Child and Adolescent Mental Health Services Debate
Full Debate: Read Full DebateLord Beamish
Main Page: Lord Beamish (Labour - Life peer)Department Debates - View all Lord Beamish's debates with the Department of Health and Social Care
(9 years, 5 months ago)
Commons ChamberI cannot disagree with that. I come from the perspective that we need to plan interventions on the basis of evidence, but how can we do that without current and relevant data on child and adolescent mental health? We certainly need that data. On the structure of the contracts, I am a firm believer in integration. There may well be issues with block contracts. The Health Committee received evidence from the south-west indicating that there are vast areas of the country where there is very little access to certain types of in-patient mental health provision, which is clearly unacceptable. One might have thought that a large block contract would make that less likely, but apparently that is not so. However, I am not an expert in commissioning; I am simply trying to identify the policy areas.
Having spent a number of years in local government, I have no doubt that local authorities wish to tackle some of the barriers that young people face in accessing mental health services. It is a complicated area, and we need to enable local areas—the hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) just referred to larger block contracts—to commission better services, and perhaps that is better done on a more local level.
Does my hon. Friend realise that one of the problems with block contracts is that, because of their size, they freeze out small voluntary organisations that could deliver services on a local basis?
That is true. Some of the organisations that submitted evidence to the Health Committee and subsequently provided briefings made that point.
Another issue of concern is the complex commissioning landscape for CAMHS, which can result in poorly co-ordinated services and a lack of clarity about roles and responsibilities, leading to gaps in provision and poor transitions from child to adolescent and from adolescent to adult. The service is certainly underfunded. We often talk in this place about parity of esteem. As other Members have reported, CAMHS nationally is receiving about £1.8 billion of the £14 billion that is spent on mental health. Local authority-provided services, which are often having to bridge the gap, are facing huge financial challenges. My local authority, which I share with my hon. Friend the Member for North Durham (Mr Jones), has had to cope with cuts of £250 million over the lifetime of this Parliament. That is forcing councils to make extremely difficult decisions about which services are funded.
I fully understand the point made by the hon. Member for Brigg and Goole, but I also fully understand the difficult decisions faced particularly by authorities in the north that seem to be suffering disproportionate cuts. Councils are embracing their new public health responsibilities—