Oral Answers to Questions

Norman Lamb Excerpts

Tuesday 15th July 2014 Commons Chamber

[Sir Tony Baldry (Banbury) (Con)]

6. What steps his Department is taking to support carers.

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

Under the Care Act 2014, rights for carers that are equal to those for whom they care will be enshrined in law for the first time. That includes support to meet their needs. My Department has also separately provided £400 million for the NHS to enable carers to take breaks from their caring responsibilities.

[Sir Tony Baldry]

As a condition of the better care fund, areas are being asked to choose local indicators, which will accompany national measures, to show progress towards the integration of health and social care. How many areas have chosen carer-reported quality of life as their local indicator, and how can more areas be encouraged to make carers a priority in their delivery of services through the better care fund?

[Norman Lamb]

My right hon. Friend is absolutely right to focus on the importance of better care fund plans, including the interests of carers. The planning guidance that was issued in December made it clear that the plans should include the well-being of carers. Updated guidance will be issued very soon, and will reinforce the central importance of carers’ being part of the plans. We do not yet have a final picture, but we are keen to ensure that all plans include the interests of carers.

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

Last week I raised with the Prime Minister the case of a 62-year-old man who is caring for his wife, who has Alzheimer’s. When he sought an urgent GP appointment for her, he was told that it would take five weeks for her to see her GP and two weeks to see any GP, or he could take her to Salford Royal hospital’s A and E department. Does the care Minister think that that is acceptable, and will he now back the creation of a duty for NHS bodies to identify carers, so that they and the people for whom they are caring are given the support and the priority that they deserve?

[Norman Lamb]

No. I do not think that that level of wait is acceptable, which is exactly why we are promoting the better care fund. We want to bring together disparate parts of the system so that care is shaped around the needs of patients, and that has been widely supported throughout the system. I should also mention that the hon. Lady’s party colleague Baroness Pitkeathley was incredibly positive about the Care Act, saying that it was the biggest advance in her 30 years of working in the interests of carers. I wish that at some point the hon. Lady would just acknowledge all the good things that the Government have done in carers’ interests.

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[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

8. What the new deadline will be for moving people with a learning disability out of assessment and treatment units and into community provision.

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

We are working with NHS England to set out clear expectations for progress and improved rates of discharge. This includes NHS England producing an action plan to measure progress against. The Winterbourne View joint improvement programme is working with local areas to identify issues and to support them to make progress.

[Mr Clarke]

Given the severe lack of funding in this area and the need for development of housing and proper support within the community to avoid the recurrence of, for example, what happened in Winterbourne, will the Minister explain how he is addressing this problem and who he is working with?

[Norman Lamb]

I applaud the right hon. Gentleman’s work on this, and it is very important that we make it very clear to the public that all of us share the ambition to get people out of institutional care when they do not need to be there. Actually, it is not about the lack of resources. The scandal is that, as a system, we are spending a fortune on institutional care when people could very often be much better cared for in their own communities. The good thing is that Simon Stevens, the new chief executive of NHS England, has shown a personal interest in this. I have discussed it many times with him. We have asked NHS England to produce an action plan by the end of August, demonstrating exactly how it will speed up the progress of getting people out of institutional care.

[Mrs Anne McGuire (Stirling) (Lab)]

20. Promises come cheap, but results take sustained action. The fact is that a promise was made to the families of those with learning disabilities to move them out of assessment and treatment units by June 2014. What exactly is the situation now? The latest figures revealed that only 35% of that promise had been fulfilled.

[Norman Lamb]

The truth is that progress is far too slow. This has been a scandal that has dragged on for many years. It is not a new problem, and helping people who are capable of living independent lives with support in the community to get out of institutional care is long overdue. Changing the culture is complex and difficult, but we are absolutely determined to sustain the pressure to ensure that change is achieved.

[Grahame M. Morris (Easington) (Lab)]

22. I thank the Minister for those replies, but I understand that Sir Stephen Budd has been asked to lead a working group on these issues, reporting to NHS England. Will the Minister say a little more about the purpose of this group and its significance, in the light of the failure to meet the June deadline?

