Mental Health and Unemployment

Debate between Paul Burstow and James Morris

Tuesday 24th February 2015 Commons Chamber

[Paul Burstow]

That is undoubtedly true and indeed some people do not go through the recruitment process in the first instance because they believe they will be discriminated against or they are fearful of disclosure. Those are serious issues to do with lack of parity and lack of equality, and the discrimination people both impose upon themselves but that also exists within our society. It is why tackling the issue of stigma is so important and why we should celebrate the progress that has been made but also be challenging the Government to continue to support campaigns like Time To Change because they are clearly demonstrating progress.

The stigma has not gone, but it is going. Time To Change, the anti-stigma campaign set up by Mind and Rethink Mental Illness and funded as part of the Government’s mental health strategy, recorded the biggest annual improvement so far in public attitudes to mental health. It found a 7% rise in people’s willingness to work with someone with a mental health problem—from 69% to 76%. We still have to go further, but that is a mark of the progress that has been made, and I hope we can see more.

The Government have made parity of esteem between physical and mental health the clear goal of their mental health strategy, and progress is being made. However, when it comes to employment and the way people with mental health problems are supported, we still have a long way to go. Four different sets of data lead me to that conclusion. First, according to the OECD, unemployment rates for people with severe mental health problems in the UK are five times higher than for people without a mental health problem. Secondly, a clinical commissioning group outcome indicator on employment and severe mental illness was included in the 2014-15 indicator set. It published its first set of results last December, and it shows a worrying decline in the number of people in paid employment with a severe mental health diagnosis, from 43,000 to 35,000, a significant 20% drop. Thirdly, the CQC’s community mental health survey for 2014 showed that 34% of respondents on the care programme approach, and over half of respondents not on the approach, said they did not receive support from someone in NHS mental health services in getting help with finding or keeping work, but they would have liked that and would like to have been told how to access that support. Fourthly, of the 150,000 people with mental health problems on employment and support allowance who have been placed on the Work programme, just 6.7% have been helped into work. That is compared with a 25% success rate for those without a health condition.

For me, what this shows is that there is a huge amount still to do. It is worth saying that while the national average employment rate for people with severe mental health problems has dropped to 5.7%, a number of areas are achieving high levels of employment for people with severe mental illness, such as Wokingham, mid-Essex and Aylesbury, all of which are achieving employment rates of 20%.

[James Morris (Halesowen and Rowley Regis) (Con)]

Does the right hon. Gentleman agree that there should be scope for the use of individual placement and support for those with serious mental health issues? I know the Government have been piloting some individual placement and support programmes. I would be interested to hear from the Minister whether they are proving to be successful in getting people with severe mental health problems back into work.

[Paul Burstow]

Yes; I want to come on to that, and I look forward to hearing what the Minister has to say about the pilots, where they have got to and the intentions going forward. It is inescapable that back-to-work support that is designed primarily around physical health problems and disabilities is poor at meeting the needs of people with mental health problems. Where the support is well-designed, it has so far not got the reach or take-up necessary to make a difference. The Access to Work mental health support service was described in the Sayce review as

“the best kept secret in Government”,

because despite its success rates—90% retention rates, for example—very few people have been helped: just over 2,500 people with a mental health problem since the service started in 2011, on the most recent data I could find. The potential is good, but more needs to be done to ensure the take-up of such programmes, so that people can benefit from the advantages that they provide.

Over the past two years, I have had the opportunity to chair an independent commission on mental health for the think-tank CentreForum and to co-chair a task and finish group on mental health and employment with Marjorie Wallace, the chief executive of the charity SANE. That group’s work has led to the NHS adopting an employment-based indicator, and to the development of a new commissioning incentive for NHS organisations to provide for adults who are in contact with secondary mental health services to help them to gain or retain employment. The group is also helping with the drafting of a new National Institute for Health and Care Excellence quality standard on schizophrenia containing a specific reference to employment.

National Health Service

Debate between Paul Burstow and James Morris

Wednesday 21st January 2015 Commons Chamber

[Paul Burstow]

I think it important for the system to learn lessons from the areas where winter planning has worked well, and for us to ensure that those lessons are transferred and replicated around the country. The NHS is not always as good as it could be at ensuring that lessons are not just stuck in one place.

[James Morris (Halesowen and Rowley Regis) (Con)]

Will the right hon. Gentleman give way?

[Paul Burstow]

I must make some progress if others are to have a chance to speak.

