Southern Health NHS Foundation Trust

Luciana Berger Excerpts

Tuesday 3rd May 2016 Commons Chamber

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

Urgent Question: To ask the Secretary of State to make a statement on the safety of care and services provided by Southern Health NHS Foundation Trust.

[The Minister for Community and Social Care (Alistair Burt)]

I thank the hon. Member for Liverpool, Wavertree (Luciana Berger) for her question. At the outset of my response, I want to express my deep concern and apologies to the patients and family members who will again have felt let down by the contents of last week’s report from the Care Quality Commission. Our first duty to patients and their loved ones is to keep them safe. This applies to all of us with a role to play in the NHS, from the frontline to this House, and the Government are therefore clear that it is imperative to be open and transparent about what has gone wrong in order to minimise the risk of similar failings occurring throughout the NHS as a whole. We must ensure that the trust itself continues to be scrutinised and supported to make rapid improvements in care. If that means intervention from the regulators, they will not hesitate to take the necessary action, and we will not hesitate to back them.

Last week’s CQC report followed a focused inspection announced and requested by my right hon. Friend the Secretary of State in December 2015. The report from the CQC set out a number of concerns, including: a lack of robust governance arrangements to investigate incidents; a lack of effective arrangements to identify, record or respond to concerns about patient safety; and a need for immediate action to address safety issues in the trust environment. The report also found that the senior management and board agendas were not driven by the need to address these issues. None of those matters is acceptable.

NHS Improvement has taken action in recent months to address the issues at the trust. It has been working closely with the CQC and the trust, and on 24 March, NHS Improvement appointed an improvement director to the trust. On 14 April, following a CQC warning notice on 6 April, NHS Improvement placed an additional condition on the trust’s licence, asking it to make urgent patient safety improvements to address the issues found by the CQC. That condition gave NHS Improvement the power to make management changes at the trust if it did not make progress on fixing the concerns raised.

On 29 April, following the resignation of the trust chair Mike Petter, NHS Improvement announced its intention to appoint Tim Smart as the chair of the trust. As chair, Mr Smart will have responsibility for looking at the adequacy of the trust’s leadership. Given the centrality of issues of governance to the CQC’s report, I welcome the action taken by NHS Improvement. The direct appointment of a new chair by a regulator is a relatively rare step, and it reflects the seriousness of the issues at the trust. NHS Improvement will continue to monitor the situation closely in the coming weeks and months.

I understand that the CQC is considering the trust’s response to its warning notice, and the risks it highlighted, before deciding whether to take any further enforcement action, and none of its options is closed. The notice required significant improvements to be made by 27 April. Dr Paul Lelliott, the deputy chief inspector at the CQC, was directly responsible for the report, and I spoke to him this afternoon. He informs me that the delivery plan required by 27 April has been received and is in the process of being evaluated. NHS Improvement is working closely with the CQC and the trust, and the improvement director appointed by NHS Improvement is on site regularly, so there is constant independent oversight of the progress being made, as well as the formal monthly progress meetings between NHS Improvement and the trust.

In addition to the action we are taking on Southern Health, it is vital that we learn the wider lessons for the NHS as a whole. First, I hope the whole House can agree that it is right that we have robust, expert-led inspection from an independent CQC that provides an objective view about issues of safety and leadership, and that this is backed with action from NHS Improvement where that is required. Secondly, it is vital that we take the issue of avoidable mortality as seriously for people with learning disabilities and mental health problems as we do for other members of our society. To that end, the learning disability mortality review programme has been put in place by NHS England to ensure that the causes of this inequality are understood, and with the aim of eliminating them. In addition, the CQC will be leading a review of how all deaths are investigated, including those of people with learning disabilities or mental health needs. There can be no question but that the CQC report makes for disturbing reading, and that it demands action at local and national levels. We owe our most vulnerable people care that is safe and secure, and I am determined that we will do all we can to ensure patient safety.

[Luciana Berger]

I thank the Minister for very brief advance sight of his response. Patients and parents have a right to be angry at the failure of Southern Health NHS Foundation Trust, and we in this House have a duty to be angry on their behalf. To read the litany of failure, missed warnings, reports and recommendations ignored, and secrecy over the last four years would make any reasonable person angry, too. Friday’s CQC report shows that very little has been done since the House last discussed the matter in December.

The scandal at Southern Health has happened on this Government’s watch, and Ministers must take responsibility for what has happened to some of the most vulnerable people in our country. We should be angry that Connor Sparrowhawk was left to drown in a bath. We should be angry that Angela Smith took her own life. We should be angry that David West died in the care of this NHS trust—his father was repeatedly ignored when he raised his concerns. All of them were denied the care that they so desperately needed. Last week, the BBC reported that over the past five years, 12 patients who had been detained for their safety or that of others have jumped off the roof of a hospital run by this trust. Access to a roof was still permitted to people at risk of suicide. If all those tragic incidents were the only signs of systemic failure, we should be angry, but there is a much bigger story of neglect and malpractice, which aggregates into a major scandal.

When the Secretary of State responded to the urgent question on Southern Health in December, he rightly said:

“More than anything”

people will

“want to know that the NHS learns from”

such

“tragedies”.—[Official Report, 10 December 2015; Vol. 603, c. 1141.]

The CQC report published on Friday shows that that clearly has not happened. So I ask the Minister: first, what guarantees can the Minister give to the 45,000 patients currently in the care of Southern Health, and their families, that they are safe? Secondly, where is the accountability, the culpability and the responsibility? There seems to be very little. I heard what he said about the chair, but does he agree that the chief executive’s position is now untenable, and that she should be sacked? Thirdly, will he listen to the heartfelt pleas of the victims’ families, the campaigners, and all of us who are demanding a full public inquiry into Southern Health and broader issues, such as the abject failure adequately to investigate preventable deaths?

As the Secretary of State said in December, such issues are not confined to one trust. The Ofsted-style ratings that he previously mentioned will make a difference only if there is proper accountability and the ability to take action to make real improvements to patient care and patient safety. The families have behaved with such dignity and tenacity, and we owe them a debt of gratitude, but it should not be left to them alone to push for accountability.

I listened carefully to what the Minister told the House, but I remain unconvinced that enough has changed. Four months ago, we heard similar reassurances. Today, we are debating the Government’s failure to act. The time for yet more warm words and hollow reassurances is over. We need action, and we need it now.

[Alistair Burt]

I thank the hon. Lady for her response. We are not actually debating the Government’s failure to respond at all. The Secretary of State did exactly what he said he was going to do, and the CQC’s inquiry and work that followed can be seen in the report that was produced last week. The report contains a number of further concerns—there is no doubt about that—and people are right to be angry, but there is a process to find out what is going on and to do something about it and that process is in place. That is what NHS Improvement is doing and it is important that that is done.

There is an issue of urgency, which is really important. There are things that are discovered and things take time to get done. I am not content with that in any way, but the process is in place to do something about that. The CQC has been engaged and has ruled out no option for further action. Its options are quite extensive, including prosecution for things that it has found. The process started by the Secretary of State is not yet finished. That my right hon. Friend has demonstrated his commitment to patient safety from the moment he walked into that office cannot be denied by anyone, and this is a further part to that.

I asked the same question that the hon. Lady asked about safety directly to the CQC this afternoon, and I spoke to Dr Paul Lelliott who compiled the report. I asked whether people are safe at the foundation trust today. People are safe because, as we know, the CQC has powers to shut down places immediately if there is a risk to patients. It has not done so, but I am persuaded that if it had found such a risk it would have closed things down. There is therefore no risk to safety in the terms that the hon. Lady suggests.

On the chief executive’s position, the power to deal with management change is held by NHS Improvement. I also offer a brief word of caution. There is a track record of Ministers speaking out, at great cost, about the removal of people in positions over which they have no authority. That is understandable in situations of great concern when an angry response seems right, but it is not an appropriate response. The chair has gone, and processes are available should any more management changes be necessary, which is important. Colleagues in the House can say whatever they like, but a Minister cannot and must say that appropriate processes can be followed, because that is right and proper.

I do not yet know about an inquiry, and I want to wait and see what comes out of the further work being done in the trust. I do not rule out some form of further inquiry, but an inquiry is physically being carried out now by the actions taking place on the ground. What needs to follow is urgent action to respond to what the CQC has said, and a long drawn-out public inquiry is not necessarily the right answer. More work might be necessary, but I need to consider that in relation to further work being done at the trust.

On preventable deaths, as I made clear in my statement, I am sure that not enough attention has been given to those cases that require further investigation across the system, often dating back many years and preceding this Government. We have turned our attention to that issue, and we will make changes because such inequality must end.

World Autism Awareness Week

Luciana Berger Excerpts

Thursday 28th April 2016 Commons Chamber

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

I congratulate the right hon. Member for Chesham and Amersham (Mrs Gillan), and the other sponsors of the debate, on enabling the House to discuss the important issue of autism. Let me echo a remark that was made by my hon. Friend the Member for Heywood and Middleton (Liz McInnes). We have heard many excellent speeches, but I am particularly grateful for the contributions of Members who have shared their experiences as parents of children with autism. That added greatly to our discussion.

I welcome one of the central calls in the motion, the call for an enhanced national awareness campaign. Raising the profile and public understanding of autism would break down some of the stigma, tackle the prejudices, and make it easier to explain autism to those who remain unaware of the realities of the condition. I pay tribute to the charities working in this field, including the National Autistic Society, Autistica, and Ambitious about Autism, which are fighting for people with autism and their families. They are campaigning for proper diagnosis, decent treatment, social acceptance and full, productive and dignified lives for people with autism. I also commend the many organisations, campaigns, towns and cities that are doing so much to raise awareness. There have been many contributors to the debate, but I have only eight minutes so I hope that hon. Members will forgive me if I do not mention them all.