[Norman Lamb]

That is absolutely right, but Sir Simon Stevens took the view that it was essential to get the voluntary sector much more involved in the whole process. There are brilliant organisations such as Mencap and the Challenging Behaviour Foundation which are absolutely committed to achieving change, and the more we can work with them to achieve that change, the more likely we are to be successful.

[Liz Kendall (Leicester West) (Lab)]

After the appalling scandal at Winterbourne View, the Minister promised to stop people with learning disabilities being sent to assessment and treatment units for long periods. He has spectacularly failed: 2,600 people are still in ATUs, including 150 children; more people are now going into these units than are coming out; and half are still on anti-psychotic drugs or subject to physical restraint. Change will only happen with real leadership, but in answer to a parliamentary question, the Minister said he had not even met one of his colleagues at the Department for Communities and Local Government. He must now set a clear, non-negotiable deadline to end this practice in two years’ time and to secure public commitments from the Health Secretary, the Communities and Local Government Secretary and NHS England’s chief executive to make sure it happens.

[Norman Lamb]

I caution against sanctimony, because this scandal continued under the last Labour Government, who did nothing to get people out of institutional care. At least this Government are absolutely committed to changing that. What we discovered is that changing the culture is a lot more difficult than I had hoped, but we are absolutely determined to achieve the change, which is so necessary.

[Mr Robert Buckland (South Swindon) (Con)]

9. What assessment he has made of progress towards achieving parity of esteem for mental health.

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

Our mandate to NHS England requires measurable progress in achieving parity of esteem by March 2015. Parity will involve extending and ensuring better access to talking therapies, in particular for children, young people and those out of work. Progress towards better access to these services has been good.

[Mr Buckland]

I thank my hon. Friend for that answer. What further measures will be taken to improve access to specialist perinatal mental health services to deal with problems such as post-natal depression, and will we see measurable objectives on that in the NHS mandate?

[Norman Lamb]

We had a very good round table discussion about this with leaders from around the country last week. What emerged is that fantastic progress is being made in many places, but it is not uniform. There needs to be a concerted effort to ensure that mothers get access to the same specialist treatment wherever they live across the country, and we are determined to achieve that.

[Mrs Madeleine Moon (Bridgend) (Lab)]

21. The all-party group on suicide prevention has been looking at the money going into suicide prevention as a result of the Government’s suicide prevention plan. It is acknowledged by most local authorities that there is more money for mental health, but suicide has been rolled into mental health and there is a distinct lack of support for those who are suicidal but do not have a diagnosable mental health problem. What does the Minister intend to do about that?

[Norman Lamb]

The hon. Lady raises an important point, which she and I have discussed before: the fact that very many people who end up taking up their own lives have had no contact at all with statutory services. I would be happy to discuss further with her what additional steps we can take to ensure that those people get the support they need.

[Dr Sarah Wollaston (Totnes) (Con)]

I am delighted to see all the members of the Front-Bench team in their places this morning—or this afternoon, I should say. The principle of parity of esteem should also apply to consent to treatment. Does the Minister agree that the offer of talking therapies and other therapies must always be based on the principle of informed consent? Has he held any discussions with his colleagues in other Departments?

[Norman Lamb]

I completely agree with my hon. Friend. It seems to me to be inherent in the nature of therapy that people go into it willingly. The idea that we could frogmarch them into therapy against their will simply would not work. We could end up with a dangerous and costly tick-box exercise that achieved nothing, so there is no plan to introduce compulsion to access therapy.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I listened carefully to what the Minister said in answer to the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), but will he confirm that there is no truth to reports that the Government are considering plans that would mean that people with mental illness would have their benefits stopped if they refused treatment? Rather than people refusing treatment, are not the increasing shortage of beds and ever longer treatment delays under this Government the real reasons why people are not receiving the help that they desperately need?

[Norman Lamb]

I can confirm, as I already have done, that there is no truth in the rumour. Indeed, in August we anticipate publishing the start of trial programmes to bring together IAPT—improving access to psychological therapies—with Jobcentre Plus. The idea of ensuring that people who are out of work and have mental health problems get access to psychological therapies is incredibly important, and I am very excited about the pilots that we will launch in August.

