Oral Answers to Questions

Norman Lamb Excerpts

Tuesday 25th February 2014 Commons Chamber

[Laura Sandys (South Thanet) (Con)]

3. What progress has been made on introducing a cap on care costs.

[The Minister of State, Department of Health (Norman Lamb)]

Everyone will be protected against catastrophic costs by the insurance that the cap will provide from April 2016, in line with the Dilnot commission’s recommendations. We are currently putting the legislative framework for the cap in place, and will consult on draft regulations and guidance to implement the cap in autumn of this year.

[Laura Sandys]

Best behaviour, Mr Speaker.

Does the Minister agree that greater investment in pre-emptive and preventive measures, such as GP annual assessment for those who are getting older, might keep the new old just a little younger?

[Norman Lamb]

I start by paying tribute to my hon. Friend for the work that she has done while she has been a Member of Parliament. I know that she has announced her decision to stand down, and she has done excellent work campaigning for elderly people and others in her constituency and beyond. She is absolutely right. The cap will, first of all, help people to prepare and plan for old age, which is an incredible advance. Also, the £3.8 billion better care fund is the biggest ever shift towards preventive health care and GPs will play a critical role in that.

[Mr Jim Cunningham (Coventry South) (Lab)]

What is the Minister doing to encourage local authorities to provide more places for care, particularly with the reduction in costs? Is he aware that local authorities are finding it difficult, because of Government cuts, to fund those places?

[Norman Lamb]

I am conscious that finances in local government are tight, but the better care fund, which I mentioned just now, has been widely welcomed. I was with a director of adult social care last Friday, who told me that his authority was planning to pool not just its share of the better care fund but the whole of its social care budget with the local health budget. That sort of radical, innovative thinking is exactly what we want and it will ensure that we protect services for vulnerable people.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does the Minister agree that the steps that the Government are taking to reform the funding of care for the elderly represent long overdue action to deal with an issue that has bedevilled this world for more than 20 years? Tony Blair promised the Labour conference in 1997 that he would deal with it, and he did precisely nothing about it.

[Norman Lamb]

I remember the quote from Tony Blair well—he did not want to live in a country where people have to sell their homes to pay for care. However, over 13 years of the last Labour Government nothing happened. There were lots of commitments—manifesto commitments and so on. However, I am proud of the fact that this coalition Government are implementing reform, and it is long overdue.

[Nic Dakin (Scunthorpe) (Lab)]

4. What assessment he has made of the role of dispensing doctors in the NHS.

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[Ms Karen Buck (Westminster North) (Lab)]

14. What recent assessment he has made of the number of available mental health crisis beds for young people in England.

[The Minister of State, Department of Health (Norman Lamb)]

NHS England has a rapid review under way to identify commissioning solutions to pressures on specialist beds for children and young people. It inherited varied provision across regions and a lack of capacity in some parts of the country for particular need. For the first time, available beds are monitored weekly, and small increases in capacity have already been secured.

[Rushanara Ali]

I thank the Minister for that answer, but 1,500 mental health beds have closed since 2011, which is causing a wider crisis, and a recent Care Quality Commission report found that, in one area over the previous year, 41 children had been detained in police cells because health-based places of safety were either not available or not staffed—and one of those children was 11 years old. How can that be acceptable?

[Norman Lamb]

The reduction in the number of mental health beds has been a long-term trend—it happened under the previous Labour Government—and rightly so, because we have to move away from institutional care. However, crisis beds must always be available. I completely agree that it is intolerable for children to end up in police cells, but that is not new; it has happened for many years and did not start in 2010. When we talk about parity of esteem, we mean it. There must be absolute equality between the ways in which mental and physical health are treated. Last week we launched a crisis care concordat to ensure that children do not end up in police cells.

[Ms Buck]

The clinical director of child and adolescent mental health services in my mental health trust recently said:

“Sometimes we have to make 50 to 100 phone calls around the country looking for a bed… young people shouldn’t be shunted around the country into inappropriate facilities.”

Another psychologist dealing with a case in my constituency told me:

“It is very difficult to get young people into in-patient services at present due to the high number of cases and reductions in funding from NHS England.”

Is that not an intolerable situation in which to leave traumatised young people? How quickly will the Minister’s review be completed so that we can end that tragedy?

[Norman Lamb]

The review being undertaken by NHS England will report in March. I agree that that situation is intolerable, but I have made it very clear on many occasions that there is an institutional bias against mental health in the NHS. Interestingly, the Health Committee report on deficits in 2006-07 specifically made the point that mental health was particularly targeted, so that always happens when NHS finances are tight. However, it cannot happen, because there has to be parity of esteem, including in the way in which money is distributed in the NHS.

[Jeremy Lefroy (Stafford) (Con)]

In Stafford hospital, many young people with mental health problems are extremely well treated in normal in-patient wards. That should not be the case, but no other facility is available. What will happen if those in-patient beds are no longer there?

[Norman Lamb]

As far as possible, we should be trying to ensure that children with mental health crises can remain at home; it does not make sense, in very many cases, to put them into in-patient care. However, we have made it clear, as has NHS England and as was confirmed in the crisis care concordat last week, that beds should be locally available whenever they are needed.

