Barts Health NHS Trust

Matthew Offord Excerpts

Thursday 19th March 2015 Commons Chamber

[Jane Ellison]

The hon. Lady is quite right to say that patients would be concerned, but they should also be reassured that this inspection regime has exposed some of the issues, and now is the time for them to be addressed adequately. The additional support that the trust will receive as part of the special measures is part of what will help it to make the necessary improvements for patients. The chief inspector of hospitals has highlighted the scale of the challenge ahead, but this is an opportunity to ensure that the trust has the extra support to meet that challenge. That is exactly why the regime exists—[Interruption.] I am sure that, like me, the hon. Lady will have been concerned to read of the culture of bullying and low morale, which is not acceptable. Part of the transparency regime that this Government have put in place involves ensuring that staff can speak out, and I am glad that some of them did. It is never acceptable for staff to feel unable to speak out on the issue of poor care, so I am glad that this report has given them the chance to voice their concerns. Those concerns must now be properly addressed.

[Dr Matthew Offord (Hendon) (Con)]

The House will be reassured by the Minister’s coming to the House today to make this statement and taking this early opportunity to highlight these issues. [Hon. Members: “What? She was dragged here!”] I am sure you would agree, Mr Speaker, that the Minister stands head and shoulders above those who failed to do anything during their time in office to ensure patient safety.

[Jane Ellison]

I thank my hon. Friend for that—[Interruption.] We are hearing a lot of chuntering from a sedentary position, but I refer the right hon. Member for Leigh (Andy Burnham), who asked the urgent question, to a quote from Roger Davidson, former head of media at the CQC, who said in evidence to the Francis inquiry that

“there were conversations between the CQC and ministers to the effect that the CQC would not cause any trouble in the run up to purdah. The message that we don't want bad news infected the whole organisation.”

However much of a small discomfort it might be to Ministers to come and answer an urgent question on such an important matter for patients, people should be reassured that it is far more important that these issues come out transparently, whatever the timing, even if it is ahead of a general election.

Jimmy Savile (NHS Investigations)

Matthew Offord Excerpts

Thursday 26th February 2015 Commons Chamber

[Mr Hunt]

I am happy to look into that, but hospitals have a responsibility to go to the LADO if there is an incident affecting one of their volunteers or staff. The report makes it clear that they should exercise that responsibility with great diligence, but I am happy to look into the idea that patients should have that access as well.

[Dr Matthew Offord (Hendon) (Con)]

This morning a legal representative of the survivors group said that she had evidence that it had been reported to senior management that Savile had committed offences at Stoke Mandeville. Can the Secretary of State advise whether that opens up the NHS to compensation claims? Can he ensure that any damages claims fall on the Savile estate?

[Mr Hunt]

We have already paid compensation claims. Initially, those claims will be taken from the Savile estate and the money left in the Savile charities, but if those funds prove not to be enough we would pay from the NHS Litigation Authority. The report is not able to confirm the extent to which senior management knew or did not know about the allegations, so it is difficult to make progress on the specific points, but that does not stop people being able to make a claim and receive compensation.

Mental Health and Well-being of Londoners

Matthew Offord Excerpts

Thursday 12th February 2015 Commons Chamber

[Dr Matthew Offord (Hendon) (Con)]

I am pleased to speak on this subject, and congratulate the hon. Member for Hackney North and Stoke Newington (Ms Abbott) on securing the debate.

The hon. Lady went through a lot of statistics, which I do not intend to repeat, but I will touch on some of the areas that she did not cover. Briefly, I wish to look at what is already occurring in the capital city, the cost of mental health and the action that I would like the Minister to take.

It is unfortunate that the hon. Lady did not acknowledge the work that the Mayor of London is already doing on this issue. Indeed, he has assisted in several projects, including the Pan-London Dementia Action Alliance and the Local Authority Mental Health Challenge, and he has worked with a range of partners to influence people, including many Members in this House. He has also worked with NHS London and the boroughs to support young people. Importantly, he has used his own office, the Greater London authority, to look at the way that it treats staff with mental health issues.

Some time ago, I wondered whether I would employ someone with a mental health condition, and I concluded that I would. What pleased me about my own self-searching was that when I considered people with other handicaps, I realised that I would not be able to employ somebody with a physical handicap simply because of the layout of this building; they would not be able to get around the Palace estate. It did challenge me to think about myself and how I approached mental health within the workplace.

