Children’s Mental Health Week 2024

Debate between Rosena Allin-Khan and Maria Caulfield

Tuesday 30th January 2024 Westminster Hall

[Maria Caulfield]

Let me point out what we are doing with our funding. We have introduced two waiting time standards for children and young people. The first is for 95% of children up to 19 with an eating disorder to receive treatment within one week for urgent cases and four weeks for more routine cases. I can showcase for the hon. Member for Tooting figures from her local integrated care board for eating disorders: 82% of children and young people under 19 are seen within four weeks. That is not 95%, so we are not where we want to be, but a significant proportion are being seen according to our new target. Our extra funding to children and young people’s services for eating disorders will rise to £54 million in the coming financial year, creating more capacity, but we absolutely acknowledge that there is more to do.

The second waiting time standard we have introduced is for 50% of patients of all ages, including children and young people, experiencing a first episode of psychosis to receive treatment within two weeks of being referred. That target is being met across the country.

Our plan for children and young people is cross-Government, because this is not just a health and social care problem. Mental health is everyone’s business. That is why we are working with the Department for Education to implement proposals from the children and young people’s mental health Green Paper.

[Dr Allin-Khan]

If the Government are interested in implementing cross-party proposals, why on earth have they scrapped the Mental Health Bill?

[Maria Caulfield]

I will touch on what we are doing and come back to the hon. Lady on that point.

Last week we met the Education Secretary and the chief executive of the NHS to discuss how we can better support school attendance, because we know that children with mental health problems are the most likely not to attend school. I do not think there was a single proposal from any of the Labour MPs, apart from on mental health support teams in schools, which we are already rolling out. We have rolled out 400 mental health support teams, covering 3.4 million pupils in England—something that Labour has not started to do in Wales, where it runs the health service. Our original ambition was to cover 25% of pupils, but we have done that a year earlier than expected; we are now on track in March this year to cover just under 50% of pupils with a mental health support team. We will also have 13,800 schools and colleges with a trained senior mental health lead, including seven in 10 state-funded schools in England.

We are already doing what Labour says it plans to do if it ever gets into government, and our evidence shows that that is making a difference across the country. In addition, in October we announced £4.92 million of new funding to develop new mental health and wellbeing support hubs for young people across all of England. We will be announcing in the next few weeks the successful hubs and where they will be based. That clearly shows that the work we are doing is on track and amounts to far more than just the warm words we have been accused of.

[Dr Allin-Khan]

Let me point out two things. First, 12,140 children are on waiting lists at my ICB, an increase of 18.15% on last year. Secondly, the Minister spoke about 1.63 million people accessing mental health services and said that 38% of them were children, but that is actually up on the 25% that I cited. She used that figure in her argument about the amount of money that has been spent on children’s mental health services. She was incorrect, and all she did was highlight that the situation is getting worse, rather than arguing against my point that only 8% is being spent on children. She did not address that point.

[Maria Caulfield]

The hon. Lady is making my argument for me. We are seeing a significant increase in demand, and that is why we are spending more on rolling out these services. She did not welcome the progress we are making on mental health support teams across our schools, or the fact that we are set to announce new mental health support hubs across England.

Last year we published our new suicide prevention strategy; my hon. Friend the Member for Penrith and The Border (Dr Hudson) talked about 3 Dads Walking, who I was pleased to meet. We are also rolling out mental health and wellbeing support in our school curriculum, teaching young people what good mental health looks like and about support mechanisms. Our strategy sets out over 100 actions to help reduce suicide and to ensure that young people in particular, who are identified as a high-risk group in the strategy, are getting the support they need. That includes making mental health and wellbeing part of the school curriculum.

--- Later in debate ---

[Dr Allin-Khan]

I thank all Members, including the Minister and my hon. Friend the shadow Minister, for their contributions. Disappointingly, I have not heard anything about the scrapping of the Mental Health Bill, which the Minister conveniently avoided.

[Maria Caulfield]

Will the hon. Lady give way?

[Dr Allin-Khan]

No, I will continue. The Minister had ample opportunity to respond to a direct intervention, and she chose not to. That Bill was a great piece of cross-party work that would have improved the lives and outcomes of so many people in our country, particularly minority groups. The Minister did not address the fact that only 8% of funding is spent on children’s mental health services, but she highlighted that the need is greater than ever.

The £2.3 billion was promised before covid. We have heard multiple arguments today that the situation has got worse post covid. There has been no money to make up for the increased need related to covid, and no assessment of how we are going to deal with the fact that adverse childhood experiences and poverty are contributing so greatly to our nation’s mental ill health.

