Dr Rosena Allin-Khan (Tooting) (Lab) I beg to move, That this House
notes with concern the scale of the mental health crisis facing the
country with patients suffering with mental health issues waiting
more than 5.4 million hours in accident and emergency last year;
further notes with concern the mental health crisis facing young
people with nearly 400,000 children currently waiting for
treatment; recognises the health inequalities within the use of the
Mental Health Act...Request free trial
(Tooting) (Lab)
I beg to move,
That this House notes with concern the scale of the mental health
crisis facing the country with patients suffering with mental
health issues waiting more than 5.4 million hours in accident and
emergency last year; further notes with concern the mental health
crisis facing young people with nearly 400,000 children currently
waiting for treatment; recognises the health inequalities within
the use of the Mental Health Act 1983; and calls on the
Government to adopt Labour’s plan to recruit thousands of mental
health staff to expand access to treatment, to provide access to
specialist mental health support in every school, to establish
open access mental health hubs for children and young people and
to bring in the first ever long-term, whole-Government plan to
improve outcomes for people with mental health needs.
After 13 years in office, this Government have delivered the
worst mental health crisis in our history. We are becoming a
brittle, anxious, fractious society, the very bonds of which are
frayed and torn. The causes of mental ill health are complex:
poverty, homelessness, neglect, loneliness, debt, bereavement,
domestic violence and child and adult trauma. Our understanding
of mental health is developing all the time. We have moved on in
the years since I trained as a doctor. We can now see how
interlinked and enmeshed the range of factors is: warm and safe
homes, fulfilling work, strong relationships, safe streets,
opportunities to learn, fresh air and green spaces are policies
for good mental health.
Nye Bevan talked about the serenity in knowing that medical care
is free at the point of need. After 13 years of Conservatives, we
are far from serene. For many of the families I meet, the future
is filled with dark clouds, fear of displacement and debt, and a
sense that society is going to hell in a handcart—a Britain where
nothing works, where everything is broken and where everything
costs more than six months ago. Zero-hours contracts, boarded up
high streets, rapacious landlords, rising lawlessness and
antisocial behaviour and the long-term effects of covid—no wonder
we are in the grip of a mental health crisis.
(Chesterfield) (Lab)
I am very pleased with the way my hon. Friend has started her
speech, because she is absolutely right. Alongside the additional
healthcare staff needed and the many measures that my hon. Friend
the Member for Ilford North () and I have been spelling out for the health
service, the society that has been created over the past 13 years
of austerity has had massive impact on the mental health crisis.
I am glad that my hon. Friend has focused on that. It will be the
job of the entire future Labour Government to support her and her
colleagues to reduce the mental health crisis.
Dr Allin-Khan
I thank my hon. Friend for his intervention; he is right. I will
talk about the need for mental health not to exist in a silo
later in my remarks. Frankly, it is the problem of every single
Government Department.
One in four people experiences a problem with their mental health
each year in England. One in six people experiences a mental
health condition, such as anxiety or depression, each week. Three
in four people with mental ill health in England receive little
or no treatment for their condition. And people with the most
severe mental illnesses die up to 20 years sooner than the
general population. I ask the House to reflect on that for a
moment. Tragically, in 2021, over 5,000 suicides were registered,
up by 300 on the previous year. The Government should wear these
statistics like a badge of shame.
(North West Leicestershire)
(Reclaim)
The shadow Minister makes an accurate assessment of the size of
the mental health crisis facing our nation, but her words would
have more resonance if she and her party had not voted in
lockstep with the Government for the disastrous lockdowns that
damaged mental health, especially that of our young people. Will
she apologise?
Dr Allin-Khan
I will take no lectures from the hon. Member, because he proudly
sat as a Member of a Government who oversaw hundreds of thousands
of unnecessary deaths. Families are still feeling the ongoing
mental effects of losing loved ones because of the mishandling of
the pandemic by his then Government.
My right hon. and learned Friend the Member for Holborn and St
Pancras (), the Leader of the
Opposition, launched Labour’s mission for health in May. He
said:
“Suicide is the biggest killer of young lives in this country,
the biggest killer. That statistic should haunt us, and the rate
is going up. Our mission—must be and will be—to get it down.”
He is right. Across the House, we are increasingly hearing brave,
moving and revealing testimonies about our own experiences and
struggles. It is vital that we challenge the stigma and talk
openly about mental health.
(Liverpool, Walton) (Lab)
My hon. Friend and I have worked on these issues over the last
couple of years. She knows that 70% of people who enter treatment
for alcohol issues also experience trouble with their mental
health. The Public Accounts Committee recently released a report
on alcohol treatment services, and recommendation 4 called on the
Government to set out, without delay
“what it is doing to help improve integrated care for people with
co-occurring alcohol and mental health problems.”
Will she use her position today to encourage the Government to
act on that recommendation?
Dr Allin-Khan
I could not be more proud to work with my hon. Friend in this
space. He is a powerful advocate and I wholeheartedly support all
his efforts, and those of Members across the House, to support
people who are living with alcoholism, and their families. I
thank him; we will continue to support his work.
(Strangford) (DUP)
I commend the shadow Minister and the Labour party for bringing
this issue forward. Support for mental health across this great
United Kingdom of Great Britain and Northern Ireland is a massive
issue, including in my constituency. For example, one of my
constituents told me they finally found the courage to seek help
for their mental health, only to be told by health professionals,
“We can’t do anything for you just now as your condition is not
severe enough yet—you have no thoughts of suicide.” Does the hon.
Lady agree that supporting those with mental health issues at the
earliest stage—right away—is more beneficial, instead of forcing
them to wait until it may be too late? At that stage, the
situation cannot be turned back.
Dr Allin-Khan
I thank the hon. Member; it has been a pleasure to work with him
in every single debate about mental health that I have held in
the past three years, since I started my role. He speaks to the
important point that prevention is the watchword that counts when
it comes to mental health.
(Lewisham East) (Lab)
My hon. Friend is making a powerful speech. Does she agree that
the Government are failing people who are experiencing mental ill
health, or even a mental health crisis? Psychiatrists are leaving
the country because they are finding jobs overseas more
accessible. People experiencing mental health crises are having
to wait in A&E departments for too long; they waited for a
total of 5.4 million hours during 2021, which is entirely
unacceptable. Things need to change.
Dr Allin-Khan
I thank my hon. Friend for assisting me in writing my speech; she
has pre-empted much of what is to come. She is a powerful
advocate for her community and I am proud to share the Opposition
Benches with her.
(Newbury) (Con)
On that point, will the shadow Minister give way?
Dr Allin-Khan
I will make some progress, but I would be happy to take further
interventions after that.
Amid all the anguish and pain, one thing comes through: people
cannot access the mental health services they need. The stark
fact is that the way the UK’s mental health services are funded
and distributed can exacerbate the problem, so instead of making
people better, they are making them worse.
The current reality is that 1.6 million people are waiting for
treatment. More than 1 million people had their referral closed
without receiving any help in the last year alone. Last year,
children in mental health crisis spent more than 900,000 hours in
A&E and almost 400,000 children are on waiting lists. In the
same period, adults experiencing a mental health crisis spent
over 5.4 million hours in A&E. Black people are five times
more likely to be detained under the Mental Health Act 1983 than
white people. People with eating disorders are being put on a
palliative care pathway.
(Runnymede and Weybridge)
(Con)
Will the shadow Minister join me in welcoming the work the
Government have done to bring forward the draft Mental Health
Bill? We both sat on the pre-legislative scrutiny Committee.
Hopefully, the Bill will right some of those wrongs.
Dr Allin-Khan
It has been a pleasure to work with the hon. Member on the draft
Mental Health Bill. However, as I will say later in my speech, I
have little confidence that the draft Mental Health Bill will
move beyond the draft stage. We need to debate the issues in the
House, to ensure that what we know needs to be fixed is actually
fixed, so that we can help people in our communities, including
black people, who are more likely to be detained under the Mental
Health Act, and people with autism and neurodiversity, who are
mistreated simply as a result of having that diagnosis, so that
their lives can be better lived. We need these issues to come
before the House, so that we can debate them and move
forward.
(Manchester, Withington)
(Lab)
My hon. Friend is making an important point about the demand on
A&E, but there is demand on other public services as well.
When I have been out with the police in south Manchester, I have
been shocked by the sheer amount of time they spend dealing with
people in mental health crisis. I am sure we all know the amount
of time our staff spend dealing with people in mental health
crisis. Does she agree that it is a false economy not to invest
properly in mental health services, because of the impact on
other public services?
Dr Allin-Khan
My hon. Friend makes a powerful point; he is right. It is also a
false economy because of the impact mental ill health has on
families. Not investing in one person’s mental ill health not
only has an impact on their working and earning potential, but
has a knock-on impact on that of their parents, siblings and
other family members. People are currently sitting at home on
suicide watch for their children because they cannot get access
to the timely help and treatment they need. This is Tory
Britain.
What has been the response from the Government to these alarming
facts? Ministers have junked the 10-year mental health plan and
binned thousands of responses to the consultation. Seni’s law,
set out in a private Member’s Bill introduced by my hon. Friend
the Member for Croydon North (), passed unanimously, but it has
not been fully implemented. It was passed almost five years ago
and there have been three subsequent Ministers, and yet we are in
the highly unusual situation where it has not been commenced in
full. Who exactly is against the monitoring of the
disproportionate use of force? The House certainly was not
against it when the Bill was passed.
The Government have announced plans for new mental health
hospitals, but those new hospitals are not new. The hospitals
announced on 25 May—Surrey and Borders, Derbyshire and
Merseycare—were already in the pipeline.
Let us talk about the Minister’s own patch, to really see the
scale of the issue. At his closest hospital, adults experiencing
a mental health crisis waited 11,000 hours in A&E last year.
There are over 5,000 children and 40,000 adults stuck on mental
health waiting lists across his integrated care board. Thousands
of local people were turned away from services before treatment;
I am sure the Minister will agree that that is unacceptable. As
ever, we have smoke and mirrors when we need bricks and mortar.
If this seems bleak, that is because it is.
(Wirral West) (Lab)
My hon. Friend is making an excellent speech about a very
important issue. One of my constituents who works in psychiatric
care has talked of staff having to deal with violence, verbal
abuse, being swilled with boiling water and more. He says that
they are under extreme pressure, which is causing some to leave
and putting more pressure on those who remain. Does my hon.
Friend agree that that is a shocking and unsustainable state of
affairs, and that we need a Labour Government who will invest in
mental health services?
Dr Allin-Khan
I entirely agree with my hon. Friend, who works tirelessly on
this issue.
