Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(6 years, 9 months ago)
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Alistair Burt
Since the beginning of the conflict in Syria, the UK has been working to equip civilians on the ground with the tools they need to collect evidence that can be used to ensure accountability and justice. We have been doing that work for some years, and we will continue to do it. The hon. Lady has called attention to the increased use of chemical weapons in the past few weeks, which is an outrage. The world community is entitled to be outraged by it, and we must ensure that, through the UN, we do something effective to bring the perpetrators to justice.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Alex Cunningham (Stockton North) (Lab)
The Minister for the Middle East (Alistair Burt)
The United Kingdom supports the concept of an international fund for Israeli-Palestinian peace. The Department for International Development’s people-to-people programme has similar aims, and brings together individuals from both sides to build support for a durable solution. We also remain concerned about the provision of healthcare in Gaza, and we are urging all the parties to take the necessary steps to improve conditions there.
Luciana Berger
I think the Minister for his response. With the UK’s increased commitment to funding coexistence projects in Israel-Palestine, which many on both sides of the House have long supported, we have an opportunity to lead the way on the global stage. Will he therefore pledge the UK’s diplomatic support to help to create that international fund, to ensure that our funding is matched by others as part of a sustainable international initiative to build the peace in the middle east that we all long for?
Alistair Burt
Many of us have worried over the years that one of the worst aspects of the conflict has been the separation of peoples. To that extent, we are following the concept of the development of this fund very carefully, and I will continue to take a strong personal interest in it. The sentiment behind it is exactly why we have the £3 million programme, but we will be watching the development of the international fund and giving it support where we can.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(8 years, 4 months ago)
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Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
As we celebrate the 68th birthday of the NHS—one of the Labour party’s proudest achievements—let us not forget the fact that there are thousands of people across our country with mental health conditions who continue to face stigma, discrimination and prejudice. Recent reports tell us that young people are waiting up to a decade to receive the appropriate treatment, and future plans for children and young people’s mental health are not up to scratch. Will the Minister please tell us how many more NHS birthdays will have to pass before real equality for mental health is secured?
Alistair Burt
How I miss the hon. Lady sitting on the Opposition Front Bench with her questions on mental health. I pay tribute to the exceptional work that she has done in this particular area. The £1.25 billion extra that is going into children and young persons’ mental health over the course of this Parliament—I along with other Members in the House have absolutely fought to make sure that it stays in the plans—will help. We have done more work than ever before in relation to combating stigma, but she is right to raise that, as it is essential that we do. It is also essential that the money that is provided centrally goes through clinical commissioning groups into mental health spending, and I am quite sure that she and I will make sure that happens.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(8 years, 6 months ago)
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Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Research published yesterday by NHS Providers and the Healthcare Financial Management Association showed that half of mental health trusts had not had an increase in their budget in 2015-16 and just a quarter of providers are confident that they will receive a funding increase for this financial year, 2016-17. Will the Secretary of State finally admit that the supposed additional investment in mental health that he talks about so often has not materialised for the patients and services that need it most? What is he going to do about it?
The Minister for Community and Social Care (Alistair Burt)
I thank the hon. Lady for her question and for her support for me in the recent London marathon. With reference to her question, it is precisely for the reasons she gives that it is so important for us to make sure that CCGs do transfer the extra money that is available for mental health into mental health services. That is why there will be more transparency and a scorecard for CCGs. She is absolutely correct—it is essential that that money flows through and we are determined to ensure that. Yesterday’s report only shows how right our current actions are to make sure that that happens.
Southern Health NHS Foundation Trust
Debate between Luciana Berger and Alistair Burt(8 years, 6 months ago)
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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.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(8 years, 8 months ago)
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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
Debate between Luciana Berger and Alistair Burt(8 years, 9 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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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.
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.
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
Debate between Luciana Berger and Alistair Burt(8 years, 10 months ago)
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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?
Male Suicide and International Men’s Day
Debate between Luciana Berger and Alistair Burt(9 years ago)
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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.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(9 years ago)
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Alistair Burt
I am grateful to my hon. Friend for raising the subject and for mentioning the forthcoming debate. The subject deserves to be looked at extremely carefully. As I have said, there should be neither complacency nor a sense of inevitability about suicide, and I am very interested in what more can be done. I have met one or two of the families who have experienced these tragedies and I am deeply impressed with their commitment to doing something for those age groups particularly affected. This afternoon I will meet a gentleman who is well known for having been involved in a suicide prevention incident. We are doing work to reduce stigma and to find places for people to talk about their concerns, and the more people are prepared to talk about things that might cause suicide, the better. This is an issue that we can give a higher profile to and do more work on, because every time there is a suicide it leaves a trail of damage for families and friends that is truly distressing to behold.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Last week, yet another report—this one from the King’s Fund—warned of a mental health system that is under huge pressure. On this Government’s watch, just 14% of patients feel that they have received appropriate care in a crisis. The number of mental health nurses has dropped, and increasing numbers of people are having to travel hundreds of miles for a bed. What action will the Minister take to turn his rhetoric into reality?
Alistair Burt
This is a cross-party matter and it is very important. We believe we have made strides during both the previous and this Government. We are investing more money in mental health services—it was increased to £11.7 billion last year—and this was the first Government to introduce standards for access and waiting times with regard to mental health, to try to put it on a par with other conditions. That was not how it was done before. We will now try to ensure that the money that goes in nationally is used to provide assistance locally, and that the money that is put in for local use is used locally.
