Eating Disorders Awareness Week

Wera Hobhouse Excerpts

Wednesday 27th February 2019 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I thank the hon. Member for Angus (Kirstene Hair) for securing this important debate. It has already been said that this debate has cross-party support, and we have come a long way in recognising and understanding eating disorders. I find it depressing that although we have made this progress, increasing numbers of people are suffering from eating disorders. We must get away from just talking and start getting some change. I hope that Eating Disorders Awareness Week will bring about that change, so that we do not stand here next year without having made significant progress.

I will limit my remarks to the research that Beat has done that shows that eating disorders do not discriminate, and the importance of early intervention and prevention. Over the past five months, I have been campaigning to raise awareness. I have spoken before in this place about the need to recognise eating disorders early. Stories such as Hope’s highlight how ludicrous it is for people seeking help to be told that they are not thin enough.

At the heart of any improvement to eating disorders treatment lies education—of our medical staff, of the whole of society, of schools and of families. I have personal experience of a family member with an eating disorder, so I know very much how families and friends suffer around a sufferer. It is not just the sufferer who is affected, but those around them.

Eating disorders are too often trivialised and seen as an illness that exclusively affects one type of person. That is reinforced by research released this week by Beat, which found that discrimination was ingrained in how we view eating disorders. Beat’s research found that four in 10 people believed that eating disorders were more common among white people, and nearly 30% thought that eating disorders were most likely to affect people from higher socioeconomic backgrounds. The reality is that eating disorders do not discriminate.

The tragedy of eating disorders is that they are preventable. By focusing on early intervention, the numbers of those suffering can be greatly reduced, but the stereotypes around eating disorders mean that certain people are far less likely to recognise the condition and seek or be referred to treatment. For example, ethnic minorities are substantially less likely to be referred to eating disorder services than white patients, but once referred, ethnic minorities receive the same treatment as white patients. A central problem is what doctors and the public understand about the population of people who suffer from eating disorders. The network of family and friends who surround those with eating disorders make a great deal of difference to their recognising the condition and receiving the correct help.

Research on specialist out-patient family intervention for children shows that it is highly effective and reduces the need for in-patient care, which eases pressure on the NHS. New ways of looking much more holistically at the treatment of eating disorders are highly effective, and we should look at them. The research identifies the importance of a truly joined-up approach to recovery, ensuring that the community around an individual with an eating disorder is supportive and supported by the medical team. Those types of programmes are being run in select areas across the country, and they must be extended, given their positive outcomes.

Treatment for eating disorders is a postcode lottery. We need to look at that. We must set standards and deliver training that will help doctors and medical staff to identify people who need treatment, regardless of any preconceived stereotypes. Additionally, it is vital that we continue to listen to the stories of real people who have suffered from eating disorders, and hear what they have to say about their experiences of the system.

The last thing I want to mention is the Local Government Association’s “Bright Futures” campaign. It highlights to councils across the country the importance of increasing funding, and ensuring that all the promised £1.7 billion for children’s mental health is spent in children’s mental health, not elsewhere. Prevention and early intervention, as we have heard several times today, are absolutely key to saving many lives from being destroyed, including those of friends and families of sufferers. Together, we can make a real difference, but let us make it happen, rather than just talking about it.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I thank all hon. Members who have contributed to this very constructive debate. They all showed massive care and compassion, with a recognition that we have come a long way but need to go a lot further. I am grateful for their constructive contributions.

I congratulate my hon. Friend the Member for Angus (Kirstene Hair) on securing this debate in Eating Disorders Awareness Week. I thank her for her very frank exposition of eating disorders, and of the helplessness felt not only by those who are suffering, but by those around them. It is essential that we ensure that people have access to the right mental health support in the right place and at the right time, because time is of the essence. Improving those services is a key priority for this Government, as part of our wider agenda to improve mental health services.

As several hon. Members have said, eating disorders are serious: they have some of the highest mortality rates of any mental health disorder. We need to ensure, more than ever, that people get access to support as early as possible, because eating disorders quite often begin when people are young. Representations have been made today about why our targets are for children, rather than adults. Those targets recognise the fact that early intervention is best and that issues often surface when people are younger, but that does not in any way diminish the challenge of ensuring that adults also have access to services.