[Kerry McCarthy (Bristol East) (Lab)]

10. What assessment he has made of the effects of trends in food prices on public health.

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[Jesse Norman (Hereford and South Herefordshire) (Con)]

13. What steps he is taking to improve care for people affected by stroke.

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

Mortality from stroke has fallen by over 40% in recent years. Awareness of stroke symptoms is being raised through the Act FAST campaign. The strategic clinical networks are sharing best practice in stroke care by, for example, working with commissioners and providers to improve stroke rehabilitation services.

[Jesse Norman]

I thank the Minister for that reply. Effective stroke care is extremely difficult to deliver in my county of Herefordshire, because patients are often scattered and inaccessible and the necessary treatment is highly time-critical. What are the Government’s plans to protect and enhance stroke care in rural communities, especially at Hereford hospital?

[Norman Lamb]

My hon. Friend raises an incredibly important point. I have the same experience in my county of Norfolk. Clinical commissioning groups are responsible for commissioning stroke care. The Herefordshire CCG is working with Wye Valley NHS Trust to improve the quality of stroke services and is seeking to establish a sustainable, hyper-acute service in the county, and it is clearly necessary that that is achieved.

[Helen Jones (Warrington North) (Lab)]

Emotional and psychological support after stroke can be just as important as physical care, yet many patients do not get the care they need even though research shows that investment in this area can not only benefit patients but save the NHS money in the long run. What steps will the Minister take to ensure that all stroke survivors get the right emotional and psychological support after stroke?

[Norman Lamb]

The hon. Lady is absolutely right. The cardiovascular disease outcomes strategy, which was published last year, acknowledges the importance of access to psychological therapies. Indeed, there is some really innovative work going on. A psychiatrist called Andre Tylee in London is doing work with heart patients, bringing in psychological therapies and improving their physical as well as their mental health outcomes, and the hon. Lady is absolutely right to make the case for that.

[Paul Burstow (Sutton and Cheam) (LD)]

14. What the timetable is for publication of a successor to the current national dementia strategy.

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[Paul Burstow (Sutton and Cheam) (LD)]

T9. Given that last year, more than 7,500 people with a mental health crisis found themselves in police cells rather than anywhere appropriate such as a hospital, given that 263 of those people were children and young people, and given that they stayed for 10 and a half hours in a police cell, is it not time that we took the evidence of street triage, which we know works, and rolled it out across the country?

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

The fascinating thing is that street triage is spreading across the country because forces and mental health trusts see the enormous value of it. The really exciting news is the significant reduction in the number of people who end up in police cells. That is in part due to the standards that we set through the crisis care concordat for the first time for mental health crisis care.

[Meg Munn (Sheffield, Heeley) (Lab/Co-op)]

I welcome the Secretary of State’s commitment to getting rid of as much bureaucracy as possible, so will he look into what is happening with NHS England in south Yorkshire that is delaying approval for a much-needed GP surgery in my constituency? Given that it is in partnership with the local authority, the delay risks us losing the surgery altogether.

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[Mrs Emma Lewell-Buck (South Shields) (Lab)]

Annually 30,000 applications for funeral payments are rejected, leaving families committed to expensive funerals that they cannot afford. People who are approaching end of life are not advised, as part of their palliative care, about planning for funeral costs or their eligibility for support. What is the Secretary of State going to do to remedy this?

[Norman Lamb]

The hon. Lady raises an important issue and I am very happy to discuss her concerns further with her.

[Iain Stewart (Milton Keynes South) (Con)]

The Secretary of State will be aware of the campaign run by the Milton Keynes Citizen, my hon. Friend the Member for Milton Keynes North (Mark Lancaster) and myself for an expanded A and E department at Milton Keynes hospital. What assurances can he give me that A and E services at the hospital will be able to meet the needs of an expanding population?

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[Norman Lamb]

No, that is entirely unacceptable. What we see in some of the best parts of the country such as Torbay, one of the integrated care pioneers, is that they are completely integrating mental health with primary care, delivering better results for patients. The sort of attitude that my hon. Friend describes has to end.

[Chris Bryant (Rhondda) (Lab)]

There is lots of evidence to show that chronic traumatic encephalopathy is now a major cause of depression, dementia and in many cases suicide, but the World cup showed that many sporting bodies are still not taking concussion seriously enough. Will the Minister, perhaps with colleagues in other Departments, bring in all the sporting bodies, the doctors and the teachers so that we can take concussion in sport seriously?