There are areas to celebrate. We are world leaders with the improving access to psychological therapies service, which has treated 3 million people since 2009. We want to build on that. We know that the service has lagged behind others in the past, which is why we are determined to do much more about it. I think it is the view of the whole House that we should do more about it, and we will.
Luciana Berger
I listened very carefully to the Minister’s response, but I reinforce the point that the suicide rate in this country is going up, not down. It is a national scandal that we need to address.
The Minister mentioned prevention. The Government have confirmed that they will make an in-year £200 million cut to local public health grants. That is a political decision. It is not going to save money and, apart from the devastating human price, it is going to cost our NHS and our local authorities more as they deal with both physical and mental ill health that could have been prevented. How can the Minister justify that?
Alistair Burt
First, £1.25 billion is going into creating new services for children and young people’s mental health services during the course of this Parliament. The hon. Lady’s party did not make that commitment before the general election. More work is being done in schools to provide a better base for mental health. We have, for the first time, appointed in the Department for Education a Minister with responsibility for mental health in schools.
The pressures on public health budgets are the same as those on every other budget. Those pressures on the national health service were met by my colleagues during the general election, with a commitment to provide an extra £8 billion—the figure is now £10 billion—by the end of this Parliament. That commitment was not made by the hon. Lady or her party. She asks for more money to be spent, but we have committed to do that and we are finding it. It is very important that we take the position that we have to do as much as we can with what we have got. Mental health services are moving forward and we should take the opportunity to say that and welcome what has been done. We have provided the resources in a way that I am afraid the hon. Lady’s party did not.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(9 years, 1 month ago)
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Alistair Burt
I believe we are. I will check to be certain, as I know the right hon. Gentleman knows a great deal about this, but I believe we are. We have £150 million for eating disorders, and £30 million is being spent this year, with additional beds allocated. I will check that the waiting target times remain because they have made a significant difference. The right hon. Gentleman’s work has been of powerful import in what we do.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Yesterday, the National Society for the Prevention of Cruelty to Children revealed that one in five children in need of mental health treatment are being turned away. Is it not appalling that young people are being denied help, only for them to become more seriously ill later on, and that the number of children turning up at A&E because of mental illness has doubled in recent years? Does the Minister accept that children’s mental health needs more money now—this year, as he promised? I can point to many different organisations across the country that would gladly receive that support now. How is he going to put his broken promise right?
Alistair Burt
May I welcome the hon. Lady to her position, not least her Cabinet position—he said carefully—and welcome the prominence that mental health now has among all parties? Let me say rather gently in response to the tirade that I have just received that under this Government we have for the first time introduced parity of esteem for mental health on waiting times and national access targets. We are spending more money—£1.25 billion over the next five years. We have the highest number of beds for young people in emergency situations; we have the first dedicated education Minister for young people’s health; we have £75 million for perinatal health; and in her own constituency, the hon. Lady will be pleased to welcome from her shadow Cabinet position an extra £1.1 million going to Liverpool for mental health treatment for children and young people. I think that is a significant response.
Oral Answers to Questions
Debate between Luciana Berger and Alistair Burt(9 years, 4 months ago)
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Alistair Burt
Yes, and the adaptation of new and innovative therapies will also assist. Ensuring that GPs are aware of the increased access to psychological talking therapies is making a huge difference. Initial reactions to that programme indicate that, since 2008, nearly 3 million people have had access, 1.7 million have completed their treatment, and 1 million have recovered. Increased awareness of that in primary care will be very important.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Last month’s Care Quality Commission report revealed serious shortcomings in emergency mental health care, including that too many people do not have access to urgent help around the clock. The lead mental health inspector said that those findings must act as a wake-up call. How is the Minister ensuring that people in a mental health emergency get the same support that we would expect them to get in a physical health emergency?
Alistair Burt
The extremely important report to which the hon. Lady refers was commissioned by the Government. It described the crisis care concordat, which is at the heart of dealing with mental health crises, as a “remarkable initiative”. It states:
“An extraordinary range of public services and other bodies have acknowledged their responsibilities”.
For me, it serves as a baseline for what we should do. The word “efficiency” is pointed out, not least in respect of A&E treatment of those with mental health crises. I regard it as a very good base on which to work and to gauge the success of what we do to deal with mental health crisis care over the next few years. I commend the crisis care concordat—it is in operation all over the country—as a first step towards ensuring that the sort of treatment we want in mental health crises becomes the norm.
Palestine and the United Nations
Debate between Luciana Berger and Alistair Burt(13 years, 2 months ago)
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Alistair Burt
The hon. Gentleman raises, in his own way, a practical issue that affects the occupied territories. It is much discussed in this House and, as we are aware, something that a settlement between the two parties will ultimately sweep away, so that we have a viable west bank and Gaza continuing the economic progress that we have seen in recent years, as supported by the United Kingdom. However, those issues have to be dealt with by the parties themselves in the negotiations that we all wish to see.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Polling consistently shows that over 60% of both Israeli and Palestinian communities support a two-state solution. Will the Minister commit to ensuring that everything is done to support the peoples of both countries in their aims and aspirations?