That brings me to a point that several hon. Members have made: the perception that eating disorders affect only young white women. They do affect adults. I have heard of a case of an elderly lady in a care home being diagnosed with an eating disorder that she had obviously been suffering from for decades. One of the tests that I will set myself is for that never to happen again, because we need to ensure that people get early diagnosis.

As the hon. Member for Islwyn (Chris Evans) very frankly reminded us, eating disorders affect men and boys too. If there is a perception otherwise, it may partly be because men and boys are much less likely to seek help than women and girls. We need to make it clear that the issue can affect absolutely anyone, as the hon. Gentleman showed very courageously by sharing his own experience; I am very grateful for his comments.

It is important to continue to raise awareness. We need to reduce the stigma associated with eating disorders so that people are more likely to talk about them. Like all hon. Members, I pay tribute to the campaigners who do so much to raise awareness, particularly the charity Beat, which does absolutely excellent work. I also pay tribute to Hope Virgo for her campaign and look forward to meeting her very soon.

We cannot emphasise strongly enough that this is not about weight; it is about the mind. Some of the stories that were shared in this debate were quite horrific. If there is such lack of understanding among medical professionals—if the people we trust to look after us end up doing harm because they see eating disorders as a weight issue—we have a serious problem to tackle. Of course training has its part to play, but I should add that we expect a lot of our GPs. One of the real challenges is to continue to roll out multidisciplinary GP service teams to ensure that there is much greater expertise in each medical practice, rather than relying on one individual to be the expert on everything. Frankly, they are only human beings—they are not God.

[Wera Hobhouse]

I thank the Minister for giving way; I know that her time is very limited. When services let people go too early, the danger of relapse is much higher. We could prevent relapses by not letting sufferers go too early, when they are half better but not fully better.

[Jackie Doyle-Price]

The hon. Lady makes a good point that I will address further if I have time. We need to look carefully at the care pathway and at the whole practice of referrals and the journey that people take, so that we can ensure that they are in a position to manage their disorder. The truth is that no one is ever cured of these things; it is a matter of managing their wellbeing to tackle them.

I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for her acknowledgment that we have come a long way. She is right that we need to ensure that we have proper specialist services to do this work, because of the risk of harm. She is also right to mention obesity, which we could do an awful more to address. I watch a lot of rubbish TV—we work long hours here, so that is my relaxation—and I am horrified by some of the channels, which basically run a succession of programmes about weight that are almost freak shows. That is not how we should be talking about the issue if we want to encourage people to access help. We need to tackle the stigma around obesity as much as the stigma around any other disorder.

The hon. Member for Westmorland and Lonsdale (Tim Farron) and I have already discussed his concerns about his area. I know that there are challenges and we need to ensure that provision is sufficient. He spoke very frankly about the guilt and terror that people around those who suffer from eating disorders feel, because they genuinely do not know how to help their friend or loved one. Reducing stigma and raising awareness is partly about helping people to understand what they can do. Everybody wants to help, because nobody wants to see people suffer so much.

Social media has been mentioned a lot. I absolutely recognise that it can be a force as much for good as for bad, but I must say that we are seeing content that encourages harmful behaviour. It is about the whole psychology of people joining communities. When people use social media regularly, they can become isolated from the physical world and join an online world in which everyone is like them. It becomes normalising, and it can worsen their experience.

Equally, social media can be a community of self-help. I agree completely with the hon. Member for Islwyn that we have to be careful: of course we must challenge companies to be responsible, but it is not black and white, and we need to handle the issue sensitively. I am pleased to say that some companies are very responsive, but not all, so we will continue to challenge them. The hon. Gentleman raised an issue that particularly concerns me. It is one thing to regulate public platforms, but encrypted direct contact is having a growing impact. We need to look at Snapchat, WhatsApp and so on, because the fact is the Government are always three steps—probably more—behind technology.

