Mental Health

Norman Lamb Excerpts

Wednesday 9th December 2015 Commons Chamber

[Luciana Berger]

I thank my hon. Friend for making that very important intervention. There are too many stories of our blue light services—not just the police, but our ambulance and fire services—being under incredible pressure in contending with such issues. I believe that the Government must do more to address that issue.

[Norman Lamb (North Norfolk) (LD)]

I am pleased the hon. Lady has called this debate. Does she share my view that yesterday’s report on perinatal mental health makes incredibly disturbing reading? Many women have lost their lives because of the absence of services. We must commit to making sure that every part of the country has good services to ensure people get through such difficult times.

[Luciana Berger]

I will come on to the very serious issue of perinatal mental health that the right hon. Gentleman raises. Again, we should all be very concerned about that issue.

I am very concerned that there has been a psychiatry recruitment crisis, with a 94% increase in vacant and unfilled consultant posts. The NHS constitution treats mental health and physical health differently. The Government claim to be increasing mental health budgets, but patients and professionals tell a different story. Ever since Ministers discontinued the annual survey of investment in mental health three years ago, we do not have an accurate picture of spending on mental health in our country.

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[The Secretary of State for Health (Mr Jeremy Hunt)]

I congratulate the shadow Minister on securing this debate. She spoke powerfully about the shortcomings in mental health provision, and although she was reluctant to recognise the progress being made, she deserves credit for having secured her first debate on her new portfolio.

President Obama recently talked of the need to bring mental health out of the shadows, and I would like to start by congratulating hon. Members on both sides of the Chamber on their bravery in doing exactly that. I recognise the bravery of my hon. Friend the Member for Broxbourne (Mr Walker), who has spoken powerfully about his obsessive compulsive disorder and its impact on his family life; of the hon. Member for Barrow and Furness (John Woodcock), who has talked about his treatment for depression; of the hon. Member for North Durham (Mr Jones), who has also spoken bravely about his battle with depression; and of my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell), who is part of the new cross-party campaign, and who opened up about his mental health challenges during a difficult period in his life.

I also thank my hon. Friend the Member for Croydon Central (Gavin Barwell) for his private Member’s Bill, supported by the Government, that repealed the laws preventing people with mental health conditions from being Members of Parliament, jurors or company directors. I also thank my hon. Friends the Members for Vale of Clwyd (Dr Davies) and for Eastleigh (Mims Davies). I thank the hon. Member for Ashfield (Gloria De Piero) for her leadership of the all-party group, and I thank the right hon. Member for North Norfolk (Norman Lamb)—no one has done more in the House to campaign for mental health. In particular, I would like to recognise the bravery of his son, Archie, who spoke about his mental health challenges. Anyone who saw the joint interview on ITV News will have been extremely moved. I would also like to recognise someone who is not a Member and is not usually praised by Conservative Members: Alastair Campbell is a very powerful advocate for mental health; his bravery and openness is a reminder to us all that depression affects people in all walks of life.

Hon. Members have sent a strong message to the public: when it comes to mental health conditions, you are not alone. One in four adults experiences mental health problems every year. They affect everyone, including our elected representatives. By speaking out, hon. Members send a message to other parliamentarians who may be suffering in silence. Despite the incredible privilege of working in this place, public life can be incredibly stressful. It can destroy not just people’s hopes but their marriages, relationships and families. Being an MP does not make us immune to the pressures that affect everyone. With the support of wonderful campaigning organisations such as Mind, Rethink, the Samaritans and Young Minds, this kind of courage has made a real difference.

In the past couple of years, we have seen huge determination from those on both sides of the House to improve mental health provision. One reason for that is that society’s understanding has improved a huge amount in the past decade. We should celebrate the fact that we know much more than we ever did before about the workings of the brain, the causes, treatment and prevention of mental ill health, and links to other societal issues, such as debt, unemployment and family breakdown. As a result, between 70% and 90% of those treated for serious mental illness see a reduction in their symptoms and an improved quality of life. That percentage is even higher if the illness is caught earlier. The best example is early intervention for psychosis, which can reduce suicide risk from 15% to just 1%.