After more than a decade of Tory Governments, if people need
help, all too often no one is there. Last year, emergency service
workers took more than a million sick days because of stress. NHS
staff are at the sharp end of this mental health crisis. I know
them, I work with them, and I see what they are coping with
daily. They are heroes, but they simply do not have the
resources, the staff or the leadership from Ministers that would
enable them to do their jobs. They themselves suffer exhaustion,
depression, stress and anxiety. About 17,000 staff—12% of the
mental health workforce—left last year.
You will be pleased to know that I have had a look at the
Government’s amendment, Mr Speaker—I do my homework. There is the
tired old £2.3 billion figure. How many times have we heard that
trotted out? Actually, I can tell the House that it has been used
more than 90 times over five years, and it has been spent in
myriad different ways. Then there is the £150 million for mental
health crisis units. But the amendment fails to mention the
serious patient safety concerns that doctors have raised, and it
is clear that the pressure on A&E remains as fierce as ever.
There is also nothing about the recent announcement from the
Metropolitan police that they will not help people in a mental
health crisis.
Ministers need to get out of Whitehall and see what is really
happening in our mental health service. If they did so, they
would see what I have seen in recent months. They would see the
junior psychiatrists whom I met recently—junior doctors who have
devoted all their training to this profession, and half of whom
plan to leave the NHS at the end of their training. They would
see the doctor who told me of an incident in which six police
officers were in A&E for 18 hours with a patient detained
under section 136 of the Mental Health Act 1983. They would see a
child arriving at A&E after self-harming, having been
referred by the GP a long time ago but not been seen for weeks,
which led to an escalation point and a crisis in A&E. We are
seeing a system in crisis, people in pain and families in
distress.
(Twickenham) (LD)
The shadow Minister has referred several times to children’s
mental health and the crisis that often occurs when they present
at A&E departments. Does she agree that schools have an
important role to play when children have moderate mental health
conditions, before those conditions escalate? The role of mental
health support teams in schools is critical, but their funding is
due to end abruptly next year, with only about half the programme
complete. Will she join me in asking the Minister to commit
himself to funding the full roll-out of mental health support
teams or, better still, to back the Liberal Democrats’ plan to
provide a qualified mental health practitioner in every
school?
Dr Allin-Khan
I invite the hon. Member to have a look at the plans we already
have in place. She will be pleased to learn that one of our
pledges is the provision of a mental health specialist in every
school. I invite her to support those Labour plans—and to come
and join us over here if she feels like it.
(Plymouth, Sutton and
Devonport) (Lab/Co-op)
Young people are bearing the brunt of the mental health crisis,
and parents are worried sick. I see evidence of that every day in
my inbox, and it is getting worse. When so little money is being
spent on young people’s mental health, even though we know that
the vast majority of mental health conditions appear in people
under the age of 18, is the balance right between the money spent
on adult mental health and that spent on young people’s mental
health? If we want a preventive system that helps to cut costs
for the taxpayer and helps people as well, is not investing early
in young people the best way to achieve that?
Dr Allin-Khan
My hon. Friend is spot on in making the point, very articulately,
that prevention is our watchword. It is vital that we have mental
health access hubs in every community to give people the support
that they need; it is essential that we have mental health
specialist support in every school; and it is essential that
mental health does not operate in a Health silo, because when it
comes to improving adverse childhood experiences that can lead to
poor mental health in later life, that is every Department’s
issue.
I have asked Ministers six times to tell us of their meetings
with mental health trusts where there are reported abuse
scandals, but they have failed to respond. In-patient services
across England must be reviewed, with patients’ voices at the
centre. After a series of allegations in different settings, the
Government have dragged their feet, and we are still waiting for
the findings of their data exercise, in which no one even spoke
to families or patients. They could start by giving statutory
powers to the inquiry into deaths in Essex mental health
units.
What else needs to change? First, we need to speed up diagnosis
and treatment. The longer we leave a mental health disorder
untreated, the worse it gets—just like cancer, sepsis and heart
conditions. Delays cost patients their wellbeing and their
families their peace of mind, and of course it costs the taxpayer
more to treat a patient who is more acutely unwell after months
and years of delay. The argument for prevention, early
intervention, speedy diagnosis and timely treatment is clear.
Labour will guarantee treatment within a month for all who need
it, which will be better for patients and better for the NHS.
Secondly, we need a tough new target for delivery—something for
the whole system to drive for, and something for the voters to
judge us on. Labour will recruit 8,500 new staff, so that 1
million more people can access treatment every year by the end of
Labour’s first term in office.
Thirdly, we will reach out to our young people, and give the next
generation the support that they desperately need. This is the
generation who have known little or no security: children who
have gone through the great financial crash, austerity and covid,
robbed of their future and dismissed as snowflakes. We will open
a mental health access hub for children and young people in every
community, providing early intervention and drop-in services, and
we will provide access to a mental health professional in every
school. This is a true community, preventive approach in
action.
Fourthly, we will stop mental health policy being placed in a
silo. As I said at the beginning of my speech, mental health
policy cannot be disentangled from social and economic policy. A
decision on Bank of England interest rates takes its toll on the
mental health of a family in Tooting. We are all interconnected.
The economy is not an abstract concept; it is people. The next
Labour Government will present a long-term, whole-Government plan
to improve mental health outcomes—mental health in all
policies.
Fifthly, Labour Ministers will allocate to mental health its fair
share of funding, as the economy grows and as resources allow.
For starters, we will close tax loopholes, putting the country’s
mental health first. That is our plan and, crucially, it will not
be solely the responsibility of the incoming new mental health
Minister; it will be the responsibility of the whole Cabinet and
the whole Government.
We have seen enough plans, we have heard enough announcements,
and we have watched enough Ministers pass in and out of the
revolving doors of 39 Victoria Street. Let us have no more Tory
sticking plasters. Labour’s health mission, guided by prevention
and anchored in community, gives children the best start and
boosts the economy, with more people in better health. With a
clear plan, with clear costings and with resolute leadership, we
will deliver the world-class health system that our society truly
deserves.
1.09pm
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O’Brien)
I beg to move an amendment, to leave out from “House” to the end
of the Question and add:
“notes the increased burden on mental health following the
pandemic, including on young people and those with severe mental
illness; recognises the historic levels of investment being
delivered by this Government into services, with an increase of
£2.3 billion per year in front-line mental health funding over
the past four years; notes that current NHS targets around access
to talking therapies and intervention in psychosis are being met
due to the efforts of NHS staff; and acknowledges the investment
in mental health teams in schools, as well as the ongoing
investment into open access mental health helplines in the 111
service and into the estate, including three new mental health
hospitals to be opened in the next two years accompanied by a
further £150 million in investment in new mental health
ambulances and the development of better alternatives to accident
and emergency services, including crisis houses, safe havens and
step-down services.”
Improving mental health is a top priority for this Government. We
can all agree that in the past it was not given the priority it
deserves, and was seen as something to be ashamed of and not
spoken about. Thankfully, we are changing that. We are working to
achieve parity of esteem between physical health and mental
health, with record amounts of investment going into NHS mental
health services in England, and the stigma surrounding mental
health is being reduced.
“The Five Year Forward View for Mental Health”, which was
published in 2016, was a major step forward and secured an
additional £1 billion in funding for mental health, so that an
additional 1 million people could access high-quality services by
2020-21. It was followed by the NHS long-term plan in 2019, which
committed an additional £2.3 billion a year for the expansion and
transformation of mental health services in England by 2024, so
that an additional 2 million people could get the NHS-funded
mental health support that they need. It is also funding the
increase in the frontline mental health workforce to meet the
plan’s ambition for 27,000 additional mental health staff by
2023-24. There were 138,610 full-time equivalent mental health
staff at the end of 2022, an increase of 8,900 on the previous
year and of 20,700 on December 2010, so the mental health
workforce in the NHS is radically bigger. In total, we spent
around £3 billion more on mental health last year compared with
four years ago. That is an increase of a quarter.
Backed by this huge investment, we are expanding access to NHS
talking therapies for adults to meet the long-term plan’s
ambition for an additional 1.9 million people to access National
Institute for Health and Care Excellence-approved treatments for
conditions such as anxiety and depression. From starting small in
2008, around 1.2 million people are now accessing NHS talking
therapies every year, with 98% waiting less than 18 weeks for
their treatment and 90% waiting less than six weeks. This means
that we are delivering well over our national waiting time
targets of 95% and 75% respectively.
Local mental health services are transforming community mental
health care to give 370,000 adults and older adults with severe
mental illnesses greater choice and control over their care and
to support them to live well in their communities. We recognise
that poor mental health is a major cause of sickness absence in
the workplace and we are providing support to employees and
employers on mental health in the workplace. We have announced
additional measures to support workplace mental health, including
a package to support the long-term sick and disabled to remain in
or return to work. This includes £200 million for digital mental
health to modernise NHS talking therapies, to provide free access
to wellness and clinical mental health apps for the population,
and to pilot cutting-edge digital therapeutics. There will be
around £75 million to expand individual placement and support
services to help more people with severe mental health illnesses
into employment.
(Kingston upon Hull West and
Hessle) (Lab)
Will the Minister give way?
Neil O’Brien
I will make a little progress first.
We know that the number of children and young people experiencing
mental ill health is rising, and that many of them will continue
to experience mental health problems later in life. Spending on
children and young people’s mental health continues to grow, from
£841 million in 2019-20 to £995 million a year later, and now to
£1.1 billion in 2022-23. This means that we are helping more
children and young people than ever before. In 2021-22, there
were over 743,000 new referrals to children’s and young people’s
mental health services, which is 41% higher than the year
before.
Several hon. Members rose—
Neil O’Brien
I will make a bit of progress before I give way.
The long-term plan will ensure that 345,000 more children and
young people can get the mental health support they need when
they need it.
We are committed to ensuring that children and young people can
access mental health support in school, so that they can access
help with anxiety and depression and other common mental health
services before problems become more serious. In that way, we can
prevent—in exactly the way we all agree on—the problems from
becoming more serious. That includes continuing to roll out
mental health support teams to schools and colleges in
England.
(Putney) (Lab)
The picture that the Minister is painting does not quite tally
with the experience that I am seeing in families, many of whom
are watching with a feeling of helplessness as their children’s
mental health deteriorates while they are on long waiting lists.
In the NHS South West London ICB area, there are over 10,000
young people on waiting lists, and many have their cases closed
without even getting the support they need. That leaves them with
deteriorating mental health and it leaves their families in
despair. How is it that the money the Minister is talking about
does not seem to get through to the young people who need
help?
Neil O’Brien
I will come to the point about waiting lists in a moment.