The National Autistic Society has brought some important survey evidence to our attention. It has already been mentioned in the debate, but it is worth reiterating that although almost the entire population of this country has heard of autism, only 16% have any real understanding of the condition. That reveals a huge gulf between awareness and understanding, which is why a national campaign to develop better awareness of the realities of autism would be a welcome development. It should be led by, and involve fully, people with autism and their families, so that the campaign can be authentic and focus on the issues that really matter. Research by Ambitious about Autism has highlighted two specific audiences for such a campaign: teachers—40% of whom say that they lack the knowledge they need—and employers and jobcentres. While 99% of young people with autism say that they want to work, only 15% of adults with autism are in employment.

It is clear that people with autism and their families face terrible prejudice and stigma. The figures in the National Autistic Society survey show that too many people with autism and their families feel socially isolated or do not go out because they are worried about how the public will react to their autism. My hon. Friend the Member for Lancaster and Fleetwood (Cat Smith) shared the fact that people do not understand what a meltdown is. People are sometimes asked to leave a public space because of behaviour associated with their autism. This paints a picture of social isolation and daily humiliation. Autism is a condition in which people have difficulty interpreting the world around them, and that is compounded by the reactions and hostility of other people.

It is obvious that we are a long way from having public spaces that are safe for all people with autism. I welcome the fact that my own city, Liverpool, has started a bid to become one of the first autism-friendly cities, but we need to become an autism-friendly nation. [Interruption.] The Minister for Community and Social Care, mentions Manchester from a sedentary position, and I note the remarks made by my hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds) in that context. I hope that the Minister will address the issues of awareness, stigma and prejudice. I hope that he will also commit to supporting the Autism Access Award, to ensure that our public buildings and spaces are autism friendly. I am pleased that the House of Commons started work on this earlier in the year, and I hope that we can make progress to ensure that our workplace also becomes autism friendly.

Many hon. Members have mentioned the challenges relating to the Department of Health. Will the Minister tell us what efforts individual Departments and agencies beyond the Department of Health are making to support people with autism and which Departments and agencies have an up-to-date strategy for dealing with autism? What commitment will he make today to ensure that any that do not have such a strategy will adopt one?

The second substantive part of the motion relates to the length of time it takes to diagnose someone with autism. Many Members on both sides of the House have talked about this today. Autism requires an early diagnosis to enable individuals with autism and their families to be properly supported. As we have heard, however, adults are having to wait more than two years for a diagnosis, and for children, the figure now stands at 3.6 years. On my weekly visits across the country, I hear many of the stories that have been echoed in the Chamber today. In my own city, Liverpool, there are no fewer than 700 families waiting for an assessment. That is totally unacceptable; it is far too long. The long wait compounds the condition and makes a bad situation worse.

I have heard at first hand from the Liverpool Autistic Children’s Alliance, a parent support group that meets in my constituency, the difficulties experienced while waiting for a diagnosis, particularly in relation to education. The parents talk about not getting an education, health and care plan and therefore having no access to training to help them to support their children. They also speak of challenges in accessing appropriate education. We have heard that the NICE quality standard on autism makes it clear that people should wait no longer than three months, once referred, for their first diagnostic appointment. That standard is clearly not being met across the country, meaning that thousands of people are being let down. Given the importance of prompt, accurate diagnosis, I hope that the Minister will commit to asking NHS England to report on autism diagnosis waiting times for every clinical commissioning group in the country and then to hold them to account when the waits are too long. I hope that he will also ensure that NHS England’s new autism care pathway includes and reduces those diagnostic waiting times.

Research presented by Autistica and drawn up by the London School of Economics shows that the costs associated with autism are more than those of cancer, heart disease and stroke combined. They are at least £32 billion a year and include expenditure on hospital services, home healthcare, special educational facilities and respite care and lost earnings for both people with autism and their parents. Despite the costs, the outcomes for people with autism remain so poor. We heard during the debate about co-morbidities, extremely high rates of mental illness, poor physical health, social exclusion, lack of opportunities for employment and education, and, tragically, early deaths. Several contributions discussed the amount spent on awareness, but research also has the power to improve all those poor outcomes. Research spending on autism remains incredibly low at just £3 million a year, which is paltry given the scale of the challenge.

As shadow mental health Minister, I am aware that mental illness is also a huge challenge for people with autism, who are far more likely to have at least one mental health condition. The burden of anxiety and depression on people with autism is vast, about which we heard many personal accounts during today’s debate and which I hope the Minister will address in his remarks.

I will conclude on an important point about the fact that too many people with autism in our country are dying too young. The figures are startling. If we look at the research that was in the press only a few months ago, we see that people on the autistic spectrum die on average 18 years earlier than the general population. For autistic people with a learning disability, that figure rises to 30 years. That cannot be acceptable in this country in 2016. People with learning disabilities are at greater risk of suicide, and the most disturbing statistic is that the risk of people with autism committing suicide is nine times higher than that for the typical population, which is a scandal. I raise it during this debate because, as we have heard in some contributions, it is a particularly specific and pertinent issue that needs addressing, particularly in the light of the fact that suicide prevention organisations are not providing autism-appropriate services. From representations from many autism organisations, I know that phone lines for those who might be having suicidal thoughts are not appropriate for someone with autism. I hope that the Minister will address suicide prevention strategies and ensure that they are appropriate for people with autism.

I welcome today’s debate and its many superb, thoughtful speeches. I hope that the families listening to our discussions will feel that we are addressing their many concerns. I look forward to the Minister’s reply.

Mental Health Taskforce Report

Luciana Berger Excerpts

Wednesday 13th April 2016 Westminster Hall

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

It is a real pleasure to serve under your chairmanship this afternoon, Mr Wilson. I congratulate the hon. Member for Halesowen and Rowley Regis (James Morris) both on securing this vital debate on the final report of the independent taskforce on mental health and on his excellent contribution. I am pleased that we have the opportunity to examine this incredibly important piece of work and to hear a detailed response from the Government. I thank all Members who have spoken in the debate; the quality of the speeches we have heard is testimony of the strength of feeling on both sides of the House on the issue of mental health.

I echo previous contributions today in saying that the taskforce report is an extremely comprehensive piece of work. I pay tribute to all those who were involved in delivering it. The recommendations it makes are robust and wide-reaching and signal what the chair of the taskforce—Paul Farmer CBE from Mind—has rightly described as a

“landmark moment for mental health”.

I also thank vice-chair Jacqui Dyer for her commitment and passion.

If implemented in full, the changes could make a huge difference to a system that is under increasing and unsustainable pressure. The real challenge lying before us now is ensuring that the aspirations set out in the report are actually delivered. For too long the rhetoric on mental health has not matched the reality on the ground. Members today have reflected the concerns felt by the people whom we represent across the country—people who themselves suffer from mental health conditions, their families and the services and professionals that care for them—who are anxious to ensure that the opportunity we now have to transform mental health in our country is not wasted.

I will focus my remarks on implementation and three key areas where unanswered questions remain—funding, transparency and accountability. Turning first to the money, the taskforce identified a £1.2 billion funding gap in mental health services each year by 2020. The Government responded to the publication of the report with an announcement of an additional £1 billion of investment for mental health services up to 2020. That is, of course, very welcome but I understand that the £1 billion will be taken from the £8 billion set aside for the NHS up to 2020. If that is the case—perhaps the Minister can confirm that for us today—I struggle to see how it will meet what the taskforce says is required.

Given that mental health receives just under 10% of the total NHS budget, it is difficult to see how the funding announced could be considered as additional, particularly in the context of the £600 million cut that mental health trusts have experienced over the course of the last Parliament. I should have thought that the Minister would have allocated that proportion of the £8 billion to mental health anyway, so I am keen to hear his response on that point.

There are also real concerns about how this funding will be distributed and what systems will be in place to ensure that it reaches the front-line services for which it is intended and not siphoned off to plug the deficits of acute trusts. That point has already been made by the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Bexhill and Battle (Huw Merriman). The Minister is right to prescribe that CCGs must increase the amount of their budget that they allocate to mental health at a rate that is at least in line with the general growth in their budget. However, as that budget information is not published centrally, I have yet to see any evidence from the Government that they are able to guarantee that CCGs are fulfilling that commitment. In fact, I have had to make freedom of information requests, which have exposed the fact that more than one in three CCGs are not meeting that expectation.

Just before Christmas, the Health Secretary announced that from June there will be independently assured Ofsted-style ratings for mental health provision by CCG area that will expose the areas that are not making the commitment to mental health that they should. I asked then if he would clarify whether that commitment would include publishing a clear picture of mental health spending for every CCG. I am still awaiting a response to the follow-up letter I wrote seeking clarification on that very important point, and I would be pleased if the Minister were able to confirm that for us today. As he will know, the Opposition strongly believe that the annual survey of investment in mental health must be reinstated. It was stopped in 2011, and it is an absolutely crucial piece of information.

That is especially important given the concerns that have been raised not only by many hon. Members today, but by the Mental Health Network, which represents mental health trusts, who have said that providers of mental health services are yet to see the difference from the investment in child and adolescent mental health services that the Government announced last year. During this debate, many hon. Members have raised specific concerns about CAMHS and the imbalance in the amount that they are allocated from the overall mental health budget. It is less than 10%, and it is a significant challenge. I am interested to hear the Minister’s response both to those very serious concerns and to the proposal from many mental health leaders that the cash should be ring-fenced—I am very keen to hear what he thinks about that.

That brings me to the second key theme of the report—the startling lack of transparency and accountability in our mental health system, which was mentioned by my hon. Friend the Member for York Central (Rachael Maskell) and the hon. Member for Gillingham and Rainham (Rehman Chishti). The significant gaps in the information that the Government collect on mental health present a significant obstacle to their ability to deliver what they have promised on mental health. On Monday we saw further shocking evidence of that information gap during the BBC’s “Panorama” programme, which highlighted the discrepancy between the data that the Government hold on the number of children who have died in in-patient mental health trusts and units and the figures from the charity Inquest’s research. I raised that in the House yesterday.