We should also recognise the progress made on depression. The World Health Organisation describes depression as more disabling than angina, arthritis, asthma or diabetes, but we know it can be treated as successfully as any of them. The BMJ’s research, published today, mentions that talking therapies for moderate and severe depression can be as effective as drugs. Our own programmes of talking therapies have a 50% recovery rate, post-treatment.

[Norman Lamb]

I appreciate the way the Secretary of State is addressing this subject. We are all on a journey on this. He will remember that last October we published a document that painted a vision of achieving genuine equality by 2020; that was not rhetoric. Central to that was introducing comprehensive waiting times standards, so that there was a complete equilibrium of rights: the same right to access timely treatment for both physical and mental health problems. Does he remain committed to that absolutely critical principle?

[Mr Hunt]

I am committed to that principle. As the right hon. Gentleman knows—we have discussed this many times—access to treatment is vital, but so, too, is the quality of treatment at the start of the process. We need to make sure that we keep a close eye on both. I think it was right to ask Paul Farmer of Mind to lead an independent review of the best way to make progress towards parity of esteem during this new Parliament. I want to wait and see Paul Farmer’s recommendations before we decide how to implement the vision that the right hon. Gentleman played such an important part in developing.

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[Norman Lamb (North Norfolk) (LD)]

Let me say at the outset that I strongly support the motion and I think the whole House should unite behind it. Although Members may disagree with aspects of the motion, it is really important that we send out a united message that we are all agreed on the imperative of achieving equality for mental health. Self-evidently, we still have a long way to go, and we should be impatient for change.

The sentiments in the motion were at the heart of the cross-party campaign that I launched with Alastair Campbell and the right hon. Member for Sutton Coldfield (Mr Mitchell). We managed to get more than 200 leaders from across society to come together to make the united case for equality for mental health and for extra investment. Why is it that so many leaders agreed to join that cause? Is it because there is now a growing recognition that we must end this absolute historic injustice and ensure equal access to treatment?

[Mr Kevan Jones]

I commend the right hon. Gentleman for his work. Does he agree that those leaders now need to translate that action into policy, both at a national and a local level?

[Norman Lamb]

I totally agree. We have to set the framework, put the funding in place and deliver services on a local basis. How can anyone in this Chamber possibly justify this: if someone has suspected cancer, they have a right to an appointment with a specialist within two weeks of referral by their GP, but a youngster with an eating disorder has no such right, yet we know that their condition can kill? That is a scandal and an outrage and it must change. There must be equality of access.

When someone does get access to treatment, too often it is a lottery. As we discussed last Friday, we have the continuing scandal—the hon. Member for North Durham (Mr Jones) referred to this earlier—of people being shunted around the country in search of a bed. That would never happen to someone suffering from a stroke or a heart condition. It is inequality of access to treatment, and it is a complete scandal.

[Mr Jones]

There is an issue with the number of beds, but does the right hon. Gentleman also accept that one of the problems is that people are in those beds for far too long? One of the crisis points in London is access to adequate housing so that people can be discharged into the community.

[Norman Lamb]

I was so pleased that the hon. Gentleman made that point in his speech, and I pay tribute to him for the work he has done. The answer is not simply to have more beds; we should also be reducing the length of stay, which often is not therapeutic for the individual. Getting them into secure housing is central to their health and wellbeing.

[Rehman Chishti (Gillingham and Rainham) (Con)]

Will the right hon. Gentleman give way?

[Norman Lamb]

I am afraid that I cannot give way, as I have very limited time.

At the heart of that inequality is the stigma that still attaches to mental health. We have made real progress in combating that stigma, but we have a way to go. My message to the Government is that the inequality of access is morally wrong. We cannot begin to justify one person not getting access in the way that somebody else does in our publicly funded NHS. I am pleased that the Secretary of State has acknowledged that that is a scandal, but the Government now have to deliver that equality of access. We have to deliver by 2020 the vision that he and I set out last October.

