Women’s Health Strategy

Debate between Lisa Cameron and Nadine Dorries

Monday 8th March 2021 Commons Chamber

[Ms Dorries]

My right hon. Friend is a huge champion for women’s rights and a Committee Chair. I would ask her, following the work that was undertaken by the all-party parliamentary group on women’s health, to contact anybody that she knows who can help to get this dealt with or who she has liaised with throughout her time as Chair of the Women and Equalities Committee, so that they can help to get this message out to the people who they know, to encourage women everywhere—and, as I said, not just women but families and anybody who wants to contribute.

Within the first minutes of the link going live this morning, we instantly had 300 responses. I have not checked what the figure is now. We need huge numbers of women and yes, absolutely, it is not just about the usual issues that get talked about, although they are an important part of this. Menopause, menstrual health, maternity and neonatal issues are the things we talk about frequently, but this will be about everything. For example, we know that drugs that are used on women are trialled and developed using all-male cohorts, and that doctors are taught in medical school to recognise symptoms that are taken from men and not applied to women. We know about the inequalities, and we need to know about any subject from disability to mental health; anything that a woman experiences in a healthcare setting, we need to know about it.

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

I welcome the Minister’s statement, which is timely on International Women’s Day. I also refer the House to my entry in the Register of Members’ Financial Interests. A gender health gap has arisen during covid-19, and the Scottish Government are also developing a plan to address women’s health inequalities. Research indicates that young women in particular have been found to have increasing anxiety, depression, suicidal ideation and loneliness. With coping strategies and social support diminished, eating disorders are tragically on the rise with high levels of morbidity. Young women disproportionately struggle to be referred for treatment due to an antiquated medical model based on body mass index to identify eating disorders rather than on a psychological model, treating the whole person. Will the Minister work with the all-party group for eating disorders and cross-party parliamentarians who want urgently to address this matter via the funding announced, but also to ensure the timely access to treatments for those crying out for help and a diagnosis, saving the lives of young women, and, in many cases, those of young men, too.

[Ms Dorries]

I thank the hon. Lady for her question. In fact, we met recently to discuss this very subject, and I have also had meetings with a number of Members from across the House who have an interest in this area. I also thank her for the work that she does in this area. I think that, as a result of our private conversations, she understands both my commitment and that of the Government. I know that she is aware of the funding that we have allocated to assist with this surge of eating disorders that have presented of late and of our commitment in the long-term plan to assist young women with both mental health issues and eating disorders in particular. An eating disorder is the most deadly of all mental health illnesses and also one of the most difficult to treat. I am delighted to hear that this issue is being taken seriously in the devolved nations as well and that Scotland is also embarking on a similar path. I hope that, as we do on all issues related to health, we and the devolved nations will share data and the methods of collecting it, experience and the evidence to develop a women’s health strategy, which will one day be rolled out across the UK.[Official Report, 12 March 2021, Vol. 690, c. 5MC.]

Eating Disorders Awareness Week

Debate between Lisa Cameron and Nadine Dorries

Thursday 5th March 2020 Westminster Hall

[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.

Children’s Mental Health Week

Debate between Lisa Cameron and Nadine Dorries

Thursday 6th February 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

It is a pleasure to respond to the excellent speech by the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill), and I thank her for securing this important debate. I also thank the Members who made interventions, to which I will respond, with your permission, Mr Deputy Speaker.

I do not recognise some of the scenarios that the hon. Lady described. I have not read her article, but if she would like to give me a hard copy, I would be delighted to read it. She is obviously passionate about this subject. I have been in the House all morning, but I have had time to glance at the Children’s Society report that was published today. I was delighted to see that the Children’s Society highlights that the Government have made huge efforts to tackle mental health stigma through tireless work with schools and the Every Mind Matters campaign, which has reached 1.3 million people countrywide.

I am pleased that this debate is occurring during Children’s Mental Health Week. Today is also Time to Talk Day, which encourages everyone to be more open about their mental health in an effort to end mental health discrimination. It is going to be difficult to achieve parity of esteem between mental and physical health until we can completely eradicate the discrimination associated with mental health.

Our most recent data shows that one in eight five to 19-year-olds has a mental disorder. When it comes to young women and girls, the data is even more striking. Young women and girls are more at risk of self-harm, with about three times as many young women and girls aged 10 to 19 self-harming compared with men. The suicide rate for women and girls between the ages of 10 and 24 is at its highest on record, and it has nearly doubled since 2012. So I am with the hon. Lady on her concern about mental health and young people, and I am particularly concerned about the mental health of young women.

Those figures are heartbreaking. However, as the recent Children’s Commissioner’s report highlights, there have been major improvements to children and young people’s mental health care in recent years. I think it is important that we accept that. We need to get to that place so we can look forward to where we take these improvements.

I would like to mention Claire Murdoch, who is the clinical lead in NHS England responsible for the delivery of mental health programmes, as highlighted in the long-term plan. Claire described this to me yesterday as a bath that had been left empty for a very long time which suddenly had had the funding taps switched on—but we cannot fill the bath from empty to full immediately. The bath is filling, and it is filling with the £2.3 billion that this Government have committed to mental health. Just to put that into perspective, that is over half of the entire prisons estate budget. That is how serious our commitment is to addressing parity of esteem and mental health, particularly the mental health of children and young people. We will continue to drive forward this progress to ensure that every child can access the high-quality mental health care that they deserve.

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

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

Funding for mental health has increased right across the United Kingdom from when I first started in the field. However, we are really trying to raise awareness at the same time, and the more we raise awareness, the more we increase the demand. Increasing awareness and demand is a good thing, but we need many more psychologists to be working in the field alongside the psychiatrists to meet the demand.