The NHS has grappled with a productivity challenge during the current Parliament, but it should be noted that it was first set up and signed off by the last Administration. The target was £20 billion, and it was to be delivered within a shorter period than the coalition Government set in their 2010 spending review. The Labour productivity programme was set in 2009, and it was clear then that the NHS was on notice that it faced a very tough settlement regardless of which party was in government after the 2010 general election. Reducing management overheads has been a key part of our efforts to balance the books during this Parliament. Focusing on the management overhead costs of the commissioning side of the NHS in the legislation that went through the House at the beginning of the Parliament was sensible, and increasing clinical involvement in commissioning was another important move.

Mental Health

Debate between Paul Burstow and James Morris

Thursday 16th May 2013 Commons Chamber

[James Morris (Halesowen and Rowley Regis) (Con)]

The more fundamental point is that a significant proportion of the money that is spent on mental health services in the national health service—about £14 billion—is focused on acute services. If we were to shift, say, 4% of that budget into community-based solutions and early intervention, that might have a much more dramatic impact on our ability to tackle the underlying problem.

[Paul Burstow]

The hon. Gentleman makes a good point. Indeed, that has been part of the approach taken in the talking therapies strategy, which is about moving the resource to where it will make the most difference at an earlier stage, and helping to promote recovery in the first place.

The Minister said that the emergency service is a stark example of where parity of esteem has not been achieved, and I want to give another example. The Royal College of Psychiatrists and its president, Sue Bailey, have been looking, on behalf of the Department of Health, at the whole issue of parity of esteem and what practical steps could be taken to address it, and it has recently published work on that. How can it be right, for example, that a recommendation by the National Institute for Health and Clinical Excellence on the availability of a drug is a must-do for the NHS but a NICE recommendation on the availability of therapies is not? This means that evidence-based non-pharmacological treatments that are clinically effective and cost-effective are often left unimplemented. I hope that that bias will soon be brought to an end.

The same can be said for access standards. There has rightly been uproar when even small changes occur in the amount of time people wait to attend accident and emergency departments. NICE has said that a person experiencing a mental health crisis should be assessed within four hours, yet only one in three people is so assessed. I am puzzled by the decision not to set a 28-day access standard for therapy, because the NHS constitution should embody parity of esteem, and that is a tangible way it could do so. Having said that, I take heart from the revised NHS constitution handbook, which said albeit it in a footnote:

“The Mandate indicates that we will consider new access standards, including waiting times, for mental health, once we have a better understanding of the current position. We need to do this work and consider carefully the implications of introducing any new standards, before we can make any firm commitments in this area.”

Why on earth is this problem still not being understood? Why do we need yet more reviews? Will the Minister give an indication of the time scale?

Southern Cross Care Homes

Debate between Paul Burstow and James Morris

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

I thank the hon. Gentleman for his comments. He should just reflect on the fact that this company and this business model were established during the 13 years when his party was in office, and on the fact that his party did not put in place the necessary regulatory measures that would have allowed anything other than the very measured approach that this Government are taking— working with the lenders and the landlords to ensure a consensual restructuring of this business. That is what the residents of these homes want, and this is what we are doing to make it happen.

[James Morris (Halesowen and Rowley Regis) (Con)]

I recently visited Roxburgh House in Cradley Heath in my constituency, where a number of vulnerable elderly residents are concerned about their future. Does the Minister agree that we need not only to address the continuity of care in those homes now, as he has described, but seriously to review the situation, once this crisis has been managed, to make sure that it does not happen again? Will he outline the steps he will take to ensure that that happens?

[Paul Burstow]

I am grateful to my hon. Friend. That is exactly what we also need to work on, which is why we are providing in the Health and Social Care Bill the necessary powers for regulations to be made that would allow such a regulatory approach to be developed. During consideration of those ideas in Committee, it was far from clear whether the Opposition believed that this was a worthwhile approach to adopt.

Southern Cross Healthcare

Debate between Paul Burstow and James Morris

Thursday 16th June 2011 Commons Chamber

[Paul Burstow]

It is important to put on record that something that the hon. Gentleman said is not, and never has been, the case. Social care in this country is not free. That is one of the big inequities of our current system and one of the big challenges that the Government are determined to address through the review that Andrew Dilnot is undertaking.

On the hon. Gentleman’s question about the good old days, I have to say that many people did not see those days as good, because the care was not personalised and individualised, and it was not always of good quality, either.

[James Morris (Halesowen and Rowley Regis) (Con)]

Will the Minister say something more about the specific steps he is taking to see that the Care Quality Commission ensures that standards of care are maintained during the transition period in homes in my constituency owned by Southern Cross? What steps will he take to ensure that the CQC takes its responsibilities seriously?