(6 years, 7 months ago)
Commons ChamberThe hon. Lady is absolutely right. The challenge, as she recognises, is how we change the language in a way that is accepted and becomes the norm. Part of this is having a much greater focus, as I hope the Secretary of State and his team ultimately will, on wellness, because that is absolutely as important as dealing with the illness when it happens.
We need to remember that in terms of stages of intervention, the whole lifecycle is not just about birth, education and the workplace; it is also about the elderly and veterans, for whom there is often not as much done to identify need and provide support. An older person in a rural area will often have the need but because they are simply out of scope—under the radar—they will, for a very long time, suffer in silence to a point beyond which they cannot be helped. The challenge of mental wellness/illness for older people needs to be a specific focus.
For all that we say, and rightly, about the importance of ensuring that our veterans are properly diagnosed and properly supported, I am certainly conscious of veterans in my constituency who are struggling to get help and support, or even an initial diagnosis. Sometimes the support they need is so complex that they can only get it in London. For somebody who does not have good mental health, the journey from Devon right the way up to London is something they simply cannot conceive of and make a reality.
I am extremely grateful to the Minister for sitting and listening to my thoughts, and for understanding my approach in terms of looking at this in a much more holistic way and seeing how we might measure and report on it so that we can demonstrate to people that we are making progress on parity of esteem. We should look at inputs as well as outputs. I look forward with a great deal of interest to his reply on the points that have been made, particularly on outputs in mental health.
I rise to speak to the amendments in my name and the names of my colleagues.
As we have all heard, our NHS needs to be properly resourced in both physical and mental health, but far too often patients are losing out under this Government, with longer waiting times, a huge increase in cancelled operations, and crumbling hospitals. Colleagues have already raised these important issues. I urge the Government to accept the amendments in the name of the Leader of the Opposition as a real signal of their intent to reverse the damage that their party has done to our national health service over the past 10 years.
My amendments focus specifically on mental health. The Government have made much of the need to ensure parity of esteem. This would mean us valuing mental health equally with physical health and adopting an approach that tackles it using the same standards that we expect for physical health patient treatment as a template for treatment that we provide for mental health patients.
I have heard warm words from the Prime Minister, the Secretary of State and Ministers about the importance of mental health and the growing need to tackle mental ill health as an urgent priority, but I have not yet seen that wholehearted commitment manifest itself in actions to tackle the situation we are in. The British Medical Association found that the mental health workforce has had little growth over the last 10 years. The Royal College of Psychiatrists found that the rate of unfilled NHS consultant psychiatrist posts in England has doubled in the last six years. The first briefing paper from the Centre for Mental Health’s Commission for Equality in Mental Health found that mental health inequalities are closely linked to wider injustices in society. Far too many patients with a mental illness are still being sent hundreds of miles away from home.
By accepting the amendments in my name, the Government would show that they are willing to be transparent about the way they go about achieving their long-stated aim of parity of esteem. The Government have already shown, with the presentation of this Bill, that they think it is a good idea to commit, in law, to a minimum allotment that the Secretary of State will make to the health service in England in each financial year for the next four years. That is designed to show that their promise is legally binding and can be scrutinised by Parliament and the public if they do not reach those targets.
To ensure that our mental health services are properly resourced and truly responsive to the various complex conditions that people present with, the public need to know how much is being spent, including how much is being proposed, and what happens in practice. That is all my amendments seek to do—they would provide Parliament and the public with the opportunity to compare the proposed allotment with the final allotment across different years.
Of course, that is not enough, and it is clear that additional resources for mental health services are only one part of the answer to tackling the mental health problems in this country. We know that education and training services are essential to bring about the necessary increase in the workforce. We know that local government provides significant elements of mental health support through public health, youth services, housing and social care, and two thirds of schools fund their own mental health support. We also know that the Government’s roll-out of universal credit will exacerbate mental health inequalities, which all too often relate to people’s economic and social circumstances. This is not the time to go into those in detail, but I urge the Government to remember the need for those essential services to have a long-term funding settlement and, in the case of social care, an agreed basis for future financing. With ambitious targets to meet in the long-term plan, there is a risk that resources will be diverted from other areas of mental health support to achieve compliance.
