Covid-19: Effect on People with Learning Disabilities

Lisa Cameron Excerpts

Tuesday 15th December 2020 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a pleasure to serve under your chairmanship, Ms Ghani. I start by thanking the hon. Member for City of Chester (Christian Matheson), who has provided such a detailed overview of the issues that need to be addressed. I thank him for that, not just as a Member who is speaking today, but as the chair of the all-party parliamentary group on disability. It is wonderful that he has secured this debate, and that he has spoken so eloquently and in such an important manner to raise the issues that the Government should be addressing.

I also thank all hon. Members who have taken part in the debate. We have heard excellent speeches, touching on education, employment and issues related to autism spectrum disorder. We also heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), who spoke about the impact of the internet and technology and the importance of access, as well as about family issues. As he highlighted, it is very important that we should not think of helping or assisting people with disabilities as something that is removed from our own lives, because these issues will touch our families at some point.

Great thanks have to go to the staff—to the teachers and care staff—who have worked with people with disabilities throughout the pandemic in our NHS and care settings, who have pulled out all the stops and shown absolute determination and dedication in their role, as well as to the charities, including Mencap, Sense and Scope, to name just a few.

In terms of the immediate consequences of the pandemic that need urgent attention, there are a number of pressing concerns, the first of which is access to healthcare under the Equality Act 2010. People with learning disabilities are, of course, entitled to reasonable adjustments when admitted to hospital. Although those adjustments have not been officially revoked under the Coronavirus Act 2020, one in four people surveyed by Mencap who work as nurses in the learning disability sector said that they had seen instances in which people with a learning disability were not allowed to be accompanied by a family member, carer or supporter in hospital due to covid restrictions.

The Scottish Government have been addressing that issue: people with learning disabilities are excluded from the no visitors policy, and a guide for clinicians working in hospitals has been provided, which I think has been very helpful in terms of shared practice. A top priority for future guidance must be to ensure that those with learning disabilities are allowed to be accompanied in ambulances, to hospital, for check-ups and so on, and to bring someone with them to help with communication and their healthcare needs.

Although the move towards remote consultation to treat many conditions during the pandemic has been welcomed—indeed, it has been a necessity—there is concern, as we have heard, that people with learning disabilities often do not have access to technology or find it more difficult to use, and many do not have the adaptations in technology that enable them to access those consultations in the most effective manner. Those are some of the issues that the Minister will also need to address when it comes to clinical need.

There has also been a disturbing increase in the use of physical restraint on people with learning disabilities reported by health and care settings since the start of the pandemic, with usage increasing by over 150% at the peak of the pandemic compared with pre-covid levels. I would be obliged if the Minister would look at that extremely important matter.

I will finish by mentioning mental health. Often, we think about physical health—particularly in the midst of a pandemic—but forget to mention mental health, and I think mental health is going to be one of the key priorities right across the United Kingdom going forward. The mental health consequences of extended periods of isolation, increased care burden and financial stress have been well documented in recent months, but those mental health outcomes are exacerbated for those with learning disabilities and those who care for them. A survey by Mencap found that over 70% of parents of children with a disability admitted that their mental and psychological health had worsened as a result of the pandemic; four out of five family carers had been forced to provide unpaid care for their family members, leading to increased poverty; and one in five people with a disabled family member feared they would go into debt as a result of the pandemic.

These are extremely serious issues, and I invite the Minister to the all-party parliamentary group on disability to further discuss them. I thank everybody who has taken part in today’s debate.

Coronavirus Regulations: Assisted Deaths Abroad

Lisa Cameron Excerpts

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

We would consider collecting more data on these questions, because it is important that any debate is conducted based on the evidence, but it is also important that the debate takes into account all views that are sincerely held and very reasonable.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I refer the House to my entry in the Register of Members’ Financial Interests.

Is the Secretary of State aware that research indicates that individuals go through a number of psychological stages—such as shock, denial, anger, bargaining, depression and then acceptance—after they have been given a diagnosis of terminal illness? We are failing so many people right across the United Kingdom by not giving them access to adequate psychological support to enable them to reach that stage of acceptance, in themselves and for their families, and then not providing the therapeutic support that they need alongside the palliative care already mentioned by colleagues.

[Matt Hancock]

The hon. Lady makes an important contribution to the debate in respect of how we should consider these issues.

Down Syndrome Awareness Month

Lisa Cameron Excerpts

Thursday 22nd October 2020 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

This is a particularly poignant debate for me to lead, as chair of the all-party parliamentary groups on disability and on inclusive entrepreneurship, which I will mention a bit more later. This year’s theme for Down Syndrome Awareness Month is “what holds me back”, which I will discuss, but I want also to speak about the real skills, abilities and potential of people with Down’s syndrome and why nothing should hold them back.

To begin, it would be appropriate to thank a number of organisations for their campaigning on Down’s syndrome inclusion and for their support in preparation for this debate and Down Syndrome Awareness Month. Those include Down’s Syndrome Scotland, the Down Syndrome Research Foundation UK, the Down’s Syndrome Association, Scope, Right To Life and Mencap, to mention but a few.

[Elliot Colburn (Carshalton and Wallington) (Con)]

Will the hon. Lady join me in also thanking organisations such as Get on Down’s in Carshalton and Wallington, and Lucienne Cooper, who has done incredible work to raise awareness of the needs of Down’s syndrome children in places such as Carshalton and Wallington?

[Dr Cameron]

Absolutely. I thank the hon. Gentleman for mentioning those very important organisations and the work that they do. It is a credit to him that he has come to the debate to speak and to commend the work they have undertaken.