The Minister talked about the fact that there are many new referrals. There are many new referrals, but she did not mention that in so many parts of this country, and even in parts of this city, it is a postcode lottery. In some places, up to 50% of referrals are closed before the person has even been seen. While I welcome the fact that efforts are being made—it would be churlish of me to suggest that they are not—the fact remains that they are not good enough, they do not reach far enough and they are not ambitious enough. Even on the £2.3 billion, I know for a fact that the head of mental health services in the NHS asked for more, and that was before covid.

I thank everyone for being here and for their contributions. Although we are all on the same page in the sense that this is an issue we all care about, regardless of how we vote, where we live or what our socioeconomic background is, this Government still lack ambition for children in this country and for their mental health. Let me again, on the record, thank all the organisations that work so tirelessly in this space.

Question put and agreed to.

Resolved,

That this House has considered Children’s Mental Health Week 2024.

Oral Answers to Questions

Debate between Rosena Allin-Khan and Maria Caulfield

Tuesday 17th October 2023 Commons Chamber

[Maria Caulfield]

I have met with 3 Dads Walking; I have not met the mums group but am very happy to do so. Because of their intervention and campaigning, we were able to successfully put their campaign about improving mental health awareness in the school curriculum into our suicide prevention strategy. It is a cross-Government strategy, and the Department for Education has very much taken their points on board.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Over 1.8 million people languishing on mental health waiting lists, black people five times more likely to be detained under the Mental Health Act 1983, and over 2,000 people with learning disabilities detained in hospital, all while the Government are dragging their feet on mental health and suicide prevention. You will be interested to know, Mr Speaker, that we had cross-party support to tackle these burning injustices through the draft Mental Health Bill, yet since the Joint Committee on the Draft Mental Health Bill published our report in January we have heard nothing from the Government, so will the Minister today commit to including reform of the Mental Health Act in the King’s Speech?

[Maria Caulfield]

I was going to pay tribute to the hon. Lady for her work on mental health campaigning, and she will know we have done a huge amount. The suicide prevention strategy is a cross-Government piece of work, which makes sure suicide is everyone’s business, not just that of health and social care. Whether by supporting families bereaved by suicide or rolling out mental health support schemes in schools, it is this Government who are delivering on mental health services.

Oral Answers to Questions

Debate between Rosena Allin-Khan and Maria Caulfield

Tuesday 11th July 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

As my hon. Friend the Member for Leeds North East (Fabian Hamilton) highlighted, all too often, children are stuck on long waiting lists for treatment. In West Yorkshire, 30,000 children are currently stuck waiting for mental health treatment, and more than 9,000 people have had their mental health referral closed without accessing treatment. Does the Minister find that acceptable? If the answer is no, what will her Government do about it? This picture is not unique to West Yorkshire, but replicated across England. This Government are letting patients down. When is the Minister going to act to tackle the crisis in mental health services?

[Maria Caulfield]

I thank the shadow Minister for her question. To highlight another initiative in West Yorkshire, the Night OWLS—Overnight West Yorkshire Living/Advice Service—helpline has been set up for children and young people. It is open between 8 pm and 8 am seven days a week for young people to access, in addition to the 24/7 helpline that is available. I am sure that the shadow Minister will also welcome the fact that we have more than 400 mental health support teams in schools in England, covering 3 million children, so that they can access mental health support directly at school.

Abuse and Deaths in Secure Mental Health Units

Debate between Rosena Allin-Khan and Maria Caulfield

Thursday 3rd November 2022 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on abuse and deaths in secure mental health units.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I am grateful to the hon. Lady for raising this important question. Everyone in any mental health facility is entitled to high-quality care and treatment and should be kept safe from harm. The findings from the investigation into the deaths of Christie, Nadia and Emily make for painful reading. The death of any young person is a tragedy, and all the more so when that young person should have been receiving care and support. My thoughts and, I am sure, the thoughts of the whole House are with their families and friends, and I want to apologise for the failings of the care that they received.

As I told the House on Tuesday, these incidents are completely unacceptable. The Secretary of State and I are working closely with NHS England and the Care Quality Commission, and they have updated us on the specific situation and the steps that the Tees, Esk and Wear Valleys NHS Foundation Trust is taking to improve the care at its services. Those include investing £5 million in reducing ligature risks across the estate; improving how it develops and implements care plans for young people; strengthening its policy on observation; and improving staff training and the culture that can exist within the trust.