I would like to invite colleagues across the House to join me on Thursday for my adjournment debate on Children’s Mental Health Week, which is this week, to discuss these issues further. I know what a commitment to transparency on mental health spending would mean for all those suffering mental ill health and those fighting for them. I hope that the Secretary of State will accept amendment 1 and new clause 1, to ensure that mental health services get a fair deal from the legislation and that pledges made by the Government and NHS England are realised in practice.
It is a pleasure to speak in this debate, because it is a rare one in so far as there is quite a lot of agreement across the Committee on the substance of it. There appears to be agreement—I await an intervention if anybody disagrees with this—that increasing funding for the NHS is a good thing, that it is good that mental health is a Government priority and that it is very important to establish what parity of esteem means in practical terms.
I would like to take this opportunity to describe what I have seen in my constituency in terms of the importance of mental health and how the increased funding will make a practical difference. One way in which the funding will make a difference is with mental health support teams. There are mental health support teams in 25 areas in the country. Hertfordshire was picked as one of those 25 areas, and we have two teams—one in my constituency, and one just outside it—that effectively piloted a hub-and-spoke model. As the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) said, it is Children’s Mental Health Week, and the aim of that model is to ensure that young people get better mental health support in and around their school, working in conjunction with the NHS.
As I have seen in my constituency and everywhere I go, when I speak to young people, one of the first things they ask me is, “How can we improve mental health?” Whenever I have spoken to young people, their teachers or local NHS staff, they say this model has the potential, as it is rolled out and developed over the coming months and years, to make a real, fundamental difference. If people are looking for the practical impact of our increased funding for mental health, these teams are one way in which we are already starting to make a difference, not just in my constituency but across the country.
I would like to mention a couple of charities I am involved with that are starting to work in an integrated way with the NHS in improving young people’s mental health. There is a charity called GRIT—a word in politics that we should all remember—or Growing Resilience in Teens. It was set up by a fantastic doctor in Hitchin called Dr Louise Chapman, and it does what it says on the tin: it is about growing resilience in mental health.
As politicians, when it comes to legislation or speaking to each other in the Chamber or outside, we think often about pounds and pence and talk about structures such as hospitals and stuff that can be measured in a very easy way, or at least what we think is an easy way. However, growing resilience is one of the things we need to ensure the NHS does more effectively. Not just in mental health, but particularly in mental health, growing resilience in our young people is an integral part of prevention. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), talked about that in his speech, saying that half of mental health problems are established before a young person is 14.
We need to grow resilience among young people to future-proof each and every one of us, and our communities and our society, against serious mental health problems in the future, at the same time as investing in mental health services such as CAMHS, which has already been mentioned several times in this debate. However, we need to do both: to grow resilience and to improve the institutional frameworks. Again, that is what the money this Bill is providing will go towards.
Another charity is called Tilehouse Counselling, which again is based in Hitchin. I do not mean to say that Hitchin has all the charities in my constituency, but in this area Hitchin is a real regional leader and, indeed, a national leader. Tilehouse Counselling provides counselling services to young people, and young people often find themselves at Tilehouse when CAMHS does not have the capacity.
I urge the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is on the Treasury Bench—she knows this because everybody knows how much she cares about the NHS, how much she knows about it and her own personal experience in it as a professional—to use the money provided by this Bill to increase the workforce and to improve the state of CAMHS so that it can treat more people. Again, that means helping the mental health hubs to work with young people and the education system to improve prevention and, when mental health intervention is needed later on if things have got more serious, making sure that CAMHS has more capacity. Again, the money in this Bill will help to provide that.
Another new organisation in my constituency is called GoVox. It has already been in discussions with NHS Digital, and NHSX, about online ways of improving mental health for young people. Increasing funding matters, and it is always worth stating and restating in the Bill that these are minimum numbers, not maximum numbers. This money is hugely needed, and it should make a big practical difference.
