Covid-19 Update

Munira Wilson Excerpts

Monday 19th July 2021 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

Like hundreds of thousands of other school children, my seven-year-old daughter is out of school at home today, self-isolating. I am sure that the Minister will agree that children have paid far too high a price in this pandemic in their mental health and in their education, missing out on school. Yet only last week, Professor Whitty said that we may see new restrictions in five weeks’ time, which is just before schools return. The Department for Education issued new guidance to schools, saying that they must be prepared to deliver remote education in the autumn. Today, the Minister said that we will not vaccinate all teenagers. What guarantees will this Government provide to pupils and parents across the country that schools will reopen in September fully and safely, and will stay open? Will he rule out any further school closures?

[Nadhim Zahawi]

We and the devolved Administrations have accepted the advice of the Joint Committee on Vaccination and Immunisation to vaccinate vulnerable children, those children who live with vulnerable adults, and 17-year-olds close to their 18th birthday. The committee is, however, keeping the situation under review and looking at more data emerging from other countries, including the United States of America, on whether we should vaccinate all children. I reassure the hon. Lady that children will have two supervised tests on their return and that testing will continue until the end of September. A combination of that and vaccinating at scale all adults helps us to control transmission. Double-vaccinated people reduce transmission rates by about 50%.

Health and Care Bill

Munira Wilson Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

rose—

[Sajid Javid]

With that, I want to listen to this particular hon. Member.

[Munira Wilson]

The Secretary of State referred to Lord Stevens and what the NHS has asked for in trying to get rid of things that stand in its way. Something that it has not asked for is a massive power grab by the Secretary of State, which is in the Bill and will lead to political interference in day-to-day operational and reconfiguration decisions, which may not always be in the best interests of patients. Why does he think that that is a sensible way forward and something that the NHS wants?

[Sajid Javid]

Clinical decisions should always be made by those with clinical expertise—I think everyone in the House would agree on that—and that should be independent of any outside interference. The Bill does nothing to alter that. What it does is recognise that the NHS is one of the public’s top priorities. We spend over £140 billion of taxpayers’ money on the NHS, and it is right that there is proper accountability for that spending to Ministers and therefore to the House. I think that most people would welcome that.

--- Later in debate ---

[Munira Wilson (Twickenham) (LD)]

I would like to make it clear that the Liberal Democrats have long supported the aim of integration between health and social care, and the far greater involvement of local authorities in the planning, commissioning and delivery of services. We recognise that the pandemic has forced many of these bodies to work closely together in a much more collaborative way, and that is welcome. However, the Bill pays lip service to social care. It is largely a Bill about NHS reform, with yet another acronym-laden reorganisation that seeks to provide the legislative basis to integrate NHS services, currently in crisis mode, with a broken, underfunded and fragmented social care system. It is a massive power grab by the Secretary of State for political interference in operational and local service reconfiguration decisions and in who runs integrated care boards. The Bill is woefully inadequate in ensuring that the plans and resources are in place to ensure that we have sufficient doctors, nurses and other healthcare professionals and carers to deliver care, both now and in the future. This is all against a backdrop of record waiting lists and staff who are burnt out, stressed and struggling to cope with the third wave of the pandemic while dealing with surging A&E visitors and tackling the enormous backlog of care.

Without meaningful social care reform, this Bill cannot realise its aim of providing citizens with better joined-up care. With over 100,000 vacancies in the workforce, 1.5 million people are currently missing out on the care they need, putting additional burdens on the NHS and, importantly, on 9 million unpaid carers. The Government have promised—at the moment I take them at their word, though they have broken it many times—that they will bring forward social care reforms later this year. So why not delay the Bill for a few months and take account of the new model of social care, rather than doing a half-baked job now?

It really beggars belief when we look back over the past 16 months of the pandemic that the right hon. Member for West Suffolk (Matt Hancock), who was the architect of the proposals, seriously thought that granting himself more powers over the day-to-day running of the NHS was a good idea. We only need to look at the PPE fiasco and the failures of test and trace, both of which were run centrally, to see that handing back power to the Secretary of State is the very opposite of what we need. Allowing him or her to meddle in the day-to-day running of our NHS seems to fly in the face of the desire for more local and regional decision making.