Let me raise a few points from the Mayor of London’s report, “London mental health: the invisible costs of mental ill health”, which the hon. Lady did not mention, although she did pick up on quite a few of its figures, including the £26 billion a year we spend on the economic and social costs of mental health issues in London. She also mentioned that one in 10 young children has a significant clinical mental health problem.

I am aware that the London boroughs—my borough of Barnet comes second in terms of spending—spend about £550 million in this area. When I was a councillor in the London borough of Barnet, as indeed the Minister was, we were keen to ensure that we not only cared for our looked-after children, but played our part as a health provider in spending on mental health disorders.

I am also aware—as I am sure other Members are—from looking around my surgery or meeting my constituents that a significant number of people in the capital suffer from depression. Indeed the Mayor’s report shows that just over 41% of people suffer from some kind of anxiety compared with 38% in other areas. What is concerning is that those figures are higher in inner London than in the outer-London boroughs. It would be interesting to find out why that is, because we could then direct resources as necessary. Indeed, we could look at local authority funding. We could lobby the Minister and the Department to ensure that out constituents were not losing out on necessary treatment because of the spending in local authorities.

I wish to make two other points. One relates to the criminal justice system. Back in the summer, I spent some time with a Barnet police team and Inspector Moseley. The biggest gripe they had related to their ability to address and to help people with mental health issues. One area where I diverge from the hon. Lady is this idea that because someone has a mental health illness they will be picked up by the police. The police will pick up people if they look like they are going to harm themselves or others, and then they will invoke section 136.

[Ms Abbott]

I probably did not make myself clear. I was saying that people of colour—black and minority ethnic people—are far more likely to enter the mental health system as a result of being picked up by the police. That is all I was saying. I was not making a general point, but a specific point about that being one of the main ways we enter the mental health system.

[Dr Offord]

I am grateful for that clarification and I thank the hon. Lady for it.

[Jeremy Corbyn]

I am interested in what the hon. Gentleman was saying about his experience with the police in his borough of Barnet. I have similar discussions with the police in my borough and although many of them are well aware of the vulnerability of people with mental health issues, it seems that there is a lack of consistency in the Metropolitan police training and a lack of continual awareness-raising for police officers, before they attend the scene, on the need to look for a mental health condition when they find somebody behaving in an odd or strange manner on the street.

[Dr Offord]

I thank the hon. Gentleman for that point, which is certainly something that I would be willing to take up with the Metropolitan Police Commissioner. That was not my experience, but as it has been the hon. Gentleman’s, I think it is a useful footnote for me to take back to show that the approach is not the same all over London. I am grateful for that.

I realise that the Minister is a public health Minister and not a Minister in the Home Office, but I am keen that police officers should not be delayed for up to eight hours of their shift by taking people to hospital to seek an assessment under section 136 of the Mental Health Act 1983 only to find that a doctor is not available and no assessment can be made. I have spoken to several custody sergeants who have made the point that I will make again: a police cell is not a substitute for a place of safety in the form of a hospital. I am keen to take that up with the Home Office myself.

The Mayor’s report said that of every £8 spent on long-term health care, perhaps £1 is spent on people with mental health issues. I spent two hours this morning at the Whittington’s wonderful ambulatory care centre opened by the Government, and I congratulate them on that. It is easy to see people who clearly have long-term medical health problems, and one suspects that their mental health might be in the same fragile state as their physical health. If we include the £1 in every £8 spent on long-term health care, that adds another £2.6 billion to the £26 billion that we are spending on health care in London cited by hon. Lady. We certainly need to address that.

I am aware that in west London there has been an initiative as part of the London growth deal to help people to get into employment. Indeed, the local enterprise partnership has secured money from the Government’s transformation challenge award, and I congratulate the Government on that. I want to see more work going ahead.

It is not only people with long-term health conditions who are likely to suffer from mental health issues, but the long-term unemployed as well. I understand that approximately 46% of the people claiming employment and support allowance for more than two years have mental health issues. I speak not as someone judging those people but as someone who has experienced mental health issues in my family and have seen the consequences of that. Indeed, the Daily Mirror was kind enough to publish an article on me and the consequences of mental health issues in my family. Although most of it was wrong, I will put that to one side. I will not use the Chamber as a confessional, but the media have an obligation and a responsibility to report issues to do with mental health in a more positive and indeed less derogatory fashion than they have.