On the pleas from Opposition Members—in relation to new clauses 1, 2 and 9, and a few others, which say that the Government must report on this or must do that—I urge the Minister for Health to commit in his response to showing how he and the Government will improve the existing reporting procedures and mechanisms so that the House can be kept fully informed. My right hon. Friend the Member for Wokingham (John Redwood) spoke about how Members of Parliament often feel distant, not from information about funding, but from outcomes. Will the Minister explain how the Government could improve that delivery mechanism, as that would allay some concerns across the Committee?
(6 years, 7 months ago)
Commons ChamberIt is an honour to follow the hon. Member for North West Norfolk (James Wild) who, along with many hon. Members this afternoon, made an excellent maiden speech. I wish him well and look forward to working with him and all new Members.
Two months ago, I stood in this Chamber and spoke of my disappointment that the Queen’s Speech included only one reference to mental health, and even that was a reference to the Mental Health Act 1983, rather than a systematic programme to tackle mental health across all demographics. According to research by the Children’s Society, of the 22,365 children in Birmingham, Edgbaston, an estimated 2,733 five to 19-year-olds are struggling with mental ill-health. That is more than 10%. At the same time, the money available for local services for children and young people has fallen by 38%. Is it any wonder that just last week, research by the Education Policy Institute revealed that more than a quarter of child referrals for children and young people’s mental health services in England last year were rejected? Even when a referral was accepted, many children had to wait for an average of two months to begin treatment in 2019—double the Government’s four-week target. Birmingham Women’s and Children’s Hospital has a median wait time of 112 days. That is almost four months.
A decade of neglect in early intervention care, and an under-resourced mental health services sector, has meant that many more young people are turning up to A&E. I had hoped that the Government would have listened when I raised the issue in the debate on the previous Queen’s Speech, but given a second chance, the Prime Minister has failed once again to show that he is serious about tackling mental ill health. Yes, reform of the Mental Health Act 1983 is important and desperately needed, but the Government also need properly to fund vital preventive services.
For the many new Members of Parliament, I will repeat the shocking statistic that failed to elicit any action last time: for the whole of Birmingham there is only one early intervention counselling service for young people. The most recent waiting list has 400 young people and their families who are waiting desperately for treatment and support. The only conclusion I can draw is that the Conservative Government are knowingly and willingly failing our children and young people.
We know what we need. We need genuine parity of esteem. We must use the standards that we expect for physical health treatment as a template, and apply them to mental health patients. We need mental health services that are truly responsive to the complex conditions with which our young people frequently present. We must listen to young people when making decisions about the mental health services they use. I will ask the Minister once again: will he listen to those of us who are calling for the Government to do more for young people with mental ill-health, and deliver on the promises that his party has been making—promises that it has so far been breaking?
As a former social worker, I was surprised that the Queen’s Speech failed to commit to a review of children’s social care—the vital system that is designed to protect some of the most vulnerable in our society. That total and utter dereliction of duty follows cuts of almost a third in services for children and young people since the Conservatives came to power. Children’s social care is coming apart, despite the best efforts of hardworking councils around the country.
It should not be just about this; it should not just be firefighting. Social care should be about providing a system to support every child. We must give children the opportunity for the best start in life, whether that is in the form of late intervention such as safeguarding teams that step in in instances of abuse or neglect, or whether it is early intervention such as children’s centres and programmes that support parents and youth services. Children’s services are not only about looking after children in care; they provide effective family support services that help more children to stay in their homes if it is safe to do so. The Conservative party manifesto recognises the underfunding of children’s social care. Does the Minister agree that local authorities still do not have sufficient resources to address rising demand, even if his Government deliver on their manifesto commitment?
(6 years, 10 months ago)
Commons ChamberIt is an honour to follow the hon. Member for Glasgow South West (Chris Stephens), who made a passionate speech, especially in respect of the women born in the 1950s who have been denied their pension rights.
I was disappointed to see only one reference to mental health in the Queen’s Speech, and even then it was a reference only to the Mental Health Act. I was disappointed to see in the attached background briefing that the Government’s much vaunted parity of esteem does not stretch to any new funding for mental health services. One in 10 children and young people in the UK suffers at some point with mental ill health. In Birmingham, nearly 40% of the population are under 25. Mr Deputy Speaker, I am sure that you will be horrified to learn that, despite that, for the whole of Birmingham, there is only one early intervention counselling service for young people.
