Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 29th October 2019 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (LD)]

People outside the House will have listened to the Minister’s warm words, yet we know that still far too many people right across our country are having to travel hundreds of miles to access services. Young people having to travel 300 miles to get a bed is unacceptable. Will the Minister tell us whether the investment she outlined will be ring fenced, because it has not been thus far? Will she also be investing specifically in young people’s mental health services?

[Ms Dorries]

That is a big question because it covers two areas. This Government have invested £2.3 billion in mental health services, a huge amount of which is to go into salaries, to deliver community health services where they are needed: close to patients and to their relatives and families. It is also to provide community health teams and support teams in schools for young people. Clinical commissioning groups are under an obligation to provide those mental health services with the set funding. If the hon. Lady would like to meet to hear more about that, I will be happy to discuss it with her.

The National Health Service

Luciana Berger Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

We are absolutely acting on the area that the hon. Lady quite rightly raises. The number of patients who are in in-patient facilities who have learning disabilities and/or autism has been falling—the number has fallen from 2,700 a couple of years ago to 2,250 on the latest figures. We have a plan to reduce that number further. We must ensure that everybody who comes out of in-patient facilities has the proper care plan and the community support to ensure that that is a sustained change in circumstance. It is something on which we are working incredibly hard. In fact, I was having a meeting with the Minister for Care only yesterday on precisely this issue, and I am very happy to ensure that the hon. Lady gets a full briefing on what we are doing.

[Luciana Berger (Liverpool, Wavertree) (LD)]

rose—

[Mr Speaker]

Order. Before the Secretary of State takes the intervention from the hon. Member for Liverpool, Wavertree (Luciana Berger), I simply make the point that 35 hon. Members wish to speak, and therefore I think I can say with great confidence that he is approaching his peroration.

[Luciana Berger]

I thank the Secretary of State for very kindly giving way, and I welcome the fact that he will be taking forward into legislation the recommendations of the independent review into the Mental Health Act. Will that be accompanied by Sir Simon Wessely’s recommendation that the sector needs £800 million of capital infrastructure to bring mental health settings up to the same standards as those of physical healthcare?

[Matt Hancock]

I want to pay tribute to the work that Sir Simon has done in bringing this matter forward. We are absolutely looking at the capital requirements, as well as the requirements for revenue funding, which have gone up in this area. We will be publishing a White Paper by the end of the year, and then we will bring forward the new mental health Bill as a draft Bill. Mental health is a priority for the Government. These reforms need to be done with care, and I hope again with consensus. The timetable for reform is that requested by the mental health community, but Members should make no mistake, we will act. I am very happy to talk to the hon. Lady with more details.

I do not think that I have ever taken more interventions in a speech, Mr Speaker, and I am now happily coming to my conclusion. This Queen’s Speech has health and social care at its heart. The reforms will help to improve the delivery of the NHS and to bring new cutting-edge treatments to work. They will make sure that our world-beating life sciences are supported; that we have a safer NHS, where we always seek to learn and to improve; that we have a permanent solution for social care, not just a short-term fix and dignity; and that we have dignity and support for everyone receiving mental health care as we put record funding into mental health services. All that will be properly funded, because we have turned the economy round—without a strong economy, we just cannot properly fund the NHS. Today’s debate has shown why we Conservatives are now regarded as the true party of the NHS and we will make sure that it is always there for generations to come up.

Debate interrupted.

Health Visitors (England)

Luciana Berger Excerpts

Wednesday 23rd October 2019 Westminster Hall

[Tim Loughton (East Worthing and Shoreham) (Con)]

I beg to move,

That this House has considered the reduction in the number of health visitors in England.

I am grateful to the hon. Members who have come to speak on this important subject. I declare an interest as the chair of the all-party parliamentary group for conception to age two—the first 1,001 days. I also chair the board of trustees of the Parent-Infant Foundation, which runs attachment facilities and lobbies for better early intervention around the country.

I will start with some slightly alarming statistics. The cost of perinatal mental ill health in this country has been worked out at £8.1 billion per annum, according to the Maternal Mental Health Alliance, with up to 20% of women experiencing some form of mental health problem during pregnancy or the first 12 months after birth. The cost of child neglect in this country has been estimated at some £15 billion, with 50% of all maltreatment-related deaths and serious injuries occurring to infants and babies under the age of one. We currently spend in excess of £23 billion getting it wrong in those early years, particularly for mums and new babies. That is equivalent to something like half the defence budget.

There are 122,000 babies under the age of one living with a parent who has some form of mental health problem. Amazingly—this statistic came out time and again during conversations on the Domestic Abuse Bill—a third of domestic violence begins during pregnancy, and suicide is one of the leading causes of death for women during pregnancy or in the year after giving birth. About 40% of children in the United Kingdom have an insecure attachment to a parent or carer at the age of 12 months, according to Professor Peter Fonagy and others. Alarmingly, there is a 99% correlation between a teenager experiencing some form of mental illness or depression at the age of 15 or 16 and his or her mother having had some form of perinatal mental ill health during pregnancy. It is that close a correlation, making it that much more important that we make sure that the mums bearing those children, and also fathers, are as happy, settled and healthy as possible in those early stages, from conception to age two.