Every year in October, people across the UK and around the world mark Down Syndrome Awareness Month. Among other things, it is an opportunity to celebrate the achievements and contributions of people with Down’s syndrome to their local communities and to our society as a whole. I tabled an early-day motion on Down Syndrome Awareness Month just a few weeks ago, and I urge Members across the House to consider signing it if they have not already done so.

Today I hope to build on this work and take the opportunity to add some individual names and narratives that speak to the talents, passions, hopes and dreams of those living with Down’s syndrome in the UK today. These are people who have been in touch with me in my capacity as chair of the all-party parliamentary group for disability and have participated on a number of occasions in our recent online meetings, which I have been extremely pleased to host and which have brought me up to speed with modern technology, much to my delight.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing the debate. In my constituency, there are a number of groups that support those with Down’s syndrome and their families. Does she share my concern about the fact that the number of babies born with Down’s syndrome has dropped by 30% in NHS hospitals that have introduced new non-invasive pre-natal tests, which will soon be available free of charge nationwide? It is beginning to mirror the process that sees almost 100% of Down’s syndrome babies aborted, which is chilling to the core.

--- Later in debate ---

[Dr Cameron]

I thank the hon. Gentleman for raising that extremely important point. I do share his concern. I understand that, in England, the number of babies born with Down’s syndrome is down by about 30%. I was alerted today to an article in one of our Scottish papers, the Daily Record, about Stacey Corrigan, whose six-year-old son, Daniel Murray, has Down’s syndrome. She said:

“When many think of Downs Syndrome it’s most often with a negative outdated view”.

She also said that the language used by medical staff when speaking to parents-to-be is really important and should not be negative, and that parents should be given “balanced information and support”.

As I was saying, I want to build on the positivity and speak about people’s talents, passions, hopes and dreams. Their accounts are not uniform and follow no common narrative, but that is exactly the point. The richness and diversity of the Down’s syndrome community across the UK reflects the richness and diversity of society at large. However, all too often their lives and contributions have historically been medicalised or pigeon-holed into discussions about difference and limitations rather than talent, skills, ability and contribution. A more comprehensive and accurate narrative needs to be provided.

One baby in every 1,000 in the UK is born with Down’s syndrome, and there are approximately 40,000 people who have Down’s syndrome living in the UK today. Down’s syndrome was first described by an English physician, John Langdon Down, in 1862, and that then became the universally accepted descriptive term. It is a genetic condition occurring as a result of an extra chromosome—chromosome 21. People with Down’s syndrome can experience cognitive delays, but the effect is usually mild to moderate and is certainly not indicative of the many strengths and talents that each individual possesses.

People with Down’s syndrome have an increased risk of certain medical conditions such as congenital heart defects and respiratory and hearing problems, to name a few, but many of those conditions are treatable. Nowadays, most people with Down’s syndrome lead healthy lives.

[Bob Stewart (Beckenham) (Con)]

I thank my friend, the hon. Lady, for giving way. My family had a child with Down’s syndrome when I was young, and unfortunately he died very young. Does she agree that modern medicine has extended the lives of people with Down’s syndrome so much that they live as long as anyone else—perhaps as long as me?

[Dr Cameron]

I thank the hon. Gentleman for all his excellent work in the House of Commons in so many ways, on this issue as well as on the armed forces. I totally agree with his point; in fact, I understand that life expectancy has increased dramatically in recent decades, from 25 years in the ’80s to 60 today. Medical science has advanced and people can live extremely healthy and long lives and be great contributors to our society.

Every person with Down’s syndrome is, of course, a unique individual. People with Down’s syndrome attend school, work, participate in decisions that affect them, have meaningful relationships, vote—which we should all remember to do—and contribute to society in many wonderful ways.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for securing this debate, having worked with people with Down’s syndrome for many years. I put on the record my huge gratitude to the Once Seen theatre company in York, where people with Down’s syndrome act. Their acting is so powerful and so moving, because it is about life experience. Does she agree that we need to put on a platform so much of the talent that people with Down’s syndrome have?

[Dr Cameron]

Absolutely. I am thankful for that intervention, which exemplifies our debate and the change in the narrative that all of us across this House wish to see. We should be promoting the excellent work of those individuals and groups with Down’s syndrome who are achieving so much in society.

Up About Down is a campaign run by the Windsor Essex Down Syndrome Association, a fantastic charity that has being raising awareness about Down’s syndrome through positive and accurate information since it was founded in 1990. It is all about changing the narrative surrounding Down’s syndrome; it is about looking beyond medical prognoses and seeing the individual stories and successes of individuals with Down’s syndrome who live happy and fulfilled lives and who are crucial contributors to local communities, economies and industries. It is absolutely in that spirit that I bring this debate before the House.

In 2019, an article was published that caught my eye, entitled “10 brilliant breakthroughs by people with Down Syndrome”. It highlighted Zack Gottsagen, a theatre major graduate of the Dreyfoos School of the Arts who starred in

“a modern Mark Twain style adventure story, The Peanut Butter Falcon, which tells the story of Zak…a young man with Down syndrome, who runs away from a residential nursing home to follow his dream of attending the professional wrestling school of his idol”.

The article also highlighted Heba Atef, who

“became the first-ever Egyptian flight attendant with Down syndrome to embark on a special flight from Cairo to Khartoum…the ‘Journey of Humanity’ took place under the sponsorship of the UN International Committee and was specifically tailored for people with special needs.”

The article notes that the Swindon Advertiser reports that

“a scaffolder living with Down’s syndrome was named Britain’s number one apprentice. His boss, the owner of Coles Scaffolding company Martyn Coles, said Todd had great determination. ‘He comes in every day and proves people wrong. Winning the award just shows he can do it.’”

Emmett Kyoshi, a teenage artist living with Down’s syndrome in Chicago, hosted his third art exhibition in 2019,

“showing the world that the extra chromosome he was born with is anything but a disability.”

