Mental Health
Mark Hendrick Excerpts(11 years ago)
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Jane Ellison (Battersea) (Con)
Thank you, Madam Deputy Speaker, for allowing me to speak in this debate. I had not planned to do so, but I realised earlier today that I wanted to address an aspect of female genital mutilation, which I have discussed often in the House. When I listened to the opening speeches, I realised that I have never talked about an issue that many of the campaigners I work with discuss a lot, namely the mental health aspects of both acute and, in particular, chronic FGM.
I just want to put the issue on the record for the Minister to think about; I do not expect any instant answers. As many Members have said, it is hard enough to talk about mental health, but raising the issue of the mental health problems of the victims of a secret, taboo and illegal practice that we have never successfully prosecuted adds several layers of difficulty to an already difficult situation. We know enough, however, for the matter to be put on the record so that somebody at the Department of Health can at least think about it. We should be worried about it.
Female genital mutilation is practised in many countries around the world, but it is predominantly an African practice. In this country, it is practised predominantly by communities from east and sub-Saharan Africa. Most professionals in the field think that the largest diaspora groups in which FGM remains prevalent are probably from Kenya and Somalia; it is certainly heavily practised in those countries.
In the absence of a more up-to-date study, people work on the numbers given in a 2007 study by FORWARD—the Foundation for Women’s Health, Research and Development—which was itself based on the 2001 census. The study established that there are at least 66,000 women with FGM living in England and Wales and that about 21,000 more girls are at risk of becoming victims. Of course, given the substantial migratory trends of people from practising countries to the UK in recent years, the real figure is likely to be higher.
In 2004, the British Medical Association recorded that it believed that there were 9,032 births to women who had had FGM. It should be noted that not all hospitals are required or able to record FGM at birth, and I know that one of the Minister’s ministerial colleagues is looking at trying to get that right. Recent freedom of information requests by the press also show that hundreds of similar women are giving birth every year in hospitals in Leeds, London and elsewhere. We know that this is a problem and that the practice is not being abandoned at anywhere near our desired rate.
During visits to schools in my constituency in recent months, I have asked questions about the issue—other Members may also have done so—but I have not received any satisfactory answers. Most recently, a headmistress who knew about the practice, which is unusual, had been told by a school community worker, “Don’t go there. Let’s not talk about that topic.” This is a problem; do not let anyone believe that it is a myth and that we do not have a problem in the UK.
A study cited by the World Health Organisation in the mid-2000s examined the effects of FGM on the mental health of women. The researchers concluded that FGM is
“likely to cause various emotional disturbances, forging the way to psychiatric disorders,”
especially post-traumatic stress disorder, possible memory dysfunction and other problems associated with trauma.
This issue was brought home to me by a Radio 5 programme I took part in recently after a two-part story on “Casualty”—they were two very powerful episodes—featured the acute health aspects of FGM. The story centred on an older sister who was trying to stop her younger sister being taken abroad to be mutilated, and on the impact of birth on the mother of the family, who had been infibulated.
One of the other guests on the Radio 5 discussion the following morning was a marvellous GP called Dr Abe from Slough, who told me that she sees two or three women a week who have chronic illnesses, some of which are mental-health related, associated with FGM. She asked me—the BMA stresses this and I will cite its guidance in a moment—to imagine the trauma experienced by a small girl who is being held down by people who are usually relatives or people she knows while a brutal procedure is carried out on her without anaesthetic. It is not difficult to imagine that such children will be troubled.
In case anyone thinks that such things do not really happen, let me point out that Dr Abe said that she regularly deals with children and young women whose bodies are contorted with pain and whose limbs are bruised, broken, battered and dislocated as a result of being held down by relatives. Few people who have that done to them by those who purport to be their loved ones will then go on to live with them as a family. I think we can all imagine the special and difficult mental health problem associated with that, and we are only beginning to understand it.
The BMA’s 2011 guidance acknowledged that little is documented about the psycho-sexual and psychological effects of FGM, but it does say:
“Long term consequences might also include behavioural disturbances as a result of the childhood trauma and possible loss of trust and confidence in carers who have permitted, or been involved in, a painful and distressing procedure”
and that
“women may have feelings of incompleteness, anxiety and depression, and suffer chronic irritability, frigidity, marital conflicts, or even psychosis.”
