berwick-upon-Tweed (Mrs Trevelyan), and I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing this debate and on her contribution over the years.

We have touched on autism awareness and autism understanding, but I would like to focus on something not explicitly mentioned so far—autism acceptance. As hon. Members have noted, public awareness of autism has grown dramatically in recent years, aided by a proliferation of books, media articles and not always accurate portrayals of people with autism on television and in film. This explosion of information on autistic spectrum disorders and the incorporation of individuals with autism into everyday culture has helped to familiarise people with the condition, and it is right that we celebrate that achievement.

Essential as it is, however, awareness alone has not necessarily led to greater understanding of ASDs, and it has not prevented the perpetuation of stereotypes and clichés, as even a cursory Google search would attest. Awareness alone has not keep people with autism from being abused, has not helped them find jobs and has not supported them to live independently. In short, we will not overcome ignorance and help those with autism— young and old—to live independent and fulfilling lives simply by increasing awareness alone.

I am lucky enough to have in my constituency a fantastic organisation called Greenwich Parent Voice. It is a group of exceptional parents, some of whom are in the Public Gallery today, who came together to support each other and to fight for a better deal for their children, all of whom have special educational needs or disabilities ranging from the mild to the most profound and complex. They have not only helped to deepen my understanding of ASDs and the challenges faced by those with autism and their parents, but have made it clear to me, over the course of many meetings, that what is really required is acceptance of autism.

Anyone who has sat and listened to parents or carers of children with autism or adults with autism for even a short time will know that the system in place at the moment, despite some improvements, still does not work. Whether it be through the problems in transferring from a statement to education, health and care plans, the difficulties trying to secure specialist support in the care system, or the strain of supporting children with autism into adulthood, the system causes families unimaginable levels of stress and exhaustion.

[Ms Karen Buck (Westminster North) (Lab)]

In common with other speakers, my hon. Friend is making a very powerful speech about awareness and understanding. Does he agree—I thought his remarks were leading towards this—that we also need to translate such awareness into some hard practical action on service delivery, and that this applies whether it be about education or housing? My hon. Friend, like others, has been dealing with parents of autistic children who are forced to share rooms or to live in 10th or higher storeys in tower blocks because housing policy does not reflect the needs of autistic children. We need to build on greater awareness, but also to resource it and turn it into some practical action that will really assist people.

[Matthew Pennycook]

My hon. Friend makes a very good point. I have dealt with allocation cases myself, and I agree that detailed policies need to be put in place that are based on recognition of the particular needs of autistic children and their families. As I have said, having to navigate the system as it stands can cause those families unimaginable stress and anxiety.

Those who can grow the sharp elbows necessary to navigate the system often do so at great personal cost, and, as the hon. Member for Mid Derbyshire (Pauline Latham) said, not everyone has the ability to do that. The range of challenges faced by those with autism and their families is vast, and this is not the debate for delving into any particular one in great detail.

My sense is, however, that our collective will and readiness to do something to help people on the spectrum would be stronger if more of us were not only aware of autism and understood it, but were more accepting of it as a society. If we were, I suspect we would be compelled more urgently to address the lack of suitable childcare provision for autistic children and the fact that too many schools are still not autism-friendly and too many children are not getting the support they require. We would be compelled more urgently to address the prevalence of mental health conditions in those with autism, and the isolation that young people with autism too frequently face in school. We would be compelled to address the cliff edge in support—that is what it is—that still faces autistic people in too many parts of the country as they transition to adulthood. We would also be compelled to address the huge challenges that still face autistic adults in terms of diagnosis, employment and housing.

I have no doubt that these challenges will be overcome in time, not least because more and more people with autism and their families, such as those who helped establish Greenwich Parent Voice in my constituency, are advocating more strongly for themselves. I believe that each of us here in this Chamber and in the wider country can hasten the process by working towards a society in which more of us are not only aware of autism and understand it, but accept those with it and indeed celebrate them and their contribution—not only as family members and friends, but as classmates, colleagues and members of our communities.