[Luciana Berger (Liverpool, Wavertree) (LD)]

The hon. Gentleman set out the costs incurred in trying to prevent such travesties. Does he agree that the figures he refers to are actually conservative estimates? I believe that he was at the launch, quite a number of years ago, of the Maternal Mental Health Alliance, which arrived at the figure of more than £8 billion. Is it not the case that, although the economic costs are significant, it is the social and moral reasons that have brought Members from both sides of the House here for this important debate?

[Tim Loughton]

If the hon. Lady is patient, I will come on to the social impacts. I think the MMHA report came out in 2014 or 2015, so obviously things will have moved on, although the birth rate has slightly fallen in that time as well. These are substantial financial figures, but as she says, most important are the social impacts and the impact on the child.

On the physical impacts, our childhood obesity rates are among the worst in Europe, while breastfeeding rates in the United Kingdom are among the lowest in the world. We have rising emergency department attendances by children under the age of five, and infant mortality reductions have recently stalled. Just last week, we had the worrying figures about the dwindling vaccination rates in England in particular, with only 86.4% of children having received a full dose of the MMR vaccine. We have effectively lost our immune status, because the World Health Organisation vaccination target to protect a population from a disease is 95%.

The Children’s Commissioner estimates that, in total, 2.3 million children live with risk because of a vulnerable family background, but that, within that group, more than a third are effectively invisible and not known to services and therefore do not get any support. We are talking about an expensive and widespread problem.

--- Later in debate ---

[Luciana Berger (Liverpool, Wavertree) (LD)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Bone. I congratulate the hon. Member for East Worthing and Shoreham (Tim Loughton) on securing this important debate and on his work with the all-party parliamentary group for conception to age two—the first 1,001 days.

I will start by paying tribute to the Institute of Health Visiting and, most importantly, to the army of health visitors themselves. I know what an important job they do from my own experience as a mum to a two-and-a-half-year-old and a seven-month-old. In particular, I put on record my thanks to Gill and Katie, who have helped me and my family. Health visitors do a brilliant job against a backdrop of falling numbers, growing caseloads and, in some cases, unconscionable pressures. In the wake of the cuts to public health, it is now clear that we have seen a steady diminution in health visitors across England.

As we have heard, since October 2015, the number of health visitors in England has reduced by a quarter from just over 10,000 to just under 8,000, which piles extra pressure on existing health visitors. Nearly a third of health visitors have case loads of more than 500, which is twice the safe level set by the Institute of Health Visiting. Unfortunately, that can only have a detrimental impact on the quality of care. At best, it risks health visitors being less helpful. At worst, it is counterproductive to their aims and goals.

Looking at a number of indicators, we see that there is mounting evidence that things are getting more challenging. The reductions in infant mortality have stalled. We have already heard about issues around breastfeeding, which is a subject that is particularly close to my heart. We now have some of the worst breastfeeding levels in Europe, and I say that as an MP in Liverpool, where so much work has gone on via our Babies and Mums Breastfeeding Information and Support—or BAMBIS—service to support and assist mums in their own homes. We have seen a great increase in the proportion of women breastfeeding in Liverpool, but levels countrywide are still far lower than they should be. We are facing an obesity crisis. Immunisation rates are falling. We have missed the target for measles and the UK has lost its measles-free status. We are living through a mental health crisis, and I reflect on the fact that the period of a woman’s life where she is 30 to 40 times more likely to experience a period of psychosis is the year after birth. That is the moment in her life where extra additional support is needed.

We see a particular challenge with adverse outcomes not being distributed evenly, which speaks to health inequalities. That issue falls far down the agenda and gets much less attention than it deserves, but we are seeing a widening of inequalities across the country. Poor health goes hand in hand with someone’s postcode, income, social status and what their parent or parents do for a living. The impact of inequality is keenly felt in too many areas, including in Liverpool and other disadvantaged neighbourhoods. Nearly 70% of health visitors have reported having to access emergency food aid and go to food banks on behalf of the families they are supporting. The Institute of Health Visiting stated in its report that those inequalities resulted in poorer physical and mental development, poorer academic achievement and poorer employment prospects at every stage of a child’s life.

We are talking about the most fundamental of issues: how can we ensure that every child born in this country has the best life outcomes and best life chances? Health visitors play such an important part in those outcomes and provide such a vital intervention in supporting new parents. The list of what they do goes on and on, and we have heard much about that already. They also play an important part in preventing ill health, rather than trying to cure it later. Health visitors play a critical role beyond health, whether that is supporting troubled families, improving early language development and learning at home, particularly where a child might have special educational needs, or improving parental confidence and knowledge to avoid unnecessary trips to our health service.

Health visitors should form part of a truly integrated system of health, care and wellbeing that is tailored to the parent and child, with the right interventions, advice and support at the right time. I reflect on that as a member of the Health and Social Care Select Committee on. We did a report called “First 1000 days of life”, in which the first priority was for every child to receive the five mandatory visits. In fact, we said that that number should be increased to six, with a visit at three or three and a half years old to ensure that every child is ready for school. We perhaps do not like to talk about that issue, but we are seeing increasing concern about it from teachers across the country.

