Eating Disorders Awareness Week

Debate between Wera Hobhouse and Jackie Doyle-Price

Wednesday 27th February 2019 Westminster Hall

[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)).

Perinatal Mental Illness

Debate between Wera Hobhouse and Jackie Doyle-Price

Thursday 19th July 2018 Westminster Hall

[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.

Oral Answers to Questions

Debate between Wera Hobhouse and Jackie Doyle-Price

Tuesday 19th June 2018 Commons Chamber

[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

Debate between Wera Hobhouse and Jackie Doyle-Price

Tuesday 8th May 2018 Commons Chamber

[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

Debate between Wera Hobhouse and Jackie Doyle-Price

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.