[Norman Lamb]

I totally agree with the point that the hon. Lady is making. I always took the view that I was operating in a fog, without access to the proper data. The “Panorama” programme made reference to the fact that I gave a parliamentary answer saying there had been no deaths in children’s mental health services—an answer that was wrong, because I was given the wrong information. I have asked the Secretary of State for a full investigation into how that happened. We have to have absolutely accurate reporting of these things.

[Luciana Berger]

I thank the right hon. Gentleman for his intervention. I believe it is absolutely imperative that we are able to see how deaths in psychiatric care are not only treated and recorded, but investigated and learned from. We have heard from the Minister that there will be progress on that front.

The situation is particularly concerning given the ongoing case of Southern Health NHS Foundation Trust, which was found to have failed to investigate more than 1,000 unexpected deaths of mental health and learning disability patients since 2011. Only last week, more than two years since the very tragic death of Connor Sparrowhawk, Southern Health trust was found by the Care Quality Commission not to have addressed serious concerns that were raised about the safety of its patients and was issued with a warning notice. I would be grateful if the Minister shared with us what the Government are doing specifically to improve the mental health data that are being collected, published and made accessible to the public. When will we have a further update on avoidable deaths in the area of mental health and learning disability? Data are absolutely critical, not only to enable the Government to understand the realities of what is happening on the ground, but to allow us to check that the Government are delivering on what they have promised.

That brings me to the final point I wish to cover today—accountability for the implementation of the taskforce’s recommendations. The taskforce asked NHS England, the Department of Health and the Cabinet Office to announce what governance methods they intend to introduce for the delivery of the recommendations. That really is needed as a matter of urgency. We need greater transparency than before in the way that the recommendations are implemented. I note that one recommendation of the taskforce report is that the Government accept the recommendations from the previous taskforce on CAMHS—another issue raised by many Members during today’s debate—which reflects the fact that the delivery of these recommendations has been too slow. I should be grateful if the Minister would confirm what plans there are to publish and publicise updates on implementation of the taskforce’s recommendations.

The Centre for Mental Health has produced a fantastic report for NHS England, exploring what helps and what hinders the implementation of policies and strategies relating to mental health. I do not know whether the Minister has had a chance to read the report but, among other things, it calls for a robust implementation infrastructure to support local agencies in delivering the report’s recommendations. I should be grateful if the Minister would share with us today what plans there are to support local authorities, CCGs and mental health trusts to deliver on that strategy.

Many recommendations in the taskforce report also require Government Departments—such as the Ministry of Justice, the Department for Work and Pensions and the Department for Education—to deliver their own areas of work that relate to mental health. I was very pleased to see those recommendations, and as I have said and will continue to say, we will not address the challenges of our nation’s mental health just from the Department of Health. Prevention and early intervention are absolutely crucial, which was a point made by my hon. Friend the Member for Coventry North East (Colleen Fletcher).

Take the work of the Ministry of Justice, for example. The report calls for the completion of the roll-out of liaison and diversion services, as well as the increased uptake of mental health treatment requirements and improvements to prison mental health care. At a time when, as a country, we are seeing one person take their life every four days in our prisons, it is absolutely crucial that we address this very serious issue.

Another point made by the taskforce was about housing and the local housing allowance, which the Government seriously need to address. During today’s debate other Members have talked about the importance of employment and what more needs to be done to support employers to help people with mental health conditions into the workforce, and to support people who might be experiencing those issues. It was disappointing that the Government accepted only formally the taskforce’s recommendations relating to the Department of Health and its arm’s length bodies. I hope the Minister will confirm today whether other Departments will accept and implement the other recommendations.

In conclusion, for the many thousands of people who could benefit from these changes and the others set out in the taskforce’s final report, Ministers must keep their promise and deliver the vital reforms that are long overdue and desperately needed. We have heard a lot of rhetoric and warm words on mental health. Now is the time for real action and to translate parity of esteem into reality. I look forward to the Minister’s reply.

Points of Order

Luciana Berger Excerpts

Tuesday 12th April 2016 Commons Chamber

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

On a point of order, Mr Speaker. I have made the Minister for Community and Social Care aware of my intention to make this point of order. In an answer to my written parliamentary question asking for the number of deaths that have occurred in child and adolescent mental health units since 2010, the Minister said that only one such death had been recorded by the Care Quality Commission. However, freedom of information requests conducted by Inquest have found that at least nine young people have tragically died in England while receiving in-patient psychiatric care since 2010. In response to this research, the Minister stated in an interview on last night’s BBC “Panorama” programme that he did not know how many children and adolescents have died in psychiatric units in recent years. This discrepancy between the Government’s account of the number of child deaths and the data collected from FOI requests raises serious questions about how the deaths in psychiatric care of some of our most vulnerable people are treated, recorded, investigated and learned from.

Can you advise me, Mr Speaker, whether you have received any indication from Ministers that they intend to clarify for the parliamentary record what the accurate figure is for the number of children who have tragically died in all NHS-funded psychiatric in-patient settings since 2010?

[Mr Speaker]

Extremely important questions are raised by this matter and by the broadcast, although not for me. We cannot have Question Time on the basis of points of order, but as the Minister of State is in the Chamber and apparently willing to say some words, we are happy—exceptionally—to hear him.

Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Alistair Burt]

There are two things that can help the hon. Lady. The first is the commitment to build £30 million a year into budgets over the next five years to support those with eating disorders, about which I spoke at a conference last week. The second is the earlier detection of eating disorders. We reckon that, by 2020, 95% of urgent eating disorder cases will be seen within a week, with routine cases seen within four weeks. There is recognition of the real danger now posed by eating disorders.

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

Earlier this month, school and college leaders reported a large rise in the number of students suffering from anxiety. Two thirds said that they struggle to get mental health services for their pupils, and of those who had referred a student to child and adolescent mental health services—CAMHS—most rated them as “poor” or “very poor”. Despite the Minister’s warm words, things are getting worse, not better. Will he confirm that every single penny promised to children’s mental health will reach those services and that none of this money will be used to plug the gap in hospital budgets?

[Alistair Burt]

Following long and frank conversations between me, the NHS and the Treasury, I can give the hon. Lady that assurance—every penny of the £1.4 billion pledged in the 2015 Budget for CAMHS and for eating disorders will be spent on children’s mental health by the end of this Parliament. It is not fair continually to say that nothing is going on. The first tranche of money—£173 million—is being spent: £75 million to the clinical commissioning groups; £30 million to tackle eating disorders; £28 million for the expansion of children’s IAPT—improving access to psychological therapies—services; £15 million for perinatal services; and £25 million to address other issues involving training. That is money already committed and it is being spent now. The problems that she mentions are a high priority and are being dealt with.

[Luciana Berger]

I listened carefully to the Minister, but by his own admission—in response to parliamentary questions—he is going to underspend this year by £77 million on his pledge to spend £250 million on CAMHS, and by £11 million on his £15 million pledge regarding perinatal mental health. He talks about the importance of intervening earlier. Does he agree with Labour that every child should receive personal, social, health and economic education so that young people are equipped with the resilience better to support their mental health?

[Alistair Burt]

We cannot have it both ways, it would seem. I have given a pledge, which the hon. Lady asked for in her first question, that the £1.4 billion committed to CAMHS will be spent by the end of this Parliament—and it will be. It is known that the first tranche has not been fully committed, but this is the first year and some money has to roll over. However, I have made absolutely sure that that money will be spent, including on perinatal services, which will reach a much better place than when we came into office, and that is very important. The work will be done. PSHE is not a matter for this Department, but I fully agree that it is important that children have such information. The pressure caused through social media, sexting and the like means that children these days need to have a very up-to-date, modern understanding of issues associated with personal health and social education, which I fully support.

Mental Health Taskforce

Luciana Berger Excerpts

Tuesday 23rd February 2016 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health to make a statement on the Government’s response to the final report of the independent Mental Health Taskforce.

[The Minister for Community and Social Care (Alistair Burt)]

Achieving parity of esteem for mental and physical health remains a priority for this Government. I appreciate the hon. Lady’s raising of the urgent question this afternoon. We welcomed the independent Mental Health Taskforce launched by NHS England last year, with its remit to explore the variation in the availability of mental health services across England, to look at the outcomes for people who are using services, and to identify key priorities for improvement.

The taskforce, chaired by Paul Farmer, chief executive of Mind—I thank him, the vice-chair, Jacqui Dyer, and the whole team for the remarkable work they did—also considered ways of promoting positive mental health and wellbeing, ways of improving the physical health of people with mental health problems, and whether we are spending money and time on the right things.

The publication of the taskforce’s report earlier this month marked the first time a national strategy has been designed in partnership with all the health-related arm’s length bodies in order to deliver change across the system. This also demonstrated the remarkable way in which society, the NHS and this House now regard mental health and how it should be seen and approached.

This Government have made great strides in the way we think about and treat mental health in this country. We have given the NHS more money than ever before and are introducing access and waiting-time targets for the first time. We have made it clear that local NHS services must follow our lead by increasing the amount they spend on mental health and making sure that beds are always available. Despite those improvements, however—and I referred earlier to the way in which we view these matters—the taskforce pulled no punches. It produced a frank assessment of the state of current mental health care throughout the NHS, pointing out that one in four people would experience a mental health problem during their lifetime, and that the cost of mental ill health to the economy, the NHS and society was £105 billion a year.

We can all agree that the human and financial cost of inadequate care is unacceptable. The Department of Health therefore welcomes the report’s publication, and will work with NHS England and other partners to establish a plan for implementing its recommendations. To make those recommendations a reality, we will spend an extra £1 billion by 2020-21 to improve access to mental health services, so that people can receive the right care in the right place when they need it most. That will mean increasing the number of people completing talking therapies by nearly three quarters, from 468,000 to 800,000; more than doubling the number of pregnant women or new mothers receiving mental health support, from 12,000 to 42,000 a year; training about 1,700 new therapists; and helping 29,000 more people to find or stay in work through individual placement support and talking therapies.