I recognise that these worrying findings come in the context of broader concerns highlighted by other recent scandals. The Minister for Health and Secondary Care, my hon. Friend the Member for Colchester (Will Quince), was at the Dispatch Box last month responding to an urgent question on the unacceptable abuses at the Edenfield Centre. These challenges are, rightly, the subject of sharp focus in my Department, and we understand that every part of our system has a responsibility to keep patients safe. That is the driving motivation behind our new mental health safety improvement programme and the patient safety incident response framework.

I am not just the Minister for Mental Health; I am also responsible for patient safety, and I am not satisfied that the failings we have heard about today are necessarily isolated incidents at a handful of trusts. The Secretary of State and I are urgently meeting the national director of mental health to look at the system as a whole, the role of CQC inspections and the system for flagging concerns. I will also be meeting the new patient safety commissioner to seek her guidance, and based on that, we will make a decision on how we proceed in the coming days.

--- Later in debate ---

[Dr Allin-Khan]

It pains me that we are here again after failings in patient care and I send my heartfelt condolences to all the families affected. Emily Moore, Nadia Sharif, Christie Harnett: these are the names of three young women who tragically lost their lives after systemic failings to mitigate self-harm. This cannot go on. I thank my hon. Friend the Member for Middlesbrough (Andy McDonald) for his tireless work with the families involved.

Sadly, those are not the only cases. In the last five weeks, there have been reports on the Huntercombe Group, the Essex Partnership University NHS Trust and the Edenfield Centre. Why do undercover reporters seem to have a better grip on the crisis than the Government? Patients are dying. They are being bullied, dehumanised and abused, and their medical records are being falsified—a scandalous breach of patient safety.

The Government have failed to learn from past failings. I wrote to the previous Secretary of State, the right hon. Member for Suffolk Coastal (Dr Coffey), yet I never received a response. I have written to the new Secretary of State and he has not replied. Are the Secretary of State and the Government taking this seriously? It certainly does not seem so.

Will the Government be conducting a rapid review into mental health in-patient services? What are the Government doing to ensure that patients’ complaints about their care are taken seriously? These reports are becoming a weekly occurrence. I ask the Minister to put herself in the shoes of patients in these units and understand what their relatives are feeling. Will she apologise for the anguish that families are experiencing? This is a scandal and the Government should be ashamed.

[Maria Caulfield]

I will not stand at the Dispatch Box and deny any of the instances that we have seen, their consequences or the failings that have been identified. I apologised in my opening remarks for the care that failed the most vulnerable patients in our system. I commit to right hon. and hon. Members from the Dispatch Box that we are urgently looking not just at these cases but across all mental health in-patient services, and not just at adult mental health, but at offenders and other users of mental health facilities.

We have brought in a number of measures. We introduced new legislation, which was enacted in March, on the use of force and restraint. We are identifying best practice and trying to get that rolled out across the country. We are looking at putting in place a number of measures to improve safety and to support staff in units where staff shortages have been identified as a cause of the problems.

With regard to the hon. Lady writing to the Secretary of State, I signed off a letter to her early on Tuesday, which she should receive any day now. I apologise that she did not previously get responses in a timely manner.

NHS England has commissioned a system-wide investigation into the safety and quality of services across the board, particularly around children and adolescent mental health services. I am pushing for those investigations to be as swift as possible.

On the issue of a public inquiry, I am not necessarily saying that there will not be one, but it needs to be national, not on an individual trust basis. As we have seen in maternity services, when we repeat these inquiries, they often produce the same information and we need to learn systemically how to reduce such failings. My issue with public inquiries is that they are not timely and can take many years, and we clearly have cases that need to be urgently reviewed and to have some urgent action taken on them now. I will look at the hon. Lady’s request but, as I said, the Secretary of State and I are taking urgent advice, because we take this issue extremely seriously. One death from a failing of care is one death too many.

Oral Answers to Questions

Debate between Rosena Allin-Khan and Maria Caulfield

Tuesday 1st November 2022 Commons Chamber

[Maria Caulfield]

The Government actually started working on the plans around delayed discharges this summer, because of course they affect mental health services. They also affect a range of acute beds. With the winter coming, we know that there will be additional pressure on those beds, and that is why we are working with local government social care services and integrated care boards which have responsibility for that in their local areas.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

In the last four weeks, there have been three investigations on abuse in in-patient mental health settings. The Government should be on top of the situation, not relying on undercover reports from Sky, The Independent, or “Panorama” that show patients languishing in seclusion, excessive use of restraints, bullying and dehumanisation, and falsification of medical records. Patients and their families rightly expect to be safe. Tory chaos has meant that the Government have not engaged with abuse allegations. For weeks there has been no functioning mental health Minister. Will the Minister conduct a rapid review of mental health services, respond to our concerns about in-patient services and apologise to patients and their families now?

