Mental Health Treatment and Support

Vicky Ford Excerpts

Wednesday 7th June 2023 Commons Chamber

[Vicky Ford (Chelmsford) (Con)]

As you and my hon. Friend the Minister are aware, Madam Deputy Speaker, there has been a tragic, historic issue of in-patient mental health deaths in Essex—it goes back to 2000—over a 20-year period. Roughly 2,000 people have lost their lives. An inquiry has been going on, but, as I said in the House in January, there has been deep concern about the lack of progress and the low level of engagement between Essex Partnership University NHS Foundation Trust and the inquiry. I also pointed out that families who have lost loved ones want to know that lessons have been learned, they want accountability, and, most important, they want to know that patients are not suffering the same today.

At the time, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), said that unless there was a

“quantum leap in the level of co-operation”—[Official Report, 31 January 2023; Vol. 727, c. 51WH.]

with the inquiry, it would move to a statutory basis. I know that the Secretary of State treats the matter seriously—he met Essex MPs recently and is close to making a decision—but it has now been four months since that debate, so may we please have a decision soon?

In the meantime, I recently met EPUT to find out what is happening with its service. I will tell some positive stories. In March, EPUT announced that it was going to launch a mental health urgent care unit in Basildon. We have all heard stories of people in mental health crisis going to A&E, waiting hours and hours, and then not getting the specialist service that they need, but that new specialist 24/7 centre saw 200 people in its first month. Instead of what happened historically in A&E—90% of people waiting a long time before being sent home without a care plan—90% of people see the experts within four hours and leave with a care plan. That is transformational. The unit is also piloting a 24-hour paramedic.

Demand in Essex is settling down. It rushed through the roof during covid but is now increasing in line with population growth. Complexity also rose during the pandemic. Prior to the pandemic, about 30% of those going into in-patient units needed to be detained. At the peak of the pandemic and post pandemic, that figure was 70%. It is now down to 60%. Our waiting time to see a psychologist, which rose to a year, is now down to 29 weeks. Vacancies for all positions have been filled, so the trust will be fully staffed from September and expects the waiting list to drop to zero.

Furthermore, EPUT is trying new technologies such as the new and innovative neuromodulation centre, which opened six months ago in Brentwood and is having great success. The trust is also encouraged by the Government’s announcements on electronic patient records. Enabling hospitals and mental health services to share patient records easily between them will make a huge difference. It is great news that the Government are behind that, but we need the funding for it.

Colleagues have mentioned eating disorders. Some may be aware that I suffered from anorexia when I was a teenager. It is still very difficult to talk about one’s own mental health. I encourage everyone in the Chamber to please be mindful of the language that they use; I have found some of the language used so far in the debate very upsetting. I completely agree with my hon. Friend the Member for Watford (Dean Russell) about being mindful of the tone that we use, because there will be people watching who are suffering with mental ill health, and we must not scare them away from getting treatment.

I am particularly concerned that what is being seen on social media today fuels eating disorders. The speed at which young girls in particular are shown eating-disorder content on social media by platforms such as TikTok is outrageous. I am glad that the Government are tackling that.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

My right hon. Friend is absolutely right to mention social media, particularly in relation to teenage girls and eating disorders. I praise her for bringing her own experience to the Chamber. Another major contributor to the rise in mental ill health among young people in the last decade has been the isolation that social media can cause through bullying and so on.

[Vicky Ford]

My hon. Friend is completely right about online bullying. It is so important therefore that we get the Online Safety Bill through—it must not be delayed too much, although there are still issues to be looked at in the Lords.

I am very pleased that Ministers have announced that they will criminalise the intentional encouragement of serious self-harm, including eating disorders. I would like them to look again at the toggle on/toggle off issue that I mentioned last time we debated this, and—on another issue that is having an impact on children—to take seriously the need to prevent children from accessing online pornography, which is of an increasingly violent nature. Those matters are all related to the mental health of the nation.

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[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

As a now non-practising former consultant psychiatrist, I have a host of declarations I should make in terms of speaking in this debate. For the sake of brevity, I draw attention to my entry in the Register of Members’ Financial Interests and my declarations as part of my work on the pre-legislative scrutiny Joint Committee, which list them in full.

