Child and Adolescent Mental Health Services

Debate between Norman Lamb and Geoffrey Robinson

Tuesday 3rd March 2015 Commons Chamber

[Norman Lamb]

I totally agree. When I embarked on the mission to introduce waiting time standards in mental health, I was very clear throughout that they must apply equally in children’s services, as in any other service. One of the first two standards we are introducing from April this year is a two-week standard to start treatment for early intervention in psychosis, where there is a wealth of evidence that quick intervention can lead to good results.

My hon. Friend the Member for Brigg and Goole (Andrew Percy) talked about the absolute importance of youngsters learning about mental health at school. It ought to be part of the curriculum, and we would benefit a lot if that was the case. He also made the important point that although lots of areas of the country have seen really ridiculous disinvestment in mental health and children’s mental health, other enlightened areas have not done that. There is no necessity for it to happen; it depends on what the local priorities are. In his area they have done the right thing and made the necessary investment.

The hon. Member for Easington (Grahame M. Morris) talked about the horror of suicide. The husband of my hon. Friend the Member for Totnes is a psychiatrist in Devon. He has been a brilliant advocate of the case for a zero-suicide ambition. Every organisation within the NHS ought to be setting the same ambition that has been set in Devon.

The Government have prioritised improving mental health as part of our commitment to achieving parity of esteem, or, as I would prefer to call it, equality. I have been frank that the current system for supporting children and young people’s mental health is simply not good enough, but let us be clear that this is not a new problem. Previous reviews into CAMHS have identified similar issues to those that the Committee highlights, such as a lack of beds, complex commissioning and referral arrangements, poor practice around transition from children to adult services, and instances of children being treated far from home or on adult wards. These issues are deep-seated and hard to resolve. Lord Crisp was recently quoted in the Health Service Journal, when asked about parity of esteem:

“If something has developed over 40 or 50 years you don’t solve it in five minutes.”

I know a youngster who in the past decade was horribly let down by mental health services at that time. This is not something that has just emerged over the course of this Parliament. I fully recognise that too many areas of the country have disinvested in young people’s mental health. I firmly believe that the situation can and must improve. The Government have taken steps to do this.

It is worth saying that, as I have done this job, I have seen some really impressive services. There is a brilliant NHS team in Accrington providing the best possible service to young people. I visited South London and Maudsley, where there is a fantastic eating disorder service based on the quickest intervention, with specialist support for youngsters very quickly reducing massively in-patient admissions. That is the sort of service we need to see across the country. There is a brilliant in-patient facility in Colchester, where there is a great school in the mental health service so that youngsters do not lose out on their education while they are receiving support. There are some brilliant third sector organisations. MAC-UK is a wonderful organisation that takes therapy out on to the streets to support youngsters who get involved in gangs, rather than expecting youngsters in those circumstances to visit traditional services. MAP—the Mancroft Advice Project—in Norwich is a brilliant service supporting youngsters in a non-stigmatising way.

Since 2010, we have raised the profile of children and young people’s mental health to unprecedented levels. We have produced the mental health and suicide prevention strategies, set out the top 25 priorities to help to achieve parity of esteem in the “Closing the gap” document last year, and we have worked, through Time to Change, to reduce the stigma attached to mental health issues. The 2014-15 mandate to NHS England sets it a clear objective to deliver equality and parity of esteem, and in 2014 we published our five-year vision for mental health. At its heart was a radical change: an ambition to set access and waiting time standards for mental health—just as they exist for physical health—including children and young people’s mental health, for all services by 2020. That is a landmark step in rebalancing our health and care system and achieving equality.

[Mr Robinson]

It is good to hear that the Government are setting those targets. Will the Minister have a look at the situation in Coventry and explain to me why it has happened? Can he also confirm that the targets he has set will be achievable, despite the £50 million cut that has been made?

[Norman Lamb]

I am very happy to look at Coventry if the hon. Gentleman wants to send me a note about that.

I make the case that there needs to be more investment in mental health, and my party has argued for £500 million of additional investment a year in mental health in the next Parliament. Investing £54 million for the children and young people’s IAPT—improving access to psychological therapies—programme has started to transform existing services, and it now covers 68% of the nought to 19-year-old population, which exceeds the original target of 60% by 2015. NHS England continues to plan for nationwide roll-out, as set out in the mandate, which should be achieved by 2018.

As part of the autumn statement, the Deputy Prime Minister and I announced £150 million of investment over the next five years to deal with eating disorders. This will help to ensure that any young person can get the help they need, no matter where they live, and will allow the development of waiting time standards for eating disorders from 2016. This is a condition that can kill, so it is so important that we get early access. We have invested £3 million in MindEd, a digital resource to help people who work with young people and children. It is an online platform designed to give them the help that they need in the work that they do.

The prevalence survey is being undertaken—we have secured the money for it—and we plan for it to be ready by 2017. The aim is for it to cover children and young people from two years to 19 years, which is a wider range than in the original survey. That should be widely welcomed.

As for the taskforce, although there has been much progress, the Government have been open about the scale of the challenge and acknowledged that there is still much to do. As the Committee is aware, I set up the taskforce last summer. It is chaired jointly by the Department and NHS England and brings together a whole load of experts from outside Whitehall and listens to the voice of young people as well. This is a massive opportunity fundamentally to modernise the way children and young people’s health services operate, embracing the role of the voluntary sector and the potential for online support for youngsters, and sorting out this ridiculous, fragmented commissioning. The problem has been there for a long time, but things need to be made much simpler, so that we can have coherent services that are easily understandable for children and their families. If we can grasp this opportunity, we can make a massive difference for young people.

Let me say a word about crisis care. In a way, this is the area where the gap between physical and mental health is greatest. The Torbay case that my hon. Friend the Member for Totnes mentioned was a shock to the system, although we have already seen considerable reductions in the number of young people going into police stations. We are on course to see a reduction of about 30% this year, but it needs to be much greater than that. In my view, we need to legislate to end the practice completely. It is surely completely unacceptable that young people under the age of 18 end up in police cells rather than in a hospital. That practice simply has to come to an end.

I applaud everyone who has participated in this debate on a really important subject. I think we have an opportunity massively to improve things.