Many of the professionals and campaigners I work with stress the growing problem of anger, particularly among young women who suffered FGM before coming to this country. They are in a conflicted state, because the mentality of those who put them through FGM could not be more different from the mentality that they see around them in Britain. It is considered entirely normal in a sexualised society for magazines to invite young women to express their sexuality and have a fulfilled sex life. If someone has had a procedure carried out on them, the entire aim of which is to stop them wanting to have sex and to be a sexual person, and to restrict them and preserve their virginity—and everything else associated with the centuries-old tradition of FGM—that leads to conflict.
Both Efua Dorkenoo, who wrote the WHO guidelines, and campaigners such as Nimco Ali of Daughters of Eve talk about a growing pool of angry young women who are caught between those two very different worlds. It is also difficult for them to talk about it, because the subject is already taboo. Some Members may have read a recent article in The Sunday Times, which reported that Nimco Ali, who has been very bold in speaking out, has been threatened by people telling her that she should stop speaking out.
Mark Hendrick (Preston) (Lab/Co-op)
Is the hon. Lady saying that FGM is taking place in this country, or are parents taking their children abroad to have it done before coming back?
Jane Ellison
That does not relate strictly to the debate topic, but I will answer. We do not strictly know, but a growing body of evidence suggests that FGM does happen here. The girls I meet through some of the groups I work with will say off the record that it is happening here, but it is more difficult to get people to say so on the record and to point the police in the right direction. For example, women are re-presenting having being re-infibulated in hospital, which is also illegal. I think there is enough evidence now to suggest that FGM is happening here, but I think that the predominant view, and that of the police and the Crown Prosecution Service, is that girls being taken overseas is still the biggest problem. Since 2004, when a private Member’s Bill closed a loophole in the Prohibition of Female Circumcision Act 1985, such girls have also been covered by British law. The extraterritorial aspect of the law means that it is against the law to take a British resident or citizen abroad to perform FGM on them. Either way, that is covered. I think it is happening here, but we do not know.
Jane Ellison
No; to the eternal shame of this country, in 25 years of this being an illegal act, there have been no prosecutions.
In recent times—I will return to the mental health aspects in a moment, Mr Deputy Speaker—we have had encouragement because Keir Starmer, the Director of Public Prosecutions, has been really good on this issue. He has a new action plan for the Crown Prosecution Service. It has reopened several old cases and is going through them with the police to see whether a prosecution is possible. It is also looking more imaginatively at prosecuting the aiders and the abetters, such as the people who set up the travel and those who supply the strong pain killers. If we wait for a seven-year-old girl to walk into a police station and report her parents, we will have a long wait. That is one reason why there have been no prosecutions. However, I am more optimistic now than ever that the police and the CPS are taking the matter seriously.
To return to the mental health aspects, a recent survey by the National Society for the Prevention of Cruelty to Children showed that 83% of teachers either do not know about FGM or have had no training on it. From memory, 16% of teachers thought that condemning FGM was culturally insensitive. That is extremely disturbing, given that it is an illegal act.
Ms Abbott
My hon. Friend’s points are well made.
Let me consider the future for mental health and set out for the House how important the role of local authorities can be in addressing the social determinants of mental ill health. Public health has become the responsibility of local authorities. They have a ring-fenced public health budget, and despite all their pressures and difficulties—which I do not seek to minimise—there is an opportunity for local authorities to do important and interesting work, bringing together education and housing with health care to address mental health problems and intervene in them early.
I was shocked to hear of a social housing project near King’s Cross that, presumably to make its tenants more manageable, did not want to give tenancies either to people who had a history of rent arrears or to people who had a history of mental health problems. Such things need to be highlighted and addressed. Sitting responsibility for public health with local authorities could address mental health, particularly in respect of early intervention and preventive work with children in schools.
I gave a speech this morning on the crisis in masculinity. We need to focus on the mental health challenges that face men. Whether it is because they are unwilling to come forward or because of stress in society, we know that, during a recession or economic downturn, suicide rates among men increase. Suicide is currently the biggest cause of death among under 35s. In planning services nationally and locally, we need to pay particular attention to that issue among others.