[Sarah Champion (Rotherham) (Lab)]

19. Will the Minister indicate when a clear strategy for the commissioning of tier 4 mental health beds will be determined and what additional resources will be made available to support the mental health needs of children and young people? The current situation is intolerable.

[Norman Lamb]

I mentioned earlier that the rapid review that is being undertaken by NHS England will report in March. It is essential that we have sufficient beds available, as close to home as possible, for children and young people. As I also said earlier, as far as possible children should be cared for at home, and only as a last resort should they go into in-patient care.

[Liz Kendall (Leicester West) (Lab)]

The pressure on children’s mental health beds is now intolerable. Earlier this month, the 14-year-old daughter of one of my constituents desperately needed a bed but the local trust’s chief executive told me that not a single bed was available anywhere in the country in the NHS or the independent sector. The Minister has said that this is unacceptable as though it is nothing to do with him, but he voted for an NHS reorganisation that is wasting time and money as vulnerable children are forced on to adult wards or transported hundreds of miles across the country. When the review reports, what action will he take and by when will it be implemented?

[Norman Lamb]

For a start, we now have 15,000 more clinicians working on the front line than when this Government came into office in 2010. Also, in the reforms that the hon. Lady mentions, we legislated for parity of esteem so that mental health is treated equally with physical health. However, I have accepted her case and agree that the situation is intolerable. We have to make sure that beds for children and young people are available when they are needed.

[Mr Andrew Turner (Isle of Wight) (Con)]

7. What proportion of medicines prescribed in the NHS are alternative medicines; and what the annual cost is of dispensing such prescriptions.

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[The Minister of State, Department of Health (Norman Lamb)]

Our mandate to NHS England makes it clear that everyone who needs it should have timely access to the best available treatment. NHS England is currently gathering information about access to and waiting times for mental health services. We will use this information to set new national access standards for the first time, to be introduced from 2015.

[Andy Sawford]

The Safe Haven in Corby provided crisis out-of-hours support to 1,300 people with mental health problems last year. For the first time ever, it has been asked to tender for its future funding. It was eight minutes late with its tender, and the service is going to be cut. What will happen to the people who need that service in the future? Will the Minister meet me to discuss it?

[Norman Lamb]

I am very happy to talk to the hon. Gentleman about that. My understanding is that the local CCG undertook a retendering exercise with a view to maintaining and, indeed, improving mental health services locally. As he says, Safe Haven did not submit its tender in time. It had a right to appeal, and it chose not to appeal. The CCG is absolutely committed to ensuring that it improves mental health services locally.

[Mr David Heath (Somerton and Frome) (LD)]

Not only do mental health services not get the attention that they sometimes deserve, but the condition of individuals is often exacerbated by the inability of the benefits system to recognise episodic illness and by the insensitivity and incompetence of Atos in work capability assessments. Will the Minister talk to his colleagues in the Department for Work and Pensions so that we can have a system that is suitable and fit for people with mental illness?

[Norman Lamb]

I thank my hon. Friend for his question. Indeed, I share the concerns that he raises, and I have recently met my hon. Friend the Minister responsible for benefits specifically because I have those concerns. There needs to be much closer working between mental health services and the benefits system locally.

[Mr Kevan Jones (North Durham) (Lab)]

The Minister knows that early intervention therapy or talking therapies can relieve pressure not only in access to beds, but in helping individuals. He has just told the House that he will look at assessments of waiting times. Will he tell the House exactly what force or lever he will have to ensure that local trusts implement such targets?

[Norman Lamb]

I think it was a big mistake to leave out mental health when the 18-week maximum waiting time limit was introduced for physical health services. To me, that is inexplicable, so I am determined to correct it: from next year, there will be waiting times standards for mental health. Indeed, when the Care Quality Commission inspects and regulates providers, it will ensure that those access standards are met, in the same way as applies for physical health.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

11. What reports he has received on the possible reclassification of ME/CFS by the World Health Organisation.

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[Penny Mordaunt (Portsmouth North) (Con)]

T2. There is great unmet need among older people in our communities, particularly for dementia care and support. In Portsmouth we are holding a community summit to join up local agencies to meet that unmet need. Will the Minister meet me to discuss what central Government can do to ensure that advice on additional funding streams is clearly and readily available?

[The Minister of State, Department of Health (Norman Lamb)]

I thank my hon. Friend for that question and pay tribute to the agencies in Portsmouth that are coming together to hold the summit and discuss that critical issue. The Prime Minister’s challenge on dementia has made real progress in improving diagnosis rates and the way that society treats dementia, and I would be happy to meet my hon. Friend to discuss the issue further.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

T4. Further to the answer given earlier to my hon. Friend the Member for Wansbeck (Ian Lavery), the lobbyist John Murray and an organisation funded by large pharmaceutical companies led a consultation and co-wrote a report for NHS England on the future of commissioning for £12 billion of NHS services. Will the Secretary of State tell the House whether it is now Government policy to have lobbyists and big drug companies drafting reports that directly influence the commissioning of NHS services?