Let me complete my thoughts on prevention, which I think we all
agree is important. There are 3.4 million pupils covered by
mental health support teams in 2022-23, which equates to about
35% coverage of pupils in schools and learners in further
education in England. We expect around 500 teams to be up and
running by 2024, covering around 44% of pupils and learners, so
it will be up from 35% to 44%. Over 10,000 schools and colleges
now have a trained senior mental health lead, including more than
six in 10 state-funded secondary schools in England. On
prevention, the Government are also providing £150 million of
capital investment in NHS mental health urgent and emergency care
infrastructure over the next two years.
(Middlesbrough) (Lab)
While the Minister is addressing the issue of young people, can I
say that I have yet to hear any news from the Department as to
whether there will be a public inquiry into the deaths of the
three young women who died under the care of the Tees, Esk and
Wear Valleys Foundation NHS Trust. Can he enlighten me on
that?
Neil O’Brien
This is an extremely important issue that the hon. Gentleman is
quite right to raise. We will be producing the results of the
rapid review in the coming weeks, so he will not have to wait
very long.
Like other colleagues, I see many children in my constituency
waiting well over a year, sometimes two years, to access child
and adolescent mental health services, so I was alarmed when NHS
England recently told me that, on the latest modelling, the
number of NHS-commissioned training posts in London for child and
adolescent psychiatry will halve by 2031. I have no idea what is
driving this modelling, but given that one in six seven to
16-year-olds have a probable mental health disorder, will the
Minister at least look into these figures and undertake to write
to me to explain why we are seeing such a drop in the number of
training places?
Neil O’Brien
Those are not figures that I am familiar with or recognise, but I
will certainly take this up with the London commissioners because
it sounds like an important issue. I have talked about the
dramatic increase we have already seen in the mental health
workforce, and we are setting out further steps in our long-term
workforce plan, but I will take that away and look at it closely
with other Ministers.
One of the issues here is that the demand for mental health
services has gone through the roof, from 3.6 million in 2020-21
to 4.5 million in 2021-22. My hon. Friend the Member for Tooting
(Dr Allin-Khan) was clear in her view, which I share, that the
policies of this Government have been a factor in driving up the
mental health demand. Does the Minister accept that? If not, what
does he put it down to?
Neil O’Brien
I was just coming to that, but on the point about prevention and
the social origins of these things, we are in agreement about
tackling the origins of these things. In terms of financial
security, that is why we are providing financial help worth
£3,300 per household, one of the most dramatically generous
packages anywhere in Europe. The question of good housing was
raised earlier. We have the Social Housing (Regulation) Bill and
we are taking action to extend the decent homes standard to the
private rented sector.
(Bosworth) (Con)
Is it not the case that we have to be really careful about what
we are talking about? There is a difference between mental
wellbeing and mental health. We all suffer with our mental
wellbeing but we do not all suffer with our mental health, and we
therefore need to have the support that is appropriate. Social
prescribing, for example, has a fundamental ability to help
people who suffer with their mental wellbeing. Are the Government
doing anything more to drive up social prescribing, so that GPs
and allied professions can get the support from the third sector
and other voluntary organisations that people so desperately need
for their mental wellbeing?
Neil O’Brien
My hon. Friend, as an experienced clinician, makes an important
and thoughtful point. This is exactly why we have so dramatically
increased the number of social prescribers in primary care. An
example in Britain is the parkrun practices initiative, which is
connecting people to sporting and cultural activities that can
improve mental wellbeing as well as mental health. My hon. Friend
is completely right, and that is why this is a priority for
us.
The suicide rate in North West Leicestershire increased by more
than 300% during the lockdown. Does the Minister know what the
increase was in his constituency?
Neil O’Brien
It is just not true there was an increase in suicides because of
the lockdowns. There have been a whole series of careful studies
of this and that is just not the case. I am afraid that my hon.
Friend is not correct about this.
(Bath) (LD)
Eating disorders are a national scandal and have reached epidemic
proportions. Anorexia nervosa has the highest mortality rate of
any mental health disorder and a third of people with binge
eating disorders are at suicide risk. With at least 125 million
people suffering from eating disorders and with soaring waiting
lists, is it not time that the Government appointed something
like an eating disorder prevention champion to tackle this
incredibly difficult but rising crisis?
Neil O’Brien
I completely agree about its tremendous importance, and I take
this opportunity to mention the incredible work on this hugely
important issue by brilliant charities such as Beat. I will
outline some of the general things we are doing to increase
capacity further.
Only a few weeks ago, I met a constituent who endured an awful
kidnapping and rape. She had some initial counselling and therapy
from specialist services, but she has now been on the waiting
list for more than a year and a half. What would the Minister say
to my constituent, who desperately needs therapy?
Neil O’Brien
I am terribly sorry to hear about the hon. Lady’s constituent’s
case, which I will look at extremely closely. This is why we are
putting in extra investment and tackling waiting lists.
Several hon. Members rose—
Neil O’Brien
I should make a little progress before taking further
interventions.
The Government are providing £150 million of capital investment
in the NHS’s urgent and emergency care infrastructure for mental
health over the next two years. Those interventions include £7
million for 90 new mental health ambulances, with the remaining
£143 million going to more than 160 capital projects with a
preventive focus. These include new urgent assessment and care
centres, crisis cafés and crisis houses, health-based places of
safety for people detained by the police and improvements to the
NHS 111 and urgent mental health helplines. The hon. Member for
Tooting talked about creating such facilities in the community,
and we are already doing that. We are also investing £400 million
between 2020-21 and 2023-24 to eradicate mental health dormitory
accommodation, improving safety and dignity for patients.
Twenty-nine projects have already been completed since the
programme commenced in 2020-21, eradicating over 500 dormitory
beds.
Will the Minister join me in welcoming the construction of the
new Abraham Cowley unit, which will eradicate the dormitories
that were in my constituency?
Neil O’Brien
I join my hon. Friend in celebrating that unit and his advocacy
for people affected by mental health.
(Vauxhall)
(Lab/Co-op)
I thank the Minister for giving way, as I appreciate that he is
trying to make progress. On the capital programme, one of the
issues that my hon. Friend the Member for Tooting (Dr Allin-Khan)
highlighted is Seni’s law, which will look at the treatment that
patients receive in mental health units, where, sadly, restraint
has led to deaths. The Minister talks about prevention, and we
need to make sure that Seni’s law, which was enacted in November
2018, comes forward now. Does he agree?
Neil O’Brien
The remaining provisions will be commenced as soon as
possible.
We are working with the NHS towards implementing new waiting time
standards for people requiring urgent and emergency mental
healthcare, in both A&E and the community, to ensure timely
access to the most appropriate high-quality support. We also
recognise that there is much more to be done to improve people’s
experience in in-patient mental health facilities. The Minister
with responsibility for mental health, my hon. Friend the Member
for Lewes (), has spoken to many
Members following reports of abuse and care failings at a number
of NHS and independent providers. We have been clear that anyone
receiving treatment in an in-patient mental health facility
deserves to receive safe, high-quality care and to be looked
after with dignity and respect.
It is vital that, where care falls short, we learn from any
mistakes to improve care across the NHS and to protect patients.
That is why we have conducted a rapid review of mental health
in-patient settings, with a specific focus on how we use data and
evidence, including from complaints, feedback and whistleblowing
reports, to identify risks to safety.
(Battersea) (Lab)
The Minister wants to talk about data and evidence. We know that,
within the mental health crisis, there are huge, long-established
racial disparities, with young black men disproportionately being
sectioned under the Mental Health Act 1983. The draft mental
health Bill is still in train, and I would like to know exactly
when the Government will table the Bill, which might stop these
racial disparities and stop young black men dispro-portionately
being sectioned.
Neil O’Brien
We are currently responding to pre-legislative scrutiny, so we
are on the case. We are not just waiting, of course, and we are
already doing things on these points, including through the
culturally appropriate advocacy pilots for those at risk of
detention and on the patient and carer race equality framework to
avoid and prevent detention in the first place.
The rapid review’s report will be published very shortly. NHS
England has also established a three-year quality transformation
programme that seeks to tackle the root causes of unsafe,
poor-quality in-patient care, including sexual safety, in mental
health, learning disability and autism settings.
Our draft mental health Bill, which has been mentioned a few
times in this debate, is intended to modernise the Mental Health
Act so that it is fit for the 21st century and works better for
people with serious mental illness. The draft Bill has completed
its pre-legislative scrutiny, and we will respond to the Joint
Committee’s recommendations very shortly.
In a world of increasing rates of multiple morbidity and diseases
of increasing complexity, it is crucial that we continue our
progress towards more person-centred, holistic care that
considers a patient’s physical and mental health needs together.
That is why we announced in January that we will be producing a
major conditions strategy to tackle the conditions that
contribute most to morbidity and mortality across the population
of England, including mental health. The call for evidence is now
open, and I encourage everyone to make their views known before
it closes.
(Blaydon) (Lab)
The Minister is talking about the mental health strategy now
being part of the major conditions strategy. Is he aware that
many mental health organisations see it as a retrograde step
that, having conducted an extensive consultation and invited
views, the strategy will now be put back even further?
Neil O’Brien
I assure the hon. Lady that all contributions were fed into the
major conditions strategy process. The reason why we are making
the mental health strategy part of the major conditions strategy,
and why we are looking at co-morbidities, is because, as the hon.
Member for Tooting mentioned, people with mental health
conditions have a shorter lifespan and, in general, the cause is
typically a physical co-morbidity. It is essential that we look
at these things together if we are to make progress on tackling
disparities.
We have committed to publishing a new national suicide prevention
strategy later this year, and we are engaging widely across the
sector to understand what further action we can take to reduce
cases of suicide. The new strategy will reflect new evidence and
the national priority for preventing suicide across England,
including action to tackle known risk factors and targeted action
for groups of concern. We are also providing an extra £10 million
over the next two years for a suicide prevention voluntary,
community and social enterprise grant fund. This competitive
grant fund will help to support the sector to deliver activity
that can help to sustain services to help meet increased demand
for support and to embed preventive activity that can help to
prevent suicide and stem the flow into crisis services.
Of course it is good that we will have a refreshed national
suicide prevention strategy, and of course £10 million is
welcome, but it is not out there yet. In the meantime, the £57
million that was earmarked for local work on suicide prevention
has run out. Will the Minister consider making urgent interim
arrangements to ensure that this vital work can continue until
the strategy is published?
Neil O’Brien
I am conscious that we need to help the sector to maintain and
grow its levels of service.
I finish by paying tribute to all those who do so much to support
people’s mental health: frontline NHS staff, those working in the
voluntary community and social enterprises, and all those who are
quietly supporting a family member or loved one.
