Autism Diagnosis

Debate between Norman Lamb and George Howarth

Wednesday 13th September 2017 Westminster Hall

[Norman Lamb (North Norfolk) (LD)]

Does the hon. Gentleman agree that NICE needs to look at reviewing its guidance? It is not just about the first appointment. There is a risk that there is gaming of the system. People get their first appointment, but then it is stretched out to three and a half years, as we know. Getting the diagnosis is the critical thing.

[Mr George Howarth (in the Chair)]

Order. Before I call Bambos Charalambous, I should say that those seeking to make a speech in the debate may consider it unnecessary to make an intervention, enabling those who for one reason or another cannot make a speech to make a short intervention. I say that in an advisory sense; it is up to the hon. Gentleman whether he accepts any interventions. As they glance around the Chamber, Members will become aware that it will be difficult to get everyone in.

Backbench business

Debate between Norman Lamb and George Howarth

Thursday 14th February 2013 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Walker. You are an appropriate Chair for this debate because of your interest in mental health and your willingness to speak out about your own experience, which meant an enormous amount to those who are fighting the stigma of mental health problems. Indeed, my hon. Friend the Member for Braintree (Mr Newmark) has done the same today. Such moments, when people are willing to speak out, are incredibly important in challenging and addressing the stigma of mental health problems in society.

I am deeply grateful to the members of the Backbench Business Committee for convening this important debate. It is good that Parliament has recently been willing to debate a number of different mental health issues in a way that perhaps has not happened in the past. Mr Walker, before Christmas you raised the issue of schizophrenia, on which we had a useful debate. The great value of such debates is that they force people to think about an issue, just as my hon. Friend the Member for South Basildon and East Thurrock (Stephen Metcalfe) has today. His experience of recognising the problem, perhaps for the first time, and talking about it with his children demonstrates the great value of such occasions, because they force all of us to think about an issue. Indeed, they force officials in my Department to think about the issue, too. I am grateful.

I do not want to detain everybody unnecessarily, but I will devote a little time to responding to the specific issues that hon. Members have raised. If the hon. Member for Romsey and Southampton North (Caroline Nokes) does not mind, I will refer first to the speech by my hon. Friend the Member for Braintree. I am so grateful that she persuaded him to come speak in this debate, because he made an incredibly valuable contribution. I was struck by his remarks about the huge stress experienced by teenagers. As the father of two boys who have been through the teenage years, I am acutely aware of the pressure on teenagers and the impact that it can have on their mental and physical health. He discussed huge stress, fear of failure and anger. I was struck by what he said: unless the mind is healed, the body cannot heal. We must look at the problem holistically.

One problem with health care is that we have institutionalised fragmentation. We have managed to separate mental health from physical health, which is ultimately not a good thing. We must consider the whole person. I know that the Opposition have been talking about that. It should not be an issue for political disagreement; it is such an obvious thing to recognise.

My hon. Friend the Member for Braintree discussed the need for education and raising awareness, including among parents. The strain, stress and anxiety that parents go through must not be underestimated. Improved awareness is needed in society of this range of conditions. He said that mental health care was the orphan within the NHS, which is absolutely true. There is an institutional bias against mental health. The way that money flows within the NHS disadvantages mental health. There is an 18-week target for physical health care and a tariff, meaning that every patient takes money with them into acute hospitals. Money is sucked through into acute hospitals, and there is great political pressure from every side to maintain the 18-week target. There is no equivalent in mental health. There is no right of access. Waiting nine months to access care and treatment is completely unacceptable. We must challenge that, and he was absolutely right to raise it. He ended on a positive note. There can be life after anorexia, however tough it is to get through it. Some, terribly sadly, do not. I will return to that point in a moment.

The hon. Member for Romsey and Southampton North made some incredibly important points. She mentioned her local organisation, April House in Southampton, and the fantastic work that it does, and she spoke about the absolute importance of raising awareness in primary care. Some people are lucky enough to find a GP who understands mental health and is passionate about it, but some are not. Families with a GP who just does not get it can be desperate; they have nowhere to turn. There is a need to raise awareness.