This is an important debate and I shall focus on two angles. One is the delivery of mental health care and treatment and the other is the framework for that. I want to celebrate today the rebuild of the Abraham Cowley unit in my constituency. It gets rid of the awful dormitories that have plagued mental health care and treatment for some time. They are now gone, and we will have a brand new, rebuilt mental hospital. In fact, tomorrow, I am going to the topping out ceremony on the site to see the progress in delivering that. It will make a huge difference to the delivery of mental health care.

I used to work as an in-patient consultant psychiatrist. When people come into hospital for in-patient psychiatric treatment, it is often at the most difficult times of their lives. It is critically important that our mental health estate is fit for purpose and is a therapeutic environment. For too long, the mental health hospital estate has been the second cousin to acute physical health care and I am delighted that we are driving change forward in my patch. If people need in-patient care and treatment, they will get it in a new hospital that is fit for purpose. I just want to celebrate that and thank everyone who has been involved in getting it over the line, as well as all the people who work in that sector, including those who are looking after the patients who would have been in the old hospital, which is now a building site, and going through a stressful period of transition while the new hospital is set up.

My second point is about the draft Mental Health Bill. A few years ago, my right hon. Friend the Member for Maidenhead (Mrs May), the former Prime Minister, suggested that we should review the legal framework we use when we treat people who are unable to consent or do not consent to treatment. Around every 20 years or so, we go through this process. We should be proud as a country that we have always been at the forefront of driving forward legislation and legal frameworks for dealing with people who cannot consent to treatment, the law of best interests and capacity. I was fortunate to be a panel member of the Simon Wessely review. I did that as part of my previous academic life, so Members can imagine my pride and delight in being part of the pre-legislative scrutiny Joint Committee on the draft Mental Health Bill.

I am slightly saddened by the debate today, because mental health—especially the frameworks we use to treat people who are severely unwell—needs to be above party politics. We are discussing the most invasive thing we do in medicine—detaining and treating people in hospital, sometimes for a substantial time. We need to think carefully about the right balance between choice, freedom and autonomy and making sure that people get the care that they need at the right time and under the right framework. I am glad that the Government have done pre-legislative scrutiny and we have worked on a cross-party basis to get this issue over the line. I hope that we will see the mental health Bill very soon.

My final point is about psychosis. The Government’s amendment mentions the treatment of psychosis, which I know is often missed out in these debates and when people talk about mental health. Psychosis is one of the most disabling mental disorders and far and away the most costly and impactful, because it can affect people when they are quite young—

[Vicky Ford]

It is incredibly helpful to have my hon. Friend’s detailed experience in this debate. Why does psychosis get missed out?

[Dr Spencer]

It is simply because of advocacy; the conditions debated tend to be mental health conditions for which people can advocate. We talk a lot about dementia, and the children of those suffering tend to advocate for them. For CAMHS, it is the parents who advocate. For common mental disorder, people are able to advocate for themselves, but psychosis can be—I do not want to make a broad generalisation—disabling and isolating, and can limit people’s ability to advocate for themselves. From my research, I know that psychosis can break down family relations and alienate people. I am nervous about broad generalisations, and for the most part people can get better and do very well, but in some cases psychosis can be very disabling and limit advocacy.

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[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to close the debate on behalf of the shadow health and social care team.

We have had a thorough debate and we have heard some heartbreaking, harrowing and concerning things during its course. The amendment that the Minister has put down in response to the motion is reminiscent of “Alice Through the Looking Glass”, because it does not bear any relationship to people’s lived experiences of the mental health system in England or the contributions made by Members from both sides of the House to the debate.

I pay tribute to all who have spoken today. There have been some incredible speeches. We heard from the hon. Members for Watford (Dean Russell) and for Penrith and The Border (Dr Hudson), from the right hon. Member for Chelmsford (Vicky Ford), and from the hon. Members for Runnymede and Weybridge (Dr Spencer), for Penistone and Stockbridge (Miriam Candidates), for Newcastle-under-Lyme (Aaron Bell), for Devizes (Danny Kruger), for St Albans (Daisy Cooper), and for Oxford West and Abingdon (Layla Moran).