The most recent count of the counselling service waiting list saw 400 young people waiting for a service—that is 400 young people in desperate need of support who require treatment urgently; that is 400 young people who will have to wait months to see someone; and that is 400 young people and families who, in most cases, have nowhere else to turn. This unwillingness to recognise or properly fund vital prevention is yet another example of the Conservative Government failing our children and young people.
Is the Secretary of State surprised that more and more young people are ending up in A&E when we neglect early intervention care? We need to listen to young people themselves about the growing needs that they have. The Government are not doing that, which is why I have launched a young people’s mental health working group, supported by Open Door, which is a local counselling charity in my constituency, and the Centre for Mental Health. This group will use its unique perspective to help to shape the services that young people use for the better.
Young people have a voice that we need to listen to, so what steps are the Government taking to ensure that they work closely with young people with lived experience of mental health when developing legislative and non-legislative actions related to mental health? Cuts have consequences. Slashing budgets removes safety nets for the most vulnerable in our society and has knock-on effects. I am sure that the Secretary of State knows that excluded students are 10 times more likely to suffer from mental health problems. What steps is he taking alongside his colleague in the Department for Education to support those students, rather than just hanging them out to dry?
An inquiry by Birmingham and Solihull Mental Health NHS Foundation Trust into 11 deaths found that they were probably avoidable. That is unacceptable, and it is vital that lessons are learnt. With one of the highest levels of beds occupied by patients with complex needs and one of the lowest numbers of beds per 100,000—coupled with cuts and underinvestment under the Conservatives—what steps is the Secretary of State taking to ensure that my constituents will be properly looked after, and that no more families will be forced to go through the pain and heartbreak of being told that a loved one’s death was probably avoidable?
I will touch briefly on the Secretary of State’s favourite private healthcare company—or at least the one he talks about the most and publicly endorses while simultaneously insisting that there will be no more privatisation of the NHS under him. The Secretary of State is not alone in his support for Babylon and, as I am sure the House is well aware, the most senior member of the Prime Minister’s team advised Babylon as recently as last year. The reason that hospitals such as the Queen Elizabeth in my constituency are being forced to take risks in using totally unproven private technical solutions is that they are not receiving sufficient support from this Government. Over the past nine years, the Tories have stripped the NHS and made it about profit, rather than patients.
My constituents are rightly worried about the continued growth of companies such as Babylon, as its tentacles in Birmingham reach out beyond the GP at hand. The Secretary of State holds this company up as a beacon of light for replacing face-to-face services, but 94% of enrolled patients are under the age of 45 and two thirds live in more affluent areas. Can he tell me how it will work for my more vulnerable constituents, and will he give us answers to the myriad other justified concerns of GPs, CCGs and professional bodies?
I conclude by paying tribute to the magnificent practitioners and staff who work day in, day out across our various health services. I thank those who come from around the world to support us when we need it—due to mental health problems, physical ailments, old age or any other issue. These people deserve to be supported, properly resourced and treated with respect, and they deserve a Government who give them more than empty rhetoric. I am sorry that, over the last nine years, under the coalition and then the Conservative Government, they have not been treated in the way in which they deserve.
(7 years, 3 months ago)
Commons ChamberThis week is Mental Health Awareness Week, and I fully support the need to break the stigma and talk about our own and others’ mental health. Public health has an integral role to play in improving young people’s mental health, but we live in a country where, because of the actions of the Conservative party, the funding and the ability to access care from trained professionals are being decimated. What happens when we realise that we need support? How long do we have to wait for help? What are we doing to provide support for people who are struggling and their families, who are left to cope without sufficient support? How do the Government expect to provide support when they have cut £700 million in cash terms of the public health grant to local government between 2015-16 and 2019-20, according to the Local Government Association, of which I am a vice-president?
Today I want to speak specifically about children and young people’s mental health. NHS figures show that one in eight people under the age of 19 in England have a mental health disorder, and half of all mental health problems start before the age of 14. I recently conducted a survey of schools in my constituency. In 10 of the 11 schools that have responded to the survey so far, the number of pupils suffering with mental health problems has increased over the last five years. One saw a 15% increase in the last 12 months alone, and all but one have seen these cases becoming more severe.