Then there are Madeline Stuart—the world’s first catwalk model with Down’s syndrome—and Francesca Rausi, who have been credited for proving society’s perception of beauty wrong. They had the opportunity of walking at New York Fashion Week and meeting some of Hollywood’s biggest stars; again, they changed the narrative.

Closer to home, Positive about Down Syndrome told me about Tom, who lives in London and has two part-time jobs as a barman and catering assistant and is also an award-winning weightlifter; Bethany who works for West Mercia police; and Hayley from Essex, who loves singing and acting and is part of a drama group performing at the London Palladium. These few accounts represent the stories of so many: those students with Down’s syndrome who are in college or university; those who have jobs and hobbies; those who are moving home, winning awards, falling in love, getting married and achieving great things.

For each of these stories, there are also children who have dreams and aspirations. I heard about Rebecca, who wants to perform on stage; Ben, who wants to be a postman; Jessica, who wants to be a pop star; Jack, who wants to play football for Nottingham Forest or Manchester United; Hollie, who wants to be a vet; James, who wants to be a police officer; and Samantha, who wants to be a make-up artist. I am sure that I speak for every parent when I say that we support and absolutely share in the dreams of our children every single day.

A sense of fulfilment and purpose that people with Down’s syndrome have from their work is a common thread connecting many of the accounts that I have mentioned. With that in mind, I draw particular attention to the work of the Down’s Syndrome Association and the importance of its WorkFit scheme. The WorkFit scheme was set up to train and assess employers who want to include those with Down’s syndrome in their workforce. All employers registered with WorkFit receive training, which includes their duties under the Equality Act 2010, and practical advice on how to make reasonable adjustments. The Down’s Syndrome Association is in constant dialogue with companies and organisations that have employees placed with them through WorkFit, to answer any queries they may have, and to work through any challenging situations. The programme was set up in December 2011, and to date it has placed 416 individuals with Down’s syndrome in a range of full-time, part-time and volunteer roles, as well as in adapted internships.

In recent weeks the Government announced the kickstart scheme, and I want to ask the Minister whether young people with learning disabilities, or disabilities, could perhaps be further supported through that scheme, or through an internship or apprenticeship. The excellent Speaker’s internship scheme for people with disabilities was developed in 2016, and perhaps there is more that hon. Members could do to support the training, inclusion, skilling and work of those who have Down’s syndrome.

I am delighted to chair the new all-party group for inclusive entrepreneurship, which was established to remove barriers and raise the profile of entrepreneurs with protected characteristics, particularly disabilities. We must also change the narrative more broadly from disability to ability, and from being solely about employees to people having the potential to become employers. Will the Minister consult colleagues in government, and find out whether there are particular supports and schemes for which those with disabilities can perhaps be given funding or additional support for adaptations, so that they can start their own businesses with their skills, talents and abilities?

A study by Mencap found that 62% of adults with learning disabilities in the UK want to work, although only 6% have a paid job. We need to address that, and we must all play our role in our constituencies, and by working across the House and across parties, to ensure an inclusive employment programme for everyone across the UK. In this time of covid a recession could occur, and many jobs are already at risk. We would not wish one of the outcomes of covid to be a further tragic impact on those with disabilities.

Government mantras of “building back better” and “levelling up” can and should include people with disabilities and Down’s syndrome, making every aspect of society richly diverse and productive. I will conclude with a quote from a young lady, Kate Powell, which was provided to me by the Down’s Syndrome Association:

“Being a person with Down’s Syndrome makes me proud. I am a person to make a difference to a lot of people. That’s me. We may find things difficult, everyone does. We should tell people about Down’s Syndrome—the more people the better. Being a person with Down’s Syndrome I can do anything in life. We may need help to do the things we want to do in life. It is good to see people with Down’s Syndrome achieving their dreams. That’s my dream.”

That, Madam Deputy Speaker, should represent all our dreams.

Covid-19 Update

Lisa Cameron Excerpts

Thursday 15th October 2020 Commons Chamber

[Matt Hancock]

I welcome my hon. Friend’s thoughtful approach to the action that is needed in Elmbridge. Of course Elmbridge’s connection to Greater London is very intense, and the travel to work patterns mean that, like him, a huge number of people who live in his constituency work in the centre of London. His council has worked closely with the national team to make this decision.

The expansion of NHS capacity is, of course, critical, as is controlling the virus—both of them. In London, we have not yet had to stand up the NHS Nightingale again, which is at the ExCeL centre. We stand ready to do so if necessary. We now have a huge quantity of ventilators; we have the Nightingale hospitals for bed capacity; we have brought more people back into the NHS over the past six months; and we have retired NHS staff on standby. It is the combination of the three—the kit, the physical space and the staff—that we need in order to expand capacity. Unlike in Manchester, where we are having to stand up the Nightingale hospital again already, we are not yet at the point where we need to that in London. I really hope that, in pulling together and following the level 2 rules, the people of London and Elmbridge can avoid that in the future.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

Many staff have put themselves on the frontline to protect the most vulnerable, but have tragically lost their lives, leaving their families absolutely devastated. Alongside support, appropriate tribute must be paid to their sacrifice. As chair of the all-party health group, I wrote to the Prime Minister a number of months ago, asking for a memorial to be commissioned in their honour, but as yet I have heard nothing back. Will the Secretary of State support bereaved families who have given their all and, at this time, take this issue forward across Government?

[Matt Hancock]

Yes, of course, we have done a huge amount to support bereaved families. It is an issue that is very close to my heart, as the hon. Lady can imagine, so I would be very happy to talk to her about how we can take this forward.

Mental Health Support: Frontline Staff

Lisa Cameron Excerpts

Thursday 8th October 2020 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I beg to move,

That this House has considered mental health support for frontline staff.