The hon. Member for East Kilbride, Strathaven and Lesmahagow emphasised peer support. I could not agree more: peer support is important for mental health generally. If I could make one challenge to NHS commissioners, it would be to recognise that providing support to people who suffer mental ill health is not just about clinicians; it is about the voluntary sector and peer support workers. If we are to really step up to that challenge, I hope to see much more imagination in how services are commissioned.

I have so much more to say, but I am running out of time. With hon. Members’ indulgence, I will write to them—not least the hon. Member for Newcastle-under-Lyme (Paul Farrelly)—to outline our response to the points that they raised. We have a lot of figures and have shown that we are meeting targets, but I think all hon. Members would be more confident if there were more granularity—not least because of the cases raised today in which people have not received the treatment that they deserve.

Motion lapsed (Standing Order No. 10(6)).

Healthcare (International Arrangements) Bill

Wera Hobhouse Excerpts

Wednesday 14th November 2018 Commons Chamber

[Wera Hobhouse (Bath) (LD)]

We have heard many comforting words from the Government today, but there is nothing comforting in the proposals in the Bill. If we Brexit, UK citizens here and abroad will lose their rights to automatic healthcare in other EU countries. The automatic right to healthcare in Europe has been one of the visible successes of the single market—a peaceful continent and EU countries working together. If we Brexit, new healthcare arrangements will need to be negotiated with the EU or EU countries individually, and the Bill is intended to make it possible for the Government to negotiate those new arrangements.

The Government intend to do this by using Henry VIII powers. Today could be the last time this Parliament discusses how 70 million UK citizens can go abroad and receive, or not receive, healthcare while there, not to mention the non-UK EU citizens who live in or travel to the UK. We have been through this debate before. Henry VIII powers are the preferred route for a Government who want to bypass parliament and get Brexit through at any price, including the price of democracy. This debate comes at a time when the Government are proposing a deal with the EU. There were only ever three possible outcomes for the UK in this negotiation: no deal, Brexit in name only, or staying in the EU. It looks like the Prime Minister has gone for Brexit in name only, although of course she will not call it that.

Brexit in name only means staying in the customs union and the single market, and it could mean retaining healthcare within the EU. That would be good news. The bad news is that no UK Minister or bureaucrat will be around the table with the EU27. We will be receiving our instructions, and that is it. When the EU decides changes, we will be notified and have to implement the changes. Henry VIII powers will be a way to hide our national humiliation.

The political question is why anybody would vote for Brexit in name only. It is not just a fudge; it is the worst of all possible worlds. It will, perversely, do the opposite of taking back control; it will keep us in complete dependency but without any say. Many parliamentarians have woken up to the fact, or have known for a long time, that our only secure economic future and the only way to guarantee all the rights we have negotiated, including free healthcare, lies in being a member of the EU. As we have heard today, rather than getting a Brexit dividend from the NHS, the new arrangement might end up being extremely costly for this country.

Why do we not dare to say it loud and clear? Not saying it loud and clear is dishonest; Brexit in name only is dishonest. To do something dishonest and call it the will of the people is a travesty. Only the people themselves should decide what is done in the name of the people. Let us ask the people. Let us give the people a say on whether they really had all this in mind when they voted in 2016. Let us give people a chance to decide that when all is said and done they want to stay in the EU. And of course that would make the Bill completely unnecessary.

Prevention of Ill Health: Government Vision

Wera Hobhouse Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right; I strongly agree. Reformulation is critical. However, it is crucial to look not just at sugar, but at calorie count. Replacing sugars with higher calorie products is not necessarily the right way forward.

[Wera Hobhouse (Bath) (LD)]

Current average waiting times for eating disorders are 27 weeks, during which time the condition can become much worse. Will the prevention strategy look into concrete proposals to reduce waiting times, with, specifically, targets for waiting times for adult sufferers from eating disorders?

Autism and Learning Disability Training: Healthcare Professionals

Wera Hobhouse Excerpts

Monday 22nd October 2018 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

It is a real honour to follow the hon. Member for Sheffield, Hallam (Jared O'Mara), who defeated a colleague of mine at the last election. It is very powerful to hear from somebody who is directly affected. However, it is also a reminder to us all how difficult it is for an institution such as Parliament to be truly inclusive and to make sure that everybody who lives in this country has their voice heard.