Finally, I pay tribute to colleagues who have worked hard on this issue. My hon. Friend the Member for Halesowen and Rowley Regis (James Morris) was instrumental not only in securing a debate in this House to which I was able to contribute but in promoting mental health issues through some of us writing an article for a pamphlet he published. I am grateful to him for that. I also congratulate my Whip, my hon. Friend the Member for Croydon Central (Gavin Barwell), who introduced a Bill to allow people with mental health disorders to stand in this place.

Although I am proud of this Parliament’s record, I would like Government action on the employment of people with mental health issues, and more Government action to provide people with a place of safety that is not a police cell. I would like the health service to ensure that its mental health professionals are always available, so that police officers do not spend their time waiting in accident and emergency departments for a professional to see a person who has been sectioned under section 136 of the Mental Health Act. I look forward to the Minister’s response.

A and E and Ambulance Services

Matthew Offord Excerpts

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

If the hon. Gentleman looks at the facts, rather than being political, he will see that in his constituency there are more doctors and nurses and more front-line clinical staff than there were, and he will find that more people are getting operations and more people are being seen at A and E departments than when his party was in power. That is why, I am afraid, it is very political. I notice that on the day when the Labour party is saying that there is a big issue with winter pressures in the NHS, fewer than 10 Labour Back Benchers are present—fewer than 10; that is how seriously Labour is interested in this issue. Is it not really about the politics?

[Dr Matthew Offord (Hendon) (Con)]

Having accompanied the London ambulance service on a shift at the Mill Hill depot in my constituency, I have seen the unrealistic demands placed on the ambulance service. Fiona Moore, the medical director of the London ambulance service, has said that more than 6,000 calls were made in the capital over the Christmas period last year in connection with alcohol-related incidents. Does the Secretary of State agree that that is unacceptable and that it places an unfair burden on the service?

[Mr Hunt]

I do. I thank my hon. Friend for going out with his local ambulance service. Indeed, I want to thank the many Members on both sides of the House who go out and see what is happening on the NHS front line. The problem that my hon. Friend raises is exactly the kind of problem we are trying to address. I do not want to pretend that all these problems can be addressed this winter. Part of the issue is that the quickest way to see a doctor is to go to A and E, where the average waiting time to see a doctor is only half an hour across the country. That is the fastest time anywhere in the world. We need to find better out-of-hospital alternatives, and better alternatives to calling an ambulance, if we are to reduce the pressure on the emergency services.

Public Health England Hub Programme and Porton Down

Matthew Offord Excerpts

Wednesday 3rd September 2014 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate my hon. Friend the Member for Salisbury (John Glen) on securing this debate. It is not his first on this subject, but he is right to use his opportunities to highlight such important topics. I also thank my hon. Friend the Member for Harlow (Robert Halfon) for his contribution.

The future of Porton Down is important not only to the constituents of my hon. Friend the Member for Salisbury, but to the whole country, given its work on a wide range of public health threats—including, as he highlighted, most recently the Ebola outbreak in west Africa. Scientists have been doing invaluable work at Porton Down since the 1950s, but its buildings are more than 60 years old and, based on independent surveys of the estate, they are increasingly unfit for purpose. My hon. Friend agrees that we need to find a solution to that problem to ensure that this vital work is able to continue in top quality facilities.

We all agree it is important that scientists have the benefit of state-of-the-art facilities that reflect the latest technological advancements, including, as my hon. Friend alluded to, the shift from the Petri dish to big data. Public Health England put forward the case that significant benefits would result from not only re-providing the facilities at Porton, but bringing together the range of public health science functions that it manages across disparate sites to create an integrated national science hub. That would enable the UK to punch above its weight on the international stage in preventing, and reducing the burden of, both communicable and non-communicable disease.

As my hon. Friend knows, Public Health England is considering a number of options to meet that challenge and its preferred option is to create a public health science hub based at the former GSK facility, in the constituency of my hon. Friend the Member for Harlow. To reach that position, it has had to consider a wide range of long and short-listed options and demonstrate which offers the best value for money.