I am conscious that my time is coming to an end, so I want to reflect on that recommendation from the Health and Social Care Committee. Health visitors play such an important role. They support families where others do not have the opportunity to do so. They enter people’s homes and they are trusted. When I think about all the health professionals I connected with as a new parent, it was my health visitor whom I relied on. We need to ensure that we are not creating the conditions for a public health crisis for future generations, and I hope that in the Minister’s response we will get some glimmers of hope that we will see an increase in the number of health visitors, not a further decrease.

The National Health Service

Luciana Berger Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (LD)]

It is a pleasure to follow the hon. Member for Hartlepool (Mike Hill) and I share a number of the assessments that he made in his contribution, because as the House pursues our debate on the Queen’s Speech, it is becoming ever more apparent that the casualty of a Tory Brexit will be Britain’s national health service.

The NHS is our greatest national asset; it is the product of the fusion of radical and enlightened minds in the last century that gave us healthcare for all based on need, not means. But now, in this century, the NHS is in great peril from a toxic combination of chronic underfunding and withdrawal from the EU, and responding to very different challenges from those when it was first created so long ago.

Notwithstanding the announcements in the Queen’s Speech, let us be very clear that the NHS is not in receipt of the resources that it needs to be effective. That was discussed only yesterday at the Health and Social Care Committee, when we had with us the Secretary of State and we talked about the backlog of £6 billion in NHS repairs alone, so an announcement of half that really is no cause for celebration. We heard from the Health Foundation, and its assessment of the Queen’s Speech funding announcement says that

“it falls well short of the scale of the challenge.”

We have a Prime Minister who announced 40 new hospitals, which then was downgraded to six within days, and we see demand for healthcare from our growing and ageing population outstripping the availability and quality of services, which means rationing and a diminution of quality of care; many right hon. and hon. Members from both sides of the House have referred to that in the debate this afternoon.

[Norman Lamb]

Does my hon. Friend agree that another sign of a system under unacceptable strain is the fact that teenagers around the country are often waiting a year or more for access to mental health treatment? I know of two teenagers who have recently had their first appointment after a year of waiting, which seems to me to be utterly intolerable.

[Luciana Berger]

I thank my right hon. Friend for making that really important contribution, and waiting times are a particular issue in our NHS, especially in the Cinderella of all Cinderella services, our CAMHS. Too many young people right across our country are struggling to get a referral and then, if they do get that referral, having to wait months on end. Frankly, it is unacceptable.

[Mike Gapes]

There is a further problem with teenagers when they reach the age of 18, because there is a gap between the CAMHS and adult services. Far too often, young people who have been given help when they are 16, 17 and 18 suddenly fall off the cliff and there is no support for them.

[Luciana Berger]

I thank my hon. Friend for making that important contribution. There is a cliff edge in our young people’s mental health services when they transition into adult mental health services. They have to start all over again and repeat themselves. There are a few places across the country that are creating mental health services for young people up to the age of 25, and that is welcome, but it is the exception rather than the rule. We need to do everything possible to ensure that young people have continuity of support in their mental health services at that fragile moment in their life, because not receiving that critical support can have a detrimental impact on their ability to access education, to maintain relationships with family and friends and to get into employment.

I am particularly concerned that we have seen a serious reduction in the state of our services in the past year. I refer to the Care Quality Commission’s “State of Care” report, which came out this month. It looked at acute wards for adults of working age, psychiatric intensive care units, child and adolescent mental health in-patient services and in-patient services for people with learning disabilities or autism, and it found a significant increase in the number of those services that are now rated inadequate. Those are services for some of the most vulnerable people in our country, and we should be improving them rather than seeing an increase in inadequate ratings from 2% to 8%, 9% or 10%. That is unacceptable, and I hope the Minister will address that serious point in his response. In particular, we know that this is as a result of too many of the people using mental health and learning disability services being looked after by staff who, according to the CQC,

“lack the skills, training, experience or support from clinical staff to care for people with complex needs.”

Again, I hope the Minister will respond to this important point.

This is not just about care for people with mental illness or disability. We are seeing that same story right across our NHS, with patients waiting far too long. We have heard significant figures, with millions of people across the country struggling to access services. They are also having to travel too far for the treatment they need, and too many areas still have too few staff and not enough resources. That is reflected in the 2019 British social attitudes survey, which shows overall satisfaction in our NHS falling by 3% in the last year to 53%. The main reasons given for that include long waiting times, staff shortages and a lack of funding.

Notwithstanding the announcements in the Queen’s Speech on patient safety and changes to mental health legislation, which I welcome, I want to reinforce the point I made to the Secretary of State that this is not just about changing the Mental Health Act and that we need to have the resources for the capital infrastructure to ensure that we raise the standard of mental health in-patient settings to the same standard as physical health in-patient settings, along the lines of the recommendations given by Sir Simon Wessely, who conducted that important review for the Government.

Let us be clear that the pressures on our NHS are urgent and that they demand action, before we even contemplate the existential threat to our NHS because of Brexit. I want to talk about Brexit, because we did not hear about it today from the Front Benches. We had a reference to it from the Secretary of State, but not an actual analysis of how Brexit will impact on the provision of our national health service. We know that the impact on our economy so far from Brexit has been between 1.5% and 2.5% of GDP since 2016, and by the Government’s own assessment, Brexit will impact on our GDP by up to 9.3% over the next 15 years. We are still waiting for those further economic impact assessments on the withdrawal Bill that we have seen in the past week.