It is an honour to move the motion with you in the Chair, Mr Paisley, now that Westminster Hall is once again available for our purposes. In this unique time of pandemic, the mental health of frontline and key workers should be fully supported. I declare an interest as a former psychologist in the NHS for 20-plus years—I am showing my age—before I came to this House, and as chair of the all-party parliamentary health group and the all-party parliamentary group on psychology.

No one should underestimate the severity of the mental health crisis that engulfs us all as a direct result of the advent and ongoing havoc wreaked by covid-19 across the UK, and indeed worldwide. I thank the organisations that have been involved on the frontline, supporting mental health strategy and the delivery of services, including: the child mental health charter and, in particular, Helen Clark, a former Member of this House; the British Psychological Society; the British Medical Association; the Royal College of Psychiatrists; Mind; the Centre for Mental Health; and EveryDoctor—that is to name but a few. I thank all the other parliamentarians who have taken the time on a Thursday afternoon to speak on this vital issue.

On 5 October, Dr Tedros Ghebreyesus of the World Health Organisation introduced the first global dataset on covid-19 access to mental health services. He said:

“COVID-19 has interrupted essential mental health services around the world just when they’re needed most.”

There were some devastating findings. Before the pandemic, countries were spending less than 2% of their national health budgets on mental health. More than 120 countries —93%—reported that mental health services had been stopped or disrupted during the pandemic, 72% said that mental health services to children and adolescents had been disrupted, and 75% had seen a disruption to mental health services in the workplace. Despite the fact that 89% of the countries surveyed said that mental health and psychosocial supports were included in their national coronavirus response plans, only a shocking 17% had full additional funding to cover the cost of those services. Together, those figures show that there is likely to be an international tsunami of mental health morbidity like no other seen in our time.

The Centre for Mental Health, a UK charity, estimates that in England alone up to 10 million people may need mental health support—including long-term support—for the foreseeable future as a result of covid-19, and that 1.5 million children may require support. Those numbers are a stark warning that the impact of the pandemic will have severe long-term repercussions for the mental health of the UK as a whole.

Those affected will need support for depression, anxiety, post-traumatic stress disorder and other mental health difficulties in the coming months and years. Of course, some groups are disproportionately affected, including those with disabilities, those from minority ethnic communities and those with pre-existing mental health conditions who have experienced increased morbidity during the pandemic. Responding to increased mental health needs must therefore be a priority when a recovery plan is drawn up for both NHS and social care sectors for the future of our public health and in fiscal planning across Governments.

On the impact on frontline staff, the national forecast for adults is that more than 200,000 NHS workers may need treatment for post-traumatic stress disorder, psychological distress and burnout. Although less data has been collected, it is likely that a similar pattern will affect those who work across social care settings such as nursing homes. Research is badly needed. Those staff must not be excluded from or let down by the data collection and resourcing that is required. I would be grateful if the Minister looked specifically at the resourcing of data on the psychological impact of covid-19 in the community, nursing and social care sectors.

The International Council of Nurses reminds us that the effects of covid-19 on the mental health of nurses and the wider health social care workforce is a ticking time bomb. Every Thursday, across the UK, we were glad to show our support for key workers on the frontline, who risk themselves daily as they confront the pandemic on our behalf, but we owe them much more than weekly applause, and Governments across the UK owe them that duty of care.

Data from previous pandemics analysed by the British Medical Journal shows that post pandemic, healthcare workers are at high risk of both psychological illnesses and physical outcomes. For frontline staff, decisions made during the pandemic have regularly determined who to prioritise for care, but they have also felt a lack of control, especially when patients are care home residents who are dying and no treatment has been available for them. Emotionally and physically, having to be there day in, day out for patients as well as their families, who often could not visit relatives in their time of need, has been unduly toiling. That has come alongside the use of personal protective equipment for long periods; times when PPE has not been provided to the extent that it should have been; and long periods of excess working hours, stress and exhaustion.

A study by Kisley and colleagues has identified risk factors for psychological distress for staff in the time of covid-19. Personal care and socioeconomic stressors included personal childcare needs, having an infected family member at one point during the pandemic, and having a lower household income, with fewer choices in how to cope. Trauma is triggered when trusted bodies act in a way that can harm their safety at work, such as the failure to obtain correct or sufficient PPE, or by the breakdown or absence of testing and systems. The study also identified enforced redeployment to care for covid-19 patients, a failure to screen and triage healthcare workers for mental health needs prior to the pandemic, and a reliance on crisis intervention when symptoms develop.

Prior to the pandemic, the British Medical Association set out in a 2019 NHS staff survey that 40.3% of healthcare staff reported feeling unwell due to work-related stress. With the onset of covid-19, the workload for healthcare workers has increased radically. Four in 10 psychiatrists have reported an increase in people requiring emergency healthcare, including new patients, in the aftermath of lockdown. NHS and social care jobs obviously involve exposure to a huge range of potential stressors, including competing demands, interpersonal conflict, complex and life-changing decision making, moral injury, shift work and long hours. Added to that in the past six months is the pausing of the working time directive, the limited scope for time off or holiday periods, the increasing morbidity of patients, and losing colleagues. As someone who has worked in the NHS for many years, I have to say that the loss of colleagues is a terrible shock, and not something that people expect in their day-to-day working lives. That is something that frontline staff have had to cope with in addition to their care roles.

People join the caring professions to make a difference and make others better, but coronavirus has created an overwhelming feeling of helplessness in the midst of this trauma. It should be noted that previous coping strategies that those on the frontline utilised may play out differently if they have to cope with a second or third wave. The adrenaline with which they coped in those vital months so that they could be there to support those in need may be replaced by the dread of going through it all again and the fear of being retraumatised.