1.29pm
(Hemsworth) (Lab)
I think the whole House agrees that there is a mental health
crisis, but the Minister’s presentation simply will not do. It
was like a series of numbers read from a brief prepared by
somebody who is remote from the reality of life in our country.
It sounded complacent and like it was coming from on high, rather
than from real experience.
I hope the House will not mind if I illustrate the general points
I want to make by referring to my own area, as the experiences I
am going to relate have a general significance for the country as
a whole. First, let me agree with my Front-Bench colleague, my
hon. Friend the Member for Tooting (Dr Allin-Khan), that the seed
beds that are creating the great demand for mental health
services lie in the social and economic conditions that have been
created following 13 years of failed government. My constituency
is 529th out of 533 English seats in social mobility—it is one of
the most immobile socially. A child who is born today in the
local hospital will die younger than those elsewhere in the
country if they are in deprivation; there is no chance whatsoever
of getting out of the crisis that so many families face, given
the absence of social mobility across the country, but especially
in areas such as mine. I am talking about deprivation where, in a
constituency such as mine, access to a house, green space,
healthy living and all the things one should expect to be able to
achieve as a human being in one of the richest countries in the
world are simply not available. That is the seed bed for the
mental health crisis. I speak about my area, but this is a
generic problem, as we all know. Even the Minister seemed to
concede that in one of his responses, although the idea that the
Government will somehow address the problems they have created
after 13 years is preposterous.
The Minister talks a good talk on the Government’s intentions,
but under his Government NHS staff wages have fallen, and nursing
bursaries have been cut, as have mental health beds. In my area
of Yorkshire we have lost a quarter of our mental health beds
since 2010—since the Conservatives came into power and Labour was
last in government. The loss of a bed may not sound much, but if
we think about it, we see that dozens and perhaps hundreds of
people would use that bed in a year. Every bed lost has a huge
impact on a series of individuals, families and even communities.
The same applies to the loss of nurses and other qualified staff;
these things are in decline. So it is no good the Minister
standing there and repeating stuff that has been provided to him
by the civil service.
It is scandalous that in my area of West Yorkshire 10,000 people
in a single year were released from acute hospital with a
recommendation that they receive mental health treatment and all
of them failed to get a mental health appointment. They were then
removed from the list without any opportunity to receive even the
basic courtesy of a single half-hour meeting. Beyond that, in the
same year, 60,000 patients in Yorkshire had to be referred to a
provider outside their area. Let us just think about this: we are
talking about people with mental health problems being sent to an
area that is unfamiliar to them, miles away from anywhere they
know or feel comfortable and loved in, in order to receive basic
treatment. It is not acceptable that that is happening in
Yorkshire.
Suicide has been mentioned by a number of colleagues, from all
parts of the House. In West Yorkshire, the figure for men
committing suicide is over 20 per 100,000, whereas the figure for
the country as a whole is 16 per 100,000. Let us just think about
that. It is because of the deprivation and the problems we face
in our area. Why should we put up with a postcode lottery that
fails to address the mental health needs of young people, with
the result that we have a quarter more suicides in West Yorkshire
than in the rest of the country? That is shocking, but this is
the kind of society that the Government have created and they
have then cut the services that would provide the basic support
that a civilised society should provide.
Let me refer to two profoundly shocking cases, which I am sure
are reproduced everywhere in the country. The first involves a
family who have an 18-year-old daughter. She has a mental health
issue and it has led to her becoming immobilised physically. She
was admitted to an acute hospital over the weekend—she is unable
to move. The hospital insisted that she left yesterday, but there
is no care package and no assistance for her. The doctor said,
“My advice to you is to get some treatment, but you won’t get it
on the NHS because you’ll wait for years. Your need is urgent. Go
to a private practitioner.” That was what he recommended. We
looked it up and found it will be £3,000 per month to get the
treatment. This is treatment that should be provided by a
civilised Government, but we do not have a civilised
Government—it is shocking. This morning, that young woman of 18
was left on her own on a sofa—not even with a commode
provided—with two glasses of water and a bloomin’ sandwich while
the family went off to work to try to earn the money to pay. It
is a disgrace that that happens in our society.
Finally, I come to the issue of people with mental health issues
in care homes. These care homes are in some ways very good, but
in other ways this is a racket. We have a care home in my area
that the Care Quality Commission condemned in 2020. Nothing was
done by the owners to improve the situation but the CQC did not
go back, presumably because of covid, until November. It then
said, “This home isn’t working, so you’ve got to move everybody
out.” There are people there who are close to the end of life and
others who have serious mental health issues. Closing that home
is going to kill some people: let us be honest and blunt about
it. It appears that its private owners are removing all the
people in there with these mental health issues and putting them
somewhere else, with no reference whatsoever and no care for
people who have basically been commodities for them to use—but
they are investing in the home. I have spoken to the CQC and
asked: are those fit and proper persons to run such a home to
care for people with mental health crises? My argument is that
they are not and they have proved the point. They did not even go
to appeal and the staff are being left on the scrapheap.
We have had a Government who, through austerity and the
particular form of economic society they have created, have
developed a major mental health crisis and then cut the required
services. There is no prospect of their doing anything else to
improve the situation. This is a serious problem. We must imagine
ourselves in the situation of the family in the case I
illustrated. This is a crisis that echoes throughout the land and
it is not acceptable.
I finish on this point. We do need money putting into our mental
health services, as everyone would agree. But why do the
Government not start by saying that the staff—the carers,
cleaners and all the clinical staff—get a proper rise? That would
at least be a decent way to try to retain some of those people in
house for now.
Several hon. Members rose—
Madam Deputy Speaker ( )
I ought to have said after the Minister had spoken that the
original Question was as on the Order Paper, since when an
amendment has been proposed as on the Order Paper, and the
Question is that the original words stand part of the Question. I
do not think that my putting that to the Chamber after the hon.
Member for Hemsworth () has spoken will have made any difference to his
speech—I do hope not. I prefer to get procedure absolutely
correct. It will be obvious that a great many people wish to
speak this afternoon and we have limited time. Therefore, we must
have an immediate time limit of five minutes, which is quite
generous really. We begin with .
1.39pm
(Watford) (Con)
Thank you, Madam Deputy Speaker. Before I begin, I will rip up my
unwritten 50-minute speech.
I have previously said in this Chamber that, if suicide were a
virus, we would be on the hunt for a vaccine; if loneliness were
a disease, we would be looking for a cure. I welcome the debate
today. I know that it is politically charged, but that is the
nature of this Chamber. Any opportunity that we have to talk
about mental health and to tackle the stigma around mental health
must be welcome.
Of course, we are talking today about the support that is
available to people, but one area on which I wish to focus is
mental health in the workplace, which is a passion. We spend most
of our lives in the workplace; we spend time with colleagues. We
are perhaps not always truthful to ourselves about how we feel.
Engagement in the workplace is essential to prevent mental ill
health. One challenge is to ensure that there is parity across
physical and mental health. I have argued about that in this
place before, and received support from all parts of the House. I
welcome parity around things such as first aid; that is
essential.
I have been very pleased with the engagement that I have had with
Ministers, especially the Under-Secretary of State for Work and
Pensions, my hon. Friend the Member for Mid Sussex (), the Minister for Disabled
People, Health and Work, my hon. Friend the hon. Member for Corby
(), and the Minister on the Front Bench today. I have
also engaged with other Ministers in the Departments of Health
and Social Care and for Work and Pensions. They have all been
open to looking at how we can get better services and better
support for colleagues in the workplace.
One challenge we face is stigma. I say gently and respectfully to
Members in the Chamber today that, while of course these issues
are politically charged and that we will all have a very strong
view on this and on the need to make sure that services are in
place, we are careful about the words that we use. When we talk
about people not being able to get support, it might put off
somebody from seeking and getting support. When we talk about
some of the statistics, I ask Members to please be mindful about
how they are used. We could deter a person in crisis from seeking
help, because they might think that that help is not there, which
could be dangerous.
I appreciate that we have a long way to go with mental health,
but we have come quite a way. The support over the past few years
and the change in stigma around mental health have been
transformative, but we still have a way to go for the situation
to be transformed. That means that, as politicians, chief
executives of businesses and community leaders, we must ask
ourselves whether we are doing enough. Are we talking about this
enough? Are we looking at those solutions enough?
Dr Evans
My hon. Friend is making a powerful speech about raising
awareness. Yesterday, I hosted members from the NFU, who candidly
said that, a few years ago, they would never have been speaking
about these kinds of issues. We know that rural communities and
farmers in particular suffer when it comes to asking for help. Is
it not exactly those organisations coming forward and speaking
about the problem that allows us to have this debate?
I thank my hon. Friend for his important intervention. This
morning, I was fortunate to host the Royal College of
Psychiatrists. We had a roundtable discussion with different
charities, organisations and leaders in this space about what we
need to do and what that looks like. It looks like more
funding—there is always an argument for that and rightly so; it
means ensuring that we support people who have gone through
crises, and that we look at that long-term support; but it is
also about how we shift the conversation. For me, it must be
about parity between physical and mental health. A few years ago,
an amendment was tabled that would have introduced more parity of
funding. As a Government, we need to look again at that
amendment. Other important steps would include a mental health
Bill. I appreciate that we need to move forward with that as soon
as possible, and I echo the calls for such legislation, but we
should not be damning everything that has been done so far,
because huge strides have been made, especially in relation to
extra funding.
When I was a councillor many years ago, I worked with local
schools to look at what support was in place. I wanted to know
whether the children as well as the teachers were aware of the
support that was available. If we were to do the same survey
today, we would find that the situation is far better than it was
10 or 15 years ago, but, as I have said, there is still a way to
go.
I want to finish on a few brief points. When we consider the
challenges around mental health, we must understand that the
problem is not mental health alone. There is always some sort of
comorbidity and there is always some impact on physical health.
When we talk about parity, we are not just saying, “one person
with mental ill health and one person with physical ill health
must be seen equally”. That, of course, is important, but we must
also be mindful of the fact that if somebody has a mental health
condition it may affect their ability to work. On the flipside, a
physical health condition may impact a person’s ability to get
out of bed in the morning and their ability to do exercise. All
those things are essential.
I hope that my words, from the Conservative Back Benches, will
echo across the House: we want to get to a position where mental
health is a priority across all of society. Both the Government
and our communities play a part in that, and how we talk about
this matters. I hope that we can talk civilly about the
opportunities that are available. I urge colleagues to talk about
what support is out there as much as, quite rightly, challenging
Government and all of us to do more.