I fully support and endorse the proposals of the right hon. Member for South West Surrey (Jeremy Hunt) on the health and care workforce independent planning proposals. They need to be properly resourced and annually reported to Parliament. Without a workforce plan, without wholesale reform of social care and while waiting lists are skyrocketing and the Health Secretary is embarking on a power grab that is his predecessor’s vanity project, this Bill will fail in its fundamental aim, shared by most Members of this House and health and care leaders—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. The hon. Lady’s time has run out.

--- Later in debate ---

[The Minister for Health (Edward Argar)]

Before winding up this important debate, I would like to put on the record, as I always do and as I know the shadow Minister does, our gratitude to all the staff in the NHS, social care and local government, and other key workers, for everything they have done in recent months. This Bill is evolution, not revolution. It supports improvements already under way in our NHS and it builds on the recommendations of the NHS’s own long-term plan, laying the foundations for our recovery from this pandemic. This Bill is backed by not only the NHS, but so many others working across health and care. A joint statement from the NHS Confederation, NHS Providers and the Local Government Association reads:

“we believe that the direction of travel set by the bill is the right one.”

It notes that working in partnership at a local level is “the only way” we can address the challenges of our time. The chief executive of Age UK has said that ICSs are to be embraced and made as effective and inclusive as they can be, and the King’s Fund is calling for us to press ahead. The list goes on; the NHS wants us to press ahead, and in the words of Lord Stevens, “The overwhelming majority of these proposals are changes the health service have asked for.” So it is vital that we in this House do right by them and by patients at this critical juncture. It is the right time for this Bill. We legislate, Opposition Members obfuscate. I remind the shadow Secretary of State of his 2017 manifesto, which stated:

“We will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.”

With this Bill, we put increased accountability for the Secretary of State at the heart of this, yet now the shadow Secretary of State no longer seems to agree with himself and characterises his own proposals as “meddling”. I know that he is dextrous in his politics and in his policy position, which is probably why he has survived under multiple Leaders of the Opposition, but this is stretching it a bit.

We have sought, in getting to this point, to work on a collaborative basis at every stage, and hon. Members can be reassured that we will continue to adopt that approach in the weeks ahead as we proceed with this Bill, when we hope it goes into Committee. My right hon. Friend the Secretary of State set out in his opening remarks his willingness to listen. In particular, he highlighted that in the case of ICS boundaries no decision has yet been made. As he set out, we are determined to embrace innovative potential wherever we find it. That is quite different from many of the accusations we have heard here today. I know it is tempting for some—even when they know better, and they do—to claim that it is the beginning of the end for public provision. It is not and they know it. They know it is scaremongering rather than reality. They know that there has always been an element of private provision in healthcare services in this country, and they should know that because, as the Nuffield Trust said in 2019:

“The…evidence suggests the increase”

in private provision

“originally began under Labour governments before 2010”.

The shadow Secretary of State should certainly know that because he was a special adviser in the Treasury and in No. 10 at that time.

With regard to the implementation of the Bill, the NHS itself wants, subject to legislation, to move at pace to implement statutory arrangements for ICSs by April 2022. That is why NHS England is beginning preparatory work, including publishing an ICS design framework. Further work, including on integrated care board design and consideration of appointments and staff from CCGs will take place, after Second Reading, of course; this is all subject to the passage of the Bill.

Let me turn to some of the specific points raised by hon. and right hon. Members. The hon. Member for York Central (Rachael Maskell) asked about “Agenda for Change”. I can reassure her that it is not the intention that ICBs depart from “Agenda for Change”. The Bill’s drafting and wording is in line with existing arrangements for other NHS bodies with regard to “Agenda for Change” and translates it into this context. However, I am always happy to discuss that with her further if she wishes. Her suggestion that this was conceived, as she put it, in a bunker is quite simply not the case. Indeed, all the stakeholders, including the NHS, have said that this is one of the most collaborative pieces of legislation development they have seen.

Turning to the workforce, as my hon. Friend the Member for Winchester (Steve Brine) said, we cannot legislate to address workforce challenges but we can and we will look very carefully at the recommendations of the Select Committee and of my right hon. Friend the Member for South West Surrey (Jeremy Hunt).