I have referred to some of the facts and figures impacting the mental health of care workers, but here are some voices from the frontline, expressed in letters sent to The Guardian and the nationwide EveryDoctor organisation, which has been in touch. One said: “The mental health exhaustion that comes from changing everything about the way you work on a weekly or sometimes daily basis for months is immense. All the while, you can see a light at the end of the tunnel, but then you are bracing yourself for the next disaster: a second wave or winter crisis, alongside mass staff absence.”

Another said: “There is the effect of not only seeing patients die, but losing colleagues. Everyone is struggling with this pandemic, but doctors are responsible for the decision making clinically. We can see that this is not going away. There is no respite in sight.”

Another said:

“I am employed on mental health wards as a support worker, helping people recover from acute problems… Covid-19 has not only affected general hospitals but has also had a huge impact on mental health facilities, which are more often run by a skeleton staff… On top of this we are also dealing with mental health patients infected with Covid-19… As we are not considered to be on the frontline, we are not equipped with proper personal protective equipment. We get a basic face mask, gloves and a flimsy apron.”

It should not be forgotten that school staff are also on the frontline, as they have to deal with the effects of the pandemic on children in their care. The mental health issues incurred by lockdown in the children they teach everyday are present upon return to schools. Anxiety and stress among a large group of pupils, alongside the experience of bereavement and a lack of community adolescent mental health services for those with acute problems, has been a feature of the recent past. That is alongside reduced assessment and diagnosis possibilities, due to staff having to change their working patterns, often from face-to-face to virtual sessions, after a period during which sessions were not offered.

Innovation will be key in ensuring that we can address the needs not only in the population but among the frontline staff who desperately need support. Using technology and ensuring that there is the capacity and technical knowledge to support the transition to other methods of care will be fundamental. Meeting the mental health needs that arise from coronavirus is a huge challenge, but it is not optional. Just as responding to the threat of the virus itself has tested our resources and resilience, so too will addressing the psychological and emotional consequences.

I am extremely grateful to the British Psychological Society, which has provided specialist guidance. I know that it has also been working with the Scientific Advisory Group for Emergencies and with the Minister’s office. It wants to see the planning of psychological support and resourcing of the psychological workforce to meet demands in the NHS and care homes and also in schools and the community. It also wants to see increased access to an in-house employee wellbeing service, which it believes will be critical, particularly if unemployment issues face the population in the coming months. It wants to see the employment of psychologists to focus specifically on staff. It tells me that it is not feasible, in the long term, to ask psychologists to work with patients in their work time and then to work with NHS staff in their spare time to meet psychological needs. The society would like to see more use of psychologists not just in supporting patients, but in a strategy to support staff over the long term.

My hon. Friend the Member for Midlothian (Owen Thompson) will be covering in depth the work of the Scottish Government in relation to mental health strategies during the pandemic, so I will focus on the issues that have been raised with me in my capacity as chair of the all-party parliamentary health group and the all-party parliamentary group on psychology.

These are some of the questions that I have been asked to raise with the Minister. What steps is the Department of Health and Social Care taking to model and plan for demand for mental health support as a result of coronavirus and the consequent impact on the economy and employment? What additional funding will be made available to mental health providers to ensure that services are covid-19 safe and that they can meet increased demand for support and deliver on existing pledges in the NHS long-term plan for mental health? What resources will be made available for local initiatives that provide early mental health support in our communities, especially for those people who have been bereaved? What proportion of schoolchildren will benefit from the wellbeing for education return funding? How will children’s mental health be supported moving forward?

What resources will be made available to support health and care staff in the NHS, social care and voluntary sectors who are experiencing post-traumatic stress disorder, high levels of psychological distress or burnout? What specialist support will be made available? What resources will be made available to ensure that research and funding are provided for those working in social care settings so that we adequately address their mental health needs alongside the NHS staff population?

What plans are being put in place to protect NHS staff from a potential onslaught of claims against them because of the pressures that they have worked under during the pandemic? That may give rise to a number of negligence suits in the future. That issue has particularly been raised by the Medical Defence Union, which is concerned that staff have often been placed on the frontline with a lack of resources and with a lack of support medically or clinically themselves.

Now is the time when I feel that I and other hon. Members should be responding in the main Chamber to a detailed statement from the Government about their proposals for mental health directly arising from the devastating impact and ongoing effect of covid-19. Such a statement could include ways in which the Government propose to protect and sustain the mental health and wellbeing of key workers and that will be distinctly and separately resourced, rather than relying on any money from pots designed for other purposes. I look forward to the Minister’s reply today. I hope, on behalf of the key workers for whom I have been given the privilege to speak, that she will tell us that the Government have set a date for the announcement of a properly and realistically resourced mental health strategy that will be both integral and central to the overall covid-19 recovery plan.

[Ian Paisley (in the Chair)]

I thought I was going to be calling Jim Shannon to speak today, but he is not here, as we know, so I call Owen Thompson.

--- Later in debate ---

[Dr Cameron]

Thank you, Ms McDonagh, and I thank everyone who has spoken. It is vital that we continue to raise awareness of mental health, particularly for frontline workers. Saturday is World Mental Health Day, so it is apt that we have spoken about the issues today. The fact that 2 million people have downloaded the Every Mind Matters app shows that the population are reaching out for mental health support, that mental health is at the front of their minds and that they want support to build their resilience.

It is absolutely correct to view mental health as a continuum, but something such as a pandemic can push people who were perhaps coping well previously towards the end of the continuum where they need additional support. Those supports have to be stepped and matched to their clinical needs. Some will have acute clinical needs, and others will be able to cope with the support of family and friends or colleagues, and in different ways. Support needs to be matched. We need to ensure, right across the UK, that best practice is shared; that people work together so that when something is rolled out, it works extremely well; and that there is dialogue and sharing for all staff in the NHS of the four nations.