1.45pm
(Bermondsey and Old Southwark)
(Lab)
I also wish to speak civilly. For me, this is fundamentally a
debate about mum. My mum was diagnosed with schizophrenia before
I started primary school, so I have been talking about mental ill
health all my life. Growing up, we saw on a weekly basis the
inadequacies in support, the rough treatment from mental health
services and the results of poor medication. We cannot ignore the
fact that there have been some improvements, but some of the
worst of the ‘80s appears to be returning after 13 years of Tory
Government. Governments have failed to improve the system, which
is described as the Cinderella service, since before Cinderella
was written, which apparently was as long ago as 1697—I
discovered that only today.
This crisis is exposed in that lack of access to support, lack of
outreach, lack of choice, lack of control over support being
received even where it is received, lack of genuine community
care and lack of priority being given to mental healthcare
overall. It is also exposed through an overuse of detention.
Detention is necessary when people cannot manage their own
safety, but it is the most costly end of mental health treatment
when all else has failed. It is more expensive than sending
people to prison in this country, but it is over-relied on by a
failing Government who are unable to see long-term needs and the
means of saving funds as well as saving people.
As has been mentioned, this is also a crisis exposed by a rising
inability to meet need, as demonstrated by the size of, and time
spent on, waiting lists. The shadow Minister mentioned 400,000
children. I bumped into Karen, my constituent, on the bus this
morning. She finally has an appointment for counselling after
three years of waiting in Southwark. Therefore I speak today from
personal experience and as an MP representing a community with a
high prevalence of mental health conditions, including some of
the highest levels of psychosis anywhere in the country. However,
I am privileged to speak as MP of an area where there is greater
support for some people.
Southwark’s Labour council has been at the forefront of
instigating measures, including online support, the Quality
Indicator for Rehabilitative Care, the Nest system for the
under-25s and an equivalent wellbeing hub for the over-25s, which
helped more than 2,000 people last year. I am talking here about
fast access, professional support that does not require a GP
referral or a long wait of time. This is vital support on the
frontline delivered by a Labour council and an integrated care
board, which are prioritising correctly.
We are also a community served by South London and Maudsley NHS
Trust. SLAM staff do their best to meet needs, but, sadly, I see
people and their families who are not best served. I know that
SLAM wants to do more—I speak to the staff and I met the chief
executive last week—but it is limited by a Government who lack
ambition and intent. The Government are not just ignoring the
crisis, but contributing to it through things such as benefit
cuts, and allowing food bank dependency and debt in a way that
contributes to mental ill health. This is also a Government who
are cutting capacity. The Minister made some claims about figures
at the Dispatch Box just now, but SLAM told me last week that,
despite the level of the crisis, it is cutting £45 million this
year. What that means in practice is horrible.
I wish to talk about the human impact. I met Stephen Crawford
through the Walworth community council. I have known him since
2010. To be clear from the start, this was a man who was known to
the local community and known to council care workers and local
mental health services. He had severe anxiety. He was a sweet,
gentle soul, but he was a target for those seeking to misuse him
and his home with criminal intent. Understandably, he became very
agitated about his home following break-in attempts and thefts.
He was ultimately sectioned and detained for his own wellbeing,
but then discharged to the unsafe home that he had told everyone
he was unable to live in. He called the London Ambulance Service
daily. He and others called the police. The police told me they
had visited and intervened 56 times in recent months due to his
behaviour. It was a crisis for him, for his neighbours in the
street, including Norma and the Groombridges, who were trying to
help him, for the London Ambulance Service, which is already
overstretched and struggling, and for the police, who now say
they may have to stop responding to mental health call-outs.
Stephen was discharged and did not get sufficient support. On
Wednesday 19 April, just three days later, he climbed through the
window frame on the top floor of a Browning Street building. He
told everyone he would take his own life. The police attended,
but he fell and was pronounced dead the following week.
That is what the mental health crisis means in practice—the loss
of life, the human tragedy. Stephen deserved better, and if
individuals like him, whole communities such as mine and multiple
public services are not to face similar situations, with the
avoidable costs and loss of human life, mental health reform must
deliver better. I hope we see a serious case review and I look
forward to that coming forward.
1.50pm
(Penrith and The Border)
(Con)
I very much welcome the opportunity to speak in this debate on a
crucial issue. We have heard already about the importance of
parity of esteem between physical and mental health, something I
have been speaking about since my maiden speech. I am passionate
that we achieve that parity.
I welcome the Government’s announcements over many months, the
actions and contributions of Ministers and the £3 billion a year
increase in funding. The £10 million in the Budget for suicide
prevention was especially welcome, as was the £150 million for
mental health facilities. I particularly welcome the £3 million
for the mental health crisis centre at the Carleton Clinic in
Carlisle.
As we have already heard across the House, prevention is
important in mental health. We have heard a lot about young
people, and we know that, sadly, suicide is the biggest killer of
people under 35. I pay tribute again to 3 Dads Walking; I have
been privileged and humbled to work with the three dads, Andy,
Mike and Tim, who tragically lost their precious daughters
Sophie, Beth and Emily to suicide. They have been able to channel
their personal tragedy into trying to help people and raise
awareness about suicide prevention. We are working hard to get
age-appropriate suicide prevention into the school curriculum.
The Prime Minister and the Education Secretary have met us and we
are making significant progress on that.
I think this is an area that really unites us in humanity across
the House. I very much respect the shadow Minister and her
clinical expertise in this area, and it is crucial that we talk
about prevention. I am grateful to the 41 hon. Members who signed
my early-day motion on suicide prevention in the school
curriculum and increasing mental health first aid provision.
My hon. Friend the Member for Watford () has been a passionate
champion for mental health first aid training. I have had mental
health first aid training during my career in higher education. I
have also had ASIST, or applied suicide intervention skills
training, and I can tell hon. Members that it is very important.
It does not make someone a consultant in mental health, but it
helps them to have those discussions and be able to signpost
people to the help they need.
I have put that training into practice with people I have worked
with, and a great sense of relief has welled up in some of these
people, who have said, “Oh my goodness, Neil, you understand.” I
could then have discussions with them about seeking the support
that they need. I passionately advocate that the Government work
to increase mental health first aid training in educational
settings and in the workplace. The more people we have on the
frontline who can signpost people who need help, the better.
I also want to talk about rural mental health. Two or three weeks
ago, our Environment, Food and Rural Affairs Committee published
a report on rural mental health. I pay tribute to those who
provide so much support to people out in rural communities,
including charities such as the Royal Agricultural Benevolent
Institution, You Are Not Alone, the Farming Community Network,
Farmerados and, more broadly, the Samaritans, Vetlife, Mind,
PAPYRUS and Every Life Matters. Rural mental health is a critical
issue.
The EFRA Committee has made strong recommendations to the
Government. I was pleased to attend the NFU reception yesterday,
which had rural mental health at its heart. Our inquiry covered
some of the issues around stigma that we have talked about in
this debate. People are reluctant to put their hand up and say
that they are struggling, including farmers and vets—as a vet, my
profession is sadly over-represented in mental health issues and
incidents of suicide. It is important that the stigma is broken
down and mechanisms put in place so that people can seek out
support.
In rural communities there are also acute stress events such as
animal disease outbreaks. I witnessed the trauma from foot and
mouth disease in 2001, and those ripples still affect rural
communities today. The mental health trauma on people when avian
influenza comes and their animals or birds are culled out is
significant.
Our inquiry has made recommendations and, as we have heard from
those on the Opposition Benches, we need cross-Government working
on the problem, with the Department for Environment, Food and
Rural Affairs working with the Department of Health and Social
Care, the Department for Education and the Department for
Transport to mitigate issues such rural isolation, connectivity,
broadband and transport. It is so important.
This is an area that unites us in humanity across the House. I
firmly believe that debates such as this can really help the
Government to develop their policies and support people’s mental
health.
1.55pm
(Chesterfield) (Lab)
At 11.33 yesterday morning, this House finished Prayers and the
first questions to the Health Secretary began. Disgracefully, two
hours and five minutes later, the Government’s business was done
and hon. Members were told that, if they had no further meetings,
they could go home. This exhausted Government had literally
nothing left to say or do.
It is therefore hugely welcome that my hon. Friends the Members
for Tooting (Dr Allin-Khan) and for Ilford North () have stepped forward on behalf of the
Government-in-waiting to ensure that today there is a debate on a
matter of considerable importance. Every week in my constituency
surgeries I meet parents exasperated that the treatment and
support that they know their children need is not available. That
can lead to the unchecked exacerbation of problems and children
missing school—not the odd day, but months at a time. Whole years
of their schooling are lost and family routines decimated as the
entire family steps in to provide the support that an earlier
intervention could have prevented.
Mental health is not a minority issue. Every year, one in four
people will experience a common mental health problem. This
Government are guilty of both underfunding mental health services
and, through their actions, causing the number of people with
mental health problems to rise. We all know that the Government
have allowed our country’s economy to end up in a terrible mess
and that money is short, but it is welcome and right that the
Labour party and my hon. Friend the Member for Ilford North have
been able to secure a commitment for additional funding from
shadow Treasury colleagues—all of us who sit in Front Bench
positions will know that is very difficult—to pursue the plans
that are so desperately needed.
I want to talk about access to services locally. Stephen Jones in
my constituency had a child with a mental health crisis that
required in-patient treatment. The child was moved to
Stoke-on-Trent, 70 miles away, because there are no child
in-patient beds available in the whole of Derbyshire. The
isolation that Stephen’s child experienced exacerbated their
problems and made it harder for the family to support them. I
stress to my Front-Bench colleagues that, while we realise that
specialist staff will not be based in every single village and
town, we need to give real consideration to providing those
specialist services close enough that families can easily play
their part in supporting patients, particularly children, in
their treatment and recovery.
I am pleased that my hon. Friend the Member for Tooting focused
on some of the causes of the mental health crisis. The Government
are quick to talk about the increased amounts they are spending,
but they are forced to spend more because there are more and more
patients coming forward. If we had a huge expansion in the number
of people with cancer, we would have to increase the number of
cancer doctors, and yet we have far more people with mental
health crises. The Government need to stop for a minute and think
about the role they have played in causing that increase.
From the start in 2010, the Government’s pursuit of people on
benefits, their targeting of the unemployed and the mentally ill,
their approach to work capability assessments and the reduction
in housing benefit, leading to record levels of poverty and
homelessness, have all played a part in increasing the pressures
on people and have in themselves added to the mental health
crisis. No one is suggesting that those are the only causes—of
course, very successful people can have mental health crises,
too—but the Government should take that expansion in the numbers
seriously.
The pressures on children in that period have exacerbated the
problems. Between 2017 and 2022 alone, the number of children
aged between seven and 16 with a probable mental health disorder
rose from 12% to 18%. Shockingly, among those aged between 17 and
19, the figure more than doubled, from 10% to 25.7%.
