Eating Disorders Awareness Week

Maria Caulfield Excerpts

Tuesday 28th February 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Harris. I thank the hon. Member for Bath (Wera Hobhouse) for securing this important debate. Both as an MP and as chair of the all-party parliamentary group, she has long been a champion of those with eating disorders.

Improving treatment for eating disorders is a key priority for the Government and a vital part of our work to improve mental health overall. We have heard from right hon. and hon. Members from across the political divide about how urgent this issue is and how many of our constituents are affected by it. It is national Eating Disorders Awareness Week, and raising awareness is an important part of improving the outcome for those suffering with this serious and often life-threatening condition. It can affect anyone of any age, gender or background.

As has been mentioned numerous times, Beat has done tremendous work in this space. It estimates that 1.25 million people live with an eating disorder in the UK. Of those, one in four is a man. I am really pleased that this year’s national Eating Disorders Awareness Week is focusing on eating disorders in men. I think that every Member who spoke in the debate covered the fact that men are often reluctant to come forward and ask for help. There is a stigma around eating disorders, particularly for men. It is important that healthcare professionals recognise that this is also an issue for men, so that if a man or a young boy seeks help, that is taken seriously.

It is vital that we recognise that these issues affect men, so that we can break down the stereotypes and help men to speak up and get help, because having an eating disorder is devastating, and not just for the individual. As the hon. Member for Strangford (Jim Shannon) highlighted, it can also be devastating for those around them, whether family or friends. We know that recovery is possible, which is why it is so important that people come forward to ask for help and support, and get timely access to the right treatment that can save their lives. That is why, under the long-term plan for the NHS, we are investing £1 billion extra in community mental healthcare for adults with severe mental health illness, which includes treatment for eating disorders. The extra funding is being used to enhance capacity for new and improved community eating disorder teams, covering the whole of England.

Hon. Members have raised concerns about long waiting times in their communities. Integrated care boards, which were set up in July, now commission services. We will hold them to account for their timelines, but hon. Members can also hold their local commissioners to account. The funding is given to them for mental health services. We do not dictate how it is spent, because that will be different for different communities, and the prevalence of eating disorders will be different in different parts of England. We expect commissioners to commission those services and to ensure capacity and timeliness for their local population, but if Members of Parliament feel that is not being done, we are happy to meet them to discuss how we can improve things locally.

Since 2016, investment in children and young people’s community eating disorder services has risen every year; there has been an extra £53 million per year from 2021. As my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) highlighted, the pandemic continues to have an impact on the mental health and wellbeing of many people, and has caused a large increase in demand for eating disorder services. Services were almost closed, or certainly severely reduced, for nearly two years during covid, and covid itself had an impact, and there is now a tsunami of people coming forward. Data shows that the number of children and young people entering urgent treatment for an eating disorder in 2021 increased by 11% on the previous year, to over 2,600, and in the year before that it increased by 73%, from around 1,300 to close to 2,400, so there are more referrals than ever before.

A number of Members, particularly my right hon. Friend the Member for Romsey and Southampton North, mentioned online safety. I reassure colleagues that we are working with Ministers from the Department for Culture, Media and Sport on the online safety legislation, but also on other issues, because there is so much work that needs to be done to ensure that online influence is reduced where it is causing significant harm.

To return to the funding being made available, this is the first Government to really put mental health on the same footing as physical health. I am proud that we are creating parity of esteem, not just in planning services but in funding services. As part of the £500 million covid recovery plan funding for the mental health recovery action plan, we have invested an extra £79 million to expand young people’s mental health services, which has allowed 2,000 more children and young people to access eating disorder services. We have delivered this, with over 4,000 more young people entering treatment for an eating disorder than did in the previous year.

A number of Members talked about setting targets for children. We have indeed set targets for children’s eating disorders services. For adults, NHS England has consulted on setting a target for mental health services. I am particularly keen for that to be introduced as quickly as possible. I am meeting NHS England’s clinical lead for mental health services in the coming days and hope to be able to update Members on progress on that, because what gets measured gets done. While we may not be meeting the target for children yet, because of the sheer scale of demand, at least we have a target, and we know which parts of the country can and which cannot meet it, and I am keen that we do the same for adults.

The issue of BMI was raised, and I take the points made extremely seriously. Let me be clear: rejection for treatment on BMI grounds should not occur. If there are instances where that has happened, I am happy to address them; that practice is not in line with any guidance, including National Institute for Health and Care Excellence guidance, so it should not be happening. If there are examples of it happening, we are very keen to hear about them. If it is happening at a local level, I urge hon. Members to contact their local commissioners to find out why, because the guidance does not recommend that practice at all.

The hon. Member for Sheffield, Hallam (Olivia Blake) raised the issue of restraint, which I was concerned to hear about. We introduced new legislation in 2018 on restraint in mental health in-patient settings. If there are loopholes in that legislation, I am very keen to look at them. Restraint should not be happening at in-patient mental health settings, but if someone is outside of that setting and it is happening, we need to look at that. The rapid review across in-patient mental health settings is looking at the safety of those services. We will be looking at the results of that review in the coming weeks. I am clear with hon. Members that this Government sees mental health services as a priority.

[Sir George Howarth]

The Minister may recall that I intervened on the hon. Member for Bath (Wera Hobhouse) about the problem of type 1 diabetics with eating disorders. Is the Minister aware of the two trials taking place, one in London and the other in Bournemouth in the west country? Once an evaluation of the success of those integrated approaches is available and published, will she undertake to look at it, because it could have some indications as to how to treat other kinds of eating disorders as well?

[Maria Caulfield]

Absolutely; I will look out for the results of those trials. I am keen that we use evidence-based medicine, and if something has proven to be effective in clinical research, it absolutely needs to be rolled out. An hon. Member touched on the lack of research into eating disorders. The National Institute for Health and Care Research does have funding available, so I would encourage clinicians, researchers and charities that want to undertake research into eating disorders to apply for funding for those trials. We need more research into eating disorders, particularly around men and high-risk groups, such as diabetics.

[Wera Hobhouse]

Will the Minister respond to the concern raised that Government money had been made available but did not reach the frontline, as a freedom of information request by Beat showed? How do the Government intend to tackle that and ensure that money reaches frontline services?

[Maria Caulfield]

The Government have made huge amounts of funding available, for both mental health and eating disorders. More funding than ever before has gone into those services, but that funding needs to reach the frontline. That speaks to my point about local commissioners: where funding is given to a particular area, commissioners are supposed to use that money to commission services at a local level. If that is not happening in some parts of the country, then I am happy to meet with those commissioners and Members of Parliament to find out why.

We want to ensure that funding is going to the frontline to make the difference that we need it to. We are the first Government to prioritise mental health, and the first to set targets for eating disorder referrals. We are the first Government to set a standard of recruiting 27,000 additional mental health workers. We have started to roll out mental health teams in our schools, and when I spoke to the Royal College of Psychiatrists yesterday, for the first time it said that it had filled all its training posts in the last year.

We are making significant progress, but patients need to feel that. That is the next step. I am happy to work with the hon. Member for Bath and the APPG on eating disorders to make sure that is happening on the ground, because, as someone said, it is great to talk about it, but we need to see the impact for patients.

I hope that reassures right hon. and hon. Members about how seriously we take this issue. I look forward to working with everyone across the House to make eating disorders a bigger priority for clinical work. Good progress has been made, but there is a lot more to do.