Mental Health Services (South-East Essex)

Norman Lamb Excerpts

Wednesday 5th March 2014 Westminster Hall

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

It is clear from the contribution of my hon. Friend the Member for Southend West (Mr Amess) how strongly he feels about the matter, and I absolutely respect that. I am not interested in any line to take from the Government. I have a speech here, but I want to address directly what my hon. Friend has had to say. I share his passion for trying to improve mental health services. That is something that I feel strongly about. I never like the idea of sweeping failures of service under the carpet. He has raised some serious concerns, although he did not have time today to go into the detail of all the things that he wanted to raise, and I would be keen to meet him to discuss those issues further.

I want to say a word about what I am trying to do in mental health. I agree that it has always been the Cinderella service, and there is what I would describe as an institutional bias against mental health in the NHS, which manifests itself in all sorts of ways. The spotlight is not on standards in mental health as it is in other areas of the health service. When the Government responded to the Francis report on Mid Staffordshire, we made it clear that addressing the concerns he raised about culture in the NHS was just as important in mental health as it was in any other part of the health service. If my hon. Friend reads the Government response to Francis, he will see that that is the case.

One of the ways in which we have responded to Francis is substantially to change how the Care Quality Commission goes about its work. My hon. Friend sought to make the case—by putting it in such a way, I do not suggest that he is wrong; I am not in a position to judge —that there is a massive gap between what he knows about a local service and what the regulators say about it. I know from my own part of the world, Norfolk, that when one raises acute concerns about, for example, the ambulance service, the response is often that everything is fine even though we know that it is not. We must try to ensure that inspectors and regulators reach a clear and accurate view of the quality of services.

The inspection regime that we are introducing, first in acute hospitals but soon in mental health trusts as well, is much more rigorous than anything that has gone before. One of the things that the previous Government did in 2008 was to remove specialist teams of inspectors, so that everyone in the CQC became a generalist. They might one week inspect a dental practice, a GP practice, an acute hospital and perhaps a mental health trust. That is no good; we must have people who know what they are looking for. It is also critical to involve clinicians and service users, who may well have an insight that others will never achieve. The CQC has appointed a deputy chief inspector who is in charge of the inspection regime for mental health, and I urge my hon. Friend to contact him directly to raise the concerns that he has expressed. At the end of the inspection process, mental health trusts will be rated so that the public has a much better view of the quality of a service in their local area.

Regulation on its own does not change culture; I absolutely get that. There must be carrot and stick. We must do things to change the culture within organisations as well as seeking to secure good standards through regulation. Regulation and inspection are a critical part of the overall picture, however, and we must have confidence in the inspection regime.

Everything that has emerged from the CQC’s work under the new leadership of David Behan and David Prior—a former colleague of my hon. Friend’s whom I happened to beat in North Norfolk to give him the opportunity to become the chair of the CQC—shows that they understand about compassionate care and high standards of care. We will shine a spotlight on mental health services and other parts of the health service in a way that has not happened before. I think that that will be of some value.

[Mr Amess]

Does the Minister understand how frustrating the whole thing is for me? The previous chief executive, Patrick Geoghegan, was in an unusual relationship, which I will not enlarge on, with someone who was first installed in a property in my constituency—there was a dispute about that—and later became a top-earning member of the board. With all this due diligence and inspection, how on earth was that allowed? What has happened is absolutely crazy, and I will need quite a bit of convincing, whoever the Minister introduces me to. It seems to be only when we air things publicly in Parliament that there is any interest—“Yes, Minister. Let’s get a brief ready.” I am not going to let the matter drop because my constituents deserve better than they are getting at the moment.

[Norman Lamb]

I hope that my hon. Friend recognises that I have sought to address his concerns directly, rather than reading from a pre-prepared speech. I share his concern about levels of pay in the upper echelons of the NHS, and I believe that that must be addressed.

On a more positive note, in the short time that I have available let me mention some of the positive things that we are doing. In January, we launched a document called “Closing the gap”, which directly addresses the fact that mental health services always fall behind physical health services. We have stated publicly, and we have put into legislation, that there should be parity of esteem and equality between mental and physical health services. The document identifies 25 areas in mental health services in which essential change is needed. One example is the widespread use of face-down restraint. Such restraint is not acceptable or necessary in a modern mental health service, and many areas have demonstrated how to create positive regimes without the use of such a barbaric approach.

[Mr John Baron (Basildon and Billericay) (Con)]

I congratulate my hon. Friend the Member for Southend West (Mr Amess) on securing this important debate. There are various shades of mental health problems, and care in the community is an important aspect of looking after those who suffer from such problems. However, day centres up and down the country, including Mundy House in my constituency, are under threat. Will the Minister look at what more can be done to support day centres as a means of caring for not only mental health patients but other patients and community members generally?

[Norman Lamb]

I am conscious that I am close to running out of time, but community services often do enormously good work in their local areas. The focus on mental health must shift towards a prevention approach. We must intervene early rather than allowing a problem to deteriorate and acting only after something has happened. We must also focus much more on recovery. So often, we seek to contain people’s ill health rather than helping them to recover in a meaningful sense.

Finally, I would like to mention our crisis care concordat, which will set high standards of crisis care in mental health that have never existed before. We expect every area to implement that concordat to ensure that people, wherever they are in the country, get access to the right standards of care.

[Mr Peter Bone (in the Chair)]

Order. I apologise to Members for having to curtail the debate, because I am sure that it could continue.