In the first mandate, a set of priorities published by the Government for the new NHS Commissioning Board, mental health has been given a higher priority than it has ever had in the NHS. The mandate makes it clear that the NHS is under a legal obligation to deliver demonstrable progress towards parity of esteem by 2015. That means treating mental health on a par with physical health. By placing the commissioning board under that obligation and disseminating the message to clinical commissioning groups, we will start to make progress on forcing the system to recognise the importance of treating mental health and physical health equally. It will not happen overnight, but it is a journey that we must take to improve the condition of many people. The hon. Lady discussed the impact on families and the unfair sense of guilt that many experience. She also mentioned waiting times, which in many cases are simply unacceptable.

I am grateful to the right hon. Member for Knowsley (Mr Howarth) for his contribution informing me and others about diabulimia. He discussed the rapid weight loss that can occur with diabetes, and how some people use the condition to lose weight in a dangerous way. He also said that in too many cases, a wrong diagnosis is made and the wrong treatment given as a result, and urged me to ensure that the condition was recognised better at a national level and the knowledge disseminated through the system. I urge him to engage with the commissioning board. I am happy to work with him on that, and for him to write to me on the issue.

[Mr George Howarth]

I am grateful to the Minister for the helpful way that he is addressing the problem. I have written to one of his ministerial colleagues on the matter. I arranged a meeting with her that she had to cancel owing to diary commitments, but I would be more than happy to meet him and anybody else he wants, including Diabetes UK and Diabetics with Eating Disorders. I am sure they would be happy to accompany me.

[Norman Lamb]

I am nervous about treading on other ministerial toes, but I am sure that in one way or another we can get the issue addressed properly. I am grateful to the right hon. Gentleman for informing me so well.

The hon. Member for South Derbyshire (Heather Wheeler) made a helpful contribution and discussed the need to raise awareness of eating disorders. She mentioned personal, social, health and economic education in schools. All schools are encouraged to provide young people with good, age-appropriate education about sex and relationships, but we are reviewing PSHE to establish how teaching can be improved. There is clearly a need to improve the teaching in many schools.

The hon. Member for North Tyneside (Mrs Glindon) mentioned her local service, NIWE, and the important work that it is doing. She spoke about the number of people who are not diagnosed but who none the less suffer from eating disorders, and about the fact that they have the highest mortality rate of any mental illness. She said that early intervention was important.

I was struck by what the hon. Lady said about recovery groups. This morning I spoke at a conference on mental health. I spoke specifically about recovery and a new way of looking at mental health. We must move from trying simply to treat the condition to working collaboratively with professionals and people experiencing the condition, and we must focus on recovery. Fantastic results are being demonstrated from that shift in approach. It is frustrating that in some parts of the country, great things are happening, but it is patchy, as many hon. Members have said, and improvement is needed. She also made the point that mental health is the poor relation, as I have acknowledged. That must change.

I pay tribute to the hon. Member for Enfield, Southgate (Mr Burrowes), who has had to leave, for the work that he has done on addictions, focusing on treatment and recovery. He has been committed to improving the experience of people suffering from a range of addictions. He, like other Members, discussed the growing prevalence of the condition among teenage boys, which should worry us all. My hon. Friend the Member for Wells (Tessa Munt) spoke movingly. She mentioned the cult of celebrity, pressure on youngsters, variability of services around the country and access to those, the quality of care being variable and the need for much improved training and for multidisciplinary teams.

Interestingly, my hon. Friend mentioned issues of consent, a difficult area about which there are strong views on both sides. I am acutely aware of the horrible position of a parent wanting to help, but being unable to because of the legal constraints that prevent them from making an effective intervention. We need to think more about that, and the Children’s Minister is also involved in the discussion.

My hon. Friend the Member for South Basildon and East Thurrock got it right. Fascinatingly, he talked about his discussion with his children last night. I am so pleased that his television is broken, because it has led to our being given a valuable insight that we might otherwise not have had. He mentioned the increasing prevalence among males, including among gay men, which is a real concern. He also talked about the need for help for parents in understanding the condition much better.

The shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), was right to talk about holistic care and the need to look at the whole individual. I will mention other things that he said as I go through my speech. I wish his son a happy birthday today, as he enters his teenage years.

The hon. Gentleman asked a couple of questions. On collating national statistics, we have a long way to go on the collection and interpretation of data relating to mental health. I have a fortnightly meeting on mental health in my office, so that we maintain an absolute focus on achieving tangible improvements. We talked specifically about data yesterday. The Health and Social Care Information Centre is getting more data but is not yet able, with the resources available, to interpret those. I want the same resources applied to mental health as to physical health. That is a challenge that I have made to the system.

The hon. Gentleman mentioned National Institute for Health and Clinical Excellence guidance. NICE is independent. I do not know whether there is a need for a review—a renewal—of the advice. I am happy to talk further to him about that.

This is an occasion on which we should not just raise awareness of the issue as part of eating disorders awareness week, but send a clear message to people with eating disorders, their loved ones and families: we hear you when you talk about your concerns. I am determined, as the Minister responsible for mental health, to do what I can to help.

I pay tribute to the work of Beat, based in Norwich in my county of Norfolk, which does brilliant work. Hon. Members have also mentioned Anorexia and Bulimia Care and the fantastic work that it does.

Eating disorders can be tremendously dangerous and damaging conditions. The UK has the highest rates of eating disorders in Europe. But it is a disease that is often hidden, as hon. Members have said. Sufferers are often unwilling to seek help or to recognise they have a problem. Reported cases are the tip of the iceberg. It is a disease that often strikes at the young. In 2009, the adult psychiatric morbidity survey showed that 20% of 16 to 25-year-olds admitted to having “a problem with food”. That is a significant percentage.

According to the Health and Social Care Information Centre, in 2011-12 the biggest increase in hospital admissions for eating disorders was among girls aged 10 to 15. The shadow Minister, the hon. Member for Denton and Reddish, mentioned admissions of those under 10, as well—shockingly, more than 50 children under 10 were also admitted.

Thalidomide Victims

Debate between Norman Lamb and George Howarth

Wednesday 5th September 2012 Westminster Hall

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

I congratulate the hon. Member for Kilmarnock and Loudoun (Cathy Jamieson) on securing a debate on this important subject, about which she spoke passionately and knowledgably, and I am grateful that she raised the issue at this crucial time. I suspect that her heart might have sunk on discovering that she would be addressing a new Minister who had been in a job for less than a day, but the good news is that there is value in this being the first issue I have had to consider. I give my personal commitment on taking the matter extremely seriously. I will try to get the right result, and I understand how important the issue is.

[Mr George Howarth (Knowsley) (Lab)]

I appreciate the reflective way in which the Minister has responded, but does he accept that there is both a principle and a practical consequence? The principle is that this is a debt of honour that the previous Government partly redeemed, although it will not be fully redeemed until the companies accept some responsibility, as the hon. Member for Strangford (Jim Shannon) pointed out. The practical consequence is that people who have additional capacity as a result of the grant are therefore less dependent.

[Norman Lamb]

I am grateful for the right hon. Gentleman’s intervention. I absolutely understand the responsibilities of society and the Government on this issue, and I shall seek to take my responsibilities seriously.

I would like to pay tribute to the work of the Thalidomide Trust. It has considerable expertise and knowledge of the needs of those affected by thalidomide, and it does much to support the health challenges that people face and to address barriers to every day living. The trust’s contribution to supporting survivors and their families cannot be overstated.

I would also like to pay tribute to the national advisory council to the Thalidomide Trust. I met its members when I was in opposition and took up their concerns with the Government. They work tirelessly in the cause of thalidomiders, often despite their own impairments. We are all grateful for their work, which has done much to highlight to the House and the public ongoing and increasing health concerns. The hon. Lady referred to new issues that have arisen and we have to understand and respond to those. I look forward to seeing the final report of the NAC project, “Securing Our Future”, which the hon. Lady mentioned, and I would welcome the opportunity to meet the council to discuss that report. I should add that on the first day of my job, I am not in a position to provide all the answers, but I am happy to meet hon. Members who are concerned about this issue.