I assure all Members that they will have ample opportunities to ask questions and debate issues as we work together to implement the taskforce’s recommendations.

[Luciana Berger]

The final report of the Mental Health Taskforce, commissioned by NHS England, provides a frank assessment of the state of mental health care, and describes a system that is “ruining” some people’s lives. It contains a number of recommendations which, if implemented in full, could make a significant difference to services that have had to contend with funding cuts and staff shortages at a time of rising demand, leaving too many vulnerable people without the right care and support.

It is extremely disappointing that the Opposition have had to compel the Minister to come to the Chamber today to ensure that Parliament can give the report and the Government’s response to it the attention and scrutiny that they deserve. It is all the more regrettable because the Prime Minister himself chose to announce their response to the media during last week’s recess—a courtesy which, had it not been for the urgent question, would still not have been afforded to the House. The Government’s apparent announcements included the announcement of a supposed “additional” £1 billion of investment by 2020, but a number of vital questions remain unanswered.

Will the Minister explain why the report was delayed and published during the recess? Did Ministers or No. 10 have a say in the timing, and, if so, does the Minister accept that such a level of interference on the part of Ministers raises questions about the independence of the report? Can the Minister confirm that no additional money will be allocated from the Treasury to fund what the Government have announced, and that it will be funded from the £8 billion that has already been set aside for the NHS to receive by 2020? Given that mental health is given just under 10% of the total NHS budget, surely mental health services would have expected to receive much of that additional money as part of the NHS settlement anyway. Can the Minister explain how the money can be expected to deliver the “transformation” in our mental health services that the taskforce says is urgently required?

Can the Minister also confirm that he is accepting all the recommendations relating to the NHS? Does he intend to respond to the other recommendations, and when can we expect that response? As the report makes clear, we do not solve the challenges of our nation’s mental health by means of the Department of Health.

On behalf of the many thousands of people who have been let down by the Government, who are desperate to see a change in the way in which we approach mental health, and who are owed a full explanation from the Government of their response to this damning report, I look forward to the Minister’s reply.

[Alistair Burt]

I thank the hon. Lady for her questions, which give me an opportunity to say still more about what we are doing in relation to mental health and how far it has come since 2010. For instance, she could have pointed out that 1,400 more people a day have access to mental health treatment than had access to it in that year, simply as a matter of comparison between what was done then and what is done now. However, it is absolutely right to make the essential point that there is more to be done—a view that we share—and that is what the report did.

The timing of the report was not up to the Government. It is an independent report, commissioned by the NHS from an independent taskforce, and the timing and the content were decided by the taskforce. I had the occasional meeting with Paul Farmer about it. I made sure to speak to him to say, “This is absolutely your report. Forget the guff in the papers about who wants what in the report and all that; this is yours and it’s got to be yours”—and it is absolutely clear that it was. The decision to publish it was theirs. The Prime Minister was able to respond, which was great, and that emphasises again the importance given to this issue now, as compared with times past.

On the finance, the important thing to note is that the Prime Minister announced in January how the £600 million in the spending review, which is included in the NHS bottom line until 2021, would be spent. That included the new money for perinatal mental health, crisis care, psychiatric liaison in A&E and the crisis care community work. What was said by the Prime Minister in relation to the taskforce report represents new money that will be available for the NHS and mental health by 2021. That will be £1 billion extra by 2021, with the additional number of people to be treated that I outlined.

I spoke to the taskforce after the issuing of the report. I do not particularly want just to produce a response to the taskforce report; I said that I would prefer a series of rolling responses, as it were, so that when we have responded to a recommendation and when we are moving on and delivering on it, I would say so. That will come in a variety of different forms, but will be related to what the taskforce has done. That may well involve announcements to Parliament, whether by written ministerial statements or other means. I did not want one big bang of a response, as it were, because the Prime Minister has already said that we will accept the recommendations, as they go with the grain of what the Government were going to do anyway. I wanted to give an indication that the report will not just sit on a shelf gathering dust. By making constant reference to it when we do something—saying, “This is a response to what the taskforce said we should be doing towards 2021”—it can get the stamp of support and recognition, which is important.

On the hon. Lady’s claim that thousands have been let down, again I would gently remind her that this Government were the first Government to set waiting times for physical and mental health—a chance missed by the hon. Lady’s Government when they were in office and set physical health waiting time limits. It is this Government who have actually made the commitment of £10 billion extra to the NHS, a commitment never made by her or her party. It is very easy for people to talk about new things in mental health when they do not have a budget or an economic team producing anything of any credibility, but this Government have got the responsibilities and are doing the work.

We are absolutely agreed that the state of mental health services cries out for more to be done; we have said that, and that is what we are doing. The direction of travel and the physical delivery is happening on a day-by-day basis. We will do more; we will continue to work together to do more, and I welcome the hon. Lady and her team’s very regular pressure on me and my right hon. Friend the Secretary of State to continue to do more. We will meet that challenge—and we are meeting it in a way that no Government have ever met it before.

--- Later in debate ---

[Alistair Burt]

I am happy to do so, and I welcome my hon. Friend’s question. As I indicated earlier, something that has perplexed me since I have been in this role is the variation in practice in different places. It has never been easier to transfer information by electronic means and make people aware of best practice, but it is still difficult to move things around. We need to make sure that there is a website—a clearing house—for ideas in such areas.

[Luciana Berger]

It already exists in the Positive Practice collaborative.

[Alistair Burt]

Absolutely. We need to make sure that we have proper ways to access all the different ideas. A lot of work has gone into this, and we need to make sure that it is easy to access different ideas. There is a lot going on, and a lot can be done in relation to spreading best practice.

Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 9th February 2016 Commons Chamber

[Ben Gummer]

The fact the right hon. Gentleman missed out was that that was a different survey, so the figures are not comparable. However, I agree that choice is important. We are still not doing enough, and we should do more. I would like to take this opportunity to congratulate the team at his local hospital, which has just been rated good by the CQC—the first hospital in the south-west to receive that rating.

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

Patients needing mental health services do not get to choose where they receive their care, as highlighted in the Commission on Acute Adult Psychiatric Care report, which was published today. The report says

“the whole system has suffered from a steady attrition in funding…in recent years.”

It highlights

“poor quality of care, inadequate staffing and low morale.”

It describes the situation as “potentially dangerous”. Does the Minister now accept that the Government have let vulnerable people down? Will he implement the commission’s recommendations in full to put this serious situation right?

[Ben Gummer]

We have just received the report. It is a good report; we have taken note of it; and NHS England is already working on its recommendations. I remind the hon. Lady that this Government have put mental health on equal parity of esteem within the NHS constitution for the first time. [Interruption.] Opposition Front Benchers say that is meaningless, but why did they not do it when they were in office? We have done it for the first time and we are acting on it, not just in the constitution but in funding for the NHS, which is going up in real terms in the course of this spending review.

Oral Answers to Questions

Luciana Berger Excerpts

Tuesday 5th January 2016 Commons Chamber

[Alistair Burt]

Indeed; the ability to see how these pilot projects respond to the different demographics in different areas enables one area to learn from another. Torbay has come up frequently in this context, and I am pleased to be able to praise it again. While I am on my feet, I should also like to point out that many of those involved in adult social care were greatly affected by the recent flooding in the north of England and that they were looking after vulnerable people and working beyond the front line. That work was very important, and I am grateful to Ray James of the Association of Directors of Adult Social Services and to all those working in local authorities in the affected areas who contributed so well to looking after vulnerable people during that period.

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

The report on the appalling failures at Southern Health NHS Foundation Trust highlighted the fact that more than 1,000 unexpected deaths of mental health and learning disability patients, many of which took place outside hospital, had not been investigated. Given that the Health Secretary did not allow the House an opportunity to scrutinise those findings before Christmas, will he or the Minister respond today to the widely held concern that the experience of that NHS trust is not an isolated one? Does the Minister agree that a national public investigation is now needed?

Mental Health

Luciana Berger Excerpts

Wednesday 9th December 2015 Commons Chamber

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

I beg to move,

That this House believes that mental health should be treated with the same priority as physical health and recognises the importance of promoting good mental health from childhood through to adulthood; believes that not enough progress has been made in translating this House’s commitment to parity of esteem between mental and physical health into practice; notes with concern that the King’s Fund has reported widespread evidence of poor-quality care across mental health services, and the latest available figures show a rise in suicide rates and the number of detentions under the Mental Health Act 1983 increasing by 10 per cent in the past year alone; further notes the delay in the publication of NHS England’s Mental Health Taskforce report; notes the concerns that have been raised with the Scottish Government regarding the rate of inappropriate admissions of young people to non-specialist facilities for mental health treatment which have increased by 38 per cent since 2011; is concerned by the absence of data on NHS spending on mental health services since 2011-12; opposes the Government’s decision not to enshrine the right to psychological therapies in the NHS Constitution; and calls on the Government to urgently rectify this systemic inequity in entitlement to treatments, reinstate the annual survey of investment in mental health services and develop and implement in full a new strategy to improve the Government’s cross-departmental response to mental health.

It is a privilege to open this debate as the first shadow Minister for mental health. The fact that we are having this debate is testament to just how seriously the Opposition consider mental health. The issue affects one in four of us every year, yet it has been neglected for far too long. Mental health has come out of the shadows in recent years, and I know that many Members on both sides of the House feel very strongly about this issue. There have been many important steps forward, but talk to anyone with a mental health condition and they will tell you that they still face stigma, prejudice and discrimination. Sadly, there remain many areas in which there has not been the progress for which we had hoped.