The main focus of those options has been on Porton, Colindale—it is good to see my hon. Friend the Member for Hendon (Dr Offord), who represents Colindale, in his place—and Harlow. Public Health England has briefed the local Members, including my hon. Friends, and the local authorities about the three sites affected and considered those views in the option appraisal.

The case submitted by Public Health England is being scrutinised by the Department of Health, the Treasury, the Cabinet Office and the Major Projects Authority. I assure my hon. Friend the Member for Salisbury that the process will be thorough and robust. Following that process, the business case will require ministerial approval, as he mentioned, and will be published once finalised.

It is not appropriate for me to give further details on the business case until the review has been completed and I hope that my hon. Friend will understand that. As he may be aware, that is to protect commercial confidentiality and the integrity of decision making. It is established practice that outline business case documents are not shared outside the Government before decisions have been made, but the Department and PHE are committed to being open and consultative throughout this process.

When I am being briefed on these issues ahead of debates, my first question is always whether we have had regular and open contact with the Members involved. I am assured that regular contact has been made between PHE and those hon. Members who are rightly concerned for the future of the facilities in their constituencies. We want to ensure transparency on the progress of the process, and at all stages we are providing opportunities to comment on the case, with this debate being the most recent example. That commitment to a consultative process has, for instance, led to all three affected authorities submitting statements about how the science hub would link with the local economy, which have been included in the business case.

[Dr Matthew Offord (Hendon) (Con)]

I congratulate my hon. Friend the Member for Salisbury (John Glen) on securing the debate. We have focused on the business side, which is very important when we introduce a national hub, but I am concerned that my constituents’ views about what will happen to them and their extended families have not been considered. Many of my constituents who work at Colindale are responsible for elderly family members and children, and they feel that that has not been taken into account. Will the Minister respond to that point?

[Jane Ellison]

I would be disappointed if that issue had not been considered. There have already been some meetings with staff, but this is an ongoing process. My understanding is that at the point at which any firm decisions are made there will be an extensive consultation process. I have time set aside to meet with my hon. Friend, who is right to highlight those concerns. We can explore them further and I can respond to any specific concerns. Those valuable members of the scientific community make an enormous contribution in lots of ways to our country and we want to ensure that they and their families are considered carefully in this process.

On the point about the consultation process, I recently received a letter from the Minister responsible for PHE’s neighbours at Porton, the Defence Science and Technology Laboratory, which praised PHE’s open, collaborative approach to discussions about the use of specialist high-containment facilities. That reassures me that a good level of communication is being achieved.

The business case contains a summary of the collaborative work. When my predecessor, my hon. Friend the Member for Broxtowe (Anna Soubry), outlined the Department of Health’s position in a debate a year ago—also secured by my hon. Friend the Member for Salisbury—she said:

“We need to be clear that although PHE and DSTL will continue to collaborate closely, PHE needs dedicated high-containment facilities to ensure that public health work can proceed in the event of the DSTL facilities being fully occupied. This will provide resilience if DSTL’s facilities are closed for any reason.”—[Official Report, 11 September 2013; Vol. 567, c. 1136.]

As my hon. Friend the Member for Salisbury said, issues of national security and our national response capability must be carefully considered before a final decision is made. It is therefore key that Public Health England continues to develop links not only with DSTL, but with all the other agencies involved in the national security response.

Another important consideration that my hon. Friend drew out in his speech is the commercial impact of the chosen solution, which must ensure that PHE can continue to work in partnership with industry to support wider growth in the UK life sciences sector. Like him, I celebrate the important work and development that has taken place in that area in recent years. I reassure my hon. Friend that PHE has undertaken a survey of its current key customers, and only one has said that moving from the Porton site would be important for their future business relationship with PHE.

In Harlow, PHE proposes that the science hub would link with the Harlow enterprise zone and the London-Cambridge corridor, which my hon. Friend the Member for Harlow mentioned. It is one of the key international centres for the life sciences sector and PHE has had discussions with Cambridge university about the opportunities for collaboration based around Harlow.

Even if a decision were made to relocate research functions and staff, PHE has confirmed that it remains fully committed to the recently announced Porton science park, which would involve PHE facilities—consisting of some 300 staff in the development, production and regional laboratories—remaining at Porton. I know PHE has briefed my hon. Friend the Member for Salisbury on the work it is doing to maximise the commercial potential of the production facilities at Porton, which he highlighted in his speech. I want to reassure him that his important concern has not been overlooked.