Before I finish, I want to mention that next year—when we have events back, which I hope will be towards the summer—the all-party parliamentary health group will host awards for staff who have shown themselves to have supported others, whether patients or their communities. I would be so pleased if the Minister and the shadow Minister were able to attend. I can let them know about it well in advance.

I also want to bring up something that I wrote to the Prime Minister about, which I hope to hear about at some point in the near future and which can perhaps gain cross-party support. That is to have a national memorial for those who served on the frontline and lost their lives during this pandemic. I hope that is another discussion that can be taken forward from today.

I thank everyone who took part. I know it is late afternoon on a Thursday, but it is so vital to pay tribute to all those on the frontline who have been there to support our needs in this time of crisis. We must always be mindful of supporting their needs, too.

Question put and agreed to.

Resolved,

That this House has considered mental health support for frontline staff.

Coronavirus

Lisa Cameron Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

That is an incredibly important subject, as we need to make sure we get the screening available. It ties into the questions on testing, because prioritising testing for those about to have NHS procedures, be they diagnostic, such as screening, or an operation of some sort, is so important, for instance, in making sure that we tackle the backlog in cancer cases that inevitably built up. We are tackling that backlog and it is down by about half. I am happy to work with my hon. Friend and all others in this House to make sure that people get the early diagnosis of cancer that can so often be lifesaving.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP) [V]]

The Secretary of State will be aware of a recent survey which found that one third of children feel more anxious, sad and stressed now than before lockdown. The charity Action for Children has therefore asked the Government to prioritise children’s mental health in covid-19 recovery planning and provide adequate funding to meet this demand. Could he tell the House exactly what he has done about that and when we can expect him to announce a covid recovery mental health strategy?

[Matt Hancock]

This is an incredibly important subject, and I commend the hon. Lady for raising it and for her work on it, along with many Members across the House. We are putting more funding into mental health, and paediatric mental health in particular, to ensure that we tackle the inevitable consequences of the pandemic.

Covid-19 Update

Lisa Cameron Excerpts

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

If people go to a shop, then it will be mandatory from 24 July to wear a mask. If they go to a hospitality venue, then it will not.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP) [V]]

As chair of the all-party group on disability, I am concerned by results from the charity Scope, which has undertaken research showing that one in five adults with a disability has said they will not leave their house until a vaccine for covid is developed, while just 5% said they would feel safe when shielding is paused. What steps will the Secretary of State take to ensure that people with disabilities are protected, but also given confidence to resume their lives after lockdown so they do not slip further into social isolation and loneliness?

[Matt Hancock]

The hon. Lady raises an incredibly important point, and she has rightly raised this point before. It is so important, especially as we lift the shielding measures at the end of this month, that people who have been shielding have the confidence to know that we are able to lift those measures because the rate of transmission of this virus is so much lower now. It is safe—indeed, it is recommended—that they go out and about. Many charities, including many that we have funded through this crisis, are available to help and support people in these circumstances. She is right to keep raising this issue, and we must keep working on it.

Coronavirus Update

Lisa Cameron Excerpts

Tuesday 14th July 2020 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP) [V]]

[Inaudible.]

[Mr Deputy Speaker (Mr Nigel Evans)]

Lisa, we cannot hear you. We will come back to you at the end. We will try to sort out the technical problem.

--- Later in debate ---

[Mr Deputy Speaker]

We will try one more time to reach Dr Lisa Cameron.

[Dr Cameron [V]]

Thank you, Mr Deputy Speaker. As chair of the all-party parliamentary group for disability, I have been hearing concerns from those who may be exempt from wearing face masks but are fearful of being confronted because not all disabilities are visible. Will the Secretary of State join me in congratulating East Kilbride’s Hannah Kelsall on developing free “chase the rainbow” carry cards that explain this exemption? Ultimately, no one should ever be challenging vulnerable people outside. It takes a lot of courage for many to leave their homes, but these innovative cards are providing reassurance for many across my constituency and beyond.

[Matt Hancock]

It is very important that, as a society, we look out for the most vulnerable, especially through this epidemic. The initiative that the hon. Lady describes is just one way in which we can all support people who have particular circumstances, and it relates directly to the introduction of the mandatory use of face coverings in shops, because there are important exemptions. It is important that people are able to express that they have an exemption because of their medical condition requiring them not to wear a mask, so that they can still shop.

Coronavirus

Lisa Cameron Excerpts

Wednesday 17th June 2020 Commons Chamber

[Matt Hancock]

Co-trimoxazole is another the prospect that we are looking at, but I am afraid that, as with my answer to my right hon. Friend the Member for Wokingham (John Redwood), the timing has to be driven by the science. If we get success, when a result in which the clinicians have scientific confidence can be met, we will stick with the clinical trial methodology that leads to concrete results. Too many other places around the world have pulled clinical trials early because of promising results that have turned out not to be well founded.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP) [V]]

The Fawcett Society has completed an important report that addresses the mental health issues of women with disabilities during this pandemic. As chair of the all-party group on disability, I am particularly concerned that the report found anxiety and isolation in more than 50% of respondents. Will the Secretary of State increase funding to mental health providers, with a view to helping disabled people to access the specialist support that they so crucially need?

[Matt Hancock]

The hon. Lady asks an important question. We have been increasing funding to mental health services, which are an incredibly important part of the response. Our mental health services, certainly across England, the area for which I am responsible, have risen admirably to the extraordinary challenge presented by coronavirus and I pay tribute to their work.

Eating Disorders Awareness Week

Lisa Cameron Excerpts

Thursday 5th March 2020 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank the right hon. Member for Knowsley (Sir George Howarth) for introducing the debate, particularly in Eating Disorders Awareness Week, on such an important issue that is often overlooked because it is hidden. He was fastidious in detailing so many of the crucial aspects of eating disorders and how our popular culture impacts on so many. I think it will go on to affect more young people as it grows under the social media stresses and pressures put on them.

