Oral Answers to Questions Debate
Full Debate: Read Full DebateStephen Kinnock
Main Page: Stephen Kinnock (Labour - Aberafan Maesteg)Department Debates - View all Stephen Kinnock's debates with the Department of Health and Social Care
(1 day, 16 hours ago)
Commons ChamberAfter 14 years of Tory neglect and incompetence, we inherited a broken NHS, and nowhere is that more apparent than in our mental health services. Too many people are waiting too long to access the care they need. To fix that, we will recruit 8,500 more mental health workers; provide access to specialist mental health professionals in every school, as the hon. Member has called for; roll out Young Futures hubs in communities; and modernise the Mental Health Act 1983.
With the Terminally Ill Adults (End of Life) Bill being amended to include a panel that will involve psychiatrists who will determine whether a request for assisted dying should be granted, as well as a number of cross-party amendments rightly calling for the involvement of mental health professionals earlier in the process, what assessment have Ministers made of whether there is sufficient capacity in mental health services, which the Minister has just noted are overstretched, to meet those demands, and on the potential knock-on impact on both waiting times and treatments for those with mental health conditions?
The hon. Lady will know that the Government’s position on the Terminally Ill Adults (End of Life) Bill is one of neutrality. I am on the Bill Committee simply to speak about the Government’s position on the workability and operationalisation of the Bill. We look forward to seeing the amendment that will be brought forward by my hon. Friend the Member for Spen Valley (Kim Leadbeater). Any comment we make or position we take will be based on the operationalisation of that amendment, should it become part of the Bill and, ultimately, should the Bill gain Royal Assent.
Thurrock community hospital does fantastic work on integrated care, particularly on integrated mental health care. On a visit, representatives said that what makes the hospital successful is a commitment to working across integrated care boards, the local authority and other relevant partners in the community, as well as a commitment to meeting people where they are, finding out what is important for them and working from there. Does the Minister see that model as integral to the reform of mental health care in this country? Will he join me on a visit to Thurrock community hospital to see what it does and what can be learned from how that work is undertaken?
My hon. Friend is a doughty campaigner on this issue in her constituency. She is right that the integration of services is crucial to ensuring that we get the best possible outcomes for people who are struggling with their mental health. I would be very happy to discuss with her the possibility of me visiting her constituency.
Is the Minister aware of the brilliant work done by Mersey Care NHS foundation trust in reducing in-patient mental health suicides to zero, which is an extraordinary achievement. Under a former Health Secretary, who may be standing not a million miles away from where I am standing now, that became an objective for all mental health in-patient units across the NHS. Will the Minister look into whether that objective still stands? If not, can it be reinstated?
I am not familiar with the detail of the case that the right hon. Gentleman mentions, but it sounds like a positive and interesting development, and I would be happy to consider it further. The Government are committed to delivering the cross-sector suicide prevention strategy for England, published in 2023. The 8,500 new mental health workers who we will recruit will be specially trained to support people at risk.
I am regularly contacted by constituents who are concerned that their children are not receiving the mental health care they need. Having met GPs in Winsford, I know that there are clear concerns that access to child and adolescent mental health services is being rationed to the point that it has become almost inaccessible to all but the most severe cases. Will my hon. Friend tell me what progress has been made towards our commitment to provide specialist mental health professionals in schools, ensuring that there is early intervention that prevents issues from escalating?
After the disastrous 14 years that we have had, we are facing a very serious situation in terms of mental health provision. It will take some time to get the workforce in place, but we have a clear commitment to having a specialist in every school. The appointment and training of those specialists will take some time. We are also rolling out open-access Young Futures hubs in every community. I am confident that the combination of those two interventions will get us back to having mental health services that this country can be truly proud of.
I welcome the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), to her place. I look forward to working with her, as I do with other Ministers.
As the Minister for Care will know, 20% of the burden on the NHS is due to mental health, yet only 10% of the budget is allocated towards it. The mental health investment standard has been a welcome maintenance under this Government. However, the Select Committee heard from Amanda Pritchard the other day that the standard is guaranteed for only the next two years. Does the Minister agree that the standard has had a positive effect on mental health community services, and would he commit to protecting it?