The hon. Member for Totnes made an important point. She said that, in our desire to reduce health tourism—a desire supported by the Opposition—there is a notion that people will need their passport when they turn up to see their GP. That runs the risk of making it harder for the socially excluded to access health care—many simply do not have a passport or such documentation.
I will not speak at this point about the merits or otherwise of the welfare reforms, but there is a lot of anecdotal evidence that they are having an effect on the mental health of some who are caught up in the system. There is a lot of anecdotal evidence that Atos, as it is currently configured and as it currently operates, does not meet the needs or seem to understand the problems of people with mental health challenges.
Mark Hendrick
I am sure that my hon. Friend, like many other hon. Members, has come across many constituents attending surgeries who are developing serious mental health problems purely and simply because of the pressures caused by the reforms to the benefits system. I am finding that people who are mentally ill and do not know it are getting worse—they are under pressure from the benefit changes that have been made and those that will take place in future.
Manufacturing
Mark Hendrick Excerpts(12 years, 6 months ago)
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Mr Wright
My hon. Friend is correct, and to conclude this part of my speech, I shall quote the director-general of the CBI with specific regard to that decision on feed-in tariffs, which was taken without notice to the industry. In keeping with our football metaphor, the director-general said:
“Moving the goalposts doesn’t just destroy projects. It creates a mood of uncertainty that puts off investors. They wonder what’s coming next…Industry trust and confidence in the government has evaporated. This bodes poorly for investment in future initiatives…A new industrial policy needs to recognise the real-term costs of bad decisions and should set out a clear path that investors understand and can believe in.”
We certainly agree with that, as the country has not got the clear strategic direction we need from this Department. We sometimes get warm words; we often get welcome, albeit ad hoc, announcements. Industry, however, is uncertain of the strategic direction in which the Government and this Parliament want to take the country in manufacturing.
Mark Hendrick (Preston) (Lab/Co-op)
Coming back to the point about job losses, many manufacturing jobs were lost under the previous Government over the 13-year period, but some of them have moved, as the Minister said, to the far east and elsewhere. Many of these jobs were not particularly high-skilled, and modern technology and manufacturing has moved on. The problem was that those jobs were not replaced quickly enough by more modern, hi-tech skilled jobs. That is the challenge the Government must face for the future.
Mr Wright
I heartily agree with my hon. Friend. My questions for BIS Ministers relate to having an active industrial policy. Where is the assessment of the sectors in which Britain has unique competitive advantages and of where we can sell our unique products to the rest of the world rather than lamely following the rest of the pack? Where are the clear milestones along the way that would allow investment and business decisions to be taken with some degree of certainty and stability?
A recurring theme of today’s debate has been the role of research and development and associated capital allowances. Again, I want this country to be the best place for any investor in manufacturing to invest in research and development, but R and D tax credits, the industry tells me, are not working. What can we do on capital allowances and R and D spend? When can we expect some clear vision from the Government about the road map that is needed as part of an effective and active industrial policy? We have had welcome announcements about funding for technology and innovation centres—I think the Minister mentioned them in his remarks—but the ad hoc decision is a diluted version of what was set up and planned under the Labour Government, with businesses now unclear about how they fit into the bigger picture. The Department promised us its manufacturing framework document over a year ago, but it has still not been published. Where is it?
Another common theme has been the concern—expressed by the hon. Members for Hexham and for Burnley (Gordon Birtwistle)—about the inability of manufacturers to secure access to finance for growth. The Secretary of State’s initiatives have not worked. Project Merlin has not secured its aims and the regional growth fund is not delivering on the ground. In the space of 55 seconds—I timed it—in yesterday’s debate, the Secretary of State went from claiming that as a result of the RGF,
“factories have been built and the jobs are being created”—[Official Report, 23 November 2011; Vol. 536, c. 333.]
to acknowledging, in response to the Chair of the Select Committee on Business, Innovation and Skills, that he could not provide a figure on the number of jobs created by that fund at all. Will the Government look again at this crucial issue of access to funding?
Many companies are sitting on a pile of cash on their balance sheets, largely because they have little confidence in economic prospects, but is anything being done by this Minister and the Department to free up some of that cash to provide much needed finance to manufacturers? I hope that the Minister will intervene to provide a degree of clarity on that; otherwise, I am happy to wait for the Chancellor’s autumn statement on Tuesday.