We have already discussed the impact of Brexit on our NHS workforce. We know that 63,000 EU nationals work in our NHS and that 104,000 work in adult social care. We should be lining up to thank each and every one of them for the role they play and the contribution they make to our national health service, instead of making them feel like unwanted strangers. I am surely not the only MP who has received representations from people who are serving our NHS and social care service, who go above and beyond under incredible pressure to provide the best possible levels of care and who are feeling worried about what the future holds. They are particularly concerned about the Home Secretary’s proposed immigration rules and the damage that they will inflict on our ability to recruit doctors, nurses and social care workers from the EU and the rest of the world.

I could talk about the threat of access to medicines, the creation of a new medicines approval regime, which will lead to further delays, and the impact on medical research.

[Chris Ruane (Vale of Clwyd) (Lab)]

Will the hon. Lady give way?

[Luciana Berger]

Forgive me, but I only have 18 seconds, so I will not give way.

We should be addressing all that as a nation, and how we keep people well was missing from the Queen’s Speech. Other people have talked about prevention, and the lack of focus on public health in the Queen’s Speech is pitiful. We could be doing so much more, and I urge the Minister to refer to that in his response.

Mental Health First Aid in the Workplace

Luciana Berger Excerpts

Thursday 17th January 2019 Commons Chamber

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

I beg to move,

That this House notes that the UK is facing a mental health crisis; further notes that, according to the Independent Review into Mental Health in the Workplace 2017 commissioned by the Prime Minister, each year 300,000 people with long-term mental health conditions lose their job; recognises that Centre for Mental Health research shows presenteeism from mental health is estimated to cost the economy £15.1 billion per annum; acknowledges this same research shows it costs the economy £8.4 billion per annum for mental health absenteeism; considers that a recent poll by OnePoll found that 38 per cent of people reported being stressed about work; observes that the Health and Safety Act 1974 made it a legal necessity for workplaces to train someone in medical first aid; and calls on the Government to change this law via secondary legislation to provide clarity that an employer’s first aid responsibilities cover both physical and mental health and to add a requirement for workplaces to train mental health first aiders.

It really is a pleasure to speak in support of this motion, alongside its co-sponsors the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Plymouth, Moor View (Johnny Mercer). The application for this debate was supported by more 60 Members from all parts of the House, and we are very grateful to the Backbench Business Committee for allocating time for our discussion today.

Following the particularly challenging moments that this House has experienced over the last few days, today’s debate is a salutary reminder that the work of this Parliament goes on, and that we are capable of debating in a constructive and collegiate fashion. Our motion addresses a real and pressing need to support people affected by mental ill health. Our argument is simple. The Health and Safety at Work etc. Act 1974 ensured that every large workplace has someone trained in medical first aid, and that is now an accepted and established part of every office, factory, warehouse, hotel and anywhere else that people work; so why not a trained mental health first aider in every workplace? We want to change the Health and Safety Act via secondary legislation so that an employer’s responsibility explicitly covers the mental health as well as the physical health of their employees. This debate is a true cross-party initiative, calling on the Government to make a small change to the law that would constitute a step towards establishing parity of esteem—real equality between physical and mental health.

[Sir Greg Knight (East Yorkshire) (Con)]

This is an excellent motion. Does the hon. Lady agree that when workplace training on first aid—including mental health first aid—takes place outside the workplace, the employer should be required to give the employee time off during working hours to attend?

[Luciana Berger]

There are many different ways in which this could be implemented. I myself have attended mental health first aid training at the workplace, but I certainly would not be averse to employers giving their staff time off for such training. I will later come to many examples showing that this is already the case with a number of employers, particularly large employers, across the country.

This debate was born out of the “Where’s Your Head At?” campaign, which was launched by campaigner Natasha Devon and supported by Mental Health First Aid England and Bauer Media, which have together collected over 200,000 names on a petition that a number of us delivered to No. 10 Downing Street. I commend those organisations for all their hard work, and pay tribute to their commitment and determination to see this positive change introduced. It really is admirable. Bauer Media—an organisation with radio stations and a number of magazines, such as Grazia—has really taken the idea forward, paying for billboards across the country to promote the campaign. I commend its social action on a matter that, as an employer, it knows would make a difference in its own workplaces.

This really would be a simple shift, but one with a huge beneficial impact on the lives of millions of British workers. No one can seriously contend that there is not a need for such a measure. Hon. Members only have to look at some of the statistics. NHS Digital suggests that one in six adults experience mental ill health, including depression, anxiety and stress-related illnesses. There are around 28 million people in work in our country, so it is not unreasonable to assume that 5 million people in work today are affected. In a recent poll, 38% of people reported being stressed about work. It is a tragedy that, according to the Stevenson-Farmer “Thriving at Work” report—a review commissioned by the Government and published just over a year ago—some 300,000 people with a long-term mental health condition are losing their jobs every single year.

[Mary Creagh (Wakefield) (Lab)]

I congratulate my hon. Friend on securing this debate. She is making a powerful case and is describing an epidemic of mental ill health that has many different sources. The Environmental Audit Committee is looking into this as part of our planetary health inquiry. When I met my local Wakefield UK Youth Parliament, I was struck by how concerned the young people were about mental health in schools, and I discovered that South West Yorkshire Partnership NHS Foundation Trust has provided mental health first aid training in schools for teachers. Does my hon. Friend agree that that needs to be rolled out across all schools so that teachers or trusted adults in schools can deal with young people and children in crisis?