While we do not always agree on everything, the hon. Member for Twickenham (Munira Wilson) made sensible points, although I would slightly tease her that she argued against the principle of the Secretary of State taking powers in reconfiguration and shortly afterwards her hon. Friend, the hon. Member for Westmorland and Lonsdale (Tim Farron), intervened on him asking him to do exactly that.

[Munira Wilson]

I did point that out.

[Edward Argar]

She did.

In response to the hon. Member for Central Ayrshire (Dr Whitford), I am again grateful for her comments and happy to accept her kind invitation to join her on a visit to Scotland.

The right hon. Member for North Durham (Mr Jones) made a very important point. In doing so, he rightly paid tribute to the work in this space done by my hon. Friend the Member for Sevenoaks (Laura Trott) with her recent private Member’s Bill. As the Secretary of State said, either he, I or the relevant Minister will be happy to meet him to discuss it further. My hon. Friend the Member for Meriden (Saqib Bhatti) was right to talk about the need for local flexibility. That is what we are seeking to do.

The hon. Member for Eltham (Clive Efford) asked more broadly about public spending constraints after 2010. He is brave, perhaps, to mention that. I recall the legacy of the previous Labour Government, which the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) summed up pretty effectively in saying,

“I’m afraid there is no money.”

On social care, which a number of hon. and right hon. Members mentioned, we will take no lessons from Labour. In 13 years, after two Green Papers, a royal commission and apparently making it a priority at the spending review of 2007, the net result was absolutely nothing—inaction throughout. We are committed to bringing forward proposals this year. Labour talks; we will act.

The NHS is the finest health service in the world. We knew that before the pandemic, and the last year and a half have only reinforced that. It is our collective duty to strengthen our health and care system for our times. I was shocked, although probably not surprised, that the Opposition recklessly and opportunistically intend to oppose the Bill—a Bill, as we have heard, that the NHS has asked for—once again putting political point scoring ahead of NHS and patient needs. For our part, we are determined to support our NHS, as this Bill does, to create an NHS that is fit for the future and to renew the gift left by generations before us and pass it on stronger to future generations. We are the party of the NHS and we are determined to give it what it needs, what it has asked for and what it deserves. I encourage hon. Members to reject the Opposition amendment, and I commend the Bill to the House.

National Health Service

Munira Wilson Excerpts

Tuesday 13th July 2021 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

It is a pleasure to follow the right hon. Member for Forest of Dean (Mr Harper), and I pretty much agree with everything he had to say. I wish to preface my remarks on these regulations by making it abundantly clear that I and my Liberal Democrat colleagues unequivocally and strongly support vaccination, and would urge everybody who is eligible to be vaccinated. We know that vaccines are safe, effective, and save lives, and for those on the frontline—whether working in social care or in the NHS—vaccination is critical. If I had a loved one in a care home, of course I would want maximum protection for them, and therefore would want all staff to be vaccinated. The question we as legislators have to grapple with is whether coercion is the answer, and what might be the unintended consequences of mandating vaccination for some of the lowest paid and most undervalued workers in our society, and for a sector that is on its knees.

As we have heard, the care sector is facing chronic staff shortages, and making vaccines mandatory has a real potential to exacerbate those acute shortages. The Government must do much more to convince and persuade care workers to get vaccinated. As many experts have said and as we have heard already, coercion is usually ineffective or, worse, counterproductive, and risks eroding trust in the sector. Indeed, the care sector has a long history of being overlooked and underfunded. Some 1.6 million social care workers earn less than the living wage; a quarter of the workforce are on zero-hours contracts; and there is a lack of any progression or career prospects. There is a real concern that those who are vaccine-hesitant may simply leave the profession rather than get vaccinated, particularly as we know that there are serious shortages in other sectors—such as hospitality—that are offering more competitive pay.

With 1.5 million older people currently not getting the care they need, already overstretched staff will become even thinner on the ground. Care providers, many of whom are already in a fragile state as a result of the pandemic, could find themselves having to deal with the costs of tribunals and legal challenges as a result of individuals losing their jobs. What support and resource is being provided to the sector to implement this policy?

