Mental Health

Phillip Lee Excerpts

Thursday 14th June 2012 Commons Chamber

[Dr Phillip Lee (Bracknell) (Con)]

I congratulate my hon. Friend the Member for Loughborough (Nicky Morgan) on securing this important debate. There have been some very impressive speeches, not least from the hon. Member for North Durham (Mr Jones). I have the pleasure of being, like him, a member of the Administration Committee because very early on in my time here at Westminster I realised that there were quite significant mental health problems among my colleagues. A few of them had approached me so I went to the usual channels, wanting to know what support was available for colleagues. As a consequence, I was put on the Administration Committee and I am now also on the medical panel. I am encouraged by the support available to colleagues if they choose to use it.

I congratulate the shadow Front-Bench team on what appears to be a decision to lead with mental health. It is an important decision that is politically astute and those on the Government Front Bench ought perhaps to reflect on their goals in that area. My advice would be not to be overambitious.

I want to reflect on my experience in this area, my family experience and my professional experience before saying a few brief words on GP commissioning. I have heard mention of the police and the concerns about their involvement in this area, so I shall comment on that. Finally, I want to mention the Human Rights Act.

At a family level, at the last count there were three suicides in my extended family. I know a number of people who have had depression and, unfortunately, a family member has recently been diagnosed with early onset dementia. I myself have had moments of, shall we say, fluctuating mood, perhaps a bit more so since I have been in this place, so I feel that I have first-hand experience through my family and myself of how prevalent the problems are.

I know from my professional experience that the nature of this topic means that it is something one does not forget. I recall clerking in a patient who was a survivor of Auschwitz—I remember the tattoo quite clearly—and the following day, that person hanged himself. I remember the relative of a senior member of the Ministry of Defence at the time breaking down in front of us, which was a quite shocking incident for me as a medical student.

Finally, I remember a case—I only remembered this as I listened to the hon. Member for Strangford (Jim Shannon)—of somebody who had been a victim of the troubles in Northern Ireland and had been relocated to where I was working under the witness protection scheme. That gentleman had experienced guns being held at his temple, in his mouth and so on, and I was in a position to be able to help him.

The nature of this subject means that it tends to throw up cases that are quite memorable and emotive. I feel strongly about it. Locally, I have done my bit. I have met Rethink Mental Illness and the first hustings I attended during the 2010 general election campaign was run locally by a mental health charity. Broadmoor hospital is in my constituency, at Crowthorne. I have visited there and I would encourage everybody to visit Broadmoor hospital. It is a very interesting place to visit with recidivism rates that are, I imagine, the envy of the prison system.

I have done my bit to try to raise the profile of the discussion and debate around mental health services, because this is a significant area of concern. About 800,000 people have dementia in this country at the moment and that number will rise—it will double. That is because of ageing and lifestyle, depending on whether it is Alzheimer’s or vascular dementia. The estimated cost of mental health is £89 billion by 2026, although perhaps that figure is out of date as I heard the shadow Secretary of State give a larger figure. Half of that is due to loss of earnings in the work place. The significance of this topic cannot be overstated.

Unfortunately, more than half of people with anxiety disorders do not interact with the service and about a third of those with depression do not interact with it. The services we have cannot deal with the demands being placed on them, so God only knows what it will be like when everyone starts turning up to see me as a GP or, now I am here, as an MP. I fear that this will need some realism on the part of the current health team and any future health team that might come from the Opposition side in terms of rationing and prioritisation of resources. For example, I read that we are now giving fertility treatment to everybody. I am sorry, but if I were to prioritise where my funding was going, I know it would go to mental health before it went to fertility treatment. I know that is a difficult thing for people to accept if they have fertility problems but we have to make decisions and I know where my priorities lie.

Let me address GP commissioning and some concerns that I want to raise with Front Benchers. There is some unease in my profession about the commissioning of psychiatric services—more so than for diabetes, hypertension or any cardiac service. In a recent poll that I saw, about 70% expressed significant concerns about this issue. I want to flag this up because most GPs do not get a lot of psychiatric experience when they are training. I happened to do a post in which I worked with depression and dementia as a junior but quite a few do not. That needs to be borne in mind. Perhaps we need to look at training in the way that my hon. Friend the Member for Totnes (Dr Wollaston) mentioned earlier. The commissioning of mental health services is complex and difficult, and we need to be cautious. I have been broadly supportive of the Government regarding commissioning but psychiatric services are different.

Another matter that I want to raise is about the police. I heard the earlier comments about the police force and I know that the police are not terribly enthusiastic about getting involved in acute psychiatric crises, but let me tell hon. Members an anecdote. A good friend of mine attended a psychiatric hospital at which someone had been brought in by the police. Six policemen had brought in that person, who was in a violent state of mind, and there was one female psychiatrist there. The six policemen had stab vests on and she was wearing a blouse. Somebody has to do that work and I am slightly concerned about who will do it if the police want to get out of it because the psychiatrists on the front line do not have the same protections that the police have.

On the Human Rights Act, let me highlight that whereas when people come on to the parliamentary estate they have their bags checked, psychiatrists cannot check the bags of a patient they are about to assess even if that patient has displayed violent intent. So someone could come in with a bag with knives and guns in it and the psychiatrist cannot investigate that bag or have it searched because of the patient’s human rights. I would very much like the Front Bench team to look at that and get back to me.

I want to take this opportunity to ask a few questions and re-emphasise that the knowledge base of GPs in this area needs to be improved, particularly for commissioning. I should like to know what the Government propose to do in this area. On the issue of choice, it is all very well wanting patients to be able to exercise choice but if they are not capable of doing so because they are profoundly depressed, demented or psychotic how on earth can they exercise that choice? Is the Minister confident that patients will get the care they need? I welcome the £400 million for talking therapies, but I should like to know where that money is being spent. What is the breakdown of the expenditure of that money? Is the Minister confident that it is being spent in appropriate areas? Anecdotally, I am hearing that it is not making much difference on the front line.

What can be done about the Human Rights Act and the example I have given? We should look at this. Perhaps it is an issue for colleagues in another Ministry, but I would appreciate a response about this.

Finally, let me raise a local issue. The Royal Military Academy at Sandhurst is in my constituency—or at least the parade ground and the buildings are. The residential accommodation is in the constituency of my right hon. Friend the Secretary of State for Education. The problem on the Surrey-Berkshire borders is that there is a difference in the mental health care provision from each trust. There is a perverse situation in which people registered at the Royal Military Academy, whether personnel or family members, receive different levels of care. I would appreciate a written response on this from the Minister or from the Ministry of Defence. We may be able to address that with commissioning groups, but it is important, particularly given the comments by some of my colleagues, with reference to our armed forces.

Finally, may I congratulate everyone in the mental health sphere and anyone who is delivering care. They do so in often challenging circumstances. Doctors, nurses and so on need all the support that they can get in a service that will be increasingly important to us in future.