I was thinking back to when I first started to think about appearances, which was probably when I was in my mid-teens, but my daughter, aged 11, is already looking on Instagram and so aware of how she looks and how many friends she has on social media. Those are not what I would call actual friendships, but these days it is all about social perception, and the pressures and stresses we put on young people through social media, which remains largely unregulated, are astronomical. We are creating a mental health catastrophe that is coming down the line for our young people. It will impact on men, who are not immune, but it impacts significantly on young women. I see that in young children of primary school age: my daughter and her friends very much relate to pictures of one another online and how they look. A societal image of perfectionism is being created that is very unhealthy for people’s mental health.

Eating Disorders Awareness Week is running this month, raising awareness of a disorder that, as has been said, affects 1.25 million people across the UK. When I worked as a psychologist in mental health services, I was aware how even then it was not a key focus in our training. Mental health professionals could benefit from much more in-depth training in eating disorders. When I was at Glasgow University, we benefited from the psychologist who came to train us having a specialist interest in the area. He is long retired and I do not know if anyone has taken his place, but training was very much dependent on individuals who had developed specialist expertise coming and lending that expertise, because those in training may not meet or have clinical experience of treating people with eating disorders unless they go on to do a specialist placement. Many of the professionals we are bringing through across the United Kingdom will not necessarily feel that they have sufficient expertise to treat eating disorders. We need to address that, particularly because, as has been said, it is not the kind of difficulty where people often come forward and say, “I have an eating disorder.” Clinicians, trying to form a picture on presentation of someone who might come with a diagnosis of depression or trauma, may notice a larger clinical picture not in the referral, but they require that expertise to pick up those symptoms early on. We know that earlier intervention creates a much better outcome for those with these conditions.

The other important issue I want to bring up is the Dump the Scales campaign, which I looked at while other hon. Members were talking. There may be more obvious signs of weight loss in individuals who present with anorexia, but those with bulimia are often bingeing and then purging, so there may not be noticeable weight loss. Such disorders can become extremely chronic before anyone picks up the symptoms. Certainly, one symptom of the disorders is denial and attributing difficulties elsewhere.

Dump the Scales is important, because my understanding is that BMI has to be at a certain level for a referral. We need to move on from that in clinical practice and look much more widely. I have just looked up the criteria in ICD-10 and, while they may have moved on, there are a number of symptoms and BMI is one of them. That needs to be considered, because, as I said, the person is not likely to come with a presentation of eating disorders in the first place and then, if some of the clinical symptoms are so stark that they cannot be referred on to appropriate services so quickly, that creates another barrier to getting the treatment they so desperately need.

Family support is another matter that we often overlook but need to focus on. We really need to get family members on board in order to have holistic treatment, particularly for young people’s mental health. It would be helpful to know more about what is being done in relation to family systems therapy and family therapy.

I was trained in the cognitive behavioural therapy model when I was practising, but it was very much a formulation-based model. I do not think eight sessions of CBT would necessarily be effective for people who have a long-standing chronic illness or perhaps other underlying issues such as trauma that need to be resolved. We need a flexible system to ensure that a person’s care pathway is at the level of service they need for the chronicity of their difficulties.

It has not passed me by that it is International Women’s Day this week, so it is apt to have this debate on eating disorders awareness, which an issue that is likely to affect so many young people—overwhelmingly women, but also men—who face this social pressure.

I will finish with a few things that the Scottish Government are trying to do. This is an area where we should share best practice and have much collaboration across the UK, and I would like to see that and be part of it. It is excellent for the way forward that an all-party parliamentary group has been reconstituted.

Last year, the Scottish Government created an online peer support tool specifically for this issue to allow young people to pair with a trained volunteer, who had themselves recovered from an eating disorder. That is important because peer-to-peer support can be extremely helpful, particularly for young people. At certain stages in life we may speak to our parents more or less readily, depending upon our stage of development, and for adolescents, among whom a higher percentage of eating disorders initially develop, peer-to-peer support will provide an excellent starting point for treatment.

The website caredscotland.co.uk is an information platform for parents and carers. We must ensure that parents and carers, who are, most often, going to be the ones who pick up the initial signs, have awareness, as well as the support they need. It is vital that parents and carers have that support because dealing with an eating disorder can take an enormous emotional toll upon an entire family. We need to look at people’s mental health in a holistic manner.

We need to do much more, right across the United Kingdom, in relation to access to treatment for those who have eating disorders. We have come some way, but we need to raise more awareness at different levels within the system. GP training has been mentioned. We also need a public awareness campaign, because often peers or families pick up the initial symptoms, and medical training for psychiatrists and those working in mental health. From my own training, I do not think those professionals have the level of training necessary to treat people in primary mental health care, which is often where an eating disorder might be picked up initially before it is referred on to secondary community mental health teams.

[Jim Shannon]

I am thinking about the dangers of social media and how it affects children and young people. Could the dangers of social media be made clear at an early stage, perhaps at school? The perfect body, clothes, hair and everything become things everyone wants, whereas the reality of getting them is quite different. For instance, in some photographs, models’ six packs or their weight are actually changed digitally. Social media has a lot to answer for.

[Dr Cameron]

The hon. Gentleman is entirely correct. Social media often creates a false world that none of us can ever live up to. That is why I welcome the Government’s work on social media, which is looking at potential regulation and other issues in relation to the impact on mental health.

This is an excellent pivotal debate, but it is not the finishing point. It is most definitely the starting point for taking these issues forward on a cross-party basis. I look forward to working with everyone who has an interest in this field, to support progress for those who have eating disorders across the United Kingdom.