Several hon. Members mentioned the huge opportunity for export markets. We have been behind the curve in emerging markets for some time. The CBI and Ernst and Young have just published a report, which demonstrated that UK businesses tend to rely on the US and continental Europe for their main export markets. The report quotes the chairman of a Mexican automotive parts manufacturer, stating:
“Overall I think the UK and its companies should pick the right battles and the right countries, and focus on specific sectors within those markets. There’s a lot of goodwill out there that’s not been exploited.”
Will the Minister respond to that and set out what has been done—he touched on it in his opening remarks—to strengthen our export capability? Time and again, firms say that they cannot exploit their potential by gaining access to export finance, that the range of such finance is limited and that things such as the export credit guarantee do not specifically address business needs. How can the Government address that?
Industry states that the supply chain to UK manufacturing needs to be improved. That is crucial in ensuring that British manufacturing is competitive in global markets throughout the world. The Secretary of State acknowledges that. In his speech to the Policy Exchange last month, he talked about how
“Government can support UK supply chains across a number of sectors critical for future growth.”
Since then, however, we have had no information or detail, or even an announcement as to when we might be given any. Industry is crying out for that as a means of boosting its competitiveness, so it would be helpful if the Minister could provide further detail.
Mental Health Services (Lancashire)
Mark Hendrick Excerpts(13 years, 5 months ago)
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Mark Hendrick (Preston) (Lab/Co-op)
I rise to speak about acute mental health service provision in Lancashire. Since August it has become clear that the Lancashire Care NHS Foundation Trust has a clear strategy of closing adult in-patient care units for people with serious mental health conditions such as schizophrenia and bipolar disorder.
Initially, the plan was to be realised and carried out in secret, without the knowledge or consent of the democratically elected governors of the trust. However, once the staff at the Avondale unit of the Royal Preston hospital became aware of the fact that patients were being refused admission or sent for care at alternative facilities, they leaked the information to the local newspaper, the Lancashire Evening Post. Very quickly, campaigners and myself decided to take on the trust—if we can call it a “trust”—and fight the case. The people of Lancashire are enraged about closures across the county, such as that of the Pharos unit in Fleetwood earlier this year, and now the planned closure of the Avondale unit before the new year.
In order to fight the closures, the campaign organisation SAFE—Save Avondale For Everyone—was set up and is led by a courageous and determined set of activists: Andy Hanson, Alison Ball, Fiona Jones, Nadia Southworth, Steve Weyer and Lisa Daley. Along with many others, they have taken on the might of the autocratic managers with six-figure salaries who have no respect whatever for the democratically elected governors of the trust, or the people of Lancashire whom they are employed to serve.
Preston needs the Avondale unit, which has served and saved many lives over the decades: it has saved people from suicide and serious mental illness. Everyone in Preston knows somebody or has a relative who has needed treatment at the unit. As the coalition cuts begin to bite, more people will become unemployed, which will cause more mental illness. Preston is a military town, with Army and Territorial Army barracks. Many armed forces personnel will return to Preston from conflict zones around the world with different degrees of mental illness. Returning forces will need that facility. Preston also has many students, many of whom suffer from mental illness because of the stresses and strains of exams—and, of course, student debt, which is topical at the moment. I understand that the Minister will be absent tomorrow; he will be with the hon. Member for Torbay (Mr Sanders) in Torbay because he does not wish to vote for the coalition’s legislation—but that is by the way.
The closures mean that extremely vulnerable patients with mental illness from Preston will be forced to travel to Blackpool, Chorley or Ormskirk for treatment and care, despite the Government’s promise to ring-fence spending on the NHS. That promise is not worth the paper it is written on, because the trust is not only cutting spending this year, but will cut spending across Lancashire by £33 million next year.
The Lancashire Care NHS Foundation Trust has this mission statement:
“To improve the lives of the people we serve and ensure that mental health matters across the whole community”
and this strategic aim:
“To deliver high-quality, person-centred, compassionate services for mental health”.
It claims to have the following values:
“Teamwork…Compassion…Excellence…Accountability…Respect ...Integrity”.
Let us check the evidence on that. What do people want in Preston? We want local integrated in-patient and community care services; choice in accessing local services, and for that choice to be respected; and the continuation of local in-patient services in the city of Preston, which is the capital of Lancashire and its administrative centre. We have overwhelming local support: I have a petition with thousands of signatures that I will present to the Minister following the debate. The petition is very clear. Everybody in Preston and the surrounding areas wants the Avondale unit to be saved.