Labour Members have deep concerns about our nation’s mental health and the services and support that are available. Three years ago, my Labour colleagues in the House of Lords won the fight to ensure that the Government wrote parity of esteem between mental health and physical health into law. However, the gap between the rhetoric we hear from this Government and the reality for patients on the ground is growing wider.

I am sure Members on both sides of the House have many constituency cases that echo such concerns. In my first few months in this position, I have been struck by the thousands of messages I have received from people up and down the country. They are desperate to see a change in how our society approaches mental health. This strength of feeling is not surprising. On this Government’s watch, there has been an increase in the number of patients who report a poor experience of community mental health care. More patients have to travel hundreds of miles just to get a bed. The number of children being treated on adult wards, which the Mental Health Act 1983 rightly says should not happen, has risen again this year. The number of people becoming so ill that they had to be detained under the Mental Health Acts leapt by 10% in the past year. The level of suicides, particularly among men under the age of 45, has been at its highest since 2001.

[Ms Karen Buck (Westminster North) (Lab)]

Does my hon. Friend share my concern about the scale of the stress—by common agreement, often inappropriate stress—on the police as a consequence of the pressure on emergency mental health services? My local police have advised me that they sometimes spend half a shift with severely mentally ill patients who are queuing for access to acute mental health hospitals. That is bad for the police and bad for the patients, and is a reflection of the terrible pressures on the acute mental health sector.

[Luciana Berger]

I thank my hon. Friend for making that very important intervention. There are too many stories of our blue light services—not just the police, but our ambulance and fire services—being under incredible pressure in contending with such issues. I believe that the Government must do more to address that issue.

[Norman Lamb (North Norfolk) (LD)]

I am pleased the hon. Lady has called this debate. Does she share my view that yesterday’s report on perinatal mental health makes incredibly disturbing reading? Many women have lost their lives because of the absence of services. We must commit to making sure that every part of the country has good services to ensure people get through such difficult times.

[Luciana Berger]

I will come on to the very serious issue of perinatal mental health that the right hon. Gentleman raises. Again, we should all be very concerned about that issue.

I am very concerned that there has been a psychiatry recruitment crisis, with a 94% increase in vacant and unfilled consultant posts. The NHS constitution treats mental health and physical health differently. The Government claim to be increasing mental health budgets, but patients and professionals tell a different story. Ever since Ministers discontinued the annual survey of investment in mental health three years ago, we do not have an accurate picture of spending on mental health in our country.

[Paul Blomfield (Sheffield Central) (Lab)]

My hon. Friend is making an important point about the transparency of spending. Last June, I asked the then Health Minister, the right hon. Member for North Norfolk (Norman Lamb), who is in his place, when figures would be published, and he told me that the Government were working with NHS England to provide meaningful data. Last month, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) tabled a question for written answer asking when the information would be available. It is still not available. Does my hon. Friend agree that the Government should come clean?

[Luciana Berger]

I thank my hon. Friend for his very important intervention. One of the key points of my speech is that there is so much we should do to shine a spotlight on what is happening to mental health funding right across the country.

[David Rutley (Macclesfield) (Con)]

The hon. Lady is of course right that this subject is vital. The Government are working hard on it. Will she join me in welcoming the Government’s promise and commitment to bringing in an extra £600 million for mental health services, as set out in the autumn statement?

[Luciana Berger]

My concern partly rests on the fact that, given the cuts we saw during the past five years, we are only returning to the levels of spending on mental health that we had back in 2010. I have asked a number of questions about how the £600 million might be presented, but I am waiting for the answers to see how the Government will allocate that money. I will come on to the pledges that the Government have made and what is actually happening in reality.

[Mr Robin Walker (Worcester) (Con)]

rose—

[Luciana Berger]

I will make a little progress, because I have my speech to get through and I am conscious that many Members on both sides of the House want to contribute to this debate.

We are calling for three things that we believe will make a difference. First and foremost—several interventions have referred to this—we are asking the Government to restore transparency to address the murky picture of mental health funding. Secondly, we are asking Ministers to address the fundamental inequality that currently exists in our NHS constitution. Finally, we are asking the Government to prioritise prevention and to implement a fully cross-departmental plan to prevent mental health problems from developing in the first place.

[Helen Whately (Faversham and Mid Kent) (Con)]

Does the hon. Lady agree that transparency is known to be a very effective lever for the Government to use to improve quality? Does she welcome the steps taken by the Government to increase transparency in the performance of mental health services?

[Luciana Berger]

I do not share the hon. Lady’s view. Just in the last week, I have written down a list of 10 things about which I have asked the Government for figures, but about which I have been told that they do not hold information centrally. Many of the statistics that were available previously are no longer available. The central request we are making today is to restore the transparency, particularly on how much is spent on mental health, which the Government took away in 2011-12. Many Members on both sides of the House would like to know those figures.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

My hon. Friend is making a very powerful speech. On prevention, is she as concerned as I am that a recent report by the University of Liverpool has estimated that an additional 590 suicides were associated with the work capability assessment process, a Government policy, between 2010 and 2013?

[Luciana Berger]

I am fully aware of the research that my hon. Friend mentions. It was carried out by a number of academics from the University of Liverpool, including one of my constituents. I have studied the research very carefully. It highlights many areas of concern, particularly the changes and reforms made by the Department for Work and Pensions that have had a negative impact. I will address the very point she raises later in my remarks.

Nowhere is this gap between Ministers’ rhetoric and the reality more evident than when we look at investment in our mental health services. Only last year, funding for mental health trusts was cut by 20% more than that for other hospitals. In 2011-12, total investment in mental health dropped for the first time in a decade. Perhaps unsurprisingly, in the same year the Government stopped publishing how much they invest in mental health.

Last year, I had to use freedom of information requests to get to the bottom of how much clinical commissioning groups were allocating to mental health: 67% of those who responded spent less than 10% of their budget on mental health, despite the fact that mental health accounts for 23% of the total burden of disease. This year, the Minister for Community and Social Care promised to do something about this. He said he would ensure that investment in mental health by clinical commissioning groups increased in this financial year in line with the increase in their overall budgets. However, as the Government do not publish a central record of these data, I had to use the Freedom of Information Act to find out for myself. Over the past summer, I found that more than one in three CCGs were not meeting the Government’s expectation. That is just one of many Government pledges on mental health that have not been translated into reality.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

The hon. Lady is making an important speech, but may I encourage her to be as bipartisan or as all-party in her approach as possible on this vital issue? It is very good to see the Leader of the Opposition and the Heath Secretary in their places, both of whom have a long-standing interest in this issue. Will the hon. Lady at least accept that the all-party campaign led by the right hon. Member for North Norfolk (Norman Lamb)—very substantially assisted by Alastair Campbell, who has some considerable expertise in this area—was successful, beyond the scenes, in persuading the Chancellor to produce an extra £600 million for mental health? All of us will try to ensure that that money is spent well, but let us try to do so with an all-party or bipartisan approach.

[Luciana Berger]

I know that the right hon. Gentleman has worked hard on these issues, as have many Members across the House. My job is to hold the Government to account for the promises they have made, and that is what I am endeavouring to do. Where there are opportunities for us to work together we should be keen for that to happen, but the Government have not delivered on their previous pledges. I am keen to know the detail of how that £600 million will be allocated and over what period, and we look forward to that information coming forward.

The spend of clinical commissioning groups is just one pledge on mental health that has not translated into reality, and—unfortunately—another is the commitment to spending £250 million on child and adolescent mental health services this year. In response to a parliamentary question, the Government have admitted that there will be a £77 million shortfall on what they have pledged to spend this year. With those spending promises so far unfulfilled, Labour Members are concerned about the lack of transparency on mental health spending. That is why we are calling on the Government to reinstate the annual survey of investment in mental health services.

It is not only in funding that equality for mental health has yet to be achieved, because a huge disparity remains at the heart of our NHS. The NHS constitution sets out the rights to which patients, the public and staff are entitled, and the pledges that the NHS is committed to achieving. The constitution enshrines our rights to access drugs and other treatments, but it does not extend that right to talking therapies. Recently, the Government consulted on adding a right to psychological therapies to the NHS constitution, but they decided not to include it in its latest version. That decision reinforces the existing bias in the system against mental health, and if the Government are serious about fair access to cost-effective mental health treatment, they must address that fundamental disparity.

[Jonathan Edwards (Carmarthen East and Dinefwr) (PC)]

I am disappointed with the tribal attacks on the Scottish health service in the motion, and it does not say much for the new politics promised by the Leader of the Opposition. Has the hon. Lady reflected on the situation in Wales—the only part of the UK where the Labour party is in charge—because the Academy of Medical Royal Colleges in Wales, which represents 16 colleges and facilities, said last month that mental health services in my country face significant inequalities? How will the hon. Lady respond to those concerns?

[Luciana Berger]

I have heard from my colleagues in Scotland about the challenges that they face with mental health services, and it is right that we should raise that issue during this debate. I have also had the opportunity to meet my colleagues in Wales and see the fantastic work that they are doing. Their pioneering piece of mental health legislation, which came into force in 2012, is the first for any developed country in terms of how it treats mental health, and it ensures that patients have a proper dedicated plan that considers not only their health needs, but their support, personal care, wellbeing, education and training. I look forward to working with my colleagues in Wales and to supporting them in the fantastic work that they are doing.

[Mr Ivan Lewis (Bury South) (Lab)]

My hon. Friend made an important point about access to talking therapies. One of the biggest consequences of not having such access is the fact that the only option available to clinicians is medication—often in very inappropriate circumstances—which can lead to people becoming dependent, sometimes for a long period of time. This is not just a minor matter about whether this provision is in the constitution; that lack of access leads to inappropriate intervention that can have a lifelong effect on many people.

[Luciana Berger]

I thank my hon. Friend for his important intervention. I am sure that too many of us hear from our constituents about how that sort of experience has been replicated across the country. We know that the number of prescriptions issued for mental health issues has risen exponentially and is into the millions for people who have to access drugs. Sometimes that is because they cannot access talking therapies, which should be of serious concern to us all.