The Chair of the Committee will have seen that we have made an explicit commitment to the mental health investment standard—we are absolutely committed to that. In addition, we have to drive reform in the system so that it is about not just the amount of investment going in, but how we ensure that it is working properly. I am absolutely confident that the commitment to 8,500 new specialists, the Young Futures hubs and having a mental health specialist in every school will facilitate the delivery of services in a far more effective way than is currently the case.
I thank the Minister for his continued commitment to supporting mental health in this country. Does he also recognise that mental health involves supporting NHS frontline staff? I had the wonderful opportunity of spending time with the East of England ambulance service on Saturday morning. They work incredibly long hours and work incredibly hard. Obviously, we need to think about their mental health as well.
We in this Chamber should, whenever possible, pay tribute to the people providing those frontline services, who every day work heroically in very difficult circumstances. My hon. Friend is absolutely right about the pressures on the workforce—we are very conscious of that. We will bring forward a workforce plan in the summer, and we are working at pace to recruit the 8,500 mental health workers.
Last week, the Secretary of State issued a new mandate for the NHS in which a number of mental health targets were dropped. I accept that targets that drive perverse behaviours should be dropped and that some sharpened focus is necessary, but mental health waiting lists are at a record high, huge numbers of people are not at work because of poor mental health, and our young people are being let down badly by CAMHS, not least in my constituency of North Shropshire. Does the Secretary of State accept that mental health targets should be reinstated and that mental health should be treated with equal priority to physical health?
What we know about targets is that if we try to overload a system with too many targets, it causes confusion and ends up with, as the hon. Lady rightly says, perverse outcomes. We are clear that we do not want to have a system based on just making policy by press release, as was the case under the previous Government, putting out press announcements about loads more targets. It all makes for nice front-page headlines, but it does not lead to any serious delivery of the strategy that we need to deliver. I am with her on the point about focus. We are absolutely committed to mental health, as is set out in the planning guidance. It is also one of the priorities in the planning guidance, and we will continue to deliver on that priority.
Hospices provide vital care and support for patients and their families at the most difficult time. I am very proud that this Government have provided a £100 million capital funding boost for adult and children’s hospices over this year and next. We are currently finalising the delivery mechanism for this funding, and we are pleased that Hospice UK is standing ready to distribute the money to local hospices across England. We are also providing £26 million of revenue funding for children’s hospices in England in 2025-26.
While I wholeheartedly welcome the £100 million capital funding boost for hospices announced before Christmas, 17 members of staff at Nottinghamshire hospice, which is a large community-based hospice serving my constituency that provides care for family members in their own homes, have recently been told they are at risk of redundancy. Can the Minister please expand on how the Government will support organisations such as this to continue to deliver excellent care in the community?
I thank my hon. Friend for this important question, and I commend the work of hospices such as Nottinghamshire hospice in his constituency, which I know does a wonderful job for people in his area. The investment I referred to in my earlier answer will help hospices such as Nottinghamshire hospice to provide quality end-of-life care to patients and their families this year and next. It can be used to improve IT systems, make it easier for GPs and hospitals to share vital data on patients, and help to develop and improve outreach services to support people in their own homes, when needed.
North London Hospice in my constituency has a site in Winchmore Hill that receives one third of its funding from the NHS, with the rest coming from the generosity of the public. Many of its services, such as out-patients and wellbeing, are funded entirely by donations. While it welcomes the announcement of the £100 million in funding, what assurances can the Government provide about long-term hospice funding, given the significant delays in accessing funding from integrated care boards this year? Hospices are anxious to seek clarity about the allocation and distribution of this funding.
I thank my hon. Friend for that question. On her point about long-term funding, last week I chaired a roundtable with key stakeholders from the sector, and we were absolutely focused on developing a plan to secure the long-term sustainability of the sector. We cannot go back to the cliff edge that we have had over the last few months, primarily due to the utterly chaotic and shambolic way in which the Conservative party managed our system in the past.