Coercion is not an effective way to overcome hesitancy. Compulsory vaccination is a blunt tool for a complex issue, and research has highlighted that pressuring care workers can have damaging effects leading to the erosion of trust, worsening concerns about the vaccine and hardened stances on refusing vaccination. Indeed, digging into the detail shows that the rate of uptake may not be as bad in some places as it initially seems. The data is somewhat encouraging in that there is a significant disparity in the percentage of staff who have taken their first jab and not their second. For instance, Wandsworth has the lowest uptake rate, with 70% of staff having had their first jab but only 53% having had their second. This could indicate that Government and NHS initiatives are bearing fruit, and that mandating vaccination could therefore be premature. Alternatively, it might suggest there is a problem with trying to get care workers back to have their second jabs. This all suggests a much more complex picture, for which this blunt tool is not the answer. As others have said, we risk going down a slippery slope to chip away at people’s rights and freedoms to make their own health choices. This decision sets a precedent and must not be taken lightly.

That leads me to my final point. In part, we have arrived at this situation precisely because the care sector has been overlooked for so long. It has long been a Cinderella service and a poor relation to the NHS, and yet again, we see that this legislation applies only to care home workers and not NHS staff, so it feels discriminatory to many in the care sector. I come back to where I started. I want to protect the most vulnerable, but I fear that these measures will do more harm than good and that we risk a mass exodus of staff from an already overburdened, overstretched and underfunded sector.

In March last year, when my Liberal Democrat colleagues in the other place and I were asking searching questions of Ministers about testing and PPE to protect care homes, there were no answers. The truth is that the tragedy we have seen unfold in our care homes throughout the pandemic resulted in thousands of excess deaths because the protective ring that Ministers talked about went in far too late. This legislation we are being asked to support is a reaction to Government inaction and failure to protect care homes, and they continue to drag their feet on reforming the sector properly. Coercion and an assault on fundamental rights and liberties should not be the response to this. We must encourage, empower and support people to make the right decision to get vaccinated, and we must pay and value our heroic care staff properly, rather than pointing the finger of blame at them.

Covid-19 Update

Munira Wilson Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

It is precisely for the reasons my right hon. Friend sets out, and for other reasons, that we have already reviewed the rules on self-isolation. That is why we have announced that there will be a change from 16 August. We will keep them under review.

[Munira Wilson (Twickenham) (LD)]

For the 3.8 million clinically extremely vulnerable people, the prospect of a so-called freedom day next week is actually anything but. They and many clinically vulnerable people, such as pregnant women, are living in fear of what living with covid means for them. Last Monday, the Secretary of State promised me that guidance was forthcoming. Last Wednesday, Members in the other place and charities met his ministerial colleague Lord Bethell and officials, who admitted that this was not good enough and that something more had to be done. Can the Secretary of State tell us today what support and guidance will be forthcoming and when, or is he pursuing a survival-of-the-fittest policy, whereby the most vulnerable will be thrown to the wolves?

[Sajid Javid]

This is one of the most important issues. As the hon. Lady says, many people are immuno-suppressed or severely clinically vulnerable. It is important that at every stage of dealing with this pandemic we are thinking of them and having them at the front of our mind. That is what I believe we have done. Of course, when people in that category are able to take the vaccine they should, but not all are able to do so. She asks about advice, and I can tell her that we are publishing it today.

Covid-19 Update

Munira Wilson Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

Yes, I can give my hon. Friend that assurance. He is absolutely right to raise this issue. As we develop our plans, we are absolutely thinking about all those more vulnerable cohorts and the impact that there may be on them. That is why when we set out the details of step 4 regarding those who are immunosuppressed there will be new guidance, and GPs will be able to use it in working with those patients.

[Munira Wilson (Twickenham) (LD)]

It is clear from comments made by the chief medical officer, the Prime Minister and the Secretary of State over the past 24 hours that, in their view, it is better to have a third wave of covid now than it is in the winter when the NHS is struggling. Will the Secretary of State please confirm explicitly whether that is the policy aim of the Government and, if so, will he confirm the estimate of his officials of how many excess deaths and additional cases of long covid that that third wave will result in?