[Lucy Frazer (South East Cambridgeshire) (Con)]

Does the hon. Lady welcome the Government’s commitment to introducing waiting time standards so that patients do not have to wait a long time to get access to a talking therapy? This Government introduced that measure, but the Labour Government did not.

[Luciana Berger]

The Labour Government created the services in the first place. In order to introduce a waiting time standard those services have to exist, which was not the case previously. We had to address the chronic underfunding of mental health that existed pre-1997, and we introduced the improving access to psychological therapies programme, of which we are incredibly proud. As things develop, it is right that those waiting time standards come forward. The Labour party had waiting time standards in place for all consultant-led services, which included physical and mental health. I am proud of that fact but disappointed that in too many cases the same equality is not also applied to mental health. If the Government are serious about fair access to cost-effective mental health treatment, they must address that fundamental disparity. That is why we are calling on the Government to commit to ensuring that all patients, regardless of whether they need a drug, a physical health treatment or a psychological therapy, have the same rights.

[James Morris (Halesowen and Rowley Regis) (Con)]

rose—

[Luciana Berger]

I hope the hon. Gentleman will forgive me but I will make some progress as I am conscious of time.

Ensuring that people have access to help early on is critical to preventing people from becoming ill, but in recent years, short-sighted cuts to key prevention, early intervention, and community services have been having a devastating impact. When the number of children with a mental health problem who turn up at A and E has doubled in recent years, when one person in prison takes their own life every four days, when a young person who is self-harming is told that because they are not suicidal they do not meet the threshold for help, and when a woman with an eating disorder is turned away from specialist services because her body mass index is not low enough, it is clear that people are not getting the right help early enough.

Too often, mental health problems are ignored, and it is only when they reach crisis point that they receive attention. More and more I hear from mental health professionals across the country that their middle-tier community services, psychologists and counsellors are being stripped out. Apart from the obvious devastating human cost, which impacts on people’s ability to hold down a job, keep a tenancy, pay the mortgage and maintain relationships with partners, friends and family, those decisions will cost our NHS and local authorities more as they struggle to deal with the consequences of serious ill health that could have been prevented. That cost is not insignificant. Recent studies have put the cost of mental ill health to our society at a staggering £105 billion a year. How can the Secretary of State and this Tory Government justify that? Ensuring that people can access support when they need it is an urgent priority, but if we are to ensure that our services are sustainable into the future, we must do much more to prevent people from becoming ill in the first place.

The right hon. Member for North Norfolk (Norman Lamb) mentioned perinatal mental health problems, which affect up to 20% of women at some point during pregnancy and/or the year after the birth of their baby. Left untreated, perinatal mental health problems cost our economy £8 billion a year. Is it not appalling that even if those women seek help, they are not always guaranteed the specialist support they need? The number of mother and baby units has dropped since 2010. The Government’s pledge to spend £15 million on perinatal mental health this year was welcome, but as of this month— according to an answer I received to a parliamentary question—the Government have spent just one fifteenth of what they promised. That is a bitter disappointment because intervening early in perinatal mental health does not just help to improve the health and wellbeing of the mothers affected, but it also improves that of their children.

[James Morris]

May I take the hon. Lady back to her point about the IAPT programme that was introduced by the previous Labour Government and is an illustration of where both parties have delivered success? It may be good to enshrine psychological therapies in the NHS constitution, but we need to build more capacity in the system to deliver on access standards. This is not something that we can just write into the constitution; we need to increase choice and access to psychological therapies across the country.

[Luciana Berger]

I do not think it is an either/or situation; it is about how we do both, and I will come on to that in the rest of my remarks.

We know that 75% of people who have mental health problems in working life first experienced symptoms in childhood or adolescence, yet only about 6% of the mental health budget is spent on child and adolescent mental health services. We need to do more to focus attention on children, young people and, crucially, prevention, and here we must look to our places of learning, our workplaces and our communities. We need schools and colleges that promote good mental health. We need to ensure that all children have access to high-quality social and emotional learning so that they acquire the skills to express how they feel and develop an understanding and awareness of good mental health. We were concerned to read the 2013 Ofsted report on personal, social, health and economic education, which stated that mental health education was often omitted from the curriculum owing to a lack of teacher training. The Government have funded the PSHE Association to publish guidance and lesson plans to support teaching about mental health, but how are the Government ensuring that schools are actually using it?

We need communities that promote good health and wellbeing. Poor housing, fuel poverty and neighbourhood factors, such as overcrowding, feeling unsafe and a lack of access to community facilities, can have a harmful impact on mental health. These, along with abuse, bullying, trauma, deprivation and isolation, are just some of the levers of mental distress in our communities that we must address.

[Nic Dakin (Scunthorpe) (Lab)]

I congratulate my hon. Friend on setting out such a strong case. Does she agree that the pressure on local government over the last few years has had a negative impact on community cohesion in relation to mental health and led to a growth in loneliness and other such things that spawn mental health problems?

[Luciana Berger]

My hon. Friend’s intervention brings me neatly on to my next remarks. I am enormously concerned about the impact of the Government’s deep cuts to local authority budgets over the past five years, of the additional £200 million in-year cuts to public health and of the cuts coming further down the line. I am concerned about their impact on our communities and the services that serve them, such as our libraries, drop-in centres, leisure centres, befriending services—my hon. Friend talked about loneliness—children’s centres, which support parents and young children, and citizens advice bureaux, which support people early on. They are the glue that support and keep our communities together, and I am concerned about what might happen over the next few years.

We need a social care system that is integrated with our physical and mental health services, and we will continue to push the Government to address the fragmentation across these systems. Billions have been slashed from social care budgets and the number of people receiving social care support for mental health has fallen by a quarter since 2009-10. This is seriously impacting on mental health trusts’ ability to discharge their patients. I hear that time and again when I visit mental health trusts across the country. They have patients they cannot move out because the social care is not available for them to move into.

We need workplaces that promote a good work-life balance and where mental health is recognised, understood and supported. Some 70 million working days are lost every year owing to stress, depression and other mental health conditions. Mental health problems cost employers in the UK £30 billion a year through lost production, recruitment and absence. As the chief executive of NHS England has rightly pointed out, the NHS has to get its own House in order. Across the health service, staff tell me they are concerned about their wellbeing and that of their colleagues. Longer hours, fewer resources, greater demands and an incredible amount of goodwill are creating a perfect storm within the NHS. The figures from the NHS staff survey show that the proportion of staff reporting work-related stress has increased from 29% in 2010 to 38% in 2014.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

In the spirit of bipartisanship touched on by my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell), will the hon. Lady accept the clear evidence showing a link between good mental health and employment and comment on the number of jobs created over the past five years, which, I have no doubt, has helped to promote good mental health?

[Luciana Berger]

I am interested in the hon. Gentleman’s intervention as I am about to talk about employment and unemployment support. I am concerned by the number of constituents coming to see me about the increase in precarious employment and their ability to budget and sustain themselves from week to week.

For those who are unemployed or lose their job because of their condition, the hope of getting back into work under the Government is unjustifiably slim. The latest statistics reveal that fewer than 9% of people with mental health conditions receiving employment and support allowance have been helped back into work by the Work programme. In fact, 83% of people surveyed by the charity Mind reported that the Work programme had made their mental health condition worse. How can it be right that programmes that are supposed to help people into work are doing the opposite?

These issues alone cover the work of at least five Departments, and it does not stop there: the arts have long played an important role in helping people with mental illness; the Ministry of Justice must do much more on mental health in our prisons; and all front-line professionals, especially those in our police and emergency services, need training and support in how to respond to mental health issues.

I come now to our third and final call: we urge the Government to implement a truly cross-departmental plan to improve their response to mental health issues within our society. “No Health Without Mental Health”, published in 2011, promised to be a cross-Government outcomes strategy for people of all ages, but we are fast approaching its fifth anniversary and progress has been limited. We need a new strategy with teeth that will co-ordinate work across all Departments and set priorities, measure progress and evaluate success. We have been eagerly awaiting NHS England’s taskforce report, which was due to be released this autumn, yet we heard the other week in the Chancellor’s autumn statement that it has been delayed until next year, when the NHS England planning guidance will already have been issued. What influence or impact do the Government hope the report can have if the NHS guidance for the coming year will not take it into account?

In conclusion, mental health matters—in our schools, our workplaces and our communities. It matters to our fulfilment as individuals and to the economic success of our society. There have been important strides forward, which we welcome, but we are also concerned that too much is at risk. We hear too often that our mental health system is in crisis. We are concerned that the right help and support is not there for people when they need it; we are worried that not enough is being done to prevent people from having to turn to these services in the first place; and we are anxious that, in some areas, changes taking effect across Departments are making things worse for our nation’s mental health. Much needs to change, and we are asking for three things that will make a difference. I commend the motion to the House.

--- Later in debate ---

[Mr Hunt]

We, as a Government, make commitments and choices in terms of where we want resources to go, and we then have a duty to ensure that they are followed up locally. As we know from our experience of the health service, sometimes—under all Governments—that advice is followed, and sometimes it is not. The introduction of proper independent ratings, area by area, will enable us to expose the areas that are not making the commitment to mental health that they should be making. As has been pointed out many times by Members in all parts of the House, failing to invest what is needed in mental health is a false economy. It stores up problems for accident and emergency departments and for the providers of mental health services, because late intervention means more expensive intervention, and it is of course a very real human tragedy for the individuals concerned.

[Luciana Berger]

rose—

[Mr Hunt]

As the hon. Lady is the shadow Minister, I will give way, but for the last time.

[Luciana Berger]

I thank the Secretary of State. Will he clarify the commitment that he has just made? Does it extend to ensuring that we will be shown a clear picture of mental health spending in every area?

