Mental Health Support: Wirral

Debate between Margaret Greenwood and Alison McGovern

Monday 24th April 2023 Commons Chamber

[Alison McGovern (Wirral South) (Lab)]

I thank the Speaker, through you, Mr Deputy Speaker, for the opportunity to raise a number of issues relating to mental health care in the Wirral. I thank my constituents, a number of whom have come to see me to share their experience, which is why I requested this debate. I also thank the many community groups across the Wirral that do incredible work to support people with mental health conditions to try to change and improve our borough, to make it a better, more supportive place for all our mental health.

As I said, the need for this debate has arisen because more and more constituents have come to see me in recent years about mental health challenges. I assume that that is common to many of us across the House. More commonly, constituents come to see me about something else, but in the process of the discussion about whatever the problem is—be it social security, education or their life at work—it has come to light that they have an unmet mental health need. I have asked them about the support and care available to them through our NHS, and it has become apparent that the services provided through our NHS in the Wirral—and I am sure across the country—are not sufficient.

It is difficult to unpick this issue sometimes because the shame and stigma that still exist around mental health mean that we are much less likely to hear from our constituents about their mental health problems. Yet if there is a problem with getting through the front door of A&E at Arrowe Park Hospital, I will hear about it almost immediately. If there is a problem with cancer waiting times, or hips and knees treatment, I am convinced that I would know about that. I worry that the problems with mental health treatment services in this country are not brought to our constituency surgeries in the same way. That made me want to have this debate—to shine a light on what is happening.

[Margaret Greenwood (Wirral West) (Lab)]

I am grateful to my hon. Friend for giving way so early in her speech. I recently met a number of local school leaders in my constituency, who are concerned about children having gone through covid, not having the opportunity to play out, to be with their friends and to have regular schooling in the way that children normally do; not being able to play outside, do homework together and have sleepovers—all those bonding situations that are important in childhood. They are concerned about the mental health of their pupils. Does she agree that we need the Government to step up to the challenge, provide more sports for schools and follow Labour’s lead by committing to specialist support for mental health issues in every single school?

[Alison McGovern]

I thank my hon. Friend and constituency neighbour for making that point. We could have another Adjournment debate on mental health support services for children and the role that education should play. I will not focus on children and young people today, but I share her concerns and I thank her for putting them on the record.

When trying to find out more about exactly what is going on in the Wirral, it was pretty frustrating and challenging to get clarity on mental health waiting times. That is a big inequality with physical health, partly because our traditional way of measuring waiting times in the NHS is referral to a consultant for treatment. But in mental health, the big focus is on services in which someone, hopefully, will not need to see a consultant. Expanding access to talking therapies, which were previously known as the improving access to psychological therapies service, is not about getting a referral to see a consultant, so I do not think there is the same political eye on mental health waiting times. Will the Minister say what plans the Government have to structurally change that and to try to figure out a way for us to track mental health waiting times more effectively? As constituency MPs, we need to be much more aware of what services are being provided to our constituents and in what timeframe.

I mentioned the NHS focus on talking therapies and the IAPT service. Having prepared for the debate, the Minister may know that unfortunately in the Wirral we have a significant backlog in waiting times for the IAPT service. Through asking questions, I have discovered a significant failure against one of the key measures. As of December 2022, the

“number of individuals accessing IAPT services as a percentage of prevalence in the borough”

was just less than 10%, but the national target is 25%. In my view, that is a big failure. It represents a significant number of people who ought to be accessing talking therapies who are not. What more can the Minister tell me about the oversight that central Government have of that?

The talking therapies staff in the Wirral are brilliant. Having inherited the backlog as a new provider, they have worked incredibly hard to try to get on top of the situation. They are doing significant and important work, but the delays have big consequences for my constituents. Some people who have come to my constituency surgeries have experienced challenging situations but not had the kind of support they needed.

Looking at the figures from NHS Cheshire and Merseyside more closely shows that unfortunately the issues get worse. Within the talking therapies service, the waiting time for the more significant level of counselling support can be up to eight to nine months, and there are nearly 700 people waiting for that counselling support. If I needed counselling and I was told that the waiting time was nine months, I would be really desperate. How is anybody supposed to deal with that wait, when they already know that they need help and support to face a life challenge? That is not fair. If the waiting time related to physical rather than mental health, I think a lot more attention would be paid to it.

Unfortunately, things are even worse in the Wirral. We know that early intervention is important, but the backlog and what was historically going on within our talking therapies service has been mirrored in the community mental health scheme. I have spoken to constituents whose loved ones have experienced significant mental health problems, and they have asked me what is going on with our community mental health team. Unfortunately, there are long waits there, too.

This is really problematic because those people may have experienced in-patient care and may need support after that. The aim may even be to prevent in-patient care. Those people should be supported in the community, but there is an average wait of 11 weeks. I worry that that situation will escalate. We know that we have real problems across our NHS, whether that is access to A&E or other parts of primary care. If people with a mental health condition are not supported as would be expected and given the care they need to improve their situation, they will end up in crisis. That is just how it is, and it will mean a knock-on for our A&E staff. It is a really frustrating situation, and I ask the Minister what the Government’s plans are for resolving it. Do they have a strategy that could support improvement in the Wirral?