Finally, let me turn to the Government’s disappointing,
inadequate and defensive amendment to the motion. It says
everything about their complacency and lack of ideas that they
should try to convince the House that they have already acted to
reduce A&E stays. Last year in Chesterfield alone, people
suffering a mental health crisis spent 5,254 hours in A&E. It
is clear from the debate that our nation’s mental health patients
are being let down and the Government have neither the wit nor
the will to fix it. I am pleased that Labour will prioritise this
crucial area of health and I endorse the motion.
2.00pm
(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 () 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.
(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.
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.
2.06pm
(Batley and Spen) (Lab)
“We should be frank. We have not done enough to end the stigma of
mental health. We have focused a lot on physical health and we
haven’t as a country focused enough on mental health.”
Those are not my words, although I agree with them
wholeheartedly. They were spoken in 2016 by the then Prime
Minister, . He went on to say that if
we
“intervene much earlier with those suffering from poor mental
health…we can stop problems escalating… By breaking the mental
health taboo, by working with businesses and charities…I believe
we can lead a revolution in mental health treatment in
Britain.”
Yes, yes and yes. My question is: why, seven-and-a-half years and
four Tory Prime Ministers later, are we still waiting? Mr Cameron
has long departed these Benches. This is not the occasion to
lament the mess that he left behind, but the experience in my
constituency—and, I respectfully suggest, in the constituencies
of many, if not all, hon. Members—is that the Government’s
approach to mental health remains, all these years later, wholly
inadequate.
We have heard a lot of statistics in the debate. The numbers
matter, because they show the overwhelming scale of the problem
that we are facing. Every one of those numbers is an individual,
and around them is a network of family and friends whose lives
are impacted day in, day out by the very real challenges of
confronting mental illness. I have met many such individuals and
families in my constituency. Just last week, I hosted a
roundtable at which I heard heartbreaking stories of such daily
struggles, many of which involve children and young people.
Amelia is now 16. She was diagnosed with autism at the age of
seven. For the past nine years, her mum, Anna, and her family
have been trying to get help and support, and they are on their
knees with exhaustion. Amelia has attempted to take her own life
several times, and has been so let down by the system that she
says that she just does not trust it anymore. It feels to her
that she only gets any kind of support when there is an absolute
crisis. I believe that, if she had got the support that she
needed a long time ago, she and her family would be in a much
better place today.
Eli is 10. He has been diagnosed with Tourette’s syndrome. He has
various tics affecting his eyes, face, neck, back, hands and
feet. He is a fantastic young man, but he is regularly in pain,
which affects his ability to cope with days at school and has a
huge effect on his mental health. Until recently, he was told
that he just had conjunctivitis. His mum, Natalie, told me that
she has struggled to find the psychiatric support Eli needs, and
every time she calls CAMHS she is passed from person to person.
She has been told that there are no NICE guidelines on Tourette’s
and the best they have been offered to date has been worry
management.
Those are just two examples, but they reflect a much bigger
problem across society and in all our communities. I have
meetings regularly with teachers across Batley and Spen, but we
spend far more time discussing the mental health needs of their
pupils and their families than we do the many other challenges
faced in education—another sector that is underfunded and
under-resourced. We cannot keep pushing this issue back on
schools. Teachers do an amazing job, but we cannot expect them to
take on responsibility for what is a widespread societal health
issue because of more than a decade of lack of focus and national
leadership on mental health.
It is not just teachers. Because we do not have the mental health
experts and provision that we need in the places where we need
them, it falls to others in the community to pick up the pieces.
In Batley and Spen, I am incredibly proud of the many voluntary
organisations, sports clubs and charities that do a magnificent
job week in and week out under huge pressure. I pay tribute to
groups such as Andy’s Man Club, Game Changerz, Blue Tulips, Team
Daniel and Luke’s Lads, but the voluntary sector is propping up
the NHS and society as a whole. That is not sustainable and it is
simply not right. We would not expect teachers, sports coaches,
voluntary groups and others to deal with a burst appendix, a
broken leg or an ear infection, so why are we asking them to deal
with the mental health crisis? They are, of course, part of a
wider, holistic solution, but they should not be the only
solution. That is not the parity of esteem between mental health
and physical health that spoke of. While I am hugely
optimistic about the excellent plans Labour has to address the
mental health crisis, people such as Natalie, Eli, Anna and
Amelia cannot wait any longer, which is why today’s debate is so
important.
2.11pm
(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—
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.
2.18pm
(St Albans) (LD)
I welcome this debate because, like every other Member, my inbox
is often full of cries for help from people who are suffering
mental ill health or from family and friends trying to help them.
Looking through recent cases I have had in St Albans, I see a
litany of problems with the system. Many constituents have told
me that they have had to wait for more than a year for diagnosis.
Some have needed an urgent medication review. One parent told me
they feared for their and their child’s safety while the child
was on a particular medication. They sought an urgent medication
review, had an urgent referral from their GP, but the matter then
sat with the psychiatrist for weeks and weeks. They were
terrified during that time, waiting for a decision.
Other constituents have told me of their relief when they finally
secured a mental health care package, only to find that it takes
many weeks or months before the package can be put in place in
practice. Those who have mental ill health and are also
neurodiverse or have learning difficulties have told me about the
hoops that they have to jump through. In some cases they have
been told, “We can offer you mental health support, but it is not
tailored or suitable for you because of your neurodiversity or
your learning difficulties.” I have heard about the frustration
that those individuals feel because those services are not
tailored to them as a person.
Then we have the emergency A&E admissions. Again, just a
couple of weeks ago, I had a parent email me in total desperation
from a hospital corridor because one of their children had
attempted suicide and had been rushed to A&E. They were not
safe to be left unsupervised, but they were supervised by
somebody who was inappropriate to supervise them. The family were
desperate to get their child to a safe place, but that did not
happen for days and days—it was only with my intervention that it
happened. As I am sure many Members know, it is really pleasing
to be able to make a difference in those cases, but it is
worrying to think about all those families who have not got in
contact—others out there who are struggling alone.
There are real problems with A&E pathways and with children’s
mental health services. I hope that the Government will focus on
those areas, but from speaking to my local mental health trust
and hearing about the pressures that it is facing, is it really
any wonder that we are having these issues? There were warnings
at the start of the pandemic of an explosion of mental ill
health, and I believe that the Government could have done a lot
more to get ahead of that problem. For example, my local mental
health trust has told me that there is not only an increased
number of people looking for help but higher acuity. Therefore,
instead of having a 2:1 staff-patient ratio, it often has to be
3:1. So even with the same staff headcount, there is less staff
time for more people seeking help.
Those who work for the trust tell me of their frustration that
the waiting lists are getting too long. They accept that
medication reviews are often delayed because of staffing and
resourcing issues, and there are huge pressures on the trust’s
budget. Not only is there the demand; there is the cost of
out-of-area placements, having to pay for private beds where none
are available in the NHS, and paying for agency staff to cover
vacancies that are not filled. Our mental health trust in
Hertfordshire is the smallest bedded mental health trust in the
country. We have huge ambition to open a new bed unit in the west
part of the county, but we need the Government and the NHS to get
behind that ambition.
So what do we need to see? We need to see prevention, and we need
to see it early. Research from New Zealand, which is often cited
here in the UK, indicates that three in four people with mental
health problems show symptoms before the age of 25. That
reinforces the need for prevention and the need to see it early,
so I would like there to be a qualified practitioner in every
single school. We need mental health community hubs in every
community. We need to empower the charity sector—a sector that
has barely been mentioned today. In St Albans, we have Time To
Talk, Youth Talk and the OLLIE Foundation, which are all
fantastic mental health charities that are working on tiny
budgets. In Hertfordshire, we need support for mental health beds
and, of course, we need to tackle the workforce problem. Until
the Government publish their workforce plan, the lack of a
workforce remains the biggest risk to service delivery in mental
health in every single part of the country. I urge the Government
to take action on those points.
2.23pm
(Penistone and Stocksbridge)
(Con)
It is well reported that mental health difficulties have become
both more prevalent and more talked about in recent years.
Lockdown has certainly had a detrimental impact on the mental
health of the nation, which is completely unsurprising. Isolation
and loneliness are significant contributors to poor mental
health. We have also had the economic consequences of inflation
putting pressure on people’s personal finances, and the
consequences of the NHS backlogs that have been referred to in
this debate, but I particularly want to focus on children’s
mental health.
As has already been mentioned by other hon. Members, we have had
a rise in diagnosable mental health conditions among children
since before lockdown. We have gone from about one in nine
children having potentially diagnosable mental health conditions
to one in six. I am sure we have all had cases in our
constituencies—tragic stories of children who no longer leave
home because they are too anxious, who are not able to go to
school. We have seen a rise in the number of ghost children, many
of whom are not turning up at school because of anxiety and
mental health issues.
The Opposition have talked a lot about all the money that needs
to be spent. The Government are spending money, boosting mental
health spending by at least £2.3 billion by 2024. The motion
calls for improved outcomes for people with mental health needs.
We all want that, but prevention is better than cure, and it is
simply not sufficient to call for ever more money to expand
remedial capacity without addressing the root cause of the
problem. It is a bit like having a leaky roof and calling for
ever larger buckets to catch the drips: we need to fix the roof.
Many will cite poverty, poor housing and not enough youth
services as the causes. All are contributing factors, I have no
doubt, but there are two less well understood, less talked about,
and potentially more significant factors contributing to poor
child mental health.
The first, which has been mentioned already, is the clear
correlation between the rise of smartphones and social media and
deteriorating mental health in young people. The extent of online
harms cannot be overstated. My right hon. Friend the Member for
Chelmsford () mentioned pornography. Violent
pornography is now routinely encountered by children on the
internet, with 1.3 million visits a month by UK children to adult
sites. There is also eating disorder and suicide content—again,
as my right hon. Friend so articulately mentioned —and child
sexual abuse material and exploitation. Anxiety issues are
compounded by social media platforms. Children stay up all night
waiting for likes on their social media profiles. There is
clearly a relationship between more time spent on screens and
less outdoor activity, which is another good indicator for poor
mental health.
There seems to be a relationship between children spending more
hours on social media and worse mental health. The Online Safety
Bill, which is going through the other place at the moment, will
deal with some of those issues, but I urge Ministers to encourage
their colleagues in Government to accept some of the amendments
that their lordships have tabled to strengthen the age
verification provisions, to make it absolutely watertight that
children cannot access some of the worst of those harms. However,
we urgently need some proper research into whether it is safe for
teens to have smartphones or to go on social media at all. Some
have said that their smartphones are as addictive as
cigarettes—that they are the opiate trade of the 21st century. I
applaud the campaign group UsforThem and its “Safe Screens for
Teens” campaign, which is calling for proper research into the
health impact of smartphones on teens and whether, like tobacco
and alcohol, it is necessary for there to be a legal age limit
for accessing some of these platforms, or indeed having a
smartphone at all.