The final decision on the outline business case will be made as soon as possible. My hon. Friend’s wish to have certainty on the case sooner rather than later is entirely reasonable and understandable, but—as he said—it is important that we get this vital decision right. I have listened carefully to his arguments—this is the first opportunity I have had to hear them laid out first hand—and to the important short speech by my hon. Friend the Member for Harlow. I will look at the document to which my hon. Friend the Member for Salisbury referred and ask PHE to respond to it. My hon. Friend is right to champion that renowned facility and his constituency, and I congratulate him on using this further opportunity to highlight his concerns, to which we will give a serious response.

Question put and agreed to.

Tobacco Products (Standardised Packaging)

Matthew Offord Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I very much welcome my right hon. Friend’s comments. He is in danger of becoming my second favourite knight of the day. I know that he speaks from personal experience. He is right to draw the House’s attention to the need to make policy carefully in this area. That is what we are proceeding to do. He illustrated the point better than I could have done.

[Dr Matthew Offord (Hendon) (Con)]

I stand in support of the statement. I congratulate my hon. Friend on the action that she has taken. Has she had an opportunity to look at the Australian experience to see how we might reduce the illicit trade in cigarettes and cigarette smuggling?

[Jane Ellison]

I thank my hon. Friend for his support. There is a significant chapter about illicit trade in the report and there are reflections on the Australian experience throughout it. If the Government’s final decision is to move ahead, we will look to glean everything we can from the Australian experience.

Business of the House

Matthew Offord Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I will of course raise that issue with the Department of Health on the right hon. Gentleman’s behalf, but he might also like to raise it himself in the pre-recess Adjournment debate, which will give Members the opportunity to mention issues of that kind. I was interested to see, in my own constituency a few years ago, that Addenbrooke’s—a major hospital—had outsourced activities of that kind, but that it brought them back to this country as a consequence of seeing the quality of service that could be delivered here.

[Dr Matthew Offord (Hendon) (Con)]

In July this year, the Prime Minister said that he fully supported the right of people to wear religious symbols at work. That position was supported by the Attorney-General and the Equalities Minister. Will a Minister therefore come to the Dispatch Box to explain why lawyers acting on behalf of the Government are contradicting the Prime Minister in bringing a case against Shirley Chaplin for wearing a crucifix at work?

[Hon. Members]

Hear, hear!

Health

Matthew Offord Excerpts

Tuesday 17th July 2012 Commons Chamber

[Dr Matthew Offord (Hendon) (Con)]

I wish to raise the issue of wet age-related macular degeneration and the treatments that are available.

The condition usually affects the sight of people from the age of 60, although it can affect people at an earlier age. AMD is the most common cause of sight loss in the western world. In the UK, more than 500,000 people have the condition and about 250,000 people are registered as visually impaired. Because people are living longer, the number of people who are affected by AMD is increasing.

Although the condition causes central vision loss and can have a devastating impact, it does not lead to complete blindness as sufferers retain their peripheral vision. Unfortunately, there is no known cure, but drugs are available that can slow the growth of blood vessels in the eye. Such anti-vascular endothelial growth factor medicines prevent blood vessels from forming or growing. Three drugs have been used in the treatment of wet AMD: Macugen, Lucentis and Avastin. It is the latter two drugs with which my speech is concerned.

Fundamentally, what is the difference between the two drugs? At first glance, the answer is the cost. Lucentis costs about £700 an injection, while Avastin costs £60. The bigger answer is that Avastin is not officially approved for eye treatments. Lucentis gained its European Medicines Agency approval in 2007. It is officially approved for use in eyes and is the treatment recommended in England and Wales by the National Institute for Health and Clinical Excellence. The certification is based on extensive trials that show that is safe and effective for all lesion types in wet AMD. The trials have shown that it stabilises sight in more than 90% of cases and improves sight in 40% of cases.

The cheaper Avastin has not been approved by the EMA for use in treatments of the eye because it has not gone through the proper clinical trials. It has been approved as a treatment for colorectal cancers, and is therefore readily available. When used for colorectal cancers, the drug is injected into a vein in the arm. When it is used for the treatment of wet AMD, it is given into the eye.