I pay tribute to Oliver’s family, and I echo the cross-party agreement on this issue. I am the MP for their neighbouring constituency of Bath, and since Oliver was a member of Team Bath, I feel that he is very much part of the Bath family. I say to his family: your campaign will become my campaign.

There are often shocking misunderstandings or misconceptions about people who suffer from autistic spectrum disorder—ASD—or mental ill health, and I find that the two are mixed up in an alarming way. ASD is a learning disability, not mental ill health, and it is important that we separate the two. Mental ill health might be an additional diagnosis, and many people with ASD also suffer mental ill health, but they are not the same. Mental ill health is often a consequence of misunderstanding and isolation, and can be avoided if a person with autism is diagnosed early and treated accordingly. Early diagnosis is therefore crucial to addressing not only the issue itself but the mental ill health that might be a consequence of it. All too often, even once people have an ASD diagnosis, mental illness can be overlooked. The National Autistic Society estimates that mental illness is far more common in people with autism than in the general population.

The debate is focused on training for health professionals to diagnose and understand autism better. So far, the Government have done very little on that. The petition was created by Paula, who is here today, and we have heard powerful testimony about her son, Oliver. I do not need to go over all the details of that, but I understand entirely how the inquest’s outcome must have been devastating the family. Clearly, something went awry. Our laws and regulations are not fully clear about the proper training that should be given, but Paula is in the petition. Her son could possibly still have been here with us. All of us here are truly sorry, and we need to do something about it.

[Darren Jones (Bristol North West) (Lab)]

I rise as the Member of Parliament for Bristol North West, which contains Southmead Hospital: it was part of Oliver’s story, from which lessons need to be learned. Does the hon. Lady agree that the important point here is that we evidently have strong cross-party consensus; that we must now focus our efforts not just on debate and consultation but on achieving real change in the health service and our public services generally and right across our country; and that today’s debate gives us the impetus to do that?

[Wera Hobhouse]

I thank the hon. Gentleman for his intervention. I have said at another occasion today that the word “Parliament” comes from the French word “parler”, which means to talk, but we are also here to take action, so we must stop talking and take action. The issue of mandatory training is something that we can fix or determine here, and I very much hope that the Government will take that on board.

The urgent need for better training on autism and learning disability and the complications of the condition could not be shown more starkly than by the failings in Oliver’s case. In February, the charity Mencap launched the “Treat me well” campaign, which is aimed at transforming how the NHS treats people with a learning disability in hospital. In particular, women with a learning disability suffer disproportionately from health inequalities. We have heard the statistics today; they die on average 29 years before women in the general population, and men with a learning disability die on average 23 years before those in the general male population. That cannot be overlooked. We have also heard these figures today, but that does not matter—it will do no harm to repeat them: a YouGov survey conducted in 2017 found that nearly one quarter of the health professionals surveyed had never attended any training on learning disability, and two thirds wanted to have more training, so what are we waiting for?

Any illness or disorder that is either misdiagnosed or diagnosed late leads to far greater problems down the line. Early intervention depends on early diagnosis, and early diagnosis on training of those who come into contact with the sufferers. We are calling today for better training of healthcare professionals, which is an obvious start, but why not go even further? Let us look at the settings to which young people are exposed from an early age—namely, nurseries and schools. Given that ASD is so widespread, nursery nurses and teachers should receive at least some basic training to recognise the early warning signs. Far too little is being done. In my constituency of Bath, we have an autism board, but it rarely meets and has not even set up a work plan yet. Clearly, none of this is good enough.

ASD and learning disabilities can be successfully treated to give sufferers a full life. The earlier we diagnose the problem, the better the outcome. Many people with ASD also suffer from mental health problems, often as a consequence of not being diagnosed early enough. Let us end this tragedy. I fully support the recommendations that have been made, and I hope that we have the cross-party consensus to really do something quickly.

[Dame Cheryl Gillan (in the Chair)]

We now move to the Front-Bench spokesmen, and it gives me great pleasure to call Hannah Bardell.