[Sajid Javid]

No one wants another wave of covid cases. As the hon. Lady will have heard, what is different this time, as we sadly see cases rise, is the vaccine. The link between case numbers and hospitalisations has been severely weakened, as I have set out to the House in quite some detail, and that is what matters.

Covid-19 Update

Munira Wilson Excerpts

Monday 5th July 2021 Commons Chamber

[Sajid Javid]

I thank the Father of the House for his kind comments. He may have heard me say earlier that the Education Secretary will talk much more tomorrow about the action we will be taking around schools and educational settings, including the removal of the bubble requirement from 19 July. He made an excellent point about working not just across the United Kingdom—despite what the hon. Member for Central Ayrshire (Dr Whitford) said a moment ago there is great co-operation between us, which will continue—but internationally, both through our leadership of the G7 and the COVAX alliance.

[Munira Wilson (Twickenham) (LD) [V]]

The Secretary of State will be aware that, compared with the rest of the population, double vaccination provides a much reduced level of protection for clinically extremely vulnerable people with compromised immune systems. He will also be aware that pregnant women in their third trimester are considered clinically vulnerable. Many people in such groups are anxious about what today’s announcements mean for them. Will he confirm what advice is being published for the clinically extremely valuable? Specifically, will he consider allowing pregnant women to have their second jab after 21 days?

[Sajid Javid]

There will, of course, be people who are sadly more vulnerable to this virus who will be concerned about step 4. I entirely understand that caution and anxiety, and we will publish further guidance along the lines that the hon. Lady mentioned. As for her question on second doses for pregnant women, I will have to take advice on that.

Covid-19 Update

Munira Wilson Excerpts

Monday 28th June 2021 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for her kind remarks. As she will have heard in my statement, it is absolutely our intention to have step 4 commence on 19 July and to remove restrictions and start returning to normal. She asked me specifically about all restrictions, or which restrictions. It is certainly our intention to remove restrictions, but as we follow the data in the coming days, we will set out more in due course.

[Munira Wilson (Twickenham) (LD)]

May I begin by welcoming the Secretary of State to his place? I look forward to engaging constructively with him on a range of issues.

The Secretary of State will be aware that during the course of the pandemic, well in excess of 40,000 people lost their lives to covid in care homes, and the “protective ring” that his predecessor talked about being in place at the start of the pandemic went in far too late. He will also be aware that two in three unpaid carers looking after loved ones—some 7 million people—have reported their mental health worsening as a result of the pandemic. Will he help his boss to make good on his promise of almost two years ago on social care reform and honour his manifesto pledge to work cross-party on this issue, and meet me and my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) to urgently start work on it?

Social Care Reform

Munira Wilson Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

My right hon. Friend makes an important point about the breadth of the reform that is needed. I can confirm that we are looking at how we can support the workforce further, including by raising skills and improving training opportunities and career progression, and how technology can be used to support better care and more independence as well as providing more time for the workforce to do personal care rather than administration. On housing, most people want to live behind their own front door for as long as possible, surrounded by their own things and in their own communities, so that is also absolutely part of our reform.

[Munira Wilson (Twickenham) (LD) [V]]

New analysis for the Care and Support Alliance found that since the Prime Minister stood on the steps of Downing Street some two years ago and promised to

“fix…social care once and for all”,

2 million requests for formal care and support from adults over 18 have been turned down by their local council; that is the equivalent of 3,000 requests being turned down every day, putting immense pressure on unpaid carers as well as the NHS. This shows the human cost of dither and delay, so will Ministers stop their internal spats and off-the-record briefings and commence cross-party talks immediately with the sector so that we can fix this issue?

[Helen Whately]

We have of course had to focus on the pandemic over the last 18 months, but we are already working on reform. We are already consulting widely with the sector; I and the Department have together met and spoken to more than 70 different organisations and representatives of the care sector, from care providers to local authorities, and including care users and carers themselves. We will be working with this broad range of people, including parliamentarians; we need to build a consensus not only across Parliament but in society as a whole for our social care reforms.