The findings of two trials comparing Avastin and Lucentis have been published recently. Those are the comparison of age-related macular degeneration treatments trial, known as CATT, which was carried out in the United States, and the inhibit VEGF in age-related choroidal neovascularisation trial, known as IVAN, which was carried out in the UK and was funded by the National Institute for Health Research. The IVAN trial, which was NHS funded, involved 610 patients in 23 hospitals. It was one of the largest research projects studying eye diseases in the UK. The one-year results were presented at an international conference in May this year and have been accepted for publication in the peer-reviewed journal, Ophthalmology.

The greatest debate about the differences between the two drugs is likely to be over their safety when used to treat wet AMD. Academics say that, overall, both drugs are extremely safe. My contention is that it is likely that cost pressures on the NHS will lead to increased use of Avastin. The IVAN researchers estimated that if the NHS were to substitute Lucentis for Avastin across the UK, it would save £84.5 million each year if 17,295 eyes were treated.

However, I am aware of the financial environment in which pharmaceutical companies operate. Like other industries, they manufacture products that must be sold at a profit, but in contrast to manufacturers in other industries their research and development costs are prohibitive. That means that they must make money on their investment. I recognise that they must not only regain their expenditure through profit but achieve profits to cover all the drugs that fail to get on to the market.

There has been criticism of NICE’s failure to recognise and adopt innovative new medicines. The UK is a world leader in medicines research, development and manufacture, but it is one of the slowest countries to enable patients to have access to innovative treatments. Avastin fits into that classification. I do not seek the Department’s licensing it immediately, but I call for the Government to establish an independent appraisal of it for use in ophthalmology. Clinicians are already using it off-label, so that would not be a leap in the dark. The savings that there would be for the NHS if the drug did work have already been quantified. However, if it is not safe, we must act to ensure the public’s health. I therefore ask the Minister to consider my request.

Mental Health

Matthew Offord Excerpts

Thursday 14th June 2012 Commons Chamber

[Mr Matthew Offord (Hendon) (Con)]

The Minister says that the Government wish to reduce the stigma surrounding mental illness, and I accept that. Does he agree that the decision of the Department of Health in 1994 to hold an independent inquiry into every death involving someone who has suffered mental illness or been part of the mental health system continues to perpetuate that stigma?

[Paul Burstow]

That is an important and challenging point, and I will want to go away and think about what we do. For patient safety, we still need to learn lessons when things go wrong in our system, acknowledge when things have not been done properly and put them right. In that sense, confidential inquiries are an important part of the learning mechanism. One point of frustration that I hear in debates in the House and see in correspondence from hon. Members is the sense that lessons are not learned. As part of our reforms, with the NHS Commissioning Board taking on responsibility for patient safety, we need to ensure that that is not the case in future.

We are investing £16 million in “Time to Change”, and we were delighted when Comic Relief decided to put in an additional £4 million, one of the biggest grants that it has ever made.

I wish to make another point that touches on the contributions of my hon. Friend the Member for Broxbourne and the hon. Member for North Durham. One in five people still think that anyone who has a history of mental health problems should not be allowed to hold public office. How many former Presidents, Prime Ministers or Ministers would have been excluded if that view had been applied? [Hon. Members: “Churchill.”] Precisely. Such a law is as outdated as asylums and as outdated as many of the attitudes that sit behind it. It has to be consigned to the history books just like asylums have been, and under the coalition Government’s watch, it will be. I congratulate the hon. Member for Croydon Central (Gavin Barwell) on securing a slot for a private Member’s Bill on the subject.

Looking ahead, although we have made progress there are still big challenges to tackle. Reference has been made to the implementation framework that will be published to support the roll-out of the “No health without mental health” strategy. That framework has been produced in conjunction with five national mental health organisations—Rethink Mental Illness, the NHS Confederation, the Centre for Mental Health, Turning Point and Mind—and many others have been involved.

We have previously had a very good debate about “Listening to Experience”, Mind’s excellent report on acute and crisis care, and Mind’s policy team have been directly involved in ensuring that the framework delivers on those issues. It will provide a route map for every organisation with contributions to make to improve the nation’s mental health. It will spell out how progress will be made, measured and reported.

