Francis Report

Norman Lamb Excerpts

Wednesday 5th March 2014 Commons Chamber

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

Police cell.

[Paul Burstow]

I am grateful to the Minister for correcting the record from a sedentary position.

There were 350 children on adult wards in 2013-14, including one as young as 12, and the use of restraint has been at a high level. I know that the Minister for care services is championing changes in that area. I very much welcome his leadership on the crisis care concordat. It is very important that the CQC leads on regulation to show that it is not just words, but will be backed by regulatory teeth.

The culture change also needs to be about listening to patients. The evidence again suggests that there is still a long way to go. The Care Quality Commission has found that a quarter of care plans showed no evidence of patient involvement. That cannot be right, whether for a long-term physical health condition or a mental health problem.

We have only just had a tariff for mental health. When I arrived as a Minister with responsibility for it, I found that the task of producing tariffs had already taken five years, having dragged on and on. Yet because of the difference in how we funded mental health services, it was easier to cut them in the past. The picture of spending on mental health is rather more nuanced than it is sometimes portrayed in debates in this place.

Given all that, we might have expected NHS England to ensure that its response to the Francis inquiry and to the Government response recognised that poor care can occur in mental health as well. The chair of NHS England, Malcolm Grant, has put his name to the statement of common purpose that prefaces the Government response to Francis. Yet NHS England has ignored this Government’s mandate to it to deliver parity of esteem. NHS England’s financial experts do not get it: they are delivering Francis’s agenda simply for the acute sector, and taking money away from mental health services through adjustments to how payments are made for them. That cannot be right. I know that the Minister agrees with me, but doing so is not sufficient: there must be a challenge to NHS England’s decision to take away money from mental health, given that both sectors need to make progress and to take steps to deal with the Francis agenda.

[Norman Lamb]

I just want to alert my right hon. Friend to the fact that David Nicholson, the chief executive of NHS England, has made it clear to area teams and therefore to clinical commissioning groups that they must take parity of esteem fully into account in financial settlements with mental health trusts. That clarification of the importance of parity of esteem on finances is critical, and I hope that he welcomes it.

[Paul Burstow]

I very much welcome that and what the Minister says.

The reason I have raised issues about mental health in this debate is that it would be a mistake for Members to see Francis simply through the lens of acute hospital care. As the Government said in their response to Francis, we need to be concerned right across the piece. That is why I make no apology for focusing my speech on mental health, and why I hope that the Government will continue to drive an agenda of parity of esteem and make it a reality.