A second, under-discussed contributing factor to poor child
mental health is family breakdown. We are not talking about a
small number of children affected: the UK has the highest rate of
family breakdown in the OECD and in the western world. Some 44%
of our children will not spend their childhood living with both
of their biological parents. There is not enough recent data on
this issue, but Office for National Statistics studies from 2010
suggest that back then, 3 million children did not live with
their father and 1 million had no meaningful contact with their
father. Given those figures, a mental health crisis among
children and young people is absolutely no surprise.
Of course, family breakdown leads to other factors that
contribute to poor mental health, such as poverty and low income.
Some 80% of single-parent households are on universal credit, I
think. That is no surprise at all, as there is only one adult in
the house to fulfil all the roles and responsibilities of a
parent. It puts pressure on housing costs, as one adult is
supporting the household—of course there are going to be
pressures on housing costs. Single parents are absolute heroes,
and I take my hat off to them. Being a parent is an incredibly
difficult job when there are two adults in the house. Single
parents are heroes, but few would say that it is an ideal
situation.
Family breakdown is far worse for the poor, which of course is
closely linked to marriage rates. Married relationships are
statistically less likely to break down than cohabiting ones, and
marriage rates have remained very high in high-income groups, but
have collapsed in low-income groups.
Madam Deputy Speaker ( )
Order. The hon. Lady has exceeded her time.
2.28pm
(West Ham) (Lab)
Can I tell Members on the Government Benches a little bit about
the mental health crisis in Newham? We have a rocketing
population that is young, with no commitment from this Government
that health funding will rise to match it. We have almost 41,000
children living in poverty. We have the highest proportion in the
country of people living in damp, mouldy, overcrowded temporary
accommodation. All of these people have no sense of security in
their home at all: they do not know when their local ties will be
shattered yet again by a forced move.
As we know, all of this impacts on mental health, and
particularly on the mental health of children. I see that
constantly in my casework, and local health leaders tell me
exactly the same thing. It can hardly be a surprise to the
Government that the number of young people being referred to
mental health services is 30% up in Newham alone. Cases are
increasingly more complex, more urgent and more in danger of
spiralling into deep crisis.
Newham is the most diverse borough in the country, with the
second highest rate of GP registrations by migrants. Our
diversity has massive benefits, and I love it, but it requires
clinicians to adapt their way of caring for people with different
cultural backgrounds and languages. Despite all that, Newham’s
mental health spend is the lowest in London. With all those
challenges, our clinicians and our health leaders are obviously
struggling to meet their targets. Average waits in Newham between
referral, assessment and treatment were at 12 weeks in 2021. Some
patients are waiting for as long as a year, and that is after
they have had a referral, which as we know is terribly difficult
to access.
Our local mental health unit, which deals with only the most
severe needs, is at 98% occupancy—far in excess of the clinical
standard. Quality of care and patient care and safety are
suffering. There is a dire shortage of specialist mental health
beds for our older adults. We have older people waiting for long
periods on utterly inappropriate wards and in beds that are no
doubt sorely needed for those waiting for other hospital
treatments. Many patients with mental health crises are waiting
in emergency departments for more than 12 hours, and local health
leaders are worried that those numbers will increase. Our mental
health services are struggling even to react to some of the most
dire situations, let alone being able to offer proactive support
that prevents mental illnesses getting worse.
We are creating even more problems—greater problems for the
future, greater costs for the Government, greater costs for the
NHS, more antisocial behaviour, more homelessness and rough
sleeping, and massive wasted economic and social potential.
People’s lives are being devastated by treatable ill health and
completely avoidable misery. If we are not sitting in this place
to avoid that, why are we here?
Labour’s plan to transform mental health treatment is desperately
needed in Newham, along with thousands more mental health staff
and professionals in every school and accessible mental health
hubs in every community. We sorely need a preventive approach so
that we can bring this crisis to an end, and we need it now. Can
I use my last 30 seconds to look at the Minister and ask whether
she will meet me and my health providers and health leaders in
Newham to talk about the massive underfunding that our borough
and my community face?
2.33pm
(Newcastle-under-Lyme)
(Con)
It is with some trepidation that I rise to speak in this debate,
given the expertise and experience we have heard from all parts
of the Chamber so far. I draw particular attention to the speech
by my hon. Friend the Member for Runnymede and Weybridge (Dr
Spencer), who is no longer in his place but who shared his
personal expertise as a clinician, and my hon. Friend the Member
for Watford (), who kicked off the
Back-Bench speeches from the Government Benches. He made a
well-constructed speech that spoke to his expertise in
campaigning for mental health so assiduously in this place. I pay
tribute to everyone on both sides of the Chamber who has brought
forward their own personal experience, their family experiences
and their constituency experiences of mental health.
I will not reiterate everything that the Minister and my hon.
Friend the Member for Watford said, but the parity of esteem we
are working towards in this country is vital, as are the record
investment of £2.3 billion that this Government have put into
mental health and the extra doctors and nurses who will support
people. Most of all, it is about reducing stigma in mental
health. It is not unfortunate that we are doing so, but it does
create more demand.
The shadow Minister said that the causes of poor mental health
were complex, and they are, but she then went on to basically try
to lay it all at the door of the Government. That is not remotely
fair or accurate, because the statistics are complex too. We
should welcome more demand from people who were previously
undiagnosed, and we should recognise, as my hon. Friend the
Member for Penistone and Stocksbridge () did a moment ago, that there
have been societal changes, particularly with social media, which
I referred to in my intervention.
At the very youngest ages, we are seeing an explosion in autism
cases. I speak to the excellent Peter Pan Centre in my
constituency, which deals with pre-school children with some of
the most severe forms of autism, including those who are
non-verbal. Next door is the excellent Merryfields special
school, where a number of them end up going. Increasingly, those
organisations are saying that the majority of their pupils are
those with autism or autism spectrum disorder, and that simply
was not the case 10 years ago. Again, that is probably because of
better diagnosis—we do not fully understand the explosion in
autism—but we must not assume that everything is to do with money
being spent on things; it is to do with better understanding of
mental health, more awareness and less stigma.
The pandemic affected the mental health of the entire nation, and
I recognise that that has put a lot of pressure on young people
in schools and universities, which I will talk briefly about as
the Member who represents Keele University. On schools, I speak
frequently with my heads and with parents who come to me trying
to get statements for their kids. As we get a greater
understanding of neurodiversity, there is obviously a real
interaction between special educational needs and poor mental
health. I was speaking to my county council yesterday, and the
big issue is the availability of educational psychologists. My
county council, Staffordshire, is doing a great job of training
more of them itself, but that is a problem across the country,
and we need to address it so that we can get children the help
that they need with their education and their mental health
earlier.
We have heard about the Department for Education funding and the
training of senior mental health leads, with 400 already
supporting more than 3 million children. There will be up to 500
next year, and more than 60% of state secondaries have a mental
health lead. I want to see that get to 100% as soon as
possible.
In my final couple of minutes, I will speak a little about
universities, as the Member who represents Keele, which has
12,500 students. I am pleased that Keele has, as many
universities do, a professional counselling and mental health
team to support its students. More generally, the Higher
Education Statistics Agency collects data from students on any
disability that they have, including mental health conditions. In
2021-22, 416,000 UK students said they had a disability of some
kind—that is 19% of UK students—and within that, 119,500 said
they had a mental health condition, which is 5.5% of all UK
students. That number is three and a half times higher than it
was in 2014-15. Higher rates are found among women,
undergraduates, full-time students and those in their second or
later years. There is an issue here that we have to address, and
I am pleased that the Government are doing so.
The covid pandemic fell heavily on students at university,
particularly during the lockdowns and associated restrictions. At
the height of the pandemic, many students, including those at
Keele, struggled with the measures employed to prevent the spread
of covid, particularly in university settings. Some had to
socially isolate regularly and could not go home to see their
parents. They were essentially locked in their room with nobody
else there for a long time. Nightline, which co-ordinates
student-run listening and information services, reported in
November 2022 that it had recorded a 51% increase in calls in
2020-21. Numbers for the next year were 30% higher than that,
which indicates that the pandemic has had a continuing effect on
universities. I welcome that the Department for Education has
asked the Office for Students to distribute £15 million for
transition into university.
I am pleased with everything that the Minister said about what we
are doing, and I end on the point that there is less stigma,
which is a good thing, and if there are more people coming
forward, that is a good thing too.
2.38pm
(Oldham East and
Saddleworth) (Lab)
As we have heard from colleagues from all parts of the Chamber,
we are in a mental health crisis. Unfortunately, it is becoming
increasingly endemic. I pay tribute to the work of our offices,
including my own team, who regularly deal with critical cases of
mental ill health, including suicide calls, for which we have had
to put on special training. That was happening before the
pandemic too, and we need to recognise that.
Recent figures show that seven out of 10 secondary school
children are expressing mental health distress. That should worry
us. It has already been mentioned, but we know that there are
risk factors and risk conditions that can contribute to the onset
of a mental health problem. I will speak about the importance of
early intervention a little later.
Oldham has the 37th highest prevalence of mental health disorders
in the country. That puts it in the highest 20% in the UK; for
reference, the Prime Minister’s constituency is in the lowest 6%.
On the other side of the coin to this higher prevalence is our
reduced funding. Research from the Children’s Commissioner found
that child and adolescent mental health services in Oldham
received over £100 less in spending per child from the Government
than those on the Isle of Wight. Similarly, in 2019 The Guardian
reported that London had nearly double the number of
psychiatrists in the north of England. As I have mentioned, it is
true that things have got worse since the pandemic, but that is
not just a consequence of the pandemic.
I want to focus on what needs to happen, because we need a
serious plan, and I am not from the Minister’s speech that the
Government recognise that. The Opposition want to recruit
thousands of new mental health professionals, which will go some
way to addressing the lack of parity of esteem between mental and
physical health services. That needs to be reflected in the
Government’s NHS workforce plan. We have waited ages for the
Government to produce that and it makes the partygate report look
quite prompt. As the Government sit on their hands and fail to
produce a plan, the crisis continues to get worse. That is why we
will commit to the biggest expansion of the NHS workforce in
history. We must also look at the metrics we use. For example, we
would guarantee treatment within a month. That would make such a
big difference to all those people stuck on what feel like
endless waiting lists in Oldham, Saddleworth and across the
country.