What does success look like? To me, it means more people having access to evidence-based psychological therapists; services intervening earlier, particularly for children and young people; services focusing on recovery and people’s needs and aspirations above all; and service users and carers being at the heart of all aspects of planning and service delivery.

Today, economists tell us that mental ill health in this country costs £105 billion a year, and that is just in England. If we succeed and put in place the right combination of public health, anti-stigma policies, accessible psychological therapies and excellent community and acute services, we can dramatically reduce that figure. Put another way, if we can deliver the right evidence-based treatment to children and young people so that their conditions do not persist into adulthood, we can prevent as many as two in five of all adult mental health disorders. As a society, we have made huge progress in how we recognise people’s mental illness, but despite that we have not fully accepted that mental health is equal to physical health and that parity of esteem is needed between the problems of the body and the problems of the mind. That is the challenge—

--- Later in debate ---

[Mr Matthew Offord (Hendon) (Con)]

I will keep my remarks short, as time is certainly against me. I want to focus on the stigma of mental illness and the reasons why I think it continues to exist. We often recoil in horror when we think of the old asylum system in which people were locked up for various reasons. I believe that the care in the community system has been welcomed by most people, and I say that with evidence from the 1994 Ritchie inquiry into the care and treatment of Christopher Clunis, which broadly endorsed the community care policy.

Even though the community care policy is widely accepted, the issue of mental health is not accepted by the majority of the British public. I say that with evidence from the 2010 public attitudes survey showing that, although people are broadly sympathetic towards those who suffer from mental illness, some of their attitudes are worse than when the Department of Health first commissioned the poll in 1994. I believe that it is fear that drives this county’s mental health system; not the fear of those who suffer from mental illness, but a fear that is perpetuated by the actions of vested interests and perpetuates the stigma. I believe that it occurs through three main areas: mental health lobby groups, politicians and the media.

First, fear of those who are mentally ill has been fuelled by lobby groups that use the rare cases of homicide to keep mentally ill people in the public’s consciousness. Although their motivations are honest, the reality is that their actions promote a fear that is not always conducive to their aims. I do not intend to criticise individuals who have suffered terrible personal tragedies, but highlighting mental health issues as aggravating causes in deaths will not reintroduce a policy of asylum hospitals for severely mentally ill people. That behaviour alienates other mental health charities, which consider it to be unproductive.

Secondly, we as politicians have to take responsibility for reducing stigma. As I have already said to the Minister, the political decision to hold an independent inquiry into every homicide involving a mentally ill person has exacerbated public fear. Following the Ritchie report in 1994, the Department of Health ordered that an inquiry should be held into every homicide involving mental health services, but mental health professionals describe the environment in which they now have to work as an inquiry culture, whereby staff are made aware that any variation from recommended perfect practice could lead to an unpleasant afternoon in front of a cynical committee and the humiliation of being named in one of their reports. Those inquiries are viewed by mental health professionals as a threat, rather than as a corrective mechanism to enforce a “safety first” culture that promotes a perception among the public that every death is preventable.

It is easy for politicians to fall into that trap of trying to face both ways; indeed, the previous Government did fall into it to some extent. They were described as “compassionate” when they embarked on what the Mental Health Commission called

“the quickest and most dynamic transformation of policy in the history of state intervention in mental health illness,”

but to the public they presented an authoritarian face, capitalising on the alarm caused by the random attack on Jill Dando and the assault on George Harrison.

The third influence on mental health policy is provided by the media. Comments have already been made about the front page of The Sun in 2003, when it faced a significant backlash for branding Frank Bruno “Bonkers” after he had been taken to a psychiatric hospital. But that was not an isolated story. There have been many others, such as “Doc freed psycho to kill” and “Psycho killer was a time bomb waiting to explode”. They all inflame public outrage and continue to promote among the public a perception that mental illness equates to dangerous murderers whom doctors allow out on to the street, free to roam and to kill at will, but that is simply not the case.

Figures show that there has been no increase in killings by people with a mental illness in the past 40 years, during which time many mental hospitals have been closed in favour of care in the community. Less than one in 10 murders is committed by someone with a mental disorder, and over the past 40 years that number has decreased as a proportion of all homicides, as the overall murder rate has increased over the same time.