[Luciana Berger]

I thank my hon. Friend for her important intervention. Of course, today we are talking about what happens in the workplace, but what happens with young people in places of education is equally critical. I sit on the Health and Social Care Committee, and we have interrogated the Government’s plans for the next generation and young people. There are plans in place to have a designated mental health senior lead in every school, and we should ensure that at least one person has that training. We could be doing better than that, but at least it is a start. I support the idea, and it is great to hear what is happening in my hon. Friend’s constituency.

Let me be very clear that we are talking about a huge number of people affected in our country every single day—our friends, colleagues and workmates who surround us. There is, of course, a huge economic cost as well as a very significant human cost. The Centre for Mental Health estimates that people with mental health conditions staying at work longer than they should costs our economy over £15 billion every single year, and that people being absent from work because of mental ill health costs our economy £8 billion a year. These are not insignificant sums. I reiterate that 300,000 people with a long-term mental health condition are losing their jobs every single year because they find themselves in an acute state, have to leave work, are not supported and get to a critical state, rather than having experienced early intervention or prevention, which might have helped them in the first place.

The Health and Safety Executive says that 15.4 million working days were lost in the last year alone because of stress, depression and anxiety, and the British Association for Counselling and Psychotherapy—I declare an interest, as I was recently appointed one of its vice-presidents— has calculated that stress is costing British businesses £1,000 per employee per year in sick pay and associated costs. That is very significant for the national economy, and for individual organisations and businesses. I do not think I need to set out any more statistics to evidence the fact that there is a clear need. Mental illness is having a significant impact on millions of workers across the country and costing our economy billions of pounds.

[Dr David Drew (Stroud) (Lab/Co-op)]

My hon. Friend is making an excellent speech. As we have all heard in our constituency surgeries, one of the real costs is that people who suffer from mental illness find it very difficult to get back into employment because of the stigma, and I have to say that the public sector is among the worst at having a bias against people with mental health problems. Does she accept that?

[Luciana Berger]

I thank my hon. Friend for making that important point. I am going to move on to talk about tackling the stigma and discrimination that we know still exist in our country. We have made some progress in the national conversation about tackling mental ill health, particularly with the younger generations, but in too many workplaces and too many communities, there is still the discrimination and taboo connected with mental ill health. As a constituency MP, I see that almost weekly. Men of an older generation feel that they are able to talk to me because I campaign on this issue and am very open about it, but they are perhaps unable to speak to their work colleagues—sometimes not even to their close family—because of the discrimination that they feel still exists. We are certainly on a journey as a country.

One objection to this proposal might be that mental health requires highly specialist medical intervention, not someone in the workplace with only a few days’ training—and of course that is absolutely true. Mental health conditions do require specialist diagnosis and treatment. That is why many of us, on both sides of the House, have been calling for more investment in this area to ensure that we have the clinicians within our NHS to address the mental health crisis in this country. But let us be very clear that this motion, with this specific initiative, is not seeking to substitute mental professionals with mental health first aiders. Mental health first aid training gives people the knowledge, the skills and the confidence to intervene early if someone is struggling with their mental health. It is not in any way intended to be a replacement for trained mental health professionals, either in the NHS or in our workplaces; rather it offers an early warning system and an opportunity for employee support. It is also, in response to the point made by my hon. Friend the Member for Stroud (Dr Drew), aimed at tackling the taboo that we often see. Raising awareness of mental ill health and placing it on an equal footing with physical ill health tackles some of the stigma and discrimination that we still have to break down.

If any colleagues would like a clearer explanation, let me say this. All of us here present would know where to go for assistance if we had a physical injury. If we had perhaps slipped, or had a burn or a cut, we could go to the officers just down there through the Chamber. Perhaps, either in this place or in a previous role, we were that first aider. But how many colleagues, or their staff would know where to go if they were struggling with their mental health? How many would have known who that person was, or if they existed at all, in their previous job? Training people in our workplaces in mental health first aid would mean that employees in workplaces right across our country had an instant answer to that question.

No one should assume that a mental health first aider is the same as a mental health professional, any more than anyone assumes that a current workplace first aider is the same as a heart surgeon, an A&E doctor or a cancer specialist. The point is that a mental health first aider provides early intervention and a critical and important signpost. They would be able to answer questions about how and where to go to get treatment. They can help to change the culture in an office or on a shop floor so that someone with a mental illness has support. They can provoke a conversation about mental health that can break down some of the stigma and prejudice. They can be a valuable first point of contact for someone struggling with their mental health in what might otherwise feel like a very lonely environment.

We do not need to talk in purely hypothetical terms. At the end of last year, the Where’s Your Head At? campaign sent a letter to the Prime Minister in support of statutory mental health first aiders. It was supported by over 40 businesses, including WHSmith, Standard Chartered and Thames Water. I am particularly proud to say that a friend of mine and good Labour colleague, Sadiq Khan, the Mayor of London, has, in the capital, done so much on mental health first aid training at City Hall and in London’s schools as part of his public health strategy. St John’s Ambulance will have trained 10,000 people by the end of this last period. Mental Health First Aid England has now trained over 350,000 people in mental health first aid. Councils are investing in this and other providers are making similar strides forward. Those who have completed the training say it is hugely beneficial to them and their co-workers. It gives people the skills, knowledge, confidence and language to spot the signs of mental ill health, provide support and make early interventions. But most critically, it is helping the people affected. It really can make a difference.