I have had the privilege of witnessing at first hand the exceptional work of my local hospices, Forget Me Not children’s hospice and the Kirkwood. However, as my hon. Friends the Members for Rushcliffe (James Naish) and for Edmonton and Winchmore Hill (Kate Osamor) have stated, they are also struggling with long-term funding pressures and have had to make the difficult decision to reduce services and staff. What further work are the Government doing to ensure that hospices thrive, and to ensure that end-of-life care is included in the 10-year NHS plan?
I thank my hon. Friend for that question. One of the three shifts that the 10-year plan will deliver is shifting more healthcare out of hospitals and into the community. In the context of the plan, we are having discussions about the long-term sustainability of the palliative and end-of-life care sector, including hospices. As we develop the plan, we will be carefully considering policies in this area, with input from the public, patients, health staff and our stakeholders. As I mentioned in response to my hon. Friend the Member for Edmonton and Winchmore Hill (Kate Osamor), last week I was pleased to chair a roundtable to discuss long-term strategies for hospices to get palliative and end-of-life care, including hospices, on to a more sustainable footing after 14 years of Tory neglect and incompetence.
Leicestershire is home to some superb hospices, such as Rainbows and LOROS, both of which are set to be massively impacted by the hike in national insurance contributions. Given the important work that these hospices do, particularly for people at the end of their lives, will the Minister urge the Chancellor to reverse this pernicious tax rise?
I am once again struck by the fact that Conservative Members seem to welcome the additional investment that the Chancellor has put into our health and care service, but do not seem to have any plan or proposals at all about how the revenue should be generated for that funding. Until we get an answer to that question, we will struggle to get much further in this House, although I note that Toby Porter, the chief executive of Hospice UK, has said that the
“funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need”.
First, may I pay tribute to those who work in hospices? I think we can all agree that they do an astonishing job. The Minister will agree that the national insurance hike has had an impact on those who work in hospices. Can he assure me that when it comes to the Scottish Government’s funding—I acknowledge the 14 years of Tory misrule and the funding settlements that were handed down—any Barnett consequentials will be passed on in full to the devolved Administrations?
We have seen the biggest settlement in many years for our health and care system across the country. It is now up to the SNP Government in Edinburgh to absorb and deliver that funding in a way that will actually improve services in Scotland—something that we have not seen for a very long time under the misrule of the Scottish National party.
The magnificent work done by those who work in hospices, including the four in Northern Ireland, needs to be reflected in the funding formula. Will the Minister undertake to discuss with ministerial colleagues the need for the Treasury to review that funding formula, particularly in relation to devolved settlements?
From the roundtable discussions, and from subsequent discussions we have been having with the sector, it is clear that we need to look at the long-term funding issue. We faced a cliff edge towards the end of last year. That is not the right way to do things. We must start getting the funding discussions moving so that, well in advance of the end of this financial year, the funding situation for the palliative and hospice sector is much clearer.
Children and young people with special educational needs are waiting too long for the NHS services that they need, in large part because local authorities have been hollowed out by 14 years of austerity. We are supporting earlier intervention through the partnerships for inclusion of neurodiversity in schools—PINS—programme, which is backed by £13 million of funding. NHS England has also launched a taskforce to look at how support can be improved for people with attention deficit hyperactivity disorder. We look forward to its report later this year.
Cambridgeshire has some of the lowest funding in England for GP practices and schools. Given the Government’s focus on growth for the area and the record demand for special educational needs and disabilities and young people’s mental health services, will the Minister work with colleagues across Government to ensure that high-growth areas no longer suffer lower than average funding?
Our commitment to improving SEND conditions is universal. We are looking at this from the point of view of improving provision right across the country. I am very pleased that the PINS programme is making progress. I draw the hon. Lady’s attention to the early language support for every child—ELSEC—programme, in which nine pathfinder sites over two years will provide early identification, and targeted and universal support for children with speech, language and communication needs in early years and primary school settings. We are working very closely with colleagues across the Department for Education and NHS England on that.
Local authority resources are a big driver of some challenges in the SEND system, but it is clear to anyone working in it that a systemic under-prioritisation of children’s health, all too often by local NHS trusts, is a big contributing factor. Young people right across my constituency waiting for assessment and lacking support are paying the price. As part of our 10-year plan to reform the NHS, how will we ensure that children’s health is front and centre again, with much more support for people with additional needs?