Perinatal Mental Illness

Wera Hobhouse Excerpts

Thursday 19th July 2018 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

It is a real pleasure to serve under your chairship, Mr Davies. I congratulate the hon. Member for Stockton South (Dr Williams) on securing this excellent debate, which perfectly brings together my personal and political lives. I am a mother of four and, like the hon. Member for Canterbury (Rosie Duffield), I had them 20 years ago so I know what it feels like to have children completely outgrow me.

This issue does not go away. When I speak to mothers in my constituency, I know that the issue of perinatal health is as alive as when I was a young mum. Some things are getting better, but others are getting worse, particularly because of the time that health professionals can give to people who come to a surgery or the time that a health visitor can give to someone in their home.

I am here because I serve on the all-party group for the prevention of adverse childhood experiences. ACEs are well known in the United States, and the APPG is doing excellent work with the WAVE—Worldwide Alternatives to Violence—Trust. I also pay tribute to the #HiddenHalf campaign group, which came to the APPG the other day and specifically campaigned on the additional six-week check-up for mothers after childbirth.

Pregnancy, childbirth and the first year of a baby’s life is one of the most life-changing experiences in a woman’s life and her partner’s life. It is meant to be amazing, exciting and wonderful. All the folklore and our societal expectations are around how wonderful all that is. Actually, it is a time of profound change. In my experience, it is not only physical change, but mental change. Most women who have experienced pregnancy and childbirth will testify that a big mental change happens, too. All women are at a vulnerable point at that time in their lives. Apart from the physical exhaustion, there is the pressure to prepare and provide for another person’s life. All parents ask themselves how they will cope, how it will all work out, and whether they will love this new being.

While medical attention is focused on the physical health of the mother, the unborn child and, later, the born child, little medical attention is given to mental health during pregnancy and after birth. We are missing out on a vital aspect of health, with enormous consequences for the mother and the child. The APPG is concentrating on this particular issue: adverse childhood experiences and what affects a child’s health from the start.

We know how vital the first 12 months are for a new baby. An enormous amount of development is happening not only physically, but mentally and emotionally. If a mother is mentally unwell—for example, if she is depressed or suffering from anxiety—she will not bond properly with her newborn baby. She cannot give the baby the attention it needs, and the child will suffer. We know that a lack of attention during the first 12 months puts a child at a severe disadvantage for the rest of their life. To address that, they will require a lot more intervention later on, with a lot of extra resources. It therefore makes utter sense to focus our attention on a mother’s mental health before, during and after pregnancy. No woman can be expected to be in perfect mental health during those profound changes in her life. Even mild mental health problems can lead to much bigger problems, with severe consequences for mother and child.

I fully support the call for a six-week check-up in addition to that which already exists and which focuses mainly on the baby. The additional check-up should focus on the mother and her mental health. In my experience, I was never asked how I felt; I was expected to get on. If anybody had asked me, I would probably have cracked up and cried—and why not? It would have brought out that I felt utterly exhausted, inadequate and isolated. I felt that I was letting people around me down. I would probably have been reassured that that was normal, and people would have kept an eye on me.

We still do not know enough about mental health, but as with physical health, early detection and intervention are key. Sometimes symptoms go away on their own, but unlike with physical health, many people will not go back to their doctors if mental health problems do not go away. Those problems can fester and grow bigger. With a six-week check-up, we have a chance of early detection and early intervention. To conclude, let us ensure that all new parents receive the full support they need and deserve. It will be of great advantage to us all.

--- Later in debate ---

[Jackie Doyle-Price]

I thank my hon. Friend for being my conscience—we absolutely must not forget dad or partner, or for that matter the wider family. Members have expressed concern about the declining number of health visitors, and the beauty of having a health visitor is exactly the fact that they develop a relationship with the family and can talk to dad as well. Quite often, dad feels excluded from the process.