We also heard from my hon. Friend the Member for Hemsworth (Jon Trickett), my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle), who made an extremely powerful contribution, and my hon. Friends the Members for Chesterfield (Mr Perkins), for Batley and Spen (Kim Leadbeater), for West Ham (Ms Brown)—I ask the Minister not to forget her request for a meeting; she is certainly someone to whom it is difficult to say no—for Oldham East and Saddleworth (Debbie Abrahams), for Leeds North West (Alex Sobel), for Sheffield, Hallam (Olivia Blake), for Birmingham, Erdington (Mrs Hamilton), for Halifax (Holly Lynch), for Kingston upon Hull West and Hessle (Emma Hardy), for Wakefield (Simon Lightwood), for Luton South (Rachel Hopkins), for St Helens South and Whiston (Ms Rimmer), for Salford and Eccles (Rebecca Long Bailey) and for Blaydon (Liz Twist). Finally, we heard from my hon. Friend the Member for City of Durham (Mary Kelly Foy); I remind the Minister that she would like a response to her request for an inquiry into issues in her local area.

We are facing a mental health emergency in this country—

[Vicky Ford]

The hon. Gentleman has said that the Government’s amendment bears no relation to the reality of what people are seeing. In my speech I mentioned the creation of a brand-new facility for patients in mid-Essex, which means that people in crisis are not spending many hours in A&E but are going to a bespoke 24/7 centre. That is the sort of provision that I want to support, and it is mentioned in the Government amendment but not in the Opposition motion.

[Andrew Gwynne]

Of course we need facilities in every part of England, but the fact is that after 13 years, too many parts of England are falling behind. We know that the mental health crisis in this country has become worse on the watch of the right hon. Lady’s Government, and she should have a little contrition about the state of mental health services in England.

[Vicky Ford]

rose—

[Andrew Gwynne]

I will not give way. We have heard enough from the right hon. Lady, supporting her “Through the Looking-Glass” amendment which bears no relation to the reality.

As we have heard today, people who require mental health support, no matter where they live—except in the right hon. Lady’s part of England—will be confronted by a system that is buckling under the pressure of 13 years of Tory mismanagement, neglect and incompetence. The right hon. Lady shakes her head, but the figures speak for themselves. Last year, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency departments. There are 400,000 children currently waiting for mental health treatment, and 1.2 million people are waiting for community mental health care, with some patients being forced to travel more than 300 miles because there are no beds in their local area. My hon. Friend the Member for Hemsworth spoke powerfully about that. The Resolution Foundation has found that, of the 185,000 young people who are unable to work, nearly two thirds cite mental ill health as the reason. Suicide is now the leading cause of death in adults under 34, with about 18 people losing their lives every single day. As the cost of living crisis has worsened, we have also seen a knock-on effect on addiction and rehabilitation. Drug-related deaths are at a record high, and last year there were 9,641 deaths in the UK from alcohol misuse, a 27% increase on the year before.

Make no mistake: the emergency in mental health has become a public health crisis, and we need to see action. Our motion calls on the Government to adopt Labour’s plan to recruit 8,500 mental health staff to expand access to treatment, to provide specialist mental health support in every school, and to establish open-access mental health hubs for children and young people. That would be paid for by the closing of tax loopholes, because politics is about priorities, and Labour’s priority is to ensure that those who need mental health support have access to it in all parts of the country. Our priority is to build a Britain where patients start receiving appropriate treatment within a month of referral. I hope that those on the Government Benches will demonstrate that they share these priorities by voting for Labour’s motion today.

Staffing is just one part of the equation. Like any public health issue, addressing mental health requires a holistic approach that recognises its complex nature. That is why Labour has committed to a whole-Government plan to improve outcomes for people with mental health needs and to address the social determinants that drive mental ill health for many people. Our mental health can be influenced by a multitude of different things. Secure jobs, fair pay and good housing are all building blocks for a healthy life, physically and mentally, and unless we improve people’s lives in the round, positive change will remain out of reach.

It is for this reason that the next Labour Government will focus as much on prevention as we do on treatment. We will pioneer a transformative cross-departmental agenda with a mission delivery board at the heart of the Government ensuring that all Departments work to improve the wider determinants of health. We will boost capacity in mental and public health teams so that people can get the support they need before presenting at A&E or turning to substance abuse. We will also encourage the integrated care systems to identify opportunities to join up services within the community. Our aim will be for more patients to have one point of contact for appointments with a range of professionals and services. This neighbourhood team will include the family doctor, carers, health visitors, social prescribers and mental health specialists.

Our vision is to turn the national health service into a neighbourhood health service with the patient right at the heart of it. The benefits of this kind of work will travel far beyond improving the lives of individuals suffering from mental ill health. For instance, in my own region of the north-west of England there were over 140,000 calls to 999 from people in a mental health crisis last year, and in my own constituency local people spent over 6,500 hours waiting in A&E for mental health treatment. If we were to help people before they reached these crisis points, we would drastically reduce pressure on the wider health system and thereby improve patient outcomes right across the board.