Mental Health

Karen Buck Excerpts

Wednesday 9th December 2015 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I beg to move,

That this House believes that mental health should be treated with the same priority as physical health and recognises the importance of promoting good mental health from childhood through to adulthood; believes that not enough progress has been made in translating this House’s commitment to parity of esteem between mental and physical health into practice; notes with concern that the King’s Fund has reported widespread evidence of poor-quality care across mental health services, and the latest available figures show a rise in suicide rates and the number of detentions under the Mental Health Act 1983 increasing by 10 per cent in the past year alone; further notes the delay in the publication of NHS England’s Mental Health Taskforce report; notes the concerns that have been raised with the Scottish Government regarding the rate of inappropriate admissions of young people to non-specialist facilities for mental health treatment which have increased by 38 per cent since 2011; is concerned by the absence of data on NHS spending on mental health services since 2011-12; opposes the Government’s decision not to enshrine the right to psychological therapies in the NHS Constitution; and calls on the Government to urgently rectify this systemic inequity in entitlement to treatments, reinstate the annual survey of investment in mental health services and develop and implement in full a new strategy to improve the Government’s cross-departmental response to mental health.

It is a privilege to open this debate as the first shadow Minister for mental health. The fact that we are having this debate is testament to just how seriously the Opposition consider mental health. The issue affects one in four of us every year, yet it has been neglected for far too long. Mental health has come out of the shadows in recent years, and I know that many Members on both sides of the House feel very strongly about this issue. There have been many important steps forward, but talk to anyone with a mental health condition and they will tell you that they still face stigma, prejudice and discrimination. Sadly, there remain many areas in which there has not been the progress for which we had hoped.

Labour Members have deep concerns about our nation’s mental health and the services and support that are available. Three years ago, my Labour colleagues in the House of Lords won the fight to ensure that the Government wrote parity of esteem between mental health and physical health into law. However, the gap between the rhetoric we hear from this Government and the reality for patients on the ground is growing wider.

I am sure Members on both sides of the House have many constituency cases that echo such concerns. In my first few months in this position, I have been struck by the thousands of messages I have received from people up and down the country. They are desperate to see a change in how our society approaches mental health. This strength of feeling is not surprising. On this Government’s watch, there has been an increase in the number of patients who report a poor experience of community mental health care. More patients have to travel hundreds of miles just to get a bed. The number of children being treated on adult wards, which the Mental Health Act 1983 rightly says should not happen, has risen again this year. The number of people becoming so ill that they had to be detained under the Mental Health Acts leapt by 10% in the past year. The level of suicides, particularly among men under the age of 45, has been at its highest since 2001.

[Ms Karen Buck (Westminster North) (Lab)]

Does my hon. Friend share my concern about the scale of the stress—by common agreement, often inappropriate stress—on the police as a consequence of the pressure on emergency mental health services? My local police have advised me that they sometimes spend half a shift with severely mentally ill patients who are queuing for access to acute mental health hospitals. That is bad for the police and bad for the patients, and is a reflection of the terrible pressures on the acute mental health sector.

[Luciana Berger]

I thank my hon. Friend for making that very important intervention. There are too many stories of our blue light services—not just the police, but our ambulance and fire services—being under incredible pressure in contending with such issues. I believe that the Government must do more to address that issue.

Health and Social Care

Karen Buck Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

I will tell the hon. Gentleman what I remember: I remember NHS waiting lists in 2010 being at their lowest ever level; I remember public satisfaction with the NHS being at its highest ever level; and I also remember leaving behind a financially solvent national health service. Let us look at it today: NHS waiting lists at a six-year high; cancer patients waiting longer for their treatment to start; A&E in crisis; and, as I said, a £1 billion deficit, and rising, at the heart of the NHS. That is the Secretary of State’s record, and a little more humility might not go amiss.

[Ms Karen Buck (Westminster North) (Lab)]

Is it not true that the NHS’s greatest resource, and indeed greatest cost, is its staff? Imperial College Healthcare NHS Trust overspent on staff by £24 million last year, and at the end of the financial year 12% of all its spending was going on agency and “bank” staff. While it is completely right to clamp down on the ludicrous overspend on agency staffing, does this not reflect the reality of cuts in training and of an attitude to staff pay by the Government? Does my right hon. Friend agree that we will not deal with agency staff without having a better deal for the recruitment and retention of permanent staff in the NHS?

[Andy Burnham]

My hon. Friend anticipates me, because this is precisely the issue I am coming on to. Under the Lansley reorganisation, workforce planning went out of the window, and that led to today’s huge workforce crisis and hospitals being in the grip of private staffing agencies. That is the single biggest driver of the NHS deficit that I mentioned a moment ago, and I will talk about that shortly.

