(5 years, 1 month ago)
Commons ChamberAs usual, the hon. Gentleman raises an extremely important point. Of course, health is a devolved matter, but that is not to say that all four nations cannot learn more from best practice in each place. I am pleased to say that we are now increasing our contact with representatives of the devolved Governments, and we will very much be sharing such best practice.
Referrals to child mental health units from primary schools for pupils aged 11 and under have risen by nearly 50% in three years. BBC research last week also found that primary school children are self-harming at school, and in four cases children under 11 had attempted suicide while at school. This is deeply shocking, so what is the Minister doing to ensure that primary school children will have support from trained mental health professionals when they return in September?
The hon. Lady is quite right to raise that, and it is incredibly troubling to see those figures. The investment we are making in mental health support teams will be of assistance. For primary schools that are well led and gripping this issue, there is some very imaginative and innovative practice to bring emotional wellbeing into the classroom from the moment pupils arrive. We need to make sure that those mental health teams start acting as soon as possible. This is something that we need to address collectively with schools and as a society to make sure that we get treatment to people at the earliest possible time.
(5 years, 2 months ago)
Commons ChamberThe hon. Lady articulates the issue extremely well. The purpose of local suicide prevention plans is very much to make sure that we have a joined-up approach to combating male suicide and to identify exactly where the gaps in the services are. The £600,000 that we announced yesterday for the sector-led improvement package is to enable local authorities to share expertise and to make sure that, holistically, they provide the leadership to make sure that the gaps are plugged. I am grateful for the hon. Lady’s interest in this matter.
This week, the Children’s Society published research to show that more than 110,000 children and young people were turned away from mental health services because their problems were not deemed serious enough—that is despite suicide rates for teenagers almost doubling in eight years and research from YoungMinds that shows that three quarters of parents feel their child’s mental health has deteriorated while they wait for treatment. Why are so few children able to get the support from mental health services that they so desperately need?
As the hon. Lady and I have discussed previously, I would be the first person to recognise that we are not where we would like to be in respect of the provision of mental health services, but that is why we are investing an additional £2.3 billion to expand access for children by 345,000. In addition to that, we are investing in a brand new workforce in all our schools so that we can have exactly the kind of early intervention that will not require more lengthy periods of care and treatment. It is essential that we equip all schools and young people with tools to manage their wellbeing.
(5 years, 3 months ago)
Commons ChamberThe right hon. Gentleman will be aware that we expect all local communities to have suicide prevention plans, part of which will be that they engage in areas of greatest risk, whether it be regarding place or their populations. Suicide is the biggest killer of young people and I expect local authorities to engage with education providers to make sure that sufficient measures are in place. We are in the process of challenging the plans to make sure they are fit for purpose.
Universities UK has warned that it simply cannot keep expanding to fill the gaps left by inadequate funding for NHS services, after university spending on mental health services rose by almost half in five years. Too often other sectors such as education are left to fill the funding gap this Government have left in mental health, so can the Minister tell me today when her Government will match our pledge to ring-fence funding for mental health?
I have always viewed the ring fence as a ceiling rather than a protection. We have the mental health investment standard and NHS England is challenging clinical commissioning groups that are not spending what we would expect.
This is a systemic weakness. We have treated children up to 18 and then considered them as adults, but the reality is that people do not suddenly achieve majority overnight. We intend through the forward plan to have the children and young people service from nought to 25. That should enable transition and stop people falling off the cliff edge at 18.
(5 years, 6 months ago)
Commons ChamberAs we outlined in the 10-year plan, we fully recognise that there needs to be much more investment in community and crisis care, including direct access via the 111 service. By April, we will be able to put more flesh on the detail of how we will roll that out. I assure the hon. Lady that I am in no way complacent about the challenges we face in ensuring that our mental health services are what people should expect of them.
Last week, The Guardian revealed that hospital admissions for eating disorders have surged in the last year. Meanwhile, the number of children and young people with urgent cases of eating disorders who are treated within a week has fallen, and the number of those waiting between one and four weeks has risen. If prevention is better than cure, why do so many children and adolescents with eating disorders end up in A&E?
The hon. Lady is right in the sense that we have waiting targets for eating disorders, whereby the most acute cases should be seen within a week. We have seen very good progress—indeed, in most areas those targets are met. I will look into the cases that she has highlighted because we need to give attention to where the targets start to be missed. However, I assure her that we recognise that tackling eating disorders among our youngest people through early intervention must be done because prevention is always better than cure.
(5 years, 7 months ago)
Commons ChamberThe hon. Gentleman has quizzed me about this a number of times, and I know that he cares very deeply about it. One of the specific issues he has raised with me is the awareness of GPs and their involvement in diagnosing these problems. Obviously we are taking that forward as part of the GP contract. I can also advise him that there is a significant expansion in perinatal services. We are confident of achieving the national trajectory of 2,000 more women accessing specialist care this year, and more than 7,000 additional women accessed such care as of March 2018.
Recent analysis of NHS digital mental health workforce statistics reveals that NHS England is not on course to meet its targets of 21,000 additional mental health staff by 2021. This means that it is unlikely to meet the goals set in the five year forward view and the recent long-term plan. Mental health services are in real danger of further decline, so may we have an absolute guarantee from the Secretary of State that these targets will be met, and if they are not, will he resign?
I have to advise the hon. Lady that we are on course to meet the targets in the five year forward view, but she is right to raise concerns about the workforce. Frankly, that keeps me awake at night. We are investing in a significant expansion of mental health services and that requires appropriate staff to deliver them. I can assure her, however, that we are in productive discussions with clinical leads in NHS England. We need to be much more imaginative about how we deliver services, and we are seeing substantial gains and improvements in performance through the increased use of peer support workers, who provide the therapeutic care from which many can benefit. However, the hon. Lady is right to hold me to account.
