Eating Disorders

Paula Sherriff Excerpts

Tuesday 16th October 2018 Westminster Hall

[Paula Sherriff (Dewsbury) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. Like others, I thank the hon. Member for Bath (Wera Hobhouse) for securing this important debate and for speaking so passionately.

As we have heard from many colleagues, eating disorders manifest in many different ways. They are mental illnesses that involve disordered eating behaviour, with types including anorexia, binge eating disorder, bulimia, purging disorder and avoidant or restrictive food intake disorder—that list is clearly not exhaustive. Their severity and complexity should never be underestimated. Sufferers will commonly go to extreme lengths to hide their symptoms and behaviours even from those closest to them.

It is thought that the majority of people with eating disorders are young women aged 12 to 20, but it is harmful to stereotype; the possibility that someone can develop such a disorder should never be ruled out. The number of boys and young men developing them is rising, and the numbers could be higher than we think, mainly due to stigmatisation and fear of speaking out. Indeed, when I visited the Navigo eating disorder service, which my hon. Friend the Member for Great Grimsby (Melanie Onn) spoke about, I met four service users of whom two were women over 40 and another was a young man in his late teens. That shows that we must not stereotype.

Eating disorders have the highest mortality rates among psychiatric disorders, with anorexia having the highest mortality rate of any psychiatric disorder. Of those who survive, 50% recover, whereas 30% improve and 20% remain chronically ill. It is estimated that 40% of sufferers will also self-harm. Given those startling statistics, it is clear that more needs to be done to help sufferers with their recovery and that access to treatments must be greatly improved. Someone with an eating disorder will currently wait an average of 3.5 years before receiving treatment. As we have heard, it is worse for adults, who statistics show have to wait twice as long as children before accessing treatment.

In 2015, clinical commissioning groups were given extra money to help children and adolescents suffering with eating disorders. Unfortunately, in the CCGs’ bid to balance the books in these times of severe NHS funding cuts, much of that money never found its way to the frontline and, of what did, little was actually used for eating disorder services. We heard from the hon. Members for Bath and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) about how services are patchy. There does appear to be a postcode lottery and disparate availability of services. However, we do recognise that some fabulous work is going on, including the service run by Navigo in Grimsby.

Much more needs to be done to raise awareness and to remove stigmas. Common misconceptions include that people with eating disorders are more responsible for their symptoms and that they would be more likely to use their disorder to gain attention than those suffering from other mental illnesses. Such misconceptions must be dispelled and greater awareness must be raised. The popular TV series “Hollyoaks” is currently running a story highlighting a young woman’s struggle with her eating disorder. Well-researched storylines such as that are an important way of educating people and dispelling myths, but there is still much work to be done.

My hon. Friend the Member for Islwyn (Chris Evans), who made a passionate speech, spoke about how the media controls much of the narrative. I remember looking at women’s magazines—I tend not to buy them so much anymore—and constantly seeing frighteningly thin models; plus-size models are rarely seen, even though being bigger than a size 10 does not necessarily mean that someone is unhealthy. Equally, social media plays a big part. Role models also have a responsibility. I remember a supermodel famously saying that nothing tastes as good as thin feels. Children and adolescents in particular look up to those people, who must recognise that they are role models in society.

Data on access, quality, workforce and investment in adult eating disorders services, which is key to the evaluation of whether services are effective, is not routinely collected and published. That would not be acceptable for physical health conditions, so why is it for a mental health condition? Furthermore, we have heard that there are no waiting time targets in place for over-18s. It would be great if the Minister responded on that.

In December 2017, the Parliamentary and Health Service Ombudsman published its findings after investigating the death of 19-year-old Averil Hart from anorexia. Its investigation “Ignoring the alarms: How NHS eating disorder services are failing patients” found that there had been inadequate co-ordination and planning of Averil’s care and that, tragically, Averil’s death could have been prevented had the NHS provided appropriate care and treatment.

The Parliamentary and Health Service Ombudsman and Beat, which I also thank—it does fabulous work and lobbies Members of Parliament to ensure that this issue is firmly on the agenda—have recommended that the General Medical Council conduct a review of training for all junior doctors on eating disorders to improve understanding of complex mental illnesses. As we have heard, although eating disorders affect an estimated 1.25 million people in the UK, training on it is limited to just a few hours over several years of training.

GPs, who are often the first port of call for people with eating disorders, must be provided with the training they need to identify the illness and to know what steps to take next. Blame is attached not to NHS staff but to how the service is run. The problems in the NHS have not come about overnight; the Government knew they would happen. Junior doctors have protested against the situation.

Much more needs to be done to aid the early stages of diagnosing and treating eating disorders because, as with much else, early intervention is crucial. A constituent of mine who was suffering from an eating disorder was praised on her weight gain during a consultation—such comments are enough to set recovery back for months. Health professionals should be given training on acceptable basic language when dealing with these sensitive issues. I am interested to explore family therapy further, because when I have met sufferers of eating disorders and their families, its great impact on the whole family has been clear. Family therapy is therefore a positive way forward.

I am conscious that I am running short of time, so I will try to summarise the remainder of my speech. NICE guidance for eating disorders states that children and young people with suspected eating disorders should start treatment within four weeks. However, a 2017 survey by Beat found that only 14% are referred within four weeks of their first GP visit. The average wait for referral is more than 11 weeks, and those aged 19 and over wait significantly longer. The situation is worse for men and boys, who make up between 10% and 20% of people with anorexia or bulimia.

We know—it has been said before—that mental health services are the poor relation in a cash-starved NHS. Some 40% of NHS mental health trusts are having their budgets cut, and we appear to be moving further and further away from parity of esteem. When I recently questioned the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), it emerged that an average of 2,000 mental health staff are leaving their posts in the NHS every month. At the end of June this year, one in 10 mental health posts was vacant, despite promises by the then Health Secretary, the right hon. Member for South West Surrey (Mr Hunt), that he would increase the mental health workforce by 21,000.

As Labour’s shadow mental health Minister, I am passionate about seeing improvements across all our mental health services—as I know everyone in the Chamber is. I am committed to delivering on Labour’s promise to have a counsellor in every high school, as early intervention is the key to preventing serious mental health issues. We would also ensure that budgets for mental health services are ring-fenced and ensure parity of esteem, providing a properly funded NHS with properly funded mental health services.