--- Later in debate ---

[Ms Dorries]

That is incredibly interesting. I had not heard about it, but I am sure that my officials will take note of it. We have an open door for anything that we can identify that helps us in targeting and providing services. We are looking for solutions to the problem. As I said, the money is there. Claire Murdoch, who I mention in almost every debate, and Professor Tim Kendall are rolling out mental health services across the country via NHS England. They have probably heard of it and are probably looking at it, but I am sure that we will take note and check if that is the case.

Although eating disorders are commonly first experienced by people when they are young, they can continue into adulthood. Following a report on how NHS eating disorder services were failing patients, NHS England convened a working group with Health Education England, the Department of Health and Social Care and other partners, which goes to the point that my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) made. We are working in collaboration to address the report’s recommendations and to take them into account when planning for improvements to adult eating disorder services. Work is in progress on that.

We are continuing the investment in mental health services through the NHS long-term plan, as I think most people know. The £2.3 billion is with NHS England, which has a long-term plan to deliver on mental health and is moving at incredible pace. Even today, although it is not relevant to the debate, it announced the opening of gambling clinics across the UK. Community services are being rolled out across the UK so that people in mental health crises do not end up in casualty. It is an incredibly impressive roll-out of mental health services across the UK, including for eating disorders.[Official Report, 5 March 2020, Vol. 673, c. 12MC.]

That long-term plan will give an additional 345,000 children access to mental health support; 380,000 adults access to psychological therapies; and 370,000 adults access to better support for severe mental illness by 2023-24. It commits to the delivery of eating disorder waiting time standards, which I have already spoken about, and I hope that we will reach those before the end of next year. The plan has also committed to the design and roll-out of a new integrated model of adult community mental health care.

To increase further the number of people seeking treatment for their eating disorder, the Government recognise that raising awareness and reducing stigma are incredibly important. Here I should come on to a few of the points made by the right hon. Member for Knowsley. I shall go through them backwards, because that will be more positive in terms of affirmative answers. He mentioned social media providers, their role in body image and the impact that they have on young women. My right hon. Friend the Secretary of State for Health and Social Care has already—this happened recently—held a roundtable with social media providers. It was an incredibly positive meeting, but that is something that needs to continue, because when it comes to social media interactors, providers and platforms need to be aware of the impact that their forums have on young women, so we are continuing that dialogue with them and, I hope, are continuing to push that point.

The right hon. Gentleman made a point about the entertainment industry and its relationship and responsibilities with regard to body image. I announced two weeks ago that I am holding a roundtable with the entertainment industry. That was as a result of the death of Caroline Flack, who took her own life. For me, that was a watershed moment. It is time for the entertainment industry to be aware that it does not have a duty of care only to the people who they take on a contract to work with them. This is not just about sudden fame and reputation loss. The industry has a wider responsibility in relation to images that it projects and how it projects them, because young women and, indeed, many people absolutely are influenced by what they see—their perceived role models—through the lens of television or the cinema. The entertainment industry definitely has a responsibility, so in response to the right hon. Gentleman’s question, I can say that I have already put that in train.

In relation to a review of the long-term effectiveness of CBT, I defer to the expertise and knowledge of our friend from the Scottish National party, the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who made the point that short-term CBT may not be as effective, in terms of how it is delivered, for such long-term conditions. It may be part of the treatment, but as we know, when it comes to eating disorders, treatment is very prolonged in some cases. I am sure that CBT has a definite role, but it should not be seen in isolation. Management of eating disorders takes the input of physicians and psychologists—people who are expert in managing these conditions and working in this field. Therefore I would say yes, but not in isolation.

[Dr Cameron]

I thank the Minister for making that point. I think that there should very much be a formulation-driven treatment plan whereby all the issues that the person presents with are taken on board, and different aspects may require different parts of treatment. I do not think that often happens currently, particularly where people present to primary care services and perhaps do not get the specialist services that they need, but I hope the work that is being done will streamline that for the majority of people in the future.

[Ms Dorries]

I am sure that Claire Murdoch and Tim Kendall at NHS England are all over that and very aware of that. A streamlining approach to treatment is about getting people seen within the first week. If people are first seen within the first week when they present with their first crisis, that is the time when greater intervention can happen and when that treatment plan can be designed and put in place and there can be that entire care pathway through. I will not say that I think that that would shorten the illness, because I do not know. The hon. Lady probably knows more than I do, but I would think that an effective treatment plan with CBT and everything that is involved in that would provide a better outcome than piecemeal interventions along the way.

The right hon. Gentleman’s first point was careful consideration of Beat and so on. I am a huge admirer of Beat. It provides an incredible service. Its helpline deals with 30,000 people a year, I think, if I am not mistaken—it is a few weeks since I saw Beat. The support service that it provides, particularly to young women who are looking for someone to talk to and advice and help, is second to none. We are absolute supporters of Beat.

Let me just go on to the point made by my hon. Friend the Member for Broxbourne (Sir Charles Walker) about diabulimia. It is also of course the point that the right hon. Member for Knowsley raised repeatedly. We are absolutely committed to ensuring that people with diabulimia receive the treatment that they need. That is why NHS England announced in February 2019 the piloting of services. The services are being piloted on the south coast and in London, and NHS England will evaluate and monitor the pilots and take the learning from them. I will raise what the results show, if the results are through yet from the pilots, and what learning there has been and how it will apply across the UK.[Official Report, 19 March 2020, Vol. 673, c. 13MC.] I am sure that the officials will take a note, and when I have had that meeting, I will report back to the right hon. Gentleman and let him know exactly what the findings are and where we are going on that. The group that we are talking about is very small, but it is at the extreme end and requires very serious consideration.

I think that those are all the points that were raised and that I need to answer.