(6 years, 1 month ago)
Commons ChamberAs I have said, NICE has published its new clinical guideline on the recognition and treatment of eating disorders in people over the age of eight, including adults, and we will make clear to NHS organisations what we expect of them. We are ensuring that we meet the waiting times for eating disorder treatment, and we are delivering against those standards.
Data from NHS Digital show that the number of beds for people with serious mental health conditions, such as eating disorders, has fallen by nearly 30% since 2009. The Government say that they are committed to ensuring that everyone with an eating disorder has access to timely treatment, but according to the hon. Member for Central Suffolk and North Ipswich (Dr Poulter)—who I believe is also an NHS doctor—there is often a long wait for patients with eating disorders who need beds for urgent in-patient care. Does the Minister agree with him?
The hon. Lady’s starting point was “since 2009”. It is certainly true that there was a decline then, for a number of reasons, not least the fact that we are improving treatment in community settings rather than acute in-patient beds. Our Five Year Forward View began in 2014, and we have been delivering improvements in the number of beds and staff since that date.
(6 years, 2 months ago)
Commons ChamberThe hon. Lady is right to raise this issue. We are determined to end out-of-area placements, but clearly that will require behavioural change on the part of commissioners, as well as making sure that the investment takes place. I know she will continue to hold me to account on this issue, because it is clear that out-of-area placements can cause harm and we must tackle them.
According to data from 48 of 56 NHS mental health trusts, 3,652 patients suffered an injury in 2016-17 through being restrained—the highest number ever. There are concerns that increased use of insufficiently trained agency and bank staff since 2013 is contributing to this increase. Employing 21,000 new staff by 2021 just is not good enough. What is the Minister doing now to ensure that wards are safely staffed and patients are not injured?
(6 years, 5 months ago)
Commons ChamberI could not have put it better myself, and this is exactly why we have brought forward the proposals in the Green Paper. We recognise that early intervention is the best way of protecting people’s mental health, so we will be encouraging all schools to appoint a designated mental health lead. We will be rolling out mental health support teams to support schools and we will be trialling a four-week waiting time standard. This will lead to a material improvement in children’s mental health.
The Care Quality Commission has reported that young people are waiting up to 18 months to receive vital treatment. The Royal College of Psychiatrists says that some health trusts are spending less than £10 per child on mental health services and that spending today is less than it was in 2012. So will the Minister tell us exactly what she is doing to fix what many health professionals say is a broken child and adolescent mental health services system?
I welcome the hon. Lady to her place on the Front Bench. I believe this is the first time we have had exchanges, and I am sure it will not be the last. We invested an additional £100 million last year. We know that more than half of providers have an average waiting time of fewer than 12 weeks and 4% of providers have a waiting time of fewer than four weeks. She is right in that six trusts are outliers and they are receiving significant attention from NHS England. We are having targeted work with them to address what might be the issues there. As I said earlier, as part of the Green Paper we will be trialling a four-week waiting time standard, and we are determined to achieve improvement in this area.
(6 years, 9 months ago)
Commons ChamberAt the risk of being really controversial, I think there are lots of elements of counselling for women that are seriously lacking. That possibly reflects the fact that decisions about the welfare of women have generally been taken by men. It is great that there are now lots more women in this House able to influence exactly that.
Does the Minister agree that it is imperative that we offer women choice in the decisions they take about their body? Will she give an undertaking this evening to investigate why the Government thought it was appropriate to award the largest sum from the tampon tax fund to an anti-choice organisation?
I understand that the hon. Lady feels strongly about this issue, and nobody can doubt her passion and commitment to women’s welfare. My understanding of the grant she referred to is that it went strictly towards the support of women who chose to go through with the birth. I am happy to look at that further. I am not entirely sure it was the largest donation, but I am happy to look into that. However, the hon. Lady is right when she says there should be genuine choice. We do not want anyone to feel that they cannot have an abortion, any more than we want them to feel that they have to have one. We really want women to be able to make informed choices and to feel empowered to have the child, if that is what they would like to do. The important thing is that we empower women. That is the whole purpose of what we are trying to do here—to empower women and allow them to make choices that are safe for them.
Since the Act was passed, there have been regular calls from all sides of the debate for changes to the legislation, and the hon. Member for Kingston upon Hull North has outlined her views clearly today. As she said, this Government and previous ones have always viewed legislative change as a matter for the House to take a view on, and there are no plans to change that.
The Act was last amended in 1991 by the Human Fertilisation and Embryology Act 1990. This reduced the time limit for most abortions from 28 weeks to 24 weeks. No time limit applies where there is a substantial risk that the child will suffer from a serious handicap or that the pregnancy would cause grave permanent injury to the physical or mental health of the mother or put her life at risk. So amendments are possible, and it is ultimately Parliament that decides the circumstances under which abortion can be legally undertaken. The Government will always ensure that regulation works to make that as safe as possible.
The hon. Lady outlined clearly her belief that abortion should be decriminalised, and the Government will no doubt take a view as and when she brings forward her Bill, as indeed will the rest of the House. It is true that any abortions conducted outside the grounds in the 1967 Act currently remain a criminal offence, and there is no intention for that issue to be dealt with by anything other than a free vote.
Turning to the impact of the Act in practice, it is important that we remember that, in the years before the Act, abortion was, indeed, the leading cause of maternal mortality in England and Wales. For example, the first confidential inquiry into maternal deaths in 1952, reported 153 deaths from abortion alone. The most recent confidential inquiry report found there were 81 reported deaths in 2012-14 for all direct causes of maternal mortality, such as obstetric complications, interventions and omissions. So since the Act came into force, women in Great Britain have had access to legal and safe abortion services.