[Mr Hunt]

I believe that we will be able to do that, but I will write to the hon. Lady to clarify exactly what we think we are able to do. I am certainly committed to ensuring that the House is given information about the quality of provision throughout the service, and investment is a factor in determining whether the standard of that provision can be as high as we want it to be.

The hon. Lady rightly spoke of the importance of cross-Government work. We have established an innovative unit with the Department for Work and Pensions, and have set up a series of pilots to help people with mental health conditions to get back to work. We urgently need to do more to reduce the stigma perceived by employers. According to the findings of one survey, up to 40% of employers would avoid hiring someone with a mental health problem. We also want to help those who are at risk of leaving work because of mental health problems. We are working closely with the Department for Education as well. We have launched a pilot programme to create a single point of contact for schools that are concerned about pupils with mental health challenges. It now covers 22 areas and 27 CCGs.

If we are to tackle this issue, however, we need to achieve something that the Government alone—indeed, the House alone—cannot deliver. We need further progress throughout society in reducing that stigma. Bill Clinton once said:

“Mental illness is nothing to be ashamed of, but stigma and bias shame us all.”

Let me end by paying tribute to the Time to Change movement, founded by Mind and Rethink, and the Dementia Friends movement, led by the Alzheimer’s Society. I also pay tribute to Members in all parts of the House who have participated in mental health campaigns, and reassure them that they have the Government’s full support as we try to change attitudes on this vital mission. Someone once said that the greatest cruelty was our casual blindness to the despair of others. Let us resolve today that when it comes to mental health, no one can ever say that about the House of Commons.

Male Suicide and International Men’s Day

Luciana Berger Excerpts

Thursday 19th November 2015 Westminster Hall

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

As the shadow Mental Health Minister, I am grateful for the opportunity to take part in this debate on International Men’s Day. I will respond specifically to the motion, which tackles male suicide.

I thank Members from throughout the House for their contributions to the debate, which have revealed just how significant a challenge male suicide is in all our communities. I also add my thanks to CALM for the work it has done to raise the profile of the issue and push for a debate on it. Its #BiggerIssues Thunderclap campaign today has reached millions of people on Twitter and across social media. That is an important indication of the strength of feeling on this issue. On Monday, the Mind media awards featured countless nominations for programmes and coverage that had raised the profile of this significant issue. The campaign award was won by the #FindMike campaign, which was run by Jonny Benjamin and Neil Laybourn, recognising the contribution that they have made to the debate.

I pay tribute to the chair of the all-party group on suicide and self-harm prevention, my hon. Friend the Member for Bridgend (Mrs Moon), for the vital contribution that she and the group have made and continue to make to the ongoing debate on suicide. As a society, we should be doing everything that we possibly can to prevent it. I also thank the Samaritans and the Royal College of Psychiatrists for their helpful briefings ahead of this debate.

The rate of male suicide in this country is a national scandal. It is shocking that in today’s society the number of people taking their own life is increasing. The fact that such a disproportionate number of those suicides are by men demands our urgent attention. I shall share again some statistics that we have already heard, because they are so significant: of the total number of suicides in the UK in 2013, 78% were male and 22% were female, and suicide is the single biggest killer of men aged under 45 in the UK. Every time a person is lost to suicide, it is a tragedy—for their loved ones, their friends, their community, and society as a whole.

Members from across the House have mentioned cases of suicide in their constituencies, and sometimes within their own families; each one is tragic and devastating in its own right. The impact of suicide can be wide-reaching and incredibly long-lasting. Apart from the obvious human cost, which often affects whole communities in schools, colleges or workplaces, we must consider the huge economic cost. I was particularly struck by the Department of Health impact assessment, which put the economic cost of just one suicide at a staggering £1.7 million.

This debate has given us an important opportunity to examine the factors that might lie behind the shocking statistics. A report by the charity Mind outlined some of the possible reasons why men are more likely to take their own life. It suggests that men compare themselves to a gold standard of masculinity, power and control, and are more likely to feel shame and guilt when they fall from that standard. There is a link between unemployment and suicide—unemployed people are two to three times more likely to take their own life. Just this week, the University of Liverpool published research into the number of suicides that, tragically, have happened in areas with a higher number of work capability assessments.

[Philip Davies]

The hon. Lady and the hon. Member for Caithness, Sutherland and Easter Ross (Dr Monaghan) try to draw attention to work capability assessments and blame suicides on them. Will she accept that it was the Labour Government who introduced work capability assessments, under which more than 60% of people were found fit for work? In work capability assessments now, only 27% of people are found fit for work, so her Government were finding more people fit for work than this Government ever have. Will she at least acknowledge that fact, rather than trying to make a rather cheap political point?

[Luciana Berger]

I pointed out just one reference to the work capability assessment that is particularly relevant because that research has been prominent in the press today. There are many other factors—that is just one—and I will come on to address them, but that research has been conducted academically and is particularly relevant this week. That is not a political point; it is something that is significant in many communities and that has been raised by Members of all parties, not just by the Opposition.

Some groups of young men are particularly at risk. Research conducted by the charity METRO found that more than a third of LGBT young people have attempted suicide at least once. Shockingly, it has recently come to light that suicides in our prisons have increased by more than 50% in recent years. Every four days a prisoner takes their own life, and the majority are men. Analysis by the Samaritans and a number of academic studies show that there is also a very strong link between socioeconomic class and suicide, with those living in deprived areas on the lowest incomes being most at risk.

Men are more likely to take risks with drugs and alcohol. They are also much less likely to open up to their friends and family and seek emotional support, as many Members have said. We have also heard concerns about the impact of economic crises on suicide rates, which I echo. My hon. Friend the Member for York Central (Rachael Maskell) referred to debt, and we also heard about the challenges in Greece, which has seen an increase in suicides.

All those individual factors are important and demand our consideration and attention, and I hope that the Minister will respond to each of them in turn. Whatever factors contribute to a person wanting to take their own life, there is one thing of which we must never lose sight: suicide is not inevitable. If people are in crisis, good care can make a vital difference, and it can and does save lives.

We have heard about the challenges in ensuring that people with mental health problems get the support that they need, and there are particular challenges due to fragmentation in the system. Service users, professionals and experts are warning of a mental health system under unsustainable pressure. The number of people becoming so ill with mental illness that they need hospital care has increased. At the same time, the number of mental health nurses has decreased, and we are hearing of too many instances of people having to travel hundreds of miles for a bed or, in some cases, not getting any help at all.

The Royal College of Psychiatrists has advised that men tend to use more lethal forms of suicide than women. It is therefore vital that the very first time someone says they have had suicidal thoughts, they get the best support possible. It is vital that that support is provided in the first 24 hours after a crisis begins. Mental health charities have long been campaigning for better crisis care. Research from the charity Mind has found that people in mental health crisis might not be able to get help immediately.

I echo the comments of my hon. Friends the Members for Bridgend and for York Central about the role of the police. Some important pilots of street triage teams are going on throughout the country. I had the opportunity to join one in Liverpool and saw at first hand the fantastic work being done by the police and mental health professionals to contend with issues of suicide and suicide prevention. They often identify people and take them to a safe place, but we know that only one third of people who use NHS crisis care services are assessed within four hours, which should concern all hon. Members. Research has found that when people present to services, perhaps after having been brought there by a member of the police or a street triage team, there are often not enough staff to provide the care that they need.

When someone has a mental health crisis and is most at risk of suicide, one of the places they are most likely to be taken is the local hospital’s accident and emergency department. I echo the point made by the hon. Member for Faversham and Mid Kent (Helen Whately): there is a serious shortage of liaison psychiatrists in acute hospitals. I have had the opportunity to join a number of such teams in A & E. They do an incredible job in very difficult circumstances and under a lot of pressure. I have heard the staff say that they are not able to deal with all the cases they would like to in an adequate time, which should concern all of us. Having experts on hand is key to ensuring that people get the support they need. I would welcome an update from the Minister on the work he is doing to increase the number and coverage of liaison psychiatrists in our hospitals.

Labour Members welcome the mental health crisis care concordat—the national agreement between local agencies to work together more closely when responding to people in mental health crisis. I note that great strides have been made in supporting the police to improve their response to people with mental health problems. However, it is not clear what tangible progress is being made on the ground in relation to suicide as a consequence of the crisis care concordat. A King’s Fund report published last week found that just 14% of people felt that they received appropriate care in a crisis. I hope the Minister will share with us his plans to evaluate what the crisis care concordat has achieved and what it might go on to achieve.

My hon. Friend the Member for Bridgend rightly raised the complex and under-researched issue of suicide contagion. I echo the concerns raised by Members from both sides of the House about the challenges caused by the lack of research into suicide. There are some great research facilities, but they are few and far between. Although their work leads the way, funding for all types of mental health research is significantly lower than funding for research into physical health conditions. Public Health England published guidance in September on how to identify and respond to suicide clusters. I hope the Minister will tell us about the work his Department is doing to understand more about and prevent suicide contagion.

Ensuring that people in mental health crisis get the support they need is an urgent priority. However, to stem the tide of male suicide, we must do much more to prevent men from reaching the crisis point in the first place. A number of hon. Members have talked about the important fact that three quarters of people who take their own life are not in contact with mental health services. Men who suffer from depression are much less likely than women to look for formal help from mental health professionals. They are also less likely than women even to talk to their family and friends about how they are feeling. We need a cultural shift so that men feel able to discuss their mental health, seek help and get the support they need.

Just as important as ensuring that men feel able to talk openly about their mental health is ensuring that when they come forward, there are services available that they feel comfortable accessing. We need to do more to ensure that men can access information about mental health problems. We must make support available in what might be considered traditionally male settings, such as where men meet, eat and watch sport. That point has already been made this afternoon. I have seen at first hand the work done by Everton in the Community, an organisation connected to Everton football club that looks at mental health in particular. It has mental health champions and does work on the football playing field and just after matches, and it has a significant impact. It is a great project and there are others, but they are not the norm, so we need to do more work.