I am working very closely with colleagues in the DFE on how we mainstream SEND provision more effectively, get more rapid education, health and care plans and autism diagnoses, and on a whole range of issues that require strong cross-party work. I would be happy to brief my hon. Friend on that separately.
After 14 years of Conservative government, 77% of people in Derby cannot access an NHS dentist. Can the Minister tell us what caused the rot to set in and how we can fill the cavities in provision?
I see what my hon. Friend did there, and she should brace herself as we drill down into this answer. The Conservative party is the cause of the rot: spending on NHS dentistry fell by a staggering 18% between 2010 and 2024, so it is little wonder that dentistry is on its knees. We will shortly set out plans to introduce supervised tooth brushing for three to five-year-olds in the most deprived communities, and we are working with the dental sector to implement our rescue plan.
It is vital that we have a palliative and end of life care service that works and is on a sustainable footing. I have had discussions with the sector. We want to ensure that we do not have the cliff edge that we had at the end of last year. The hon. Gentleman is right to point to this, and we will report back in due course.
The Minister will be aware that the contract uplift for dentists is facing a near 11-month delay. Can he confirm that dentists will be receiving their uplift? What will be done to make sure that they receive enough money to cover the costs of NHS dentistry?
I can reassure my hon. Friend on that point. We implemented the contract uplift on 29 January. Dentists will therefore be receiving their uplifted payments in March, backdated to 1 April 2024. For the first time in more than a decade, we have also increased payments for practices training a foundation dentist.
We are in negotiations about the future contract with the General Practitioners Committee England of the British Medical Association. Those negotiations are proceeding, and the right hon. Gentleman is right that we need serious reform; we will be pushing reforms through on that basis. On his point about the estate, we have a £102 million commitment on capital for the primary care estate, which I think will go some way towards reassuring him.
I thank my hon. Friend the Minister for all the support he has given the University of East Anglia to set up its dental school, but he will be aware that all those shiny new dentists coming out in a few years’ time will be going into the private sector, not the NHS, unless we can sort out the NHS dental contract. Can he give us any kind of timeline for when we can expect to hear an announcement on that critical factor?
I wish my hon. Friend all the best with his efforts to get that dental school up and running. As for the need for serious reform, there is no perfect payment system, but we have to get a payment system in place that makes NHS dentistry attractive—at least as attractive as doing work in the private sector. We are working at pace on that, and I will report back on that as rapidly as possible.
Shortly after the election, the new Government announced £4.3 million for a new community mental health hub in Whitehaven. Unfortunately, the local mental health trust followed that decision by announcing the closure of the Yewdale ward for acute mental health services. Does the Minister agree that we need to get early intervention right before we close acute services, and will he bring together a meeting to scrutinise that decision?
Integrated care boards are responsible for providing mental health services to meet the needs of their local populations. As part of our plan for change, we will reduce delays and provide faster treatment. We are working with NHS England to transform mental health services, shift care from hospitals to local communities, and increase access to support for people across the country, including in rural areas.
Insomnia affects many patients, including my constituents, who are being advised by their GPs to try cognitive behavioural therapy as an alternative to medication. However, digital CBT programmes are not available on the NHS, leaving many without access to drug-free treatment. Will the Minister outline what steps the Government are taking to ensure that patients have access to digital therapies, so that more people can get access to evidence-based, drug-free support?
The NHS South East London integrated care board provides services to my constituents, and I have discussed some ways in which we could better deliver services by redeveloping the Erith community hospital site in Northumberland Heath. Is the Minister able to provide an outline of the Government’s plan to provide capital funding for expanding community services like those at Erith hospital?
I would be delighted to meet my hon. Friend so that we can get into a bit more detail about what is happening in his constituency, but he is absolutely right to point to the need for more and better community health services. That will be at the heart of our shift from hospital to community in the 10-year plan that we are delivering.
Health authorities in Devon are set to trial the relocation of a vital coronary service from Torbay to Exeter, which is 24 miles away. Will the Minister meet me and fellow south Devon MPs who have grave concerns about the impact on patient safety?