|
Most recent appearances
- May 20, 2013:
- Social Services | Health | Written Answers
To ask the Secretary of State for Health with reference to his statement of 11 February 2013, Official Report, column 593, on social care funding, if he will publish the evidential basis for his statement that up to 100,000 more people will receive financial support with their care further to the implementation of a cap on care costs.
- Social Services | Health | Written Answers
To ask the Secretary of State for Health with reference to his Department's analysis of public expenditure on care and support by wealth quintile of care users (2012-13 prices); if he will place the data from which the graph was generated in the Library.
- May 16, 2013:
- Mental Health | Commons debates
I thank the Backbench Business Committee again for enabling us to have the debate. I also thank those on both Front Benches, my hon. Friend the Member for Broxbourne (Mr Walker) and the hon. Member for Bridgend (Mrs Moon), and every other Member who has either intervened in the debate or contributed directly.
Today's debate on mental health, like last year's, has created and elevated a sense of hope. It has made it clear that there is a real commitment across parties in the House to do better and to do more: to enable people to gain access to the right care, at the right time, in the right place. That means starting early. It means starting in our schools. It means ensuring that when there is a crisis, we have an emergency service that is as good as our physical emergency services. I welcome what the Minister has said about that today.
A number of Members have suggested that this should become an annual debate. Clearly Parliament needs to hold the Government and the NHS Commissioning Board to account on these issues, and it would be good if we could find time every year to see just how much progress has been made.
It has been very interesting for those of us who follow Twitter to see just how many people have been tweeting about the debate. It has already extended well beyond the confines of this place, and that is to the good. I am pleased that so many Members have taken part, and I am very grateful to them. I hope we will eventually reach a place where there is no health without good mental health.
Question put and agreed to.
Resolved,
That this House has considered the matter of mental health.
- Mental Health | Commons debates
That is a welcome announcement from the Minister about achieving parity of esteem in emergency and crisis care. However, in the wake of the Francis inquiry, which rightly drew our attention to serious
patient safety and dignity issues in our physical health care system, I suspect that we will need to ensure that we are not distracted or led into not addressing the same issues-which clearly exist-in our mental health systems.
- Mental Health | Commons debates
Thank you, Mr Deputy Speaker. I was looking at the time and at my notes and thinking that I should conclude so that other hon. Members can contribute fully to the debate.
My final point concerns the power of data and the difference they can make. Will the psychiatric morbidity survey, which is due to be repeated in 2014, be repeated? I draw attention to the value of the cancer intelligence network, which has demonstrated the power and effectiveness of nationally co-ordinated data. Given that, as I have said, mental health accounts for 23% of the total disease burden in this country, it really would make sense to have a mental health intelligence network to bring together all the relevant data. I hope the Minister will address how that might be achieved.
In conclusion, estimates put the cost of mental health in England, Scotland and Wales at £116 billion, but the right combination of public health, sustained effort to tackle stigma, easy access to psychological therapies for all ages, and good community and crisis care could make a huge difference to that figure. More importantly, it could deal with and reduce the suffering experienced by people with mental problems as a result of our past failures. I hope the Minister will respond positively to this debate, and I am grateful to the other Members who wish to take part in it.
- Mental Health | Commons debates
- Mental Health | Commons debates
The hon. Gentleman makes a good point. Indeed, that has been part of the approach taken in the talking therapies strategy, which is about moving the resource to where it will make the most difference at an earlier stage, and helping to promote recovery in the first place.
The Minister said that the emergency service is a stark example of where parity of esteem has not been achieved, and I want to give another example. The Royal College of Psychiatrists and its president, Sue Bailey, have been looking, on behalf of the Department of Health, at the whole issue of parity of esteem and what practical steps could be taken to address it, and it has recently published work on that. How can it be right, for example, that a recommendation by the National Institute for Health and Clinical Excellence on the availability of a drug is a must-do for the NHS but a NICE recommendation on the availability of therapies is not? This means that evidence-based non-pharmacological treatments that are clinically effective and cost-effective are often left unimplemented. I hope that that bias will soon be brought to an end.
The same can be said for access standards. There has rightly been uproar when even small changes occur in the amount of time people wait to attend accident and emergency departments. NICE has said that a person experiencing a mental health crisis should be assessed within four hours, yet only one in three people is so assessed. I am puzzled by the decision not to set a 28-day access standard for therapy, because the NHS constitution should embody parity of esteem, and that is a tangible way it could do so. Having said that, I take heart from albeit a footnote in the revised NHS constitution handbook, which said:
"The Mandate indicates that we will consider new access standards, including waiting times, for mental health, once we have a better understanding of the current position. We need to do this work and consider carefully the implications of introducing any new standards, before we can make any firm commitments in this area."
Why on earth is this problem still not being understood? Why do we need yet more reviews? Will the Minister give an indication of the time scale?