One of the elements of the mental health first aid training that I completed was about what to do if someone you work with is experiencing suicidal ideation and might be considering taking their own life. Some 6,000 people in our country have taken their own life in the past year and this particularly impacts on young men. This is an area where quite often people do not know what to say or do, but training such as this, and training from the Zero Suicide Alliance, which offers a free online half-an-hour session, are the tools that can really make a difference. In some cases, it really is a life or death situation.

A number of unions have come out in support of the change to the law we are seeking to make today. Community, The Teacher’s Union and Unite were all signatories to the letter to the Prime Minister I just mentioned, and the Communications Workers Union and the GMB have since joined calls for this change to the law.

The costs of training—another question that is often raised—are very clearly outweighed by the benefits of better mental health in our workplaces. Training can typically take place over a number of days, but it can also take place over one day—or half a day, providing opportunities particularly for small businesses and organisations to train people in mental health first aid, too. The training that I did was with the Liverpool city region Mayor, Steve Rotheram, and the senior leadership of Merseytravel in Liverpool. I have half a day left to do, but I have done almost the whole course and seen what the benefits can be. So we do not need to gaze into a crystal ball. We can talk to people who have been trained. But again, in particular, we can reflect and engage with the people who have been helped.

I would like to share some of the thoughts of organisations that have gotten in touch in recent days to share their experience of training mental health first aiders, the value they place on this important initiative and why they are supporting our call today. The insurance company AXA has trained over 100 of its staff to become mental health first aiders, so now each of its UK offices has one. It has also trained as mental health first aiders the staff of the companies that it provides insurance to, helping other businesses across the country to improve mental health in their organisations.

Another success story is that of Thames Water, where 350 employees across the organisation are trained in mental health first aid. They wear green lanyards so that they can be easily identified by the wider workforce. A further 250 employees have joined the company’s mental health online engagement forum. Thames Water has calculated that there has been a 75% reduction in work-related stress, anxiety and depression among its employees—a not insignificant impact.

Colleagues may not know—I was certainly not aware of this—that the construction industry is the sector where workers are most affected by mental ill health. In response to that, the Construction Industry Training Board has now committed £500,000 to the Building Mental Health initiative, which will train 156 construction workers as mental health first aiders. Further to this, Mates in Mind is a fantastic charity that works to address the stigma around poor mental health and improve positive mental wellbeing in the UK construction industry. It aims to have reached 75% of the construction industry by 2025.

I give these examples as evidence to colleagues that a number of businesses across the country have been proactive in their approach to mental health and are reaping the rewards. There are many more I could have shared, but I am conscious that many Members want to contribute to the debate.

This is an idea whose time has come. In a decade from now, when mental health first aiders are an established part of the workplace, we will wonder why we did not start sooner. It is good to have the Minister here today. As I am sure she recognises, this is a measure that can bring us together across party lines. The Minister and the Government have the chance to do a really important thing in supporting this motion. I should say that that is in line with their own pledges in the Conservative party manifesto in 2017. The Government have the opportunity to amend the 1974 Act and to take a clear step towards achieving real equality.

The term, “parity of esteem”, may seem meaningless, but it means real equality between physical and mental health. We legislated for that principle in the Health and Social Care Act 2012. We are now seven years down the road and still waiting to realise that ambition. The Minister will also know that the Prime Minister has been clear on this from the start of her premiership, when she made the commitment to address the inequality between physical and mental health one of the key “burning injustices” that she wanted to erase. This motion, and the policy that it seeks to implement, gives the Prime Minister and her Government the opportunity to solidify her commitment to this mission.

Unlike certain other matters that we are discussing in the House this week and over the weeks ahead, this initiative has cross-party support. It has the support of businesses and of our constituents—over 200,000 people have signed the petition. It has the support of so many mental health campaigners across the country. I sincerely hope that all Members on both sides of the House will support it here this afternoon.

--- Later in debate ---

[Norman Lamb]

I absolutely do. I was going to say, “Don’t talk to me about the work capability assessment, because it will get me very angry.” We need reform of the welfare system to help to facilitate people returning to work, rather than just treating them as second-class citizens, as it often does.

[Luciana Berger]

I am listening very carefully to the right hon. Gentleman’s remarks, which are very pertinent. On people being in work or not in work if they are affected by a mental health condition, I was struck to learn that for my local mental health trust, Mersey Care, which provides services for the whole of Merseyside, the latest available figures—not the most recent financial year, but the previous one—show that just 3% of the patients under its care, in both the community and in in-patient services, were in any form of work. That figure is similar for patients under the care of many mental health trusts across our country. Does he believe that people outside this place might not be aware of that fact, but it is staggering and should concern us all? We should be doing everything possible to support people with mental ill health conditions into the workplace.