I want to place on record my thanks to my hon. Friend the Member for Ogmore (Chris Elmore) for his chairing of the all-party parliamentary group on social media and young people’s mental health and wellbeing. The group’s recent inquiry found that 27% of children who are on social network sites for three or more hours a day have symptoms of mental ill health. That stands against 12% of children who spend no time on such sites. The Government’s online harms White Paper concurs with research by the Royal College of Paediatrics and Child Health, which reported that there was
“moderately-strong evidence for an association between screen time and depressive symptoms.”
The Government need to take real responsibility for the children in this country and their wellbeing. Instead, we have heard that they will support further research without saying what that will be, and that they welcome industry efforts. What parent would feel reassured by that? The industry has taken some steps to regulate itself, but it is obvious that it is not doing enough. Public health cannot be left to businesses, and with the mental health of children and young people at stake, we need to look at the various contributing factors. It is not enough simply to acknowledge the problem and not to address what is seen to be one of the growing risks to our children’s mental health and wellbeing.
Let us take the next step of the process: when a child has mental health problems, how are they identified? Teachers are often the individuals on the frontline most likely to spot this need, but they are working with larger classes and increased pressures, without teaching assistants or additional support. Schools in my constituency and many across the country are doing an amazing job in trying to make appropriate provision for their pupils to deal with mental health problems—from developing their own wellbeing support to check-in sessions and peer mentors—but this is not sustainable. Schools in my constituency have told me that immediate support is usually unavailable to vulnerable children and parents; response times from overburdened mental health agencies are poor; there are long waiting lists; and early help support is limited. Because of the fall in the ability to access core public health services, schools are forced to pick up the slack despite often not having had the appropriate training or resources to do so. A quarter of 11 to 16-year-olds with a mental health disorder have self-harmed or attempted suicide, and that figure rises to as high as 46% among teenage girls with a disorder.
The Children’s Commissioner has said:
“There is a danger that we continue to have a system that fails to help children until they are so unwell that they need specialist intervention.”
Funding pressures mean many councils are being forced to cut early intervention services that support children with low-level mental health issues and avoid more serious problems in later life, which cost far more over the coming decades. If we are to improve provision of preventive and early intervention services, it is vital that the Government adequately fund public health in the forthcoming spending review, as reducing spending on public health is short-sighted and irresponsible at the best of times.
(8 years, 2 months ago)
Commons ChamberThere certainly is. The pattern to date had been very different in tone between the two sides. My right hon. Friend is right to challenge the NHS on this, because the truth is that we do not adopt new treatments and new medicines nearly quickly enough. I hope that this new settlement will mean that we can change that.
The Government have promised parity of esteem for mental health. Can the Secretary of State clarify whether there is a ring-fenced element of this funding for mental health?
I can clarify that NHS England has a mandatory—[Interruption.] I can confirm, if the Opposition would be kind enough to listen to what I am about to say, that NHS England has a mandatory mental health standard, which means that every CCG is required to increase its mental health funding by more than its total funding. That is an effective ring fence.
(8 years, 3 months ago)
Commons ChamberAs we have heard, this year marks the 70th anniversary of the creation of our national health service. The NHS is the jewel in our nation’s crown and represents the very best attributes that we as a society hold dear. I truly believe the creation of the NHS, which was born of a yearning desire for things to change following the death and destruction of the second world war, to be the greatest achievement of the Labour party and, indeed, any Government.
It is because both I and my party hold the NHS so dear that Labour Members are concerned by the parlous state in which it finds itself. Pushed to the brink by the biggest financial squeeze in NHS history and reeling from the worst winter crisis on record, the NHS is at breaking point. People are waiting far too long for operations, and performance targets are so far from being met that they are now about as realistic as the Government’s infamous immigration targets.
Official data show that patient waiting times, bed shortages and ambulance queues have hit record levels. The chair of the British Medical Association succinctly summed up the situation when he said:
“the ‘winter crisis’ has truly been replaced by a year-round crisis. Doctors and patients have just endured one of the worst winters on record…We cannot accept that this is the new normal for the NHS.”