- Mental Health | Commons debates
I am grateful to the Minister. Perhaps in his own speech he can say a little more about how we might better incentivise this change. Despite the compelling economic and medical benefits, these services are still not being provided widely enough.
- Mental Health | Commons debates
I note that the Minister paid close attention to that intervention and I am sure the hon. Gentleman will enjoy the exchange of correspondence on the matter.
I want to discuss the health care aspects of parity of esteem. Curiously, not all general hospitals have 24/7 access to a mental health liaison service offering immediate support, yet we know that when that works well it can make a big difference to the quality of care, help to reduce the length of stay in hospital, especially for older people, and generate savings four times greater than the cost of running the service. There are good examples of where this has been done, particularly in Birmingham, and it is odd, given such obviously compelling evidence, that it has not yet been taken up more widely.
- Mental Health | Commons debates
I will give way one last time, but then I really must conclude.
- Mental Health | Commons debates
Yes, and that issue, which I know is of concern to Members on both sides of the House through their constituency casework, for example, was raised in last year's debate. Although some steps have been taken to try to improve those processes, they still do not seem to me to capture fully the important differences in dealing with mental health and, as a result, can exacerbate mental health problems. There is more to do in that area and I look forward to the Minister picking up on that issue. Given that the Cabinet committee that had co-ordinating responsibility for the mental health strategy, which is a cross-government strategy, is no longer in place, I wonder how tackling those sorts of issues will be co-ordinated in future.
It is worth noting that there are a considerable number of working-age people with a history of schizophrenia, for example, who are able and-I stress this point-willing
to work. Indeed, Rethink's schizophrenia commission identified employment rates in that group as being about 8%, with a range of 5% to 15% across the country, compared with the obviously much higher rates for the general population. Individual placement and support schemes, which are some of the most effective forms of employment support for people using mental health services, really can achieve remarkable transformations in people's ability to take up employment. I hope that the Minister can say something on how such issues are being addressed with DWP colleagues, because that is where a cross-government strategy really should be making a difference, rather than simply addressing direct NHS provision.
- Mental Health | Commons debates
I entirely agree. That is one reason why the Government have committed to the talking therapies service for children and young people that has so far been rolled out. I am meeting head teachers in my constituency tomorrow to discuss how we can ensure that they commission the right mix of services to support children and young people, not least because conduct disorders, for example, cost society hugely and hold young people back from realising their potential, academic or otherwise. That is undoubtedly the case with integration, which is a key theme of tackling these issues more effectively. That is why I welcome the fulfilment of the commitments made in last year's care and support White Paper, which my hon. Friend the Minister announced earlier this week, regarding integration pioneers and the new integration framework.
Work on mental health must be embedded in physical health services, which must be embedded in mental health services. When we consider that people with severe mental illness die, on average, 20 years younger than the rest of the population, and that that is due mostly to physical health problems, we begin to understand just how profound that diagnostic overshadowing of mortality can be. It is a scandal and it needs to be addressed. I am delighted that the Government are taking many steps to tackle it.
- Mental Health | Commons debates
The hon. Gentleman makes an important point about the need for a greater focus on well-being. It is one of the reasons why I am so pleased that the Care Bill which was introduced in the House of Lords last week has as its first and clear mission for our social care system the promotion of well-being, and it goes on to stipulate what that means in practice. It is about control and people's ability to lead ordinary lives-the lives they want to lead in their communities. That must be at the heart of an approach to mental health that sees the whole person, rather than trying to treat them in constituent parts of the presenting conditions.
The point about failure to join up services is key. All too often, long-term physical health problems overshadow mental health problems. The results of that are all too clear-slow, and in some cases no, recovery and people living with long-term physical health problems that could have been better treated in the first place. The cost in wasted resources in our national health service is about £10 billion a year and up to a further £3 billion on medically unexplained symptoms.
- Mental Health | Commons debates
Yes, I am concerned. The picture is complex. The figures show that spending on adult mental health services over the past couple of years overall has reduced by about 1%, which is not good, but deeper analysis of those figures shows that about half of commissioners have increased their investment and the other half have reduced their investment, so the picture is more complex than it first appears. None the less, it is concerning that services are being withdrawn where they involve providing peer support or reaching into harder-to-reach communities, particularly black and minority ethnic communities, which often get left behind and often are most prone to being subject to the most coercive parts of our mental health system. So I agree with what the hon. Gentleman said.
In the debate last year I was delighted to be able to signal the Government's support for the Mental Health (Discrimination) (No. 2) Bill, which was introduced by my hon. Friend the Member for Croydon Central (Gavin Barwell). It is a rare thing-as we heard earlier in the business statement, only about 10 Bills last year which were introduced as private Members' Bills made it on to the statute book. It was great that that Bill made it on to the statute book, and I congratulate my hon. Friend and all those involved in taking it forward.