Coronavirus

Munira Wilson Excerpts

Wednesday 16th June 2021 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

It feels a little like groundhog day—another month, another debate on covid regulations—yet we really should not be here having this debate today. For people and businesses up and down the country, this four-week delay to fully restoring our freedoms is a huge and very costly blow, yet the sacrifices that continue to be demanded of the British people are not being coupled with the support that they need to do the right thing. That is why Liberal Democrats will not be voting with the Government tonight on the public health provisions. While we support the motion on continuing the hybrid proceedings in this place, I gently ask the Minister why the Government think we as Parliament need to continue meeting in a hybrid way whereas councils up and down the country have been forced to meet in person, often at great cost when they are already under huge pressure.

As my Liberal Democrat colleagues and I have been saying for the past six months, the way to restore our freedoms must be three-pronged: vaccination; test, trace and isolate; and robust border controls. The point has already been made countless times that the reason we are here is that Ministers undoubtedly failed completely on the last of those three points by putting India on the red list far too late, for political reasons, allowing the delta variant to be seeded into the community. Even once the Secretary of State recognised it as a variant of concern, we know there was a 17-day delay in designating it as such, which meant that surge testing commenced far too late. That cannot happen again.

The situation we find ourselves in was avoidable. Ministers must take full responsibility for having to delay the lifting of restrictions next week, and part of that responsibility is to support people to do the right thing. With businesses on their knees, jobs are at risk and many of the self-employed have yet to get a penny of support. The hospitality, events, weddings, culture, tourism and travel industries are on their knees. Even after domestic restrictions are lifted, we know that the travel sector will have to continue to bear the brunt of restrictions, given that the biggest threat to our full reopening in the UK will be variants brought back in through international travel, so the complete lack of a bespoke package of support for those industries beggars belief.

If we want to restore our freedoms fully next month, as the Prime Minister has promised us, and allow our economy to thrive again, it will be critical to test every potential case, trace every contact and support self-isolation. Experts have been calling for better financial and practical support for the past year, and finally the penny dropped earlier this month for the former head of Test and Trace that supported self-isolation was the missing piece. Even so, there has still been no comprehensive package announced to pay people their wages to self-isolate, provide accommodation if necessary and support those with caring responsibilities. That is the way to break chains of transmission and stop new outbreaks in their tracks, and it is an awful lot cheaper than blanket restrictions.

Learning to live with this virus, as I believe we absolutely must, requires a proper strategy and an action plan—not hoping for a fair wind. It means bringing together the UK’s world-leading genomic sequencing capability with traditional public health test and trace at a local level, coupled with the right support. Our public health directors up and down the country are crying out for that. They will continue to be our frontline in managing this virus as we learn to live with covid. Let us give them the tools they need and not be back here again in a month’s time asking for a further delay—or, worse still, be asked to reintroduce restrictions months down the line.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call Dame Andrea Leadsom—congratulations on your well-deserved recognition in the Queen’s birthday honours list.

Children and Young People’s Mental Health

Munira Wilson Excerpts

Wednesday 16th June 2021 Westminster Hall

[Munira Wilson (Twickenham) (LD)]

I beg to move,

That this House has considered children and young people’s mental health.

It is a pleasure to serve under your chairmanship, Sir Gary. I am very grateful to be given the opportunity to lead a debate on this critical issue. Eighteen months ago in my maiden speech, I pledged that children and young people’s mental health would be an issue that I champion in this place. It is a cause for which I will fight relentlessly, because children and young people are our future. Their hopes and dreams depend upon us doing the right thing by them.

Those who are struggling with their mental health and wellbeing, whether those suffering mild anxiety to those young people attempting to take their own life, deserve the very best care and support. Yet children and young people do not have a voice in the political system and are too often overlooked. In fact, the former Children’s Commissioner, Anne Longfield, said in her final speech earlier this year that in Government there was an “institutional bias against children”—never more so than during the pandemic when, frankly, they have been an afterthought at every turn. From new born babies to schoolchildren to university students, the Government have let them down in planning and providing for their social and educational needs, and again in their announcements about children’s recovery.