Let us be clear that this is not an unavoidable situation or the result of some unforeseen circumstances; the situation has come to pass as a direct result of this Government’s policies. By stark contrast to the policies of the Conservative party, in our 2017 manifesto Labour promised immediate investment in our NHS and, just as importantly, explained how we would pay for it.
The issue of privatisation within the NHS is both an important and an emotive one. I believe in a publicly owned NHS, free at the point of delivery, but the creeping privatisation of services poses a very real threat to that most essential of principles. The figures are irrefutable. Since 2010, NHS expenditure on private health providers has doubled from £4.1 billion in 2009-10 to £9 billion in 2016-17, while the percentage of funding allocated to private sector providers has grown from 4.4% in 2009-10 to 7.7% in 2016-17. Spending on elective treatments outsourced to the private sector rose significantly from £241 million in 2015-16 to £381 million in 2016-17.
Since the Government’s disastrous Health and Social Care Act, one third of contracts have been awarded to private providers, some of which have resulted in failure and the waste of millions of pounds of taxpayers’ money. We have seen the grotesque spectacle of Virgin Care successfully suing our NHS for £1.5 million after losing out on an £82 million contract for children’s health services in Surrey. This has to stop. Labour is committed to reversing privatisation, repealing the Health and Social Care Act and reinstating the powers of the Secretary of State for Health to have overall responsibility for the NHS.
The creation of wholly owned subsidiary companies represents another concern. These new arm’s length private companies appeal to NHS trusts because they can reduce their VAT payments and cut the pay and pensions for any new staff. They result in millions of pounds being wasted on consultancy fees, with the Clatterbridge Cancer Centre in Birkenhead alone spending more than £660,000. That money could have paid for new staff to work in such hospitals.
I am fortunate to have the amazing Queen Elizabeth Hospital in my constituency. Among many other things, it cares for our brave men and women who are injured while serving their country in our armed forces. I want that hospital to continue to flourish and serve the people of Edgbaston and further afield, but I consider privatisation to be a threat to that happening.
(8 years, 10 months ago)
Commons ChamberWe have heard that the Local Government Association has estimated that adult social care faces a £2.3 billion funding gap by 2020, and the reasons for that are wide-ranging. They include a growing population requesting adult social care support, cuts to local authority budgets in recent years and increases in costs to providers, including the national living wage and costs relating to sleep-in arrangements. In addition, the adult social care provider market is increasingly vulnerable, with 69% of councils reporting to ADASS that they have been affected by providers ceasing trading or handing back contracts. That can have a massive impact on the lives of people relying on this care. These short-term pressures must be addressed with additional funding, alongside allowing local areas to use additional funds in the way that addresses their local health and care issues.
(8 years, 10 months ago)
Commons ChamberI am sure that the hon. Lady will not want to confuse her patients by suggesting that relying on a single surgeon for prolonged periods is necessarily in their best interests. The facilities that remain in Central Manchester University Hospitals NHS Foundation Trust are intended to remain and include CHD outpatient services for adults and children. Level 2 services also continue to be provided in Manchester.
By passing the Care Act 2014, this Government established a national eligibility threshold that defines the care needs that local authorities are required to meet. This eliminates the postcode lottery of eligibility across England. Social care continues to be a key priority for this Government. That is why local authorities in England will receive an additional £2 billion for social care over the next three years. In the longer term, we are committed to establishing adult social care on a fair and more sustainable basis.
Age UK estimates that nearly 1.2 million older people have unmet care needs. After the Government dropped their disastrous dementia tax policy during the general election, all they can offer people is yet another consultation. In the words of the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, is it not time the Government just got “on with it”?
I do not recognise Age UK’s assessment of unmet need. As I said, the requirements are enshrined in statute and local authorities should be held to that. In response to the hon. Lady’s final point, let me say that we are getting on with it, but we need a real cultural change in how we tackle these issues. There is a long-term issue to address in the fact that we are all living longer. This is not just going to need a sticking plaster; we will need to take the public with us. So this is not just another consultation; it is a vehicle for making sure that we as a society tackle this issue once and for all.