Francis Report

Debate between Paul Burstow and Paul Farrelly

Wednesday 5th March 2014 Commons Chamber

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

I will certainly watch the clock very carefully, Madam Deputy Speaker.

I want to pick up on one or two of the contributions that have already been made, particularly that by the right hon. Member for Cynon Valley (Ann Clwyd), with whom I agree about statistics. Given how much reliance we need to place on some of the absolutely key statistics about mortality, the manner and timeliness of their collection and publication, and the certainty with which we can then act, are very important.

The hon. Member for Stafford (Jeremy Lefroy) made a fantastic speech; it was very thoughtful indeed. His comments about the need to listen to individual stories and complaints, which is absolutely key, were echoed in subsequent contributions. It is also important, as he said, for chief executives to see and sign responses to letters of complaint and, indeed, for boards to be much more clearly sighted on, and open to, such issues. He also made it clear that it is absolutely key to join the dots between individual cases in order to identify, challenge and take cases forward.

The hon. Member for Stoke-on-Trent North (Joan Walley) made some very important points about the TSA process, which I think we will come back to next Monday or Tuesday. There are issues about how that system has always operated, how it is evolving and how it is being used, and we need to be clear about what should happen before a TSA process even starts. There are too many examples of the NHS not being very good at changing services and making compelling cases to the population. Too often, the case is made behind closed doors and then sold as a finished product to the public, rather than being co-designed by the public and stakeholders such as hon. Members, local councillors and many others. Until the NHS has a culture that is open to that sort of approach, we will always wind up with a crisis in administration, health care or finance that gives the pretext for triggering a TSA process. For those reasons, the hon. Lady is right to raise the issue.

[Paul Farrelly]

Will the right hon. Gentleman give way?

[Paul Burstow]

I cannot, because of what Madam Deputy Speaker has said.

My main point is about mental health. It is important that we discuss mental health in the context of Francis, because in their response the Government said:

“Whilst this poor care was in a hospital, poor care can occur anywhere across the health and social care system.”

That is absolutely right and we need to keep it in mind. I very much support the work the Government are doing to change the culture and to have more openness and compassion, and I think that an ethic of learning is part of that.

I want to focus on mental health because we could be in danger of missing it out in all this. I am convinced that there remains an institutional bias in how mental health is treated, and that needs to be tackled. We still have a long way to go to deliver the parity of esteem that this Government have put into legislation, that we have established in policy and that is now accepted, I think, as what we should all aspire to.

Francis talked about

“an engrained culture of tolerance of poor standards”,

which the issue of mental health throws into stark relief, including premature mortality figures that show a huge gap in life expectancy for those with severe mental health problems; the fact that only one in four people with mental health problems receives any treatment; and the absence until next year of waiting time targets, standards, choice and proper measurements for mental health.

The NHS has always treated mental health as a poor relation to physical health and it has a long way to go to catch up, but I welcome the fact that this Government are taking some of those steps. We need to take them as rapidly and as sensibly as we can. Another example is the routine failure to provide NICE-recommended treatments. The iniquity whereby some things are “must dos”, while others just become nice NICE things to do, cannot be right and must be changed. It is good news that my hon. Friend the Minister of State is leading work on changes to standards.

Francis talked about a failure to put patients first in everything that is done. We see that with the 7,700 people who end up in a prison cell, which they call a place of safety. The most recent figures include 41 children, which is a shocking indictment and is surely unacceptable. I just wonder whether the time has come to consider whether to attach a sunset provision to the use of powers under section 136 of the Mental Health Act 1983 so that, over the next three or four years, we work towards no children finding themselves in a prison cell because of a mental health crisis and, in due course, no adults finding themselves in a prison cell—