We accuse the funding bodies, the primary care trusts and the Lancashire Care NHS Foundation Trust of driving through hidden changes that will have profoundly detrimental psychological, economic and social effects on the people of Preston. There will be many other downsides. For example, the Lancashire Evening Post recently reported on the anger at the travel ordeal that patients will face in future. On 14 July it said:
“Mental health patients may have to travel from Preston to Chorley following the closure of…facilities in the city”.
The chairman of the Lancashire mental health and social care partnership board believes that the consultation process was inadequate. He said:
“It is unclear how the priorities identified at these events translate into a one option consultation—surely this means that there is no choice.”
Let me give a few examples of what patients will be faced with in future. If someone travels from Preston to Blackpool to get treatment, the cost implications for one adult visiting five days out of seven is £29 a day, with a minimum travel time of three hours a day. The average length of stay is 34 days, so the total cost would be around £145. For someone being treated in Ormskirk, the travel cost is £45 a day and minimum travel time is five to six hours. Again, if an average length of stay is 34 days, the total cost would be £225.
The authority clearly wants to adopt a strategy of having some provision at home. The claim is that
“when people are able to stay in their home environment they maintain contact with their family and friends, have less risk of losing their jobs, and can continue living their normal lives.”
That is a quotation from Steve Ward, the medical director of NHS Central Lancashire trust. The chief executive of the trust said:
“We know that community services such as crisis resolution, home treatment and assertive outreach teams enable more people to be treated safely and successfully in their own home or in the community, which is where they tell us they prefer to be treated”.
That is code for cuts, and it is finance-driven, not care-driven.
When the Care Quality Commission looked at the provision of services in its community survey, only 5.5 out of 10 was scored on the question of whether
“those that had used the crisis number in the last 12 months…believe…they received the help they needed, the last time that they called this number.”
On trust performance review, a staggering 66% of patients have had to have a formal review of their care within 12 months, which clearly shows that the current system of providing care in the home is inadequate.
On the subject of suicides in Lancashire, the actual number of suicides in the Preston area in January to March this year was 12, and for April to June it was nine. The total number of suicides for people in contact with Lancashire Care NHS trust mental health services over the last two years is 80. The removal of local patient beds in Preston will increase the already unacceptably high number of suicides. All of these suicides were in the community. One headline reads “Suicidal patient told ‘no beds at Avondale’”.
There has been no consultation on the total closure of Avondale, and no working in partnership or public involvement. As I said earlier, the governors of the trust have been treated with contempt. There has been complete disregard of and disrespect for the wishes of the people of Preston, as the petition, which has thousands of signatories, makes clear. There has been a total lack of openness and transparency. Plans are only now being talked about in any detail, and are being presented as a fait accompli—by diktat, not by discussion with the governors or the people of Preston.
Preston community mental health services will be unable to manage crisis without local beds; they are struggling now. In order to close Avondale, they have had to refuse patients or move them elsewhere, in many cases to private units, which is privatisation by the back door. Patients in Preston face an unclear and constantly changing service plan. The governors have no power over the executive, which has become unaccountable and unrepresentative in its decision making.
The question is not whether Preston can manage without Avondale, but whether it should have to do so. The answer is clearly no. People manage to live through most disasters, but should we allow a publicly funded organisation to develop into a disaster for some of the most vulnerable people in Preston’s population? The evidence of the impending disaster is clear. In the review in 2006, Whyndyke Farm, Ribbleton hospital and Burnley were seen as sites that could have either new facilities or extensions to existing facilities. The plan was to close smaller units. No evidence exists that remote, large hospitals improve mental health care, but there is a lot of evidence that they do not. The deal on new facilities has now been reneged on. There is planning permission for Whyndyke Farm near Blackpool, but Ribbleton hospital will not receive an extension and Burnley will probably never get off the ground. Indeed, I would be very surprised if the extension at Whyndyke Farm sees the light of day. Questions remain over the capacity of local community health services to manage crisis without local in-patient beds in the long term.