The Secretary of State gave us a pious warning about temperate language, yet this is the Secretary of State who today on the front page of The Daily Telegraph is saying that the NHS has enough cash and now must deliver:

“the time for debating whether or not”

it has enough money is over, it

“now needs to deliver its side of the bargain”.

Not for the first time, that is a statement by the Secretary of State that will have caused jaws to drop across the NHS. People will not forget the time he accused hospitals of coasting when they were in the middle of an A&E crisis, but even by his standards this was a staggering piece of spin.

The simple fact is that the NHS does not have enough money. In fact it is seriously short of money. It is facing a £1 billion deficit this year, with two thirds of hospitals in the red, which marks a major deterioration from what the Conservatives inherited in 2010, when there was a surplus of over £500 million.

National Health Service

Karen Buck Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I will give way to my hon. Friend before making more progress.

[Ms Karen Buck (Westminster North) (Lab)]

If the causes of the A and E crisis are deep and structural, as the Secretary of State has implied, why is it that the number of people in London waiting outside A and E in ambulances rose by 66% in one month—between November and December?

[Andy Burnham]

As usual, my hon. Friend puts her finger on the issue: the crisis is not as the Secretary of State describes. I will come on to that right now, but the first request I will make of him today is to publish the research that proves that the three top reasons he gave in this House two weeks ago are indeed the reasons for the increased demand in A and E, because I do not believe that they are. Perhaps they have made a small contribution, but they are not the real reason for the crisis. Our analysis of what is behind the extra pressure is very different from his. Let me introduce an important and revealing fact into this debate, which picks up on my hon. Friend’s point.

Over the past four years of the previous Government, annual attendances at A and E increased by 60,000. Over the first four years of this Government, they have increased by 600,000. That is a dramatic increase, which is explained not by those long-term structural issues, but by decisions taken by this Government.

A and E and Ambulance Services

Karen Buck Excerpts

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right, and I commend what is happening in his constituency. He will be pleased to know that this is beginning to happen all over the country. The heart of the long-term solution is to have people in the social care system, people in primary care and people in hospitals to see themselves as part of one system, in which people are properly flowing between different parts of the system in the way that is right for them, ignoring organisational or institutional barriers. Where that happens, we are making good progress and we are getting the right performance in A and Es.

[Ms Karen Buck (Westminster North) (Lab)]

Last week, the chief executive of Imperial College Healthcare NHS Trust told me that it had a ward of patients that it was unable to discharge into the community. This week the Care Quality Commission ranked the A and E unit at St Mary’s as being inadequate owing to a lack of bed capacity and physical capacity in the ward. Yesterday the London ambulance service had to call in emergency help because it is under such pressure. What is the Secretary of State doing to turn around the crisis in central London’s health service? Will he remind us again why it made sense to close two west London A and E units in the middle of an A and E crisis?

[Mr Hunt]

It is funny how the hon. Lady talks about the closing of A and E departments without talking about the opening of A and E departments and the improvement of facilities. The plans for north-west London involve significant improvements, including weekend opening of GP surgeries, which is one of the key things that the shadow Front-Bench team has talked about as something that will help A and E departments. As for what is happening specifically, I was disappointed with the CQC report about the A and E at St Mary’s, but I gently say to her that it was this Government who set up an independent inspection regime with a chief inspector who gives the public information in a way that they did not have before. I think that is the biggest spur to making sure that the right changes are made quickly.

Health

Karen Buck Excerpts

Monday 9th June 2014 Commons Chamber

[Ms Karen Buck (Westminster North) (Lab)]

It is often in the specific and the particular that we understand how public policy is most effective, far more than in mission statements, PowerPoint presentations and the sub-sections of the legislation that we pass. That is particularly true of the NHS. We have heard two striking examples of that already in the contributions from my right hon. Friend the Member for Cynon Valley (Ann Clwyd) and the hon. Member for Burnley (Gordon Birtwistle) talking about social care. It is also true of the reconfiguration and change in the health service, which I shall address in the few minutes available to me.