[Norman Lamb]

I totally agree. My plea to the Government is that, as we hopefully commit to spending more on mental health, we spend at least part of that on preventive measures. If we can get someone into work, it makes a whole difference to their lives. The evidence shows that many people who are helped back into work are then able to stay in work; reducing the burden on the NHS and the benefits system, but giving people dignity and self-respect.

Another initiative we are undertaking in the west midlands is the wellbeing premium. It was my idea, which again is being supported by the Government and I am grateful to them. The idea, which we are trialling over a year, is to give an incentive to employers to improve the way in which they support people in work by training their line managers—the most critical thing one can do—and see whether we can reduce the number of people who end up on sickness absence. The idea is to give them a temporary incentive for one or two years, for example by a reduction in the business rate or a reduction in national insurance payments. If by that we can reduce sickness absence, the number of people falling out of work through ill health and the problem of presenteeism, everyone benefits. It will be interesting to see how that succeeds.

In the west midlands, we are also pursuing the thrive at work commitment, which is trying to build a social movement of companies that all sign up to a commitment to up the level of support that they provide people, changing the culture in workplaces. A toolkit is provided to companies, and that could make a substantial difference across the region.

The action plan also has a commitment to train up 500,000 people across the west midlands in mental health first aid. That is a totally different approach to what we have been used to, which is an NHS very much focused on sickness and providing treatment for sickness after what is often a very long wait, as the hon. Member for Plymouth, Moor View pointed out. Instead, the whole focus of the system should be on prevention. If we do that, we can achieve a real breakthrough.

To conclude, let us amend the legislation and get mental health first aid to become the standard in every workplace. Critically, that should be part of a much wider programme that is focused on prevention and on building good healthy workplaces with the right culture, where people have respect, are engaged in the work they are doing and are treated with dignity. With that commitment is a dedication to the work they are doing and a commitment to raise awareness of mental ill health among all staff and to train managers properly. Through a combination of regulation and incentives, we can make a real difference for people.

--- Later in debate ---

[Luciana Berger]

I want to thank and put on the record my gratitude to colleagues who have joined us and made contributions this afternoon. I appreciate that we are extremely busy with Brexit proceedings, so I am most grateful to everyone who has made the time to be here for this important debate. I also thank those who have made interventions. In particular, I thank my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) and my right hon. Friend the Member for North Norfolk (Norman Lamb)—I call them friends because we have worked very closely together on this and other related mental health matters—as well as my hon. Friend the Member for Dagenham and Rainham (Jon Cruddas), the hon. Member for Waveney (Peter Aldous), my hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) and the hon. Member for Strangford (Jim Shannon), and the Front Benchers, the hon. Member for Glasgow South West (Chris Stephens), my hon. Friend the Member for Burnley (Julie Cooper) and the Minister, for their responses.

I hope that my opening speech and the personal, passionate and informed speeches of other Members on both sides of the House have made clear that there is a robust moral, social and economic case for a change to the law to place on employers a legal obligation to make provision for employees to be trained in mental health first aid, in addition to the training they already have to provide for physical health first aid. That is the crux of the issue. If we expect and require businesses with 25 employees or more, including in the public and charitable sectors, to train at least one person in physical health first aid, an equal requirement should be extended to the provision of mental health first aid, if we are serious about the principle of equality for mental health.

Having listened closely to the remarks and representations that have been made, I appreciate that this should not be a tick-box exercise. The proposal is not going to fix the many challenges in mental health services and it is by no means a replacement for clinical professionals, who do a very important job, or the only thing that should happen in workplaces. It is an additional measure. I listened carefully to the Minister, who said that our workplaces should have a holistic culture of wellbeing; of course that should be the case, but the proposed provision should not be viewed in isolation.

I, along with the right hon. Member for North Norfolk, the hon. Member for Plymouth, Moor View, and just under 210,000 signatories to the “Where’s Your Head At” petition are asking the Government to enact this legislative change, to expand the legal responsibility of employers to make provision to train employees in mental first aid as well as physical first aid, and to make that positive and decisive step towards ensuring parity of esteem—parity of esteem was enshrined in law seven years ago in the Health and Social Care Act 2012—between physical and mental health in this country.

I do not think that we can be seen as impatient, as it was seven years ago that that principle was put into law. I and many others see this as one step—not the only step—that we should make. It is just one of the six principles proposed in the Thriving at Work report, which was a really important piece of work that was published one year and three months ago. This is just one step in that suite of tools at the disposal of businesses and organisations to make that difference.

I say to the Minister that it was the manifesto commitment of her party to bring forward this change. Having listened carefully to what she has said today, I can say that, obviously, she has not made that commitment yet, but, going forward, I urge her to make that change in the near future as it is one thing that could really make a difference.

Question put and agreed to.

Resolved,

That this House notes that the UK is facing a mental health crisis; further notes that, according to the Independent Review into Mental Health in the Workplace 2017 commissioned by the Prime Minister, each year 300,000 people with long-term mental health conditions lose their job; recognises that Centre for Mental Health research shows presenteeism from mental health is estimated to cost the economy £15.1 billion per annum; acknowledges this same research shows it costs the economy £8.4 billion per annum for mental health absenteeism; considers that a recent poll by OnePoll found that 38 per cent of people reported being stressed about work; observes that the Health and Safety Act 1974 made it a legal necessity for workplaces to train someone in medical first aid; and calls on the Government to change this law via secondary legislation to provide clarity that an employer’s first aid responsibilities cover both physical and mental health and to add a requirement for workplaces to train mental health first aiders.