The same is true of wider economic productivity. As we have heard in the debate, the Mental Health Foundation and the London School of Economics have estimated that poor mental health costs the British economy £117 billion a year. That is a phenomenal amount of money and a huge loss to our country’s economic power. Improving mental health outcomes is therefore not just a moral imperative—although it is certainly that—but a practical one, and one that is essential if we want the United Kingdom to prosper, as I hope and believe we all do. That is what we come to this House for. We want to leave our country in a better shape for our children than it has been for ourselves.

That brings me again to the motion. All Members of the House have the opportunity today to support a fully funded plan to improve mental health treatment. Those on the Government Benches can choose to put party politics first, but that will not change the fact that this Government have failed people on mental health. No matter what amendments they put before us, that does not change people’s real, lived experiences or the experiences of Members on both sides of the House who deal with the impact of mental ill health in their constituency casework. The system is crumbling and more of the same will just not cut it, so I am enormously proud to be supporting Labour’s motion today and I would strongly urge Members on both sides of the House to back it. It is time to give those suffering from mental ill health the treatment and support they deserve, and I commend our motion to the House.

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[Maria Caulfield]

My hon. Friend is absolutely correct. As my hon. Friend the Member for Bosworth (Dr Evans) said, we had an event with the NFU yesterday, and that is exactly the point we wanted to make. It was my right hon. Friend the Member for Maidenhead (Mrs May) who set about changing the status of mental health, putting it on a level playing field with physical health, not just in the services we provide but in funding and staffing, with parity of esteem across the board.

Let us look at some of the progress that has been made over the last 10 years. The shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), said in her opening remarks that she is bored of this figure, but it is true that £2.3 billion of additional funding is being put into frontline mental health services, supporting another 2 million people to access NHS-funded mental health services.

We are already doing much of what shadow Ministers have set out this afternoon. We are already recruiting 27,000 additional staff into mental health services, with 20,000 of them already in place. My right hon. Friend the Member for Chelmsford highlighted the difference that is making in her local area. We are removing dormitory accommodation across the country through a £400 million capital programme, and 29 schemes have already gone through—that is 500 beds that are no longer in dormitory-style accommodation.

My hon. Friend the Member for Runnymede and Weybridge highlighted the difference that funding is making in his constituency. We are moving to a system of community crisis support and early intervention so that people do not get to a point where they need to be admitted. Our £190 million of capital funding is being used to build community crisis facilities up and down the country. We are investing in mental health ambulances: 20 are already in place, 40 will be in place by the end of the year, and 47 will be in place next year. The shadow Minister laughs about this, but when somebody is going into crisis, it is more appropriate that a mental health specialist team visits them in a mental health ambulance than an ordinary paramedic, who will inevitably take them to A&E.

Suicide is the leading cause of death in new mums, which is completely unacceptable. That is why we are investing in perinatal mental health services in every part of England—these services saw 31,500 women last year.

As we remove the stigma, it is important that we have the services to deal with the rising number of people who come forward and ask for help, as we want them to do. We have introduced three targets, the first of which is on access to talking therapies, where 75% of people should begin treatment within six weeks. Currently, 90% of people are doing so and we are meeting that target. When children and young people are referred for eating disorders, the target is that 95% should be seen within one week. We are currently at 77%, whereas last year’s figure was 61%, so despite the rising numbers we are seeing more children with eating disorders—

[Vicky Ford]

I was incredibly upset by the shadow Minister’s suggestion that I do not care about mental health. As someone who has suffered with mental ill health in the past and spoken in the Chamber about how hard it is to speak about that, I found that very upsetting. Mental health suffered greatly during the pandemic, especially that of children and young people—I was the children’s Minister at the time. We all know that we need to do better, which is why it is important that we learn about what is working now and about new innovations. On eating disorders, I particularly thank the Minister for getting the waiting list time down.

[Maria Caulfield]

I thank my right hon. Friend for that. It is important that we take the politics out of this argument, because no one in this Chamber, on either side, does not care about mental health.

The psychosis target we have introduced is that 60% of people should start treatment within six weeks, and we are currently at 72%. We are overperforming on many of those targets. NHS England has five new targets that we hope to introduce soon—