In many respects we understand across the piece what changes need to take place, yet we find that so many of the changes that have taken place at a higher level of public policy, particularly those implemented by the Government through the Health and Social Care Act 2012, have made it harder rather than easier to bring about the change that we need to deliver. In London in particular, an exceptionally complex environment, we saw that set out very clearly by the King’s Fund in its report last year, which made it clear that the Government’s reorganisation of the health service, carried out at considerable expense, had made it harder rather than easier to deliver the fundamental changes that we need by fragmenting its structure and undermining its capacity to introduce strategic leadership.

In north-west London, which we have already heard mentioned today, we are facing one of the most fundamental changes in the delivery of health care since the establishment of the national health service. The “Shaping a healthier future” agenda is rooted in a set of principles with which most of us could agree. We want to reduce the number of accident and emergency attendances and, in particular, to reduce the number of accident and emergency admissions when patients can be better cared for elsewhere, particularly within primary and community services, and we want to reduce the length of stay, particularly for elderly patients who would be better and much happier to be cared for with appropriate social care support in their own homes. Those are undeniable facts that are supported by the general principle that in many cases the higher level of acute care is more efficaciously provided in larger and more specialist units. Those things go together and they are worthy objectives.

It is in the detail of the implementation that we have a major problem. NHS England is apparently seeking to have a total of 780,000 fewer patients admitted to A and E over the course of the next two years. The “Shaping a healthier future” agenda translates into a reduction of 15% in the number of A and E admissions to be achieved in north-west London. As the King’s Fund’s health economist John Appleby has said, that is “not realistic or feasible”. The problem is not that it is not desirable or that we do not want to see it achieved over time, but that we are in the middle of a period of rising demand for A and E and the capacity simply is not there, either elsewhere in the acute hospitals sector or in community and primary care services.

Only a few months ago, Imperial College Healthcare NHS Trust, at the heart of the “Shaping a healthier future” agenda, said:

“We are yet to see any impact of primary care and community Quality, Innovation, Productivity and Prevention…schemes and therefore are planning to maintain the level of emergency care we provided”

over the course of this winter. So, a hospital is saying that it cannot rely on the primary and community services being in place to divert people from A and E, yet almost in the same week the Secretary of State’s letter confirmed that the closure of the accident and emergency units at Hammersmith and Charing Cross, as we understand them, will go ahead as soon as possible. We now have a date in September, and his letter stated that

“the process to date has already taken 4 years causing understandable local concern”.

[Mr Slaughter]

My hon. Friend has written a devastating critique to the new chief executive at Imperial about the fact that Hammersmith A and E in my constituency as well as other A and Es are being closed before there is appropriate provision to replace them. I would not hold my breath for a reply if I were her. I am still waiting for one to the letter I wrote to the clinical commissioning group on 26 April on the same subject of failure to provide primary care.

[Ms Buck]

I am grateful to my hon. Friend, who reinforces my exact point.

Since the Secretary of State’s letter and the decision to proceed with the Hammersmith and Charing Cross closures, it has been reported in the Evening Standard that Imperial is having to use winter pressure beds routinely to cope with patients displaced by the planned A and E closures, admitting that there are “risks” of over-crowding, and warning that ill patients will have to spend longer in ambulances. This is a demand for winter pressure beds in the middle of the summer. The expectation is therefore that there is already insufficient capacity years before the construction of a planned new and improved A and E unit at Imperial hospital. The closures are going ahead and Imperial clearly cannot cope. An Imperial official said:

“We have extra acute beds at St Mary’s Hospital, normally used during the busy winter period to ensure we can quickly admit those patients”

in need. That is fine, but what will happen if and when we have a winter crisis or simply during the additional winter pressures? That capacity will not be available to help deal with them.

None of this is meant to suggest that there are not fine people in clinical and managerial practice focusing their attention on ensuring that services are in place to assist with that transition, but the scale of the challenge appears to be beyond what can be achieved realistically within the timetable. In the middle of all this—and no doubt connected to it—there came halfway through the year a letter from the west London clinical commissioning groups announcing that they have

“made an important decision to put funding into a central budget…£139 million…which means CCGs with a surplus will be supporting those with a deficit…We also agreed to explore how to bring together commissioning of primary care services across organisational boundaries”.

That seems to me to be perilously close to the end of clinical commissioning groups as far as we understand them. My understanding was that clinical commissioning groups were designed to be rooted in their local communities, to work in effective local partnerships and to reflect the local service providers, particularly primary care service providers and patients, at a local level. That has all gone with the wind in west London and I am extremely worried about it.