[Wera Hobhouse]

Valuable and important as that exchange is, the point about the #HiddenHalf campaign is that often attention is diverted away, because the baby and the dad are there. #HiddenHalf is looking for quality time for the mother in particular. I want that space to be preserved, however much is done by the GP. It is important that a woman who has gone through the trauma that the Minister described is able to feel, “Someone is just looking after me.” It is important to recognise that.

[Jackie Doyle-Price]

I agree and do not think the two points are in conflict. We need both—we need the wider package of support.

The theme we have been considering—of women not always being asked about themselves, and its being all about the baby—is not confined to the issue of perinatal mental health. Women face that across the board with respect to their health. The hon. Member for Worsley and Eccles South (Barbara Keeley) spoke about a women’s health strategy and women’s mental health. I co-chair a women’s mental health taskforce with the chair of Agenda, and in the coming weeks we will present our report on a year-long piece of work. It will have information about tools to enable the health service in general better to support women’s mental health. I am also doing more to raise the whole issue of women’s mental health, because I feel strongly that women are often disempowered in health settings. We need to give them the tools to take control of their own care and to feel empowered to engage in good conversations with medical professionals, to benefit their health.

We have heard anecdotal accounts of women’s experiences, and what has come across is the arrogant behaviour of some medical professionals. They see a large number of patients and they are not always sensitive to how best to communicate with certain individuals. We need that practitioner-patient relationship to work a lot better, particularly in the case of women. I am open to representations from everybody about what tool we can use.

The hon. Member for West Ham (Lyn Brown) is no longer in her place, but I have been impressed by her work on hysteroscopies with women. We are developing tools on that. I reassure all Members that women’s health and the way in which the national health service can better serve women are high on my agenda. I am not going to stand here and say that the world is perfect, but we have made perinatal mental health a priority in the five year forward view. We are midway through that review, so I should give Members an account of how far we have got and what more needs to be done.

To go back to 2010, the situation was really quite poor. Only 15% of localities had fully fledged specialist services in the community, and 40% of communities provided absolutely no service at all. People talked about a postcode lottery; clearly, we could not allow that to continue. We need to work towards universal provision. We are implementing the recommendations of the five year forward view for mental health taskforce, which reported in 2016. From 2015 to 2021, we are investing £365 million into perinatal mental health services. NHS England is leading a transformation programme to ensure that, by 2021, at least 30,000 more women each year are able to access specialist mental healthcare during the perinatal period. In May, NHS England confirmed that, by April next year, new and expectant mums will be able to access specialist perinatal mental health community services in every part of the country. We are making progress. The key to that is community provision.

Childhood Obesity Strategy: Chapter 2

Wera Hobhouse Excerpts

Monday 25th June 2018 Commons Chamber

[Steve Brine]

It was a pleasure to visit my right hon. Friend’s constituency to see how Bexley Council is using its power, money and public health grant—the council made it very clear to me that it would like more, and my right hon. Friend is a very good advocate on the council’s behalf—to bring forward a whole community response like the one I saw in Amsterdam. I would like to see much more of that in England.

[Wera Hobhouse (Bath) (LD)]

We have heard that obesity is caused not only by the wrong food but by a lack of exercise. Far too few children walk or cycle to school. Will the Minister engage with all our schools to make sure we have proper, realistic travel plans in place so that many more children walk or cycle to school?

[Steve Brine]

Yes. The Daily Mile happens when children are in school, but getting to school is important. I work with Sustrans, a charity, quite a lot in my constituency, as I am sure many Members do. It works to help children to cycle and scoot to school. That is very important, and the hon. Lady is right to raise it.

Oral Answers to Questions

Wera Hobhouse Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Hunt]

I sincerely hope so, because Scottish NHS patients are currently 30% more likely to wait too long for their elective care.

[Wera Hobhouse (Bath) (LD)]

What comparison has the Minister made of the cost of preventing children and young people’s mental health issues by tackling adverse childhood experience in the first few years of life, rather than letting them develop into much costlier issues for school-age children?

[Jackie Doyle-Price]

The hon. Lady will be aware that there is much work going on in this area. We are clear that we need to tackle these issues in schools, which is in the Green Paper, but more support also needs to be given in the early years. We are looking at how we can do that.

