Mental Health

Robin Walker Excerpts

Wednesday 9th December 2015 Commons Chamber

[Luciana Berger]

My concern partly rests on the fact that, given the cuts we saw during the past five years, we are only returning to the levels of spending on mental health that we had back in 2010. I have asked a number of questions about how the £600 million might be presented, but I am waiting for the answers to see how the Government will allocate that money. I will come on to the pledges that the Government have made and what is actually happening in reality.

[Mr Robin Walker (Worcester) (Con)]

rose—

[Luciana Berger]

I will make a little progress, because I have my speech to get through and I am conscious that many Members on both sides of the House want to contribute to this debate.

We are calling for three things that we believe will make a difference. First and foremost—several interventions have referred to this—we are asking the Government to restore transparency to address the murky picture of mental health funding. Secondly, we are asking Ministers to address the fundamental inequality that currently exists in our NHS constitution. Finally, we are asking the Government to prioritise prevention and to implement a fully cross-departmental plan to prevent mental health problems from developing in the first place.

--- Later in debate ---

[Mr Robin Walker (Worcester) (Con)]

It is a pleasure to follow the right hon. Member for Exeter (Mr Bradshaw). Like him, I want to talk about concerns raised by my constituents. However, I also welcome the £2 billion of extra funding that the Government have put into mental health, and the fact that we have put parity of esteem into law. My right hon. Friend the Member for North Somerset (Dr Fox) made a powerful case for the need to invest in in-patient capacity. In Worcestershire, I welcome the improvements made in the Holt ward in Newtown hospital, but there is clearly a need for more investment of that kind. It is also essential that we take on the remaining stigma around mental health, and I echo the words of support for brave colleagues who have spoken out on this issue.

Members of the Worcestershire Youth Cabinet have, over the last year, set themselves the challenge of raising awareness of mental health issues, combating stigma and providing better signposting and co-ordination for young people with mental health problems, and I commend their collective effort in this regard. In particular, I commend the passion with which my young constituent, Darian Murray, has spoken out on this issue, and the leadership he has shown in bringing together different groups from around the county.

[Maggie Throup (Erewash) (Con)]

Does my hon. Friend agree that young people are probably more able than older generations to talk about mental health issues?

[Mr Walker]

I agree with my hon. Friend. The way in which young people have spoken out about these issues is very impressive. As in many other areas, perhaps they are showing us the way in relation to taking on that stigma.

In that vein, I also welcome the excellent work done for people with learning difficulties by members of the Worcestershire People’s Parliament. In the hustings they organised during the general election, and in their subsequent campaigns on mental health, they have attracted cross-party support in Worcestershire. Attitudes towards mental illness have changed for the better in recent years, and I hope we will see further progress in the years to come.

I welcome the fact that the Under-Secretary of State for Disabled People, my hon. Friend the Member for North Swindon (Justin Tomlinson), has held a reverse jobs fair in his constituency to help people with disabilities of all kinds, but particularly with mental health issues, to find work. I am planning to copy his idea in the new year, and to work with local charities and businesses to promote opportunities for people with mental health and learning difficulties.

I have some concerns about a recent consultation carried out by the Worcestershire Health and Care NHS Trust on vocational centres for mental health. In Worcestershire, we have three such centres providing therapeutic support, re-enablement and support to people who might otherwise have difficulty getting back into work. One of the centres is in my constituency at the Shrub Hill workshop. Another is in the constituency of my hon. Friend the Member for West Worcestershire (Harriett Baldwin) at Link Nurseries. The third is in the constituency of my hon. Friend the Member for Redditch (Karen Lumley) at Orchard Place. Earlier this year, the trust launched a consultation on the future of those services, saying that the commissioners were reducing their budget by a third and implying that they were considering moving from three centres to two.

Many of my constituents contacted me to express their strong support for Link Nurseries and the Shrub Hill workshop, and a number of people gave examples of how the services had helped them to turn their life around. I have no doubt that my hon. Friends in neighbouring constituencies will have heard similar stories from their constituents. It became apparent that it was not necessarily the best use of resource for the trust to run the centres itself, and that there were many charities doing excellent work in that space that it could commission to do that. My hon. Friend the Member for West Worcestershire has been working with staff and supporters of the very popular service at Link Nurseries to see whether the service could be taken over as a social enterprise by staff, who could continue to deliver the service that has been offered with such success.

That is an approach I would support, and I have written to the trust and spoken to local commissioners to encourage them to explore it. I was pleased to see in an update from the trust today that the matter is under active consideration. It is, however, a matter of great concern that although the initial consultation suggested a move from three centres to two and a greater focus on outreach, the trust’s latest thinking appears to involve closing all three of the centres and replacing them with a single one as part of a hub-and-spoke model. It is small comfort that the proposed single hub would be in my constituency. We all recognise the benefit of having more outreach, but I have to question the whole approach of a consultation that appears to be cutting back on an important service, valued by service users, at a time when demand is apparent and the overall budgets of health commissioners are being increased. I urge the Minister to look into this matter and see whether he can do anything to encourage the commissioners to have another look.

Another aspect of mental health provision in Worcestershire that causes me concern is support for A&E. We piloted 24-hour mental health liaison for the A&E at the Worcestershire Royal hospital, and the acute trust and the health and care trust found it incredibly helpful. At the end of that pilot, both trusts asked for that support to continue. I note that the crisis care concordat calls for people to be given access to support 24 hours a day before crisis point, and to be given urgent and emergency access to mental health care. As the Secretary of State said, it is welcome that, since the concordat, the number of people going through mental health crises who are held in police cells has halved nationally. However, I am afraid that in south Worcestershire, the commissioners decided early in 2014 that the 24-hour cover was to be withdrawn, and replaced with a specialist nurse during the daytime and access to telephone support overnight. The Minister has given a helpful reply to written question on this matter.

[Helen Whately]

My hon. Friend mentions psychiatric liaison in A&E. Does he agree that it is incredibly important for hospitals to have a comprehensive psychiatric liaison service, so that when people go to A&E, there is a specialist capable of giving them the right help?

[Mr Walker]

I wholeheartedly agree with my hon. Friend. The provision of specialist care in those situations is vital.

The Minister replied to my written question in July, saying that the Government’s mandate to NHS England states that access to crisis services for an individual must be

“at all times as accessible, responsive and high quality as other health emergency services.”

Does this mean that he has the power to mandate that mental health support to A&E services be provided by practitioners, rather than merely through phone support? I urge Ministers to consider the case for all emergency departments, especially those as busy as the one at the Worcester Royal hospital, having 24-hour access to mental health experts.

I draw the Minister’s attention to the case of a constituent who, as a result of the absence of this support early in 2014, went through an acute episode, having left A&E without receiving the help she needed. This involved the calling of multiple police cars and ambulances. That use of the emergency services incurred far greater cost than simply having the support in place would have done. Any savings made from the failure to commission overnight cover would, in my view, be a case of being penny wise and pound foolish. As the Secretary of State said, not investing in mental health can sometimes be a false economy.

Overall, however, I welcome the progress made. I welcome the additional investment, including in my constituency. I hope that the Minister can respond to my concerns.