On the representation of mental illness on television, the Scottish Recovery Network found that 45% of characters with mental health problems in soap operas were portrayed as violent or as posing a threat to other people. In real life, it was very concerning when in 2007 Nikki Grahame, someone who clearly has mental health issues, and Pete Bennett, who suffers from Tourette’s, were allowed on “Big Brother” simply to increase its viewing figures.

Kerry Katona has admitted that when she sought to go on the same programme on Channel 4 in 2010, she failed the psychological test, as she had just come off her bipolar medication and a doctor advised her that it would not be sensible to appear. In 2011, however, when the show went over to Channel Five, that broadcaster did not produce any psychological tests and she was allowed to go on, the consequences of which could be seen each day.

The biggest change over the past decade has been the increase in protests from people with mental health problems who use the services on offer. Their dissatisfaction is with treatment, its greater emphasis on risk reduction and containment and its narrow focus on medication. Those who suffer from mental health problems dislike the heavy use of antipsychotic and sedative drugs, given their side effects, with some even rejecting completely the biomedical approach, which defines mental health problems as illnesses to be medicated, rather than as social or psychological difficulties to be resolved with other treatments, including talk therapies, for example.

There were some good measures in the Mental Health Act 2007, but there were also some negative ones, so I ask the Minister to address them and, in particular, to outline the benefits that he thinks the 2007 Act has introduced or, if he does not think that it has introduced any, the coalition Government’s policies to address the need for legislation that is fit for the 21st century.

The public and politicians want to be assured that the services people receive from mental health organisations are safe and will protect people from such rare but catastrophic attacks as those that have occurred in the past. People with mental health problems, and their families, however, want to be assured that the services are responsive and supportive, not coercive. They want to be included as active partners in, not passive recipients of, their care. However, a coercive service whose priority is public safety is vote-catching, while concern with civil liberties for a minority group, and one with a dangerous image at that, is not.

Patients continue to be treated with drugs rather than therapy, yet the constant cry is for more talking treatments, which NICE now accepts work for conditions such as schizophrenia. Carers are still neglected; their views are ignored and they lack support. There is huge variability, with some places having great services while others, as has been described today, have appalling services.

Perhaps the biggest scandal in mental health provision is in physical health. Evidence shows that people with severe, enduring mental illness die 15 to 20 years younger than on average. That is partly due to high levels of smoking and the use of other drugs—in effect, self-medication. There is also evidence that people with mental illness suffer discrimination in relation to their physical health. They do not get seen as quickly and they do not get treated as well as those in other parts of the NHS dealing with patients who do not suffer from their conditions.

The prescription for Ministers appears to be this: more talking treatments; better physical care; concerted action to reduce stigma; and more direct payments for those who can cope with them, allowing those on benefits to buy their own care rather than relying on social services.

[Several hon. Members]

rose—

Oral Answers to Questions

Matthew Offord Excerpts

Tuesday 12th July 2011 Commons Chamber

[Anne Milton]

The Department is very clear, and the general medical services contract makes it very clear, that GPs are not allowed to do it. There are a number of options open to GPs who already have such telephone contracts, such as calling patients back, altering the contract arrangements or, indeed, paying the costs themselves.

[Mr Matthew Offord (Hendon) (Con)]

9. What steps he is taking to improve NHS patient outcomes.

[The Secretary of State for Health (Mr Andrew Lansley)]

I am committed to ensuring that the NHS achieves improved outcomes for patients. The NHS outcomes framework will drive continuous improvement in those outcomes. By way of example, we have made good progress in reducing the number of health care associated infections. In the year ending March 2011 the number of MRSA bloodstream infections decreased by 22% and clostridium difficile infections decreased by 15%, compared with the year before. Those are key positive results in the drive to protect patients from avoidable harm.

[Mr Offord]

I applaud the Minister for his work in those areas, and I draw attention to the increased work in cancer care, which I also applaud. However, may I ask him to assure the House that he will not lose focus on other areas, such as mental health, and that the Government will continue to address problems in those areas, which have such consequences across the country?

[Mr Lansley]

I certainly will. Indeed, the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), and I launched the outcomes strategy for mental health earlier this year, in order to make it absolutely clear that across the NHS, and indeed public health, we ensure that mental health services attract the right priority and focus as we develop outcome measures.