A city the size of Preston needs its own in-patient beds and deserves to be consulted about what kind of care its citizens can expect to receive. A city the size of Preston should not be treated as if it were an afterthought, and it should not be forced to fit in with a corporate, financially-driven view of what Lancashire should look like. Lancashire Care NHS Foundation Trust does not care, and cannot be trusted.
As part of the campaign, there have been public meetings, demonstrations and a whopping petition that I shall serve the Government with at the end of the debate. I call upon the Minister and the Secretary of State to approach Lancashire Care NHS Foundation Trust and tell it that this plan does not serve the interests of the people of Lancashire or their mental well-being. The proposal is vandalism, and flies in the face of the Government’s promises to protect the NHS. It will result in more suicides and more vulnerable people coming to harm from others, as well as from themselves.
The former Prime Minister Margaret Thatcher claimed that the NHS was safe in Conservative hands. Well, we all know what happened. If this Government repeat her mistakes, they will pay for it with the lives of vulnerable people in Preston and across the country. Ultimately, they will pay for such actions by being turfed out of office again for those mistakes.
The Minister of State, Department of Health (Paul Burstow)
I congratulate the hon. Member for Preston (Mark Hendrick) on securing this debate. On the many occasions during my 13 years in the House that I have secured these Adjournment debates, I have always taken the view that one should see them as an opportunity to present a case, not to try to score party political points. There are plenty of other opportunities to do that. Indeed, my hon. Friend the Member for Wyre and Preston North (Mr Wallace) perhaps demonstrated the way in which a case can be made without scoring cheap points.
There are also some points that I would like to spend some time making. In my view, the hon. Gentleman’s comments about students being under pressure and his suggestion that this causes them to rely on mental health services were deeply stigmatising and really unhelpful in trying to promote a sense of mental health and well-being. He does students a disservice by portraying them in that light. The suggestion has also been made that there is some sort of hidden agenda. Well, if there is a hidden agenda, let us be clear that this issue goes back to 2006. The work done then—which resulted in the plans that we are discussing, including the proposals for Avondale—came out of a set of principles in a national service framework for mental health that was drawn up by a Government of whom the hon. Gentleman was a member. That prompts some questions about quite where his attention ought to be focused now and where it ought to have been focused in the past.
Mark Hendrick
I will indeed make reference to the 2006 consultation and the report that came afterwards. It recommended that new facilities be built, but as I said, those facilities are very unlikely to be built, because of the financial pressures created by the Government’s cuts. On the one site there is only planning permission, and on the other two sites there is no sign of any building or any commissioning of building yet to take place.
On the question of students, many are indeed suffering great deals of stress and worry about debt. There are cases up and down the country of students who have committed suicide or who are suffering from mental illness as a result of stresses associated with debt, worries about exams, and pressure from parents and society. It is glib of the Minister to dismiss that in the way that he has.
Paul Burstow
The hon. Gentleman’s contribution may well have been glib; my concern is about stigmatising people and creating even more concern about mental health problems.
The 2006 consultation looked at strengthening community-based services, in order to reduce reliance on acute hospital care, as well as phased closures of 15 facilities over a number of years, as demand reduces owing to other measures. They were to be replaced by a smaller number of purpose-built units, which I will talk about in a moment. Lancashire primary care trusts spend £23 million a year on community-based mental health services—an increase of 46% since the 2006 consultation, which has resulted in spending per head that is higher than the average for England. Just 4% of service users now need in-patient care in Lancashire, and many facilities are significantly underused as a result.
Many existing in-patient facilities are not fit for purpose—dormitories rather than single rooms; problems separating male and female sleeping areas; no outside space; privacy compromised. Indeed, my hon. Friend the Member for Wyre and Preston North made a case about some of those facilities in his speech. The PCT has plans for four new purpose-built units, the first of which, at Whyndyke farm, is due to open in 2013. The PCT assures me that plans to develop the Ribbleton hospital site are proceeding.
The hon. Member for Preston mentioned concerns about beds. I am assured by the PCT that the closure of facilities has been carefully phased to ensure sufficient capacity. I have looked at the figures, and I have been told that there is an average of 35 spare beds across Lancashire. I shall take no lectures from the hon. Gentleman on the use of taxpayers’ money to get the best possible results for patients, but it hardly makes sense to have an excess of supply of beds such as we are seeing in Lancashire. Indeed, only last week, the King’s Fund demonstrated that better outcomes could be achieved through effective use of resources.