I am all the more worried because the whole transition programme is predicated on the delivery of improved social care, and it is social care with which we are now struggling to cope. In my local authority area, 1,000 fewer residents are getting social care than in 2010, and there will be a further £2.9 million cut this year. It is no surprise that the chief financial officer at Imperial trust, Bill Shields, has said:

“The cynic in me says”

that the proposal to take money away from the national health service to fund social care

“is a way of taking money from the NHS and passing it on to the local authority…this will allow them to make good the cliff edge they have been through in the last few years and rebuild the local government public finances.”

It would also mean

“a significant real-terms reduction in NHS income…going forward”.

[Mr Slaughter]

My hon. Friend makes a point about this panicked attempt to find more money in the primary care budgets and slosh it around west London at any consultation, and that is exactly the issue on which I am still waiting for an answer. This is chaos in the health service and is a reaction to closure programmes that have been carried out on financial grounds and that have now reduced the health service in west London to a chaotic and dangerous state.

[Ms Buck]

It is extremely worrying because the whole thing is shrouded in a lack of transparency and a lack of effective communication about what is going on. The local authority is cutting its own social care funding and needs money to fill its black hole, whereas the trust at Imperial says that that is exactly what it is worried about. It says it is concerned about the transfer of money because that might not give it the increased local community services that would allow it to reduce emergency A and E admissions, which is what we want. In fact, those things are so far from being effectively integrated in a common purpose that the different sectors of the health service appear to be at war with each other financially, if not in any other way.

The problem is that the fragmentation and delay caused by the reorganisation in the national health service since 2010 have undermined what should have been a sensible method of progressing and building up community services to reduce the pressure on the acute sector. Meanwhile, today and in the coming weeks my constituents will find that their hospital is at capacity but is expected to deal with the extra demand from the Hammersmith and Charing Cross accident and emergency closures, whereas the constituents of my hon. Friend the Member for Hammersmith (Mr Slaughter) face the loss of their accident and emergency units without any appropriate provision. It is a shambles, I am extremely concerned, and I hope it is not too late to ensure that we can put something in place to prevent a true winter crisis this winter that would be of the Government’s own making.

Oral Answers to Questions

Karen Buck Excerpts

Tuesday 25th February 2014 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

6. What recent assessment he has made of the number of available mental health crisis beds for young people in England.

[Ms Karen Buck (Westminster North) (Lab)]

14. What recent assessment he has made of the number of available mental health crisis beds for young people in England.

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

NHS England has a rapid review under way to identify commissioning solutions to pressures on specialist beds for children and young people. It inherited varied provision across regions and a lack of capacity in some parts of the country for particular need. For the first time, available beds are monitored weekly, and small increases in capacity have already been secured.

[Norman Lamb]

The reduction in the number of mental health beds has been a long-term trend—it happened under the previous Labour Government—and rightly so, because we have to move away from institutional care. However, crisis beds must always be available. I completely agree that it is intolerable for children to end up in police cells, but that is not new; it has happened for many years and did not start in 2010. When we talk about parity of esteem, we mean it. There must be absolute equality between the ways in which mental and physical health are treated. Last week we launched a crisis care concordat to ensure that children do not end up in police cells.

[Ms Buck]

The clinical director of child and adolescent mental health services in my mental health trust recently said:

“Sometimes we have to make 50 to 100 phone calls around the country looking for a bed… young people shouldn’t be shunted around the country into inappropriate facilities.”

Another psychologist dealing with a case in my constituency told me:

“It is very difficult to get young people into in-patient services at present due to the high number of cases and reductions in funding from NHS England.”

Is that not an intolerable situation in which to leave traumatised young people? How quickly will the Minister’s review be completed so that we can end that tragedy?

[Norman Lamb]

The review being undertaken by NHS England will report in March. I agree that that situation is intolerable, but I have made it very clear on many occasions that there is an institutional bias against mental health in the NHS. Interestingly, the Health Committee report on deficits in 2006-07 specifically made the point that mental health was particularly targeted, so that always happens when NHS finances are tight. However, it cannot happen, because there has to be parity of esteem, including in the way in which money is distributed in the NHS.