There is a real need for joined-up working between different sectors, including health, social care, education, employment, social welfare and the Ministry of Justice, to reach out to men who are depressed and at risk of suicide. Underpinning all of that is the need for a concerted and co-ordinated approach from the Government to prevent suicide. The Government’s suicide prevention strategy was published in 2012, yet there is still a high rate of suicide in our country. The strategy has not been as successful as any of us would like. My hon. Friend the Member for Bridgend said that she is concerned that the strategy lacks teeth and that there are no timeframes or tangible reporting mechanisms by which to measure its success. Does the Minister agree that it is time for an urgent review of the suicide prevention strategy? We also need timely access to data about suicide. It is not right that there is a two-year delay in receiving such figures. What plans does the Minister have to improve the availability and transparency of information about suicide across the country?

In the light of the rising suicide rates, it is clear that we need a revolution in suicide prevention to address the fact that many more men than women take their own lives. For too long, mental illness has been the subject of stigma and prejudice, which means that people—particularly men—often feel that they cannot talk openly about their mental health problems. A few brave public figures, such as Stephen Fry, Graham Norton and my hon. Friend the Member for North Durham (Mr Jones), have spoken up about their own mental illness, but for too many people mental health remains hard to speak about openly. Only last week, in my constituency surgery a man in his 50s told me that he is not able to relate to either his siblings or his parents about the mental health condition he has been affected by throughout his adult life.

It is incumbent on all of us to make the rhetoric about parity of esteem a reality. Challenging stigma is key to making equality for mental health a reality. We need a cultural shift in our schools, colleges, universities and workplaces to enable men to discuss their mental health and feel able to seek help. We need to overcome the stereotypes of masculinity placed on men’s shoulders and give them the support they need. Each suicide is a terrible tragedy and a waste of precious life. Members from both sides of the House have talked about the important work that must be done to tackle the challenge and about the many practical steps that must be taken. It is clear from their contributions that together we can prevent suicide and save the lives of many men. I look forward to the Minister’s response.

--- Later in debate ---

[Alistair Burt]

My hon. Friend is absolutely right. Those connected with housing increasingly recognise the relationship between housing, mental health issues and suicide. When I was with my hon. Friend the Member for Derby North, I met the lady responsible for the YMCA there and its housing outreach, and she made some pertinent comments. Housing and homelessness are closely connected with the problem we are discussing, and I commend the constituent that my hon. Friend the Member for Worcester mentioned.

We know that men are often reluctant to talk about mental health problems. Many colleagues have referred to men’s attitudes, so I do not think that I need to labour that point. They are reluctant to seek help when they need it. In part, we know that is because some men feel that it may be a form of weakness. We need to assure men that that is not the case, as many colleagues have said. We, along with the charities Mind and Rethink Mental Illness, are seeking to reduce the stigma around mental illness through the Time to Change campaign.

Time to Change aims to empower people to challenge stigma and speak openly about their own mental health experiences—particularly men—and to change public attitudes towards those with mental health problems. The campaign has improved the attitudes of more than 2 million people. However, we know that men can be a particularly hard-to-reach group, and we are looking at further ways to improve reach in that area.

We know, tragically, what the outcome of unacknowledged mental ill health can be for a person. When someone bottles it up—that phrase was used in this Chamber today—their condition can worsen and may, in the worst cases, increase the risk of suicide. As I mentioned earlier, suicide rates in England remain low compared with in other European countries and other UK administrations, but I am concerned, as we all are, to see that rates have been rising in recent years. We anticipated that after the global financial crisis in 2008, and it has been seen in other countries around the world, as the hon. Member for York Central said. We know about that, but it is important that the inevitability of that does not go unchallenged. We can appreciate that such times bring extra pressures, but we need to ask what we can do when we know they are coming.

We know that the recent rise in suicide rates has been driven by an increase in male suicides, which is what led my hon. Friend the Member for Shipley to call for the debate in the first place. The threefold difference between male and female suicide rates has increased further, and we know that is a common experience in other countries around the world. It is right, therefore, that preventing suicide is dominated by efforts to prevent male suicide, but we recognise that this issue affects everyone. Whether men or women, boys or girls, when it happens it is an immense tragedy.

The greater risk of suicide among men is a complex issue. Many of the clinical and social risk factors for suicide are more common in men. Cultural expectations that men will be decisive and strong can make them more vulnerable to psychological factors associated with suicide, such as impulsiveness and humiliation. It is critical that, in addressing those issues, we provide information and support in a way that suits men’s needs and behaviours, and that we provide services that are appropriate for men, which may include moving away from traditional health settings.

What are we doing about it, and what will we do about it? We published the cross-Government suicide prevention strategy for England in 2012, and I am committed to implementing it by working across Government and with our partner organisations in the NHS and other sectors such as transport and the community, voluntary and charitable sectors. I will also be speaking to our partner organisations soon to discuss how we can review and strengthen the national suicide strategy. I want to make it clear that I see that as a dynamic and flexible instrument, not as something that we will do and then I will see how it works and make some decisions in years to come. We are looking at it now. It needs to be reviewed and refreshed now. It is an ongoing process, and I am committed to it.

The objectives of the strategy are to reduce suicide and to support the people bereaved or affected by it. It is right that men are identified in the strategy as a high-risk group for whom our suicide prevention activities should be and are prioritised. The strategy also recognises that schools, social care and the youth justice system have an important contribution to make in suicide prevention by promoting mental wellbeing and identifying underlying issues such as bullying, poor self-image and lack of self-esteem.

As well as having the strategy, we continue to provide financial support for the National Suicide Prevention Alliance, which brings together our key partners across Government and the community, voluntary and charitable sectors with expertise in suicide prevention. I am particularly pleased to say that many of the organisations that campaigned for the debate are members of the NSPA. It has been working with all those organisations to develop its strategy for delivering improvements in suicide prevention, which I welcome. My Department of Health officials are helping with that work. Those organisations make tremendous individual contributions to suicide prevention. The Campaign Against Living Miserably, which was prominent in calling for this debate, works tirelessly to target men specifically, and to support them, so that they feel able to talk about mental health issues. The Department of Health provided financial support to CALM in its early days, and I am proud to see how it has grown in size and profile.

I have had a variety of meetings on the issue since I took office; I have mentioned some already. I went to see the Samaritans bereavement centre in Peckham for World Suicide Prevention Day, and to mark the launch of a new initiative between Cruse Bereavement Care and the Samaritans. I met the British Transport police and saw the extraordinary work they do with Network Rail. I saw some of the triage work going on in Birmingham, including placing a mental health professional in the police control room 24 hours a day to help provide necessary information. I held a meeting on suicide prevention on 29 June, with researchers, the Samaritans, and representatives from areas such as Merseyside, the east of England and the south-west.

We have started to look at something called zero suicide. I have an interest in the concept and ambition of zero suicide. It was pioneered in Detroit by a college acquaintance of mine from many years ago, Ed Coffey, and I am very interested in his work. We can follow part of it, although some things are different in the States and will not be pertinent here. The whole concept of zero suicide—recognising that as an ambition, and challenging the inevitability of suicide—is really important and has very much grabbed my attention. Public Health England also recently published the refreshed “Help is at Hand” document, which provides compassionate support and information to people bereaved by suicide.

I will conclude by saying a little about research and data, as it will cover a number of issues raised by colleagues. One of the key drivers for improving our approach to suicide prevention is investing in research and data. I want us to lead the world in suicide prevention research, and to be at the forefront of service delivery, using the best knowledge and information to provide the best care. We have invested over £1.5 million in suicide and self-harm prevention research since bringing in the national suicide prevention strategy, to inform and target our strategy for reducing suicide rates. I will have a look at whether that is enough, and at what more needs to be done.

The hon. Member for Bridgend mentioned longitudinal studies. We are committed to carrying on the work on that. We have provided the Multicentre Study of Self-harm in England with £300,000 this year. I will very much bear in mind the opportunities that there might be for us to do more.

The zero suicide ambition I mentioned is being piloted in three areas: Merseyside, the south-west and the east of England. Early learning from the pilots has identified some innovative practice, which I am sure will help other areas to develop innovative plans for reducing suicide in their communities. There will be more research that we can work through to find whether it could have applications elsewhere.

[Luciana Berger]

Will that work extend to our prisons, which are a particular area of concern?

[Alistair Burt]

I know the Ministry of Justice is looking closely at the increase in prison and detention suicides. Again, it is not huge, statistically, but any increase is a matter for concern.

The work capability assessment has been mentioned. It started in 2008, which is about the time that the rise in suicides began. The authors of the recent study that has been mentioned have said that they were cautious about making a link or claiming cause and effect, but I have already asked the Department of Health to have a look at that study, because I feel it is important that my Department looks at the matters involved.

This has been a really good and important debate. First, it has put the issues connected to International Men’s Day on the agenda and allowed us to talk about male issues, in a way that is not a zero-sum game. We have been able to make reference to some difficult issues that are not discussed enough, and I am grateful to my hon. Friend the Member for Shipley for that. We have spent the bulk of our time discussing suicide, and Members on both sides of the House have been able to work together and demonstrate a common interest in things that affect us all. The sense I get from everyone is that none of us is prepared to accept the status quo and simply see the statistics accepted—my hon. Friend the Member for Bury North made that point.

These will not be easy issues to tackle. More men commit suicide than women, not because someone is making them do so—it is not anyone’s fault—but that is a fact. What more can we do? What can we learn from overseas and from the work being done in different areas of this country? I am absolutely confident that this House will talk about this issue again. I hope that when we do, we will have learned still more. People and organisations outside the House do such excellent work on this; with the benefit of that work, perhaps our ambition to make this the country with the best suicide prevention strategy in the world can, in time, become a reality.