Teenagers and young people in my constituency who are ambassadors for the fantastic local charity Off The Record tell me that uncertainty over exams, combined with the social isolation of being stuck at home away from their peers, worries about loved ones and now concerns about their future job prospects have all taken their toll. But this crisis in children and young people’s mental health started long before the pandemic. One reason why I made it my priority at the start of last year was because following my election, I was astounded week in, week out by the emails from parents or conversations at my surgeries, of stories of battles with child and adolescent mental health services to access treatment for children who are considering suicide, self-harming or withdrawing themselves from school. Yet they were having to wait six months or sometimes a year for treatment.

At a lower level, support in schools is patchy, with only some having access to a counsellor or mental health support team. Community-based support to intervene early can be dependent on voluntary sector provision in any given area. The pandemic has only served to highlight and exacerbate the existing lack of access and inequalities within children and young people’s mental health. In 2017, one in nine children had a diagnosable mental health condition. That rose to one in six at the height of the pandemic. The Government need to use this moment to renew their focus on mental health and overhaul the support available.

I want to focus on three elements within the system and what needs to be done: CAMHS, schools and community services. Turning first to CAMHS, referrals are at their highest ever level, with over 65,500 referrals for 0 to 18-year-olds received in March 2021. That is more than double the number in March 2020 and almost 70% higher than in March 2019. Behind the staggering numbers is a child or a younger person in turmoil, often left in limbo waiting for treatment, and a carer beside themselves with worry. From talking to NHS leaders in my area, I know that unplanned admissions for children suffering a mental health crisis are at extremely high levels with services struggling to cope.

While it must be acknowledged that the Government have increased spending in this area, resulting in the NHS slightly exceeding its 2019-20 target of community mental health support for 34% of children needing support, there is still a long way to go. Last week, a local GP said she is increasingly finding that children she refers to CAMHS are being knocked back, and she is routinely requesting schools make a supporting referral to secure therapy. When referrals succeed, the wait can seem interminable. I heard from the adoptive father of a seven-year-old who suffered significant trauma and abuse within her birth family. She was referred to treatment, the initial assessment took several months to secure, and then the family were told that there would be a year’s wait—yes, a year’s wait for a seven-year-old for an eight-session course of treatment, only if deemed necessary.

There is a postcode lottery of spending across the country. Eight local areas spend less than £40 per child on mental health services, while 21 areas spend more than £100 per child. That brings me to an important point about data and reporting, which is so important for accountability. Inconsistencies in financial reporting across clinical commission groups makes it difficult to interrogate the data to check they are meeting NHS England guidance to increase year-on-year the proportion of spending on children and young people’s mental health. This measure should be included in the mental health investment standard.

The other issue with data collection and publication is that it is impossible to judge whether different areas are meeting access targets, as the percentage of young people with a diagnosable mental health condition is only available nationally, not on a local basis. The Children’s Commissioner should not have to request this comprehensive data on waiting times and referrals every year. The Minister will know that I tabled an amendment during the passage of the NHS Funding Act 2020 to improve transparency in operational expenditure and performance at a local level. I discussed this with her ministerial colleague, the hon. Member for Charnwood (Edward Argar), a few months ago. He assured me that the Minister is taking this forward, and I hope she can update us on when this local data might be routinely available.

However much money is pumped into CAMHS, improving access to it is contingent on plugging big holes in the workforce. The Royal College of Psychiatrists’ 2019 workforce census found that the rate of unfilled NHS consultant psychiatrist posts in England has doubled in the last six years, with one in eight CAMHS psychiatrist posts vacant. We urgently need a proper long-term work- force strategy, adequately resourced and with an annual report to Parliament. The forthcoming heath and care Bill is the ideal opportunity to hardwire this provision.

Turning to the role of schools in tackling mental health concerns, they are key to early intervention, and step in where children do not meet the CAMHS threshold. Provision of counselling and other mental health support services in schools can be variable and dependent on already massively overstretched school budgets. Mental health support teams can fill the gap. However, the current roll-out rate is very slow. The Government are aiming to reach a fifth to a quarter of the country by 2022-23, and have recently provided more funding to accelerate the roll-out, but I urge the Minster to be more ambitious.