I have referred to the mental health strategy for which I had some responsibility. At its heart is the radical-I might even say revolutionary-idea that there should be parity of esteem between physical and mental health. That idea is gathering momentum. We have seen the Government place that notion in the mandate for NHS England as a driving force for the way the Commissioning Board takes its responsibilities forward. It is increasingly on the lips of policy makers and service commissioners. But the recognition that there are critical interdependencies between physical and mental health still has a long way to go.
There are more than 4.6 million people in this country living with long-term physical and mental health problems, and far too often their experience of the NHS is that they are broken down into their constituent diseases, rather than being treated as a whole person. As a result, their physical health needs are treated in one place-in many cases, in many places-and their mental health needs, if they are identified at all, are dealt with in another.
- Mental Health | Commons debates
I am grateful to the hon. Gentleman for that question. He is absolutely right that access to talking therapies-begun as a result of Lord Layard's initiatives before the general election, which the coalition Government continued to support and which is being rolled out-is very important in enabling people to recover socially, get back into work and get on with their life. At the best performance rates, as many as half the people that go through talking therapy services recover, and that can make a huge difference to them, their families and the figures I was talking about earlier. I shall return to the subject of talking therapies in a moment.
Last year I took part in the debate from a slightly different position-I spoke from the Dispatch Box. I was able to report some important progress. We had a new mental health strategy. We had the continued roll-out of talking therapies, which the hon. Member for Harrow West (Mr Thomas) just asked about. Groundbreaking work was being done to reinvent child and adolescent mental health services from the inside out, to offer access to talking therapies for children and young people. We had the flowering of a new movement to establish social recovery as a goal for mental health, with the establishment of recovery colleges channelling the lived experience of mental illness into practical learning and skills, and resilience to enable people to get on with their lives.
There was the good news that the Government had backed financially the task of Time to Change, the charity sponsored by Rethink and Mind, really motoring to tackle issues of social stigma in our country. Reports since then show that the first phase of that programme has materially altered public views about mental health in this country, but the programme needs to be sustained.
- Mental Health | Commons debates
I certainly would. The fact that a large number of hon. Members are present, hoping to contribute to the debate, that the Backbench Business Committee advocated the debate, and that the Government have given the time suggests there is cross-party consensus that mental health has for far too long been hidden in the shadows and not awarded sufficient priority. The cost to our society of mental ill health across England, Scotland and Wales amounts to over £116 billion a year, but that does not adequately capture the human cost-the misery-that arises from it. Given that the burden of mental ill health is about 23% of the burden of all disease in our country, it is surprising that for so many years it has not been tackled with the necessary vigour. So I agree absolutely with the hon. Lady.
- Mental Health | Commons debates
I beg to move,
That this House has considered the matter of mental health.
There can be no health without mental health, and, above all else, I hope that today's debate communicates that clearly and powerfully in the country and in this House. I start by thanking the Backbench Business Committee for recommending this most important of subjects for a debate, and the Government for finding the time to make it possible. Undoubtedly, there is a lot to debate on mental health, and I am grateful to my two colleagues-one on either side of the House-who have joined me in seeking this debate. I refer to the hon. Members for Bridgend (Mrs Moon) and for Broxbourne (Mr Walker), who hope to catch your eye, Mr Speaker, and contribute as we proceed.
Last year the House had a remarkable, moving debate on mental health, which was very personal for some hon. Members. It demonstrated that mental health is not an issue of "them and us", but affects all of us. One in four of us may experience a mental health problem at some point.
- May 13, 2013:
- Health and Social Care | Commons debates
When the right hon. Gentleman chaired the Health Committee, it published the report that led to the banning of smoking in enclosed public places. That ban was only secured by a free vote in this House. Does he agree that, if we cannot get the Government to act, we need a free vote so that we can make the change in that way?
- Health and Social Care | Commons debates
The hon. Lady is making important points about carers-an issue on which she has campaigned consistently. Would she join me in welcoming the announcement from the Royal College of General Practitioners over the weekend about the priority it wants attached to carers and the guidance it is now issuing to GPs to ensure that they do more? One in 10 of a typical practice's patients are carers, so they could do a great deal more by identifying them.
- Health and Social Care | Commons debates
I will try to do that in the one minute and 14 seconds left to me.
The ADASS survey paints a quite disturbing picture of the next two years. More providers will face financial difficulties and there will be increasing pressures on the NHS as social services shunt people into health care services.
The spending review that is under way is for just 12 months. It needs to fund the successful implementation of this legislation, and not least the introduction of the Dilnot proposals. More than 450,000 people will need assessments to get into the new system. The spending review also needs to sustain the transfers of money from the NHS to social care. Beyond that, the spade work needs to be done now to make the case for the critical interdependencies between social care and health that will sustain our social care system and make our health system deliverable and affordable.
The Queen's Speech, with its specific commitment to this legislation, contains a landmark reform that will do a great deal to improve the quality of life of our constituents.
|
