Mental and Physical Health: Parity of Esteem

Lord Bragg Excerpts

Thursday 10th October 2013 Lords Chamber

[Lord Bragg (Lab)]

My Lords, I, too, thank my noble friend Lord Layard for securing this important debate and for his comprehensive and definitive speech, one of many erudite and moving contributions. Mental health—or, rather, its opposite—is a subject that impinged on me personally and crucially, some years ago. It was partly for that reason that I joined Mind and eventually became its president for 15 years. I handed over to Stephen Fry a year or so ago. I have talked to my friend, Paul Farmer, Mind’s chief executive, about this debate.

The bleak statistics have been set out clearly by many of your Lordships. The list of lacks is long. Six million adults suffer from different forms of depression; the cost of poor treatment is pain, distress and, we are told, £60 billion. As we have heard eloquently and graphically today, the injustice is intolerable, the neglect is shameful and the effects are often disastrous and on many levels.

The cleverness of this proposal, in my view, lies in the phrase “parity of esteem”. That is key; it opens up several doors, some of which lead to better prospects than others. We all agree that this parity must be based on parity of treatment with physical illness, as has been well said again and again. Progress depends on investment, but it also depends on something just as important, which is a fundamental change of attitude and the will to bring it about. The ancient stigma is dissolving, but very slowly, and is still, I suggest, however unconsciously, the major impediment to the parity that my noble friend Lord Layard seeks.

In terms of investment there is a deep problem; perhaps that is the elephant in the Chamber. We have an outstandingly good health service. I experienced it recently through myself, my family and two of my friends over the past 18 months, in the north-west of England, in Edinburgh and here in London. In every case we met high skills, courtesy and care—and still free, as Bevan intended. It is an amazing asset and a flagship for this country’s decency.

Today, however, this is accompanied in general terms by a rarely and uneasily articulated, yet growing, fear that this noble ideal—this vow in our country to deliver such a service, from however difficult a childbirth to however lingering a death—is now under serious threat, failing, falling and going. The extensive and inclusive nature of our health service is both its greatness and, in some people’s view, is proving to be its weakness. From the latest intricate and expensive surgery to looking after dumb Saturday night drunks; from the increasing flood of the complex ailments of old age to cosmetic surgery; and from dialysis to a small bruise, it serves a multiplying range of complaints and demands. As the needs increase, can we continue to afford it? Do Governments want to afford it? We read about subtraction, but rarely about additions: cutting is the sound of the day.

In that context I suggest that at present, sadly, mental health is low down on the list of priorities. It is a very demanding aspect of national health and of the utmost concern to all of us here, as it should be to everyone in the country. All of us here are trying to improve the position of those afflicted, at whatever level. Although we must keep up the pressure, it seems that we cannot merely reach out to the Treasury. We have to find other ways, if only as interim measures.

The direction to which my noble friend Lord Layard points us is as much in the human as in the economic sphere. Mind’s steady encouragement of people in the public eye to admit to mental health problems is one useful method. I did so myself when I became president of Mind 17 years ago; the public reaction was one of overwhelming relief. “I found that I was not alone”, people said, again and again. Too many people still are alone.

Next to increased investment, one of the best ways to meet this challenge is to find parity in the workplace, which gives people esteem in the eyes of others and of themselves. The knock-on effects are extremely encouraging. This has already been tried and encouraged by Mind. I will give one example. As part of Mind’s employee support programme, EDF offered psychological support—cognitive behavioural therapy—to employees and trained more than a thousand managers to recognise mental health problems among staff and develop support strategies. Job satisfaction has already, over a couple of years, risen from 36% to 68%. There also have been marked savings through increased productivity and increased profits. All this is a reason for some optimism this afternoon.

This programme could be developed further and would benefit from a higher profile. Does the Civil Service, do local authorities and do we here in Parliament take on and help people in the workplace with mental health problems in that way? Could we introduce legislation to move that along? It could help, and would be widely welcomed as a positive move; it could set an example. Could we not find a way to develop that?

In short, we need more money, more understanding and more resources. However, we also need more attempts to integrate people into the workforce and to educate those more privileged in health to understand and throw out a new lifeline. Parity of esteem might come most surely of all from friends at work and the respect gained by working with other people. I believe that many people in this country are ready to support that.