As my hon. Friend the Member for Wirral West (Margaret Greenwood) said, we could have the same debate all over again—I will not suggest we do so tonight, because our staff may be hoping for a bit of an early night—about services for children and young people. Waiting times for them in the Wirral and across the rest of the country are really bad. The consequences of not getting support early are often worse for children and young people, who may be realising for the first time that they have a mental health condition. We need a strategy from the Government that includes children and young people, for all the reasons that I am sure the Minister is well aware of.

The gaps in performance and the poor quality of service across the Wirral and, I am sure, across the rest of the country are exacerbating inequality. Somebody who realises how long the wait on the NHS is for talking therapies or counselling, and who is in a well-paid or well-supported job may be able to access support almost immediately through their work plan, particularly if their job comes with an employee assistance programme. That is a good thing, because those people need help, but someone in a less secure job—on a zero-hours contract, perhaps, or on the minimum wage, as many social care staff and other key workers are—cannot access that support, so the situation is exacerbating inequality in our borough. I could say as much again about the structural causes of mental ill health, poor employment, poverty and other things, but I am sure the Minister is as concerned as I am about the exacerbation of structural inequality.

[Margaret Greenwood]

The Royal College of Psychiatrists published a report last year on the number of patients who are receiving support out of area, sometimes hundreds of miles from home. Anecdotally, I have heard about that happening in the Wirral. Does my hon. Friend share my concern about that? May I press the Minister today for an assurance that the Government will tackle the issue as a matter of urgency?

[Alison McGovern]

I thank my hon. Friend and constituency neighbour for that intervention, which I am sure the Minister has heard and will respond to.

There are three points on which I would really appreciate a response from the Minister. Having met providers of the talking therapies service and having listened to a whole host of professionals and constituents, I have come to the conclusion that one simple thing is needed to improve our mental health service in the Wirral: we need more staff. We need more people in primary care, especially because it will help to free up our secondary and specialist care. We have to get to people early. At the moment there is a false economy: people cannot be seen when they first present themselves to their GP, so their conditions end up getting worse. We need much more community mental health care in the Wirral. I would love to hear from the Minister what the workforce plan is. How can we get people into counselling and therapeutic roles, so we can get them quickly into a place where they can tackle the problems that people face?

We also need much smarter targets. As I have said to the Minister, I have found it exasperating how hard it is to work out what is going on. I know that targets can sometimes create a perverse culture, and we do not want to impose targets that are unhelpful, but it should be a basic feature of our NHS that people who need care are able to know roughly how long they will wait, and that we as politicians are able to judge whether that is appropriate. That is what we do, as constituency MPs, when it comes to every other aspect of the NHS. I am simply asking the Minister for smarter and more visible targets which will help us to improve the quality of mental health support in the Wirral. As I said earlier, most people do not need to see a consultant, so I do not think that the traditional way of doing things in the NHS works. Can we not have a simpler, basic access-to-service mental health target that will work?

Finally, let me say something about staff targets in respect of treatments and pathways. The Wirral is a very innovative place for mental health care. We are doing great things with social prescribing, which I invite the Minister to investigate if she does not know about them already. We have developed new partnerships with a host of organisations, targeting young people in particular, and considering how we can use the voluntary and community sectors in much better ways. The Minister may be aware of “Open Door”, which has delivered some particularly innovative ways of providing peer-to-peer support. Thinking more about the different kinds of support that are available, how they can help and how they can be delivered in the most cost-efficient way possible is, in my view, an urgent job of analysis for the Department, and I would love to hear more from the Minister about the Government’s plans for putting the various different treatments and pathways in place.

Ultimately, it comes down to this simple fact about the Wirral: we are not where we should be when it comes to giving people access to support. We need more counselling, and we need more therapeutic staff. I am keen to work with the Minister to try to deliver that.

Social Security

Debate between Margaret Greenwood and Alison McGovern

Monday 4th March 2019 Commons Chamber

[Margaret Greenwood]

I thank the hon. Lady for making the point so powerfully.

The benefit freeze increases poverty. According to the Joseph Rowntree Foundation, the freeze is set to drive almost 500,000 more people into poverty by 2020. In 2018, a couple with children claiming universal credit were up to £500 worse off, and a lone parent with children was up to £400 worse off, due to the benefit freeze. The JRF says that the freeze is the single biggest policy driver behind rising poverty levels. Before the freeze was introduced in the Welfare Reform and Work Act, working-age benefits were capped at 1%, yet living costs are rising. In the 12 months to September last year, prices grew by 2.4%, according to the CPI inflation measure. The Joseph Rowntree Foundation says that between the introduction of the benefits freeze in April 2016 and November 2018, the annual cost of living for people on low incomes rose by £900.

Rising living costs and frozen social security mean that the value of benefits is increasingly inadequate to protect people from poverty. A recent report by the National Audit Office shows how the real value of the basic rate of jobseeker’s allowance and income support has fallen nearly every year since 2012-13, and it is now below its value in 2009-10. Overall, the real cut to many benefits from the four-year freeze is over 6%. According to the Resolution Foundation, child benefit is now already worth less than it was in April 1999. Beyond a family’s first child, child benefit in April 2019 will be worth 14% less than it was when it was fully introduced in April 1979. This is compounded by the Conservatives’ broken economy: low wage growth and the rise of insecure and zero-hours contracts mean that incomes are failing to meet the rising cost of living.

[Alison McGovern]

Simply, child benefit is easy to claim and has wide support in society, so are not the statistics my hon. Friend has laid out absolutely terrible for working families?

[Margaret Greenwood]

My hon. Friend makes an absolutely pertinent point, and I thank her for it.