On children’s recovery from the pandemic, most of the education catch-up funding announced by the Government has been largely focused on academic catch-up, with little focus on emotional wellbeing and mental health support. All the research shows that it is difficult for children to learn if they are struggling with their mental wellbeing. Liberal Democrats supported YoungMinds’ call for a £178 million ring-fenced resilience fund to allow schools to provide bespoke mental health and wellbeing support packages, as appropriate to their pupils and context. So far the Government have committed just £17 million of dedicated mental health support for schools as part of the recovery. A recent Ipsos MORI poll showed that parents put increased wellbeing support at the top of their priority list as part of any education recovery plan.

Finally, I will touch on the importance of community support services. We know that half of all mental health conditions present themselves by the age of 14 and three quarters by the age of 24. That is why prevention and early intervention are so critical. We know that some children and young people do not want, or are unable, to access mental health support in schools, but community-based services can be a lifeline.

Waiting until children reach crisis point is far too late. For younger children, family-based interventions, such as those offered by Kids Matter, are an effective approach. The Purple Elephant Project in Twickenham, founded by the inspirational Jenny Haylock, who has built a team of art and play therapists, works with children and their families from a very young age. Coram is also doing some incredibly important work on boosting children’s self-esteem and resilience.

For teenagers and young adults, I warmly welcome the campaign launched by a range of children’s and young people’s mental health charities, called “Fund the Hubs”. It calls for early-support hubs, offering easy-access, drop-in support on a self-referral basis for young people up to the age of 25, who do not meet the threshold of CAMHS.

The hubs would offer a mix of clinical staff, counsellors, young workers and volunteers, providing a range of support services. Additional services could be co-located under one roof, such as sexual health services or employment advice. The hubs could be delivered in partnership with the NHS, through local authorities or working with the voluntary sector, depending on the local area. Such an approach has already been tried in Manchester, Ireland and Australia, and has been shown to relieve pressure on and deliver cost savings to the health service. I hope the Minister will look at that innovative model.

In conclusion, we owe it to our children and young people to offer them the very best start in life. As a Liberal, I am passionate that every child gets the maximum opportunity to reach their full potential. With spiralling figures of children suffering anxiety, who are self-harming or struggling with eating disorders, as well as many more who are grappling with low confidence and self-esteem, we need to use this moment as we emerge from the pandemic to hit the reset button.

I urge the Minister, who I know shares my passion on this issue, to develop a proper cross-departmental strategy to tackle this growing crisis. Let us re-envision what support looks like for children and young people. Let us break down the silos between schools, local authorities and the NHS. Let us make sure that we prevent and intervene early to stem the tide, while also investing in training the mental health workforce.

I have heard too many times, from too many parents sick with worry, that CAMHS is simply not fit for purpose. I have yet to see much evidence to disagree with them. I hope the Minister will make it her mission to fix it, and work cross-party, if she is willing. I stand ready to do so for the sake of our children and their future, and I hope my Labour counterpart will, too. Not only is it morally the right thing to do, but our country’s recovery depends on their success.

[Sir Gary Streeter (in the Chair)]

Colleagues, we have 45 minutes and nine Back-Bench speeches to fit in, so that is exactly five minutes each. Please try to keep to time, so that I will not need to impose any restrictions.

--- Later in debate ---

[Munira Wilson]

I thank all hon. Members who contributed in such a knowledgeable and passionate way to this debate. I hope the Minister has seen that there is cross-party support for greater support for and investment in mental health services. I recognise that the Government have put more money in, but one of the themes has been whether it is getting through to the local level and the frontline. That is why my hon. Friend the Member for Bath (Wera Hobhouse) and I keep picking up the point about data, and the hon. Member for Newton Abbot (Anne Marie Morris) did the same. I am grateful to hon. Members for picking up points that I was not able to cover, such as the baby blind spot, eating disorders and disabled children. There are so many issues; this is multifaceted.

The Minister talked about definitions and said that we are conflating mental health and wellbeing, but it is all part of a continuum. That is why it is so important, as part of the prevention agenda, to focus on wellbeing as much as the serious mental health concerns. That is why I was trying to cover that vast spectrum in my speech. I reiterate that I stand ready to work with the Minister.

The hon. Member for Strangford (Jim Shannon) quoted JFK. Well, I will quote Mandela back at him:

“There can be no keener revelation of a society’s soul than the way it treats its children.”

Motion lapsed (Standing Order No. 10(6)).