Health and Social Care

Luciana Berger Excerpts

Wednesday 16th January 2019 Ministerial Corrections

The following is an extract from Health and Social Care Questions on Tuesday 15 January 2019.

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

The Minister will know that the Health and Social Care Committee interrogated the Government’s plans on mental health for our young people. We found a massive gap: many schools that are passionate about their students’ mental health have had to cut the provision that they previously provided, including the educational psychologists, the councillors, the pastoral care workers and the peer mentors. Can she tell us—as the Education Minister could not tell us—what her plans will replace? We know that an army of those professionals are no longer working in our schools.

[Jackie Doyle-Price]

I know that the hon. Lady is very passionate about all this, and I can say to her that, in rolling out this additional support, we do not want to crowd out anything that is there already. It should genuinely be working in partnership with the provision that has already been undertaken, but we recognise that we need to be rolling out further investment. We are introducing a new workforce that will have 300,000 people when it is fully rolled out, but we must ensure that we invest in the training in such a way that it will be effective.

[Official Report, 15 January 2019, Vol. 652, c. 1004.]

Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price):

An error has been identified in the response I gave to the hon. Member for Liverpool, Wavertree (Luciana Berger).

The correct response should have been:

Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 15th January 2019 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend is right: it is important that we get the best value from any investment we make in improving the nation’s mental health by making sure that it is evidence-based. On that basis, the Government engaged extensively with a range of expert organisations and individuals, including children and young people, to inform our proposals to improve mental health support, including through a consultation. We also commissioned academics to undertake a systematic review of the evidence which directly informed our proposals and we will, of course, learn from the trailblazers as we commission additional services later this year.

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

The Minister will know that the Health and Social Care Committee interrogated the Government’s plans on mental health for our young people. We found a massive gap: many schools that are passionate about their students’ mental health have had to cut the provision that they previously provided, including the educational psychologists, the councillors, the pastoral care workers and the peer mentors. Can she tell us—as the Education Minister could not tell us—what her plans will replace? We know that an army of those professionals are no longer working in our schools.

[Jackie Doyle-Price]

I know that the hon. Lady is very passionate about all this, and I can say to her that, in rolling out this additional support, we do not want to crowd out anything that is there already. It should genuinely be working in partnership with the provision that has already been undertaken, but we recognise that we need to be rolling out further investment. We are introducing a new workforce that will have 300,000 people when it is fully rolled out, but we must ensure that we invest in the training in such a way that it will be effective.[Official Report, 16 January 2019, Vol. 652, c. 8MC.]

Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 27th November 2018 Commons Chamber

[Matt Hancock]

Yes, it is. I have been briefed on the example that Bromley is setting, which has been brought to my attention by its brilliant local representative, my hon. Friend. Social prescribing systems such as this one are on the rise, because the evidence shows that social prescribing helps to keep people healthy and out of hospital.

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

A fortnight ago, during his statement to the House on prevention and how the Government intend to keep our nation well, the Secretary of State told me that he would look at my Health Impacts (Public Sector Duty) Bill, which had its Second Reading on Friday. Unfortunately, on Friday, the Government objected to my Bill. Which elements of the Bill did the Secretary of State object to?

[Matt Hancock]

I know the hon. Lady has done an awful lot of work on this, and I respect that work. We did look at the Bill, but we thought it was, unfortunately, technically deficient. I know she cares a lot about this, however, as do I, and I want to work with her to see what we can do.

Assessment and Treatment Units: Vulnerable People

Luciana Berger Excerpts

Tuesday 6th November 2018 Commons Chamber

[Caroline Dinenage]

Yes. I think this speaks to the whole theme of people working together, communicating, collaborating, and putting the care that is needed in place for people when they need it. The ability to work across borders is fundamental to that.

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

It was over seven years ago that we came to this House to reflect on the incredibly disturbing “Panorama” footage of what happened at Winterbourne View. We have had countless statements in this House. I obtained an urgent question about this two years ago. We have seen data about the deaths that have occurred, and the fact that the numbers have not reduced. I would echo the question asked by the hon. Member for Kettering (Mr Hollobone). The number of children in these units has doubled in the period in which the Government told us they would reduce the number by 50%. It is, frankly, a dereliction of duty, and Ministers should be apologising to the people outside this House, in this country, who are detained in those assessment and treatment units.

Can the Minister tell us categorically, and actually answer the question—why has the number of children in these units doubled, and what exactly are she and her Government going to do to ensure that she meets their target of reducing it by 50% by next March?

Prevention of Ill Health: Government Vision

Luciana Berger Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

My right hon. Friend makes an incredibly important point. The way that money for primary care is allocated is being looked at right now, taking that and other things into account.

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

To really make a difference to keep our nation well, prevention has to be the preserve of both local and central Government. I note that the conclusion of the Secretary of State’s report says that he will be considering what a health-in-all-policies approach to policymaking could look like next year. Will he signal his support for the health-in-all-policies principle by supporting the Second Reading of my Health Impacts (Public Sector Duty) Bill on Friday 23 November?

[Matt Hancock]

The hon. Lady makes a great plea, which I will look into in some detail.