[Maria Caulfield]

Of course we apologise for the cases that we have seen; anyone who watched some of those programmes will have seen the distressing and unacceptable care. I am the Minister with responsibility not just for mental health but for patient safety, so I will be looking at the cases in “Panorama” and other programmes, and at cases across the board, because I want to ensure that in-patient mental health services are as safe as possible. We know that these are some of the most vulnerable patients who often cannot speak out when there are problems. We are looking at the staffing, training and reporting mechanisms. On the case that was highlighted in “Panorama”, the Government are working closely with NHS England, the Care Quality Commission and the individual trusts.

Oral Answers to Questions

Debate between Rosena Allin-Khan and Maria Caulfield

Tuesday 19th July 2022 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Thank you, Mr Speaker. A&E waiting times are through the roof, and we have people waiting without a bed—not even a trolley. This is removing the dignity that every patient deserves, but, sadly, it is not a one-off; this is commonplace up and down the country. It is not the Health Secretary who is on the receiving end of it, but staff, who are running from patient to patient trying to ease pain, diagnose illness and save lives—most importantly, it is of course the most vulnerable themselves. When the Minister hears reports such as this, does she not feel ashamed of the decisions her Government have made over the past 12 years?

[Maria Caulfield]

I say gently to the hon. Lady, who does amazing work on the frontline in A&E, that I have worked in A&E under the last Labour Government—I am showing my age now—and there were trolley waits and ambulance queues then as well, just as there are in Wales, where Labour is running the NHS, and in Scotland and in Northern Ireland. This is unprecedented pressure, because we are trying to live with covid and deal with a backlog of procedures and rising cases. The shadow Secretary of State was not here yesterday, so he may have missed some of the support that we are putting in. We are putting £150 million of extra funding into the ambulance service, £50 million into 111 to increase capacity, and £30 million into an auxiliary ambulance service to increase support. We are supporting the service, but we must recognise that it is facing unprecedented pressures.

[Dr Allin-Khan]

With respect, I will take no lectures from the Minister about working in A&E under a Labour Government and a Conservative Government. I have worked in the NHS under a Labour Government, when NHS waiting times hit record lows, and I have worked under a Tory Government, when NHS waiting lists hit record highs.

The Minister can use the pandemic, the heatwave, or even winter as justification. I have seen that emergencies do increase demand for services, but there is no excuse for not hitting the four-hour A&E waiting target for seven years. There is no defence for stroke and heart-attack victims waiting almost an hour for an ambulance. Undoubtedly, lives will be lost that could have been saved. Will the Minister apologise for those failings?

[Maria Caulfield]

The hon. Lady says there is no excuse for missing those waiting times, but perhaps she can explain why the Labour Government in Wales are also missing those times.

Tenant Fees Bill

Debate between Rosena Allin-Khan and Maria Caulfield

3rd reading: House of Commons & Report stage: House of Commons
Wednesday 5th September 2018 Commons Chamber

[Maria Caulfield]

I want to touch on two issues to do with fees and enforcement. I want to put on record my thanks to the Lewes citizens advice bureau, which did extensive research for my Adjournment debate in May 2016. While the explanatory notes to the Bill say that letting agents’ fees are on average £200 to £300, in my constituency —probably because it is in the south-east—they are on average between £200 to £1,000. On top of a deposit of six weeks’ rent in advance, that means someone can have to find £2,000 to £3,000 in advance.

This legislation will make a huge difference to tenants in my constituency of Lewes. However, I have some concerns about default fees, which I raised on Second Reading and in Committee. I am pleased to see Government amendments 5 and 6, which tighten these provisions. As stated in my entry in the Register of Members’ Financial Interests, I am a patron of the charity Homelink, which provides more than £100,000 of support to tenants looking for deposits in the Lewes district. The charity is still slightly concerned about default payments, but amendments 5 and 6 are really welcome because they tighten the provisions and state that default payments have to be listed in advance in any tenancy agreement and that there has to be evidence that those fees exist.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Will the hon. Lady give way?

[Maria Caulfield]

I will not give way, simply because of the time constraints on us.

If tenants are found to be in breach of those requirements, they will be liable to penalties and to prosecution, so I am more reassured than I was at the start of the debate. I welcome the fact that the Minister has listening ears, because he has really tried to listen to all Members on this matter.

