NHS Funding Bill

Lucy Allan Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

I wish to speak to new clause 2, which is tabled in my name and those of my Liberal Democrat colleagues. As you know, Dame Rosie, I intended to push the new clause to a vote, but I understand that time pressures will not allow me to do so. I am disappointed by that, but I will be pressing the Government on this issue time and again. I want them to make it a high priority and to put it at the forefront of their policy making and commitments to the mental health of children and young people.

It is a pleasure to hear such a unified voice across the Committee about the importance of mental health, and there is a clear commitment to parity of esteem and to ensuring that mental health across the board gets the funding it deserves. I am therefore encouraged by the amendments, many of which I and my colleagues will support.

New clause 2 focuses specifically on the crisis—I used that word advisedly—in the provision of child and adolescent mental health services. It places a spotlight on the chronic underfunding of CAMHS, and seeks to encourage the Government and NHS England to deliver on their promises and improve transparency and accountability on those priorities.

Before I arrived in this place, I was aware of this significant and pressing issue. Less than two months since my election, however, I am utterly horrified by the cases of children and young people in crisis that cross my desk on a weekly basis—or more often—either through my surgery, my inbox, or anecdotally when speaking to acquaintances and contacts in my constituency and well beyond. New clause 2 seeks to make the Government and NHS England more accountable for the funding that they provide annually to CAMHS. That is very much in the spirit of the Bill. The Government are seeking to codify their promised expenditure on the NHS, and the new clause seeks simply to do the same thing in this important area, given that a number of welcome commitments have been made about CAMHS spending.

There are concerns that that funding is not reaching the frontline. Indeed, the evidence is clear. Just last week a report by the Children’s Commissioner stated that many CCGs are spending less than 1% of their mental health budget on children and young people. In 2017, the CQC revealed that CCGs have prioritised adult mental health over CAMHS because of the need to ration services. Other amendments seek to talk about mental health more broadly, but that is the reason why we need a particular spotlight on children and young people’s services.

The phrasing of new clause 2 seeks to ensure accountability against the ambitions of the long-term plan. Subsection (2) would help to demonstrate whether the promises on the growth of CAMHS spending outstripping mental health spending, and NHS spending across the board, are kept.

Subsection (3) shines a spotlight on regional variability. The Children’s Commissioner’s report last week talked about the enormous postcode lottery of spending on services. The numbers cited were staggering. In terms of low-level services, they ranged from 72p in some areas to £172 per child. On specialist services, they ranged from £14 to £191. We all expect some level of variation, but I am sure the Government would agree that that level of variation is utterly unacceptable. It needs to be tracked very publicly, so that spending and services can be improved to meet need.

Why is that so critical? As has been stated by various Members, half of all mental health problems are established by the age of 14. We know that 1.25 million children and young people had a mental health disorder in 2017. We have heard that since 2010 there has been an increase of 330% in admissions to A&E of children and young people diagnosed with a psychiatric condition. We know that only one in four children and young people is being seen by a specialist when they need to.

It is very easy to cite statistics, but behind them are individuals: children and young people and their stories. The stories I have heard are of teenagers self-harming, teenagers who are suicidal, teenagers who are a danger to themselves and their families, and young people who are excluded from school or are taking themselves out of school because of their mental health conditions. One piece of correspondence I received from a parent talked about her 17-year-old being referred for specialist treatment last November. He might be assessed, if he is lucky, in March and he will not get treatment for four to six months after that. That cannot be right. This child has at times been suicidal. I have also had a case of a 10-year-old with tier 3 needs waiting a similar amount of time for the initial choice assessment, who will be waiting a similar amount of time again for treatment.

We have had many plans, many vision documents and many strategies setting out wonderful lofty ambitions for the NHS. As I said, the long-term plan has some very laudable commitments on CAMHS. The Bill seeks to put into law what the Government promise on NHS spending. New clause 3 simply seeks to put into law the Government’s promises on spending on children and young people’s mental health disorders. I cannot press new clause 3 to a Division, but I very much hope that the Government will accept the spirit of my new clause and look to see what measures they can put in place to improve transparency and accountability. We owe it to those children and young people, because this really is a crisis and they need us to step up to the plate.

I will end my remarks with a quote from the mother of the 17-year-old I referred to earlier, because she puts it far better than I could:

“All these young people are our future and if we do not help them now, we are looking at a bleak future as these young people will end up being isolated from society, lack skills for work and relationships, find employment hard, perhaps even get into crime and ultimately will end up not having fulfilled lives and maybe end up being yet another statistic. We have not got this right and it is not just about the budgets or party politics; we need all of you to work together on this and treat this as an emergency.”

[Lucy Allan (Telford) (Con)]

What a pleasure it has been to listen to so many excellent speeches. In particular, I want to say how much I value the contribution of the former Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Jeremy Hunt)—I am sure that Ministers will have listened to what he said. I thank everybody who has tabled amendments, which are very thoughtful and well considered. I am particularly grateful for the amendment on patient safety, and again, I am sure that Ministers will have heard what has been said on that issue.

It is a pleasure to speak in a debate where we are not politicising something that matters so much to our constituents and where we are coming together to contribute our experiences, either in our constituencies or professionally. For that reason, I am delighted to be speaking.

I do not support the amendments, however well intentioned, well formulated and well thought out many of them are. However, I would like to speak to the amendment on capital budgets because there are some learning opportunities for the Government in how they spend significant capital investment on hospitals, upgrades and reconfigurations of hospital services. Those upgrades and reconfigurations are indeed happening now, as was set out in the manifesto, but they were also happening before that. My constituency and the county of Shropshire have experienced significant capital investment, but there has been a very difficult, painful and protracted process in trying to bring that forward as something that will benefit the whole community and improve patient care across the county.

I raise that issue because I hope that Ministers will take away from that experience the fact that it is fundamentally wrong to have significant capital investment where local communities are pitched against one another, as has happened in Shropshire. We saw local CCGs propose that Telford should lose all its acute services and be stripped of its A&E and women and children’s services, with them being transferred to another community some 20 miles away that is significantly more affluent and has better health outcomes. In addition, it was intended that that community would also receive £312 million of capital investment in new facilities. I am sure that hon. Members can imagine how that would make our community feel, particularly when it is disadvantaged in many respects. It is a growing new town that will have 200,000 residents in the next 10 years. We have to provide services with equal access for all, because as this Government have said, they are about one thing: levelling up. They are about narrowing health inequalities and ensuring that there is equality of access to health services across our communities. Of course, the NHS has always been about need. Funding in the NHS should follow need.

I will not delay the House too much with further discussion of the situation in my constituency because I believe that my CCGs, after six years of debating this issue, have had another thought about how they might resolve the problem. It will require more Government funding, but they have already made it clear that the proposal that is currently on the table will also require more Government funding. It will provide a fantastic opportunity for us to resolve this situation, which has been ongoing for so long. So, if the Minister is listening to pleas for more capital funding, may I ask that we complete the proposal in Telford, which will be of such value to our community?

There are other learning points that come from the capital investment programme. CCGs and health trusts have a duty—indeed, the Secretary of State has a statutory duty—to narrow health inequalities. We see that across the country where there have been controversial reconfigurations of local hospital trusts and hospital builds. It is not just in Shropshire either; many MPs on both sides of the House have spoken of the need to narrow health inequalities and to ensure that more affluent communities do not benefit at the expense of more disadvantaged ones. This new Government could not tolerate that continuing in areas of disadvantage.