--- Later in debate ---

[Ms Dorries]

One of our announcements has been to launch the trailblazer schemes, which we are hoping to have in 25% of schools by 2024. I do understand the problem in the hon. Lady’s area. I recently spoke to a headmaster at a school in Birmingham, and he told me that a third of the pupils in his school were receiving pastoral care or mental healthcare, and the reason was that a third of his children came from chaotic homes where either one or both parents were addicted to gambling, drugs or alcohol. As a consequence of having a third of the school roll in this situation, the school had serious problems with the children in the school.

So in some areas the challenges are very difficult. The hon. Lady said that we cannot just throw money at this, but the money has to fund the services—that is where it has to start, and then the workforce have to come.

The trailblazer schemes are doing incredibly well. I went to see one in Hounslow recently. We have committed to having 50,000 more nurses and are trying to train more mental health nurses, and we are having great success in getting people through universities and through the right courses and into schools. The school I visited in Hounslow, where the mental health workers were working for the children, was incredible to see. I spoke to a large group of the children who are receiving mental health support during the day, and they told me that they are being taught coping strategies. One young boy, whose name I will not mention, said to me that he suffers from anxiety—he gets anxious—and they have put an app on his phone so he has his time to be anxious and panic. His app time is at six o’clock, and he will go on to his phone and use his app.

There are so many aspects to the care being provided in school. There is early intervention, spotting mental health problems as they begin very early on. They could spot eating disorders almost as soon as they were arising in young girls. There are also issues such as anxiety and depression, and others that may not wholly be mental health-related but where the presentation of the problem was a mental health issue.

We are hoping to have 25% of schools across the UK covered by 2024, but, as I said, the bath was empty, so when we turn the tap it cannot fill straight away. The work has started. The people are being trained; they are being rolled out in schools right now, as we speak. I can say that early intervention, having seen it at work myself, is working. That was reassuring, because 18 months ago there were none of those teams in schools; there was no early intervention in any school anywhere. So the fact that we are watching these teams roll out into schools is incredibly reassuring.

On eating disorders—I will work my way through my speech, just to make sure I cover every aspect—more young people are getting the treatment they need. There has been a significant improvement in treating times in NHS care. An extra £30 million is being invested every year into children’s eating disorder services and there are 70 new or expanded community-based teams covering the whole country. Nationally, we are on track to meet the target of 95% of children and young people with an eating disorder accessing treatment, with a one-week referral for urgent cases and four weeks for routine cases.

I went to an eating disorder unit a week last Friday and met some of the young women there. It was fantastic to see the work being done. Once the young women go in, they have to stay in for quite some time. I am not sure that many people realise that an eating disorder is the deadliest mental health condition. One in four young women die from their eating disorder. It is the only mental health condition where the person suffering from it is scared of getting better. It therefore presents an incredible challenge to the mental health professionals who are working with those young girls. I saw the new eating disorder unit up and running, the work it was doing to turn the young women around and the investment that has gone in. The unit is managing to turn those young women around in a shorter time; it is just fantastic to see.

While recognising that we are still filling the bath and that there is more to do, what I really want to do is celebrate—I do not think that the hon. Lady will blame me for doing so—the good work being done by NHS professionals, including doctors, mental health nurses and those coming out of universities, to work on our trailblazer schemes in schools with young people. I want to celebrate their achievements. I am also very pleased that, after years of under-investment, NHS funding for children and young people’s mental health service is now rising and will continue to rise as we work towards the goals set out in the long-term plan. Funding for mental health services will grow faster overall in the NHS budget, in real terms worth at least £2.3 billion. The funding for children will grow faster than the funding for mental health care, which will grow faster than the overall NHS budget. This transformative investment will mean that by 2023-24 an extra—this is an important figure—345,000 children and young people from nought to 25 will receive mental health support every year.

Of course, some children will unfortunately experience a mental health crisis and will need rapid mental health support. I, like others across the House, am pleased with the strong focus on crisis care in the NHS long-term plan, which sets out investment of about £250 million in crisis care. I am not sure who mentioned A&E and hospitals; maybe it was the hon. Lady. We now have, in almost all A&Es across the country—I think it is 97%—a mental health liaison worker.[Official Report, 12 February 2020, Vol. 671, c. 9MC.] When somebody—a child or an adult—presents at A&E with a mental health condition, they are now seen by an A&E mental health liaison officer.

I am aware, however, that there is also a need to provide more support in the community, and to encourage early intervention and prevention. In fact, most of the £2.3 billion that has been allocated to mental health is for community services. Tim Kendall, NHS England’s national clinical director for mental health, says that no mental health service is ever better provided in a hospital than it can be provided in a community, except for the most serious cases. That is why we are delivering a new school and college-based service to help children and young people, staffed by a new workforce, through our children and young people’s Green Paper on mental health. It is about encouraging partnership working between services, and bringing together health and education to provide early intervention mental health support for children.

[Dr Cameron]

The Minister is being extremely generous in giving way. There is a lot of good work being done, as she has underlined, but one of the gaps—this is often raised by Members across the House—is autism diagnosis and intervention at an early stage, so that children get the support they need with the least detriment to their learning, development and education. She may not be able to respond today, but perhaps she could let me know about that at some point.

[Ms Dorries]

It would not be appropriate for me to respond to that because autism is not in my brief as a Minister. That comes under the Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), but I will make sure that the hon. Member gets a response to that question.

To turn to the children and young people’s mental health Green Paper, every school will be encouraged to have a senior lead for mental health as well as access to mental health support teams, which are the trailblazer schemes.