On the enforcement issue, I am still concerned—not because of this legislation, but because of the failure to enforce the existing legislation requiring letting agents to publish their fees. I welcome the fact that, under clause 7, district councils will be able to keep the penalties charged, and I very much welcome the Minister’s announcement today that there will be £500,000 of up-front loading for councils to enable them to invest in staff and to start taking on enforcement. I want to pursue this, however, by asking what will happen if that still does not result in enforcement, because we will be no further forward with this brilliant legislation if enforcement does not happen. I also put on the record my interest as a vice-president of the Local Government Association, which asked for the up-front loading.

If we are giving councils the money in advance and they are able to keep the penalties, they really must step up to the mark and enforce the legislation. It will make such a difference to tenants’ lives if they know in advance what fees they will have to pay and that those fees are evidence-based, and if they know that if those fees are abused, there will be prosecutions and severe penalties. I cannot support the Opposition’s amendment 3, simply because schedule 1 sets out which fees will or will not be payable, while the Opposition have only given some examples of such fees. That is not really strong enough, and the amendment would severely weaken the legislation.

I congratulate the Minister, who has done a fantastic job in listening to everyone. I still have some slight concerns about enforcement and the default payments, but I am very happy to support the Bill.

[Sir Christopher Chope]

It is a pleasure to be able to speak in this debate. I am neither a landlord nor a tenant, but I am the chair of the all-party group on the private rented sector, and that sector is under substantial pressure on issues relating to regulation and interference by the Government.

The Residential Landlords Association has estimated that, in the past nine months alone, there have been over 25 consultations across Whitehall proposing changes that will have an impact on the private sector. More than 140 Acts of Parliament and more than 400 regulations affect landlords in the private sector already. That is why many of those landlords choose to get help from letting agents, and this Bill is a direct attack on the profession of letting agents. As my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) has said, this is not a Conservative measure at all, and I despair at the fact that so many people seem to want to support this exercise in socialism and control.

Why should a Conservative Government be engaged in preventing professionals from charging a fee for services rendered? Doctors in my constituency charge those aspiring to become social tenants £15 a time to get a medical certificate in support of a social housing transfer. That—in response to my hon. Friend the Member for Harrow East (Bob Blackman)—is not a cost, but a charge. It is a charge, and it is an arbitrary charge: it is imposed, but payable. As I understand it, the Government are not proposing to abolish the right of doctors to charge for writing letters, so why are we proposing to prevent letting agents from charging for the services that they provide?

NHS and Social Care Funding

Debate between Rosena Allin-Khan and Maria Caulfield

Wednesday 11th January 2017 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend, but that is obviously not of interest to Labour Members. I have been a nurse for over 20 years and have seen 20 years’ worth of winter crises. They are not unusual. There is no doubt that there is more pressure this year than ever before—we have heard about record numbers of people attending A&E—but there have been winter crises under many previous Governments. It was not unusual when I worked in A&E for patients to be treated in corridors or on chairs—wherever there was space. It was not unusual for ambulances to be queued up around the block, waiting for hours to unload patients—[Interruption.] I still work in the NHS and disagree with the chuntering from the Opposition Benches.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Will the hon. Lady give way?

[Maria Caulfield]

I will not. I must make progress and others want to speak.

It was not unusual for my hospital to declare a major incident because we could not take any more patients. It was not unusual for us to take on the extra work when neighbouring hospitals declared major incidents. The truth hurts, but that is what has happened over my 20 years of working in the NHS and what has happened over the past few days of this winter crisis. It outrageous for Labour Members to suggest that it is something new. They are in denial if they believe that it has not been happening for many years.

The Labour Government was so fixated on the four-hour rule that managers used to bully us and tell us which patients would get a bed based not on clinical need, but on the need to meet a target that was about to expire. I want to tell the House a story. One night I was working in a busy A&E when an elderly gentleman was admitted. He had fallen at home and broken his hip and had to be nursed on a trolley in the middle of a busy corridor. The four-hour target was looming, and at three and a half hours he called out to me and said, “Nurse, I desperately need to go to the toilet.” I had no cubicle to put that man in. He could not get off his trolley owing to his broken hip. The best that I could do under that Labour Government was to wheel a curtain around him and he went to the toilet there in the middle of a busy hospital corridor, with his war medals on his chest. Now, he got to a ward within four hours—his target was met—but that was not good care. If Labour Members think that it was and think that this is a new problem, they have buried their heads in the sand.

[Dr Allin-Khan]

Will the hon. Lady give way?