Oral Answers to Questions

Wera Hobhouse Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Speaker]

Some young people are mothers and do have mental health problems, upon which important matter the hon. Member for Faversham and Mid Kent (Helen Whately) has Question 19, which, sadly, will not be reached. If she wishes to give the House the benefit of her thoughts now, she is most welcome to do so, but it is not obligatory. [Interruption.] We will get her in later.

[Wera Hobhouse (Bath) (LD)]

Given that children of mothers with perinatal health problems are at much higher risk of developing mental health problems themselves, why does the Government’s Green Paper on mental health not address prevention in respect of perinatal health?

[Jackie Doyle-Price]

As I have said before, the proposals in the Green Paper on children and young people’s mental health were very much focused on what we were going to be delivering through schools. Alongside that, we have a very ambitious programme on perinatal mental health, where we are spending an extra £365 million on delivering both acute care and more support in the community. Today, I have just announced the second wave of that funding.

Mental Health Act: CQC Report

Wera Hobhouse Excerpts

Tuesday 27th February 2018 Commons Chamber

[Jackie Doyle-Price]

Clearly, if we can determine the causes of the increase in mental health detention, that will become part of the toolkit that we use to tackle the issue. This is one of the things that we are asking Sir Simon Wessely to look at. There are anecdotal examples of why this might be happening, but the fact that we are seeing higher rates of detention among the black community and among women raises some interesting questions that will bear further examination. I recognise my hon. Friend’s point completely. Good medical practitioners will use detention under the Mental Health Act only as a last resort, and we must ensure that that good practice is spread as far as possible.

[Wera Hobhouse (Bath) (LD)]

An acute mental health facility in my constituency has been forced to close because refurbishment would be too expensive, and patients are forced to travel a long way outside Bath. Is not a local facility much better suited to treating mental health problems than a facility that is many miles away, particularly because carers are a long way away as well?

[Jackie Doyle-Price]

Generally, I would say that local facilities were better, but there is also a tension between a local facility and a good facility. It is better that patients should get the best possible support rather than the closest possible support to them. That is a balancing act, and it is something that needs to be determined by local commissioners.

NHS Continuing Care

Wera Hobhouse Excerpts

Monday 27th November 2017 Commons Chamber

[Norman Lamb]

I am aware of that. Often there is no change in such people’s condition, but sometimes their condition deteriorates. Sometimes the cost is pushed on to the local authority, but sometimes it is pushed on to the family, which is another very serious concern.

There are also a great many complaints about the process that is used. There are complaints about evidence being ignored, which can result in a judgment that someone is ineligible for NHS continuing care, and about professionals lacking an understanding of the condition that they are supposed to be considering. A survey conducted by the Continuing Healthcare Alliance found that 66% of people felt that professionals knew little about the condition that was under consideration. More seriously, there were allegations that medical opinions were being ignored. The BBC heard from three health workers who revealed, effectively as whistleblowers, that medical opinions were actively ignored as part of the process.

[Wera Hobhouse (Bath) (LD)]

It took one of my constituents several months and many phone calls even to receive an assessment for her relative. When she finally managed to receive it, the nurse on the day said that it was unlikely that continuing healthcare would be provided. Does my right hon. Friend agree that treating relatives in such a way when they are already going through a very difficult emotional time is unacceptable, and that staff should be given training before undertaking such assessments?

[Norman Lamb]

I do agree. The problem is compounded by the long delays that people have to face, often at very stressful times when they are wondering whether they will have to sell a home to pay for care and have no idea what the outcome of the process will be.

There are a number of cases around the country in which the costs of packages have been capped, with top-ups required from relatives. A growing number of clinical commissioning groups are applying a cap to what they will pay for home support packages above the cheapest care home alternative. That is really insidious. At the extremes, it is reasonable to recognise the pressures on public finances but, as the BBC reported on “You and Yours”, 19 CCGs refused to pay for home care packages if the costs were 10% higher than the costs of a care home. There are many cases in which couples who may have been married for decades are suddenly forcibly separated. What are we doing? That is inhuman, and, as I have said, it breaches a human right—the right to a family life.