That inequality of access is not only morally wrong, but economically stupid, as many Members have mentioned. The Centre for Mental Health reckons that neglecting mental ill health costs us about £105 billion a year, so continuing to neglect it is stupid and completely counterproductive. If we make the investment up front, we will achieve savings further down the track. I therefore welcome the £600 million that the Chancellor indicated in the spending review would be made available over this Parliament for mental health. That is real progress, but it is not enough. We have to keep arguing the case for genuine equality.

We need to do two things. First, we need to spend the money differently. Many hon. Members have made the point that we need to shift resources away from containing people, often in long-stay, secure settings, to early intervention, recovery and ensuring that there is proper crisis support in the community to stop hospital admissions, which can be so damaging to someone’s wellbeing.

Secondly, up-front investment is needed to fund a programme for comprehensive maximum waiting time standards, including for children and young people, so that there is a complete equilibrium, with equal rights of access to treatment. We published that vision last year, and I hope that the Secretary of State will deliver it. If we give up on the right of equal access, if we give up on ending that discrimination at the heart of our NHS, and if we do not end this historic injustice, we will let down countless families across the country, and that would be an utter disgrace.

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[Heidi Allen (South Cambridgeshire) (Con)]

If I may, Madam Deputy Speaker, I would like to ask you to cast your mind back to the summer. As a new MP, I was sitting on the grass on a Sunday reading through my casework. There were many of the usual items of correspondence on housing, planning and so on, and then a letter, and a moment I will never forget. It was from a constituent, Steve Mallen, telling me about the tragic suicide of his 18-year-old son—a brilliant, gifted young man with grade 8 piano, straight A*s at A-level, and a place reserved at Cambridge University. Ten months ago today, Edward Mallen took his own life in front of a train. “Mental health”—they are not dirty words. We all have a state of mental health, just as we all have a state of physical health. We have good days and we have bad days. We all have them, every one of us. For most of us, the good days follow the bad days and overcome them, but tragically this did not happen for Edward.

Today I want to talk about what we in this Chamber can do to make sure that there are no more Edwards. Members will know that I want this House to work together to resolve problems, not to point fingers at failure. So I urge those in all parts of the House to recognise the good work that has been done so far and to commit, from this day, to working together to achieve more. I believe that we are building on the foundations laid by the tremendous work of Norman Lamb and the Health and Social Care Act 2012. We have seen investment of £1.25 billion to help deliver the Future in Mind Initiative, the appointment of Sam Gyimah, and the appointment of Natasha Devon as the Department for Education’s first schools mental health champion—and boy, what a fireball she is! Only this week, we had the announcement of a £3 million pilot programme to support mental health leaders in schools across the country. Given that 10% of children under 16 have a clinically diagnosable mental health problem, and 75% of all mental illness predates higher education, we are focusing on the right things.

Prevention is far better than a cure, because by the time a cure comes, families, communities and the wider economy have been devastated. Ask Steve Mallen, his family and the village of Meldreth, because they know. We could argue all day about whether the Government are spending enough on the cure, but I do not want us to do that.

[Norman Lamb]

The hon. Lady is making a passionate case, particularly in relation to the tragic case of her constituent. Does she agree that we need to get the whole of the NHS to sign up to a commitment to a zero suicide ambition? That is not about setting a target, but about changing the culture so that everyone focuses on saving lives.

[Heidi Allen]

That is fundamental and there should be no alternative. The right hon. Gentleman is absolutely right.

Nobody doubts the need to improve mental health care or the fact that money does not grow on trees. Investment is increasing, but I fear that the scale of the problem is far greater than any Government cheque book. It is so much bigger than that, but the good news is that we are capable of being bigger than that, too. Let us cast aside party politics and make this our issue, not just the Government’s issue.

In South Cambridgeshire, we are pooling together the resources of schools, world-leading academics, mental health charities, business, local authorities, politicians and parents—everyone—to do things differently. With Steve and the memory of his son, Edward, at the helm, we want to roll out a timetabled early intervention and prevention programme in every single one of our schools. We are trialling and developing it, and in March next year we will launch it at an international conference in Cambridge, which Alistair Burt has kindly committed to attend.