Paul Burstow
I will in a moment.
That is why we believe that the proposals make sense, and simply to talk about a potential mental health beds crisis is unnecessary scaremongering.
Mark Hendrick
This is far from scaremongering. People are committing suicide in Lancashire, and people are being turned away because of a lack of beds. People come to my surgeries who are suffering from stress and mental illness, or who are caring for someone who is trying to get into the Avondale unit. The Minister mentioned the 36 spare beds, but that is the figure across the whole of Lancashire. The occupancy rates across Lancashire range from 85% to 90%, which are rates that any hotel would be proud of.
Paul Burstow
It is important that the changes that are resulting from the consultation in 2006 are properly implemented, that they are led by clinical evidence, that they take account of legitimate public concerns, and that they involve appropriate scrutiny. That is why I have asked questions about the nature of the consultation that took place in 2006. More than 115,000 consultation documents were sent out, 74 public meetings and events took place, and independent evaluation by Salford university found that the engagement process was robust and comprehensive. All Members of Parliament, including the hon. Gentleman, were sent the consultation documents and offered briefings by the chair of the primary care trust’s joint committee. However, the only MPs to respond were the hon. Member for West Lancashire (Rosie Cooper) and the former Member for Fylde. I am surprised that the hon. Gentleman appears to have come late to this issue. I understand that he started to get interested in it only earlier this year. I must question why he did not pursue it when it was being consulted on in 2006, when he might have had an opportunity to shape the proposals a little more than he has so far.
Paul Burstow
In a moment.
When the proposals went to the Lancashire joint overview and scrutiny committee, which was formed in 2006 to consider the proposals, it was committed to ensuring that there was proper engagement. It took the view that there had been significant engagement around these proposals.
Mark Hendrick
I want to address two of the points that the Minister has made. First, we were happy with the consultation that took place in 2006, and with the report. Now, however, the NHS trust is reneging on that report, because it will not have the necessary resources—and, in my view, it does not have the determination—to complete the new units that were promised. On the Minister’s point about not contributing to the consultation or making any objections, we were perfectly happy to see the Ribbleton Hall site extended and improved to accommodate extra beds, but at the moment there is no sign that the extra beds will go there. Until the new facilities are built, I see no logic in closing the Avondale unit, or any other facilities.
Paul Burstow
I have just given an indication of the PCT’s position in respect of Ribbleton Hall. The PCT is in the process of conducting a further review of the proposals and has produced a revised case for change. That explores the overall clinical model, but does not alter any plans for specific site closures. It does revise the case, which is supported by GP commissioners. I will, however, make sure that the points that both hon. Members have raised in the debate are passed to the PCT, so that it is aware of their ongoing concerns.
The hon. Member for Preston also talked about a city the size of Preston having the right to be consulted. It is worth bearing in mind that, while the city council raised its concerns in August this year, and objected to the closure of Avondale ward, Preston councillors who were sent the original consultation—just like everyone else in Lancashire—and invited to offer feedback and comments about the proposals, did not offer a response, yet the proposals in 2006 included the proposal about Avondale.
I am of course aware of the petition that the hon. Gentleman has mentioned, but I do not think that his presentation of the case has helped his constituents advance this matter at all. He has been stigmatising in some of his remarks about mental health, and I think it is important to value community-based care. It is essential that we see continuing developments in that regard. There is clear evidence that it leads to better clinical outcomes for patients, and the NHS in Lancashire should be congratulated on its strong record of investing in community services.
Changes to acute mental health services, including the closure of outdated facilities, are a necessary part of the local NHS’s strategy for mental health and are necessary to deliver better results and better value for money as well. It is the right approach, delivered in the right way with proper engagement and careful management of available beds, to deliver better results for people in this area of health care.
I have listened carefully and I will make sure that the hon. Gentleman’s representations are fed back to the primary care trust and other NHS organisations concerned. I am sure that he will continue to make these points, and we will continue to improve mental health services, as this Government are determined to do. We entirely reject the notion that there is in any way an agenda of cuts and closures driven by this Government. These initiatives started under the previous Government. They were about improving services then, and they are about improving services now. That is what this Government will deliver.
Question put and agreed to.