Finally, I am pleased to see our party committing to a paradigm
shift from the medical to the social model of health, focusing on
prevention in communities as well as treatment. The Leader of the
Opposition has committed himself to that in Labour’s health
mission, and we have also pledged that there will be a mental
health hub in every community. We will go further than that: our
commitment to addressing the rampant health inequalities across
our country includes tackling the inequity in mental health. As
we develop national policy from education to transport and
finance, we will consider the impacts on health and health
inequalities, including mental health. This is the difference a
Labour Government will make. The next Labour Government have a
plan that is both radical and credible, and for my constituency
and for our country, it is long overdue.
(Haltemprice and Howden)
(Con)
On a point of order, Madam Deputy Speaker. You will be well
aware, because you have chaired many of the debates, that there
has been a campaign in this House for over a year to stop
SLAPPs—strategic lawsuits against public participation—which are
used by very rich men to oppress free speech in this country.
Just in the last hour or so, the High Court has ruled one of
those SLAPPs cases out of order: the case of Mr Mohamed Amersi
against the ex-Member of this House has been struck down. In
my view, that is a great victory for free speech. Because it is
so important, I give notice that I will be raising the matter on
the Adjournment.
Madam Deputy Speaker ( )
I thank the right hon. Gentleman for his point of order. It of
course needs no comment from the Chair, except to say that I
think the whole House will agree with him that this is a good
judgment and an important step forward. I do indeed recall
chairing many debates on the matter, and I am sure the whole
House will look forward to his raising it on the Adjournment. We
will recommence the debate with .
2.43pm
(Devizes) (Con)
It is a pleasure to follow the speech of the hon. Member for
Oldham East and Saddleworth (), who is a great champion
of this cause. I am very proud to work with her on the all-party
parliamentary group for prescribed drug dependence, which, after
this debate, I am going to ask her to co-chair with me.
I want to call the House’s attention and that of Hansard to the
speech made by the hon. Member for Bermondsey and Old Southwark
(). The distressing and powerful
story he told of a constituent of his will remain with me as a
terrible example of the state of so many of our constituents and
of mental health services that do not work properly.
I welcome this debate, and I am afraid to say that I do recognise
many of the descriptions given by Members on both sides. I want
to call attention to the excellent services provided in my
constituency of Devizes by the Green Lane Hospital, a mental
health hospital that has been there for many years. However, even
there we have many cases of constituents feeling that they have
been let down and of genuine difficulty in accessing the services
that are needed in time. Despite the good efforts made from the
top of the system to the bottom, we simply are not doing well
enough, so I welcome the debate, and I recognise the general
point being made.
Of course, I agree with the argument put forward by the
Opposition that we need more mental health services. The question
is what those services should be, how they are organised and,
indeed, whether we should use services as the frame for this
whole debate. I wonder whether the term “services and
relationships” would be more appropriate, and Members have
mentioned the primacy of relationships. The fact is that we do
not fully understand all the neurological origins of mental
health conditions, but we do know that they are exacerbated by
social circumstances, and that while medical treatment can help,
what really helps is good relationships.
I know this from my own experience. For many years, I ran a
project working in prisons and with ex-offenders, and we saw so
clearly that, while of course the official and the essential
responsibility for crime and criminality rests with the
individual, it is usually relationships and relational skills or
the lack of them that lead somebody into crime and into prison,
and it is relationships and relational capacity and skills that
help people to get out of an offending lifestyle. We also know
this very well from all the evidence in studies of addiction,
which is very closely correlated to mental health.
What do we do? There is consensus that we need more services and
better services, but my concern is that we will end up focusing
the system’s efforts on quantifiable measures or quantifiable
inputs—most of all, the prescription of pills and pharmaceutical
treatments—so we will end up medicalising mental health, just as
we medicalise so much physical health. I chair the APPG on
prescribed drug dependence, as I have mentioned. The research
that the APPG has supported, particularly by of Oxford University, shows
that a fifth of adults are on antidepressants, many of them
because they cannot get off these pills, even though they are
only supposed to be prescribed for a certain time. We spend £500
million a year on prescriptions for medication that people should
not be on, according to the guidance for those pills.
I worry about the trend towards the medicalisation of mental
health, and I particularly worry about the Government’s major
conditions strategy, which I welcome. We cannot have a focus just
on pharmaceuticals; we have to make it much wider. It should not
just be about services, but about the relationships that support
good mental health. I am pleased there is a strategy on mental
health and there does need to be top-down action, but I would
like it also to focus on undoing this over-medicalised model. We
need more training for GPs to understand the social relationships
at the heart of mental health, including how to support people
who have acute conditions. We need more funding for social
prescribing—that has been mentioned—which is a tremendous
initiative. We need support for withdrawal services and a
helpline for people who are addicted to prescribed drugs.
Overall, however, we need a bottom-up approach. I respect
Labour’s plan for more access hubs for mental health, more school
mental health workers and more staff, but really we need system
reform. The hon. Member for Tooting (Dr Allin-Khan) mentioned the
community mental health approach, and I like that phrase, but I
think it includes much more than just more hubs and more staff.
We need a whole system reform that prioritises the civil society
organisations, families and community groups that have such a
powerful role to play in supporting people with mental
health.
Lastly, I draw attention to the new developing model called
outcomes partnerships, whereby the public sector pays for
results—not for inputs and not even for outputs, but for actual
demonstrable improvement, whether it is in healthcare or mental
health. It brings together all the different providers from civil
society, the public sector and, indeed, businesses—we have
mentioned the importance of workplace training—so that we get all
the different players involved in a person’s life, and so that
the funding is more local and can be used on the preventive
agenda, which is so important. Rather than just trying to pour
more money into the top of the NHS and thinking that is going to
work, we need to fund it from the bottom up.
Several hon. Members rose—
Madam Deputy Speaker ( )
Order. I need to reduce the time limit to four minutes with
immediate effect.
2.48pm
(Leeds North West)
(Lab/Co-op)
I want to highlight the crisis faced by families dealing with
mental health issues, particularly those with children.
The crisis has been brought to my attention by many constituents
over the time I have been an MP, but today I would like to raise
the issue of my constituent Stephanie, whose son is autistic,
non-verbal, and has complex developmental and communication
delays. Stephanie knew that her son needed an attention deficit
hyperactivity disorder diagnosis from an early age, but was told
that he could not be diagnosed until he was seven. When her son
did receive a diagnosis, Stephanie was told by the doctor that it
was obvious how much he was struggling to cope with his life due
to his ADHD. He is suffering from elevated levels of distress and
unable to sleep through the night due to his inability to sit
still for long.
Sadly, Stephanie was informed that there would be an 18 to
24-month wait for the community service MindMate to sign off the
diagnosis and to be referred to child and adolescent mental
health services, along with the medication plan. The CAMHS wait
would mean a further 18 to 24 months to receive medication, so if
they hit the longest waiting times at both services, her son
would have been told that he needed medication at the age of
seven and only receive his prescription at 11. Long wait times
for diagnosis and medication mean that families across the
country are turning for help to charities and support groups such
as ZigZag, a Leeds autism support group based in my constituency
that offers essential advice and support to thousands of families
across Leeds. Stephanie has expressed her concerns and garnered
support from other families with similar experiences.
The situation is at crisis point and requires immediate attention
from the Government. We cannot ignore the struggles faced by
families across the country dealing with the complexities of
mental health issues. It is the Government’s responsibility to
ensure that our most vulnerable citizens have access to prompt
and proper care. Those issues are just the start. For instance,
Leeds University reports that it has seen an about 60% increase
in demand for mental health services and that the issues are a
lot more complex than they were before covid. It says that many
students are arriving at university with anxiety and mental
health issues as the support they needed in their formative years
was simply not available. Huge pressure is being built up, like a
dam that is going to burst.
Adult ADHD services in Leeds currently have 3,300 people on their
diagnostic waiting list—that does not include all the people who
cannot be bothered to see their GP because of the length of the
waiting list—and they are receiving more than 170 referrals a
month, which far exceeds their capacity. The waiting list is
currently upwards of three years, with an added wait for
medication after having received a diagnosis. Similarly, the
adult autism diagnostic service in Leeds currently receives more
than 100 referrals a month, but it has the resources to complete
only 40 assessments a month.
The current situation is completely unacceptable. We need the
Government to create a more effective and efficient mental health
care system that is responsive to the needs of communities. We
cannot continue to let down families like Stephanie’s at every
turn. It is crucial that we invest in the mental health sector
and prioritise the wellbeing of all our young people.
2.51pm
(Sheffield, Hallam) (Lab)
As an officer of the all-party parliamentary group on eating
disorders—an issue that I will raise in my speech—I thank the
right hon. Member for Chelmsford () for her bravery in sharing her
experience.
The statistics on the crisis in the NHS, as raised by my hon.
Friend the Member for Tooting (Dr Allin-Khan) and others, speak
for themselves. The 5.4 million hours that people with mental
health problems are waiting in A&E is a scandal. We know that
the longer patients wait for treatment, the worse and more
dangerous their conditions can become. While I would love to make
this speech about the importance of prevention, unfortunately we
see a crisis in the NHS, so I will focus on the issues of acuity
mentioned by the hon. Member for St Albans (). Many of those who cannot
access the mental health care that they need are children. A
quarter of 17 to 19-year-olds have a probable mental illness.
Nearly one in 10 seven to 16-year-olds and a third of 17 to
24-year-olds have tried to self-harm. My own NHS South Yorkshire
integrated care board has a waiting list of 10,015 children.
If those figures were not horrific enough, I want to talk about
one further horrifying effect: that of people with eating
disorders—often children or young people—having to wait to be
given a tier 4 bed in a specialist ward owing to the acuity of
their condition and because of the lack of preventive care
available. Last year, a parent wrote to tell me that they were
struggling to secure a mental health bed for their child, who had
been diagnosed with anorexia. They would have gone anywhere in
the country to get their child seen given the care they received
while they were waiting. They needed urgent in-patient mental
healthcare, but no tier 4 beds were available, so they had to be
admitted to a general ward instead.
When the parents first contacted me, their child was being
restrained most days to be fed. They were worried that, without
specialist support, repetitive restraint was only making things
worse. I have since spoken to numerous eating disorder
specialists, researchers and medical staff who have all told me
about the rising number of children with eating disorders being
restrained—often unnecessarily —by staff in general medical wards
without training, recording or following guidance. I have heard
more first-hand stories. I warn hon. Members that these are not
nice experiences to relay, but they should be shouted from the
rooftops because they are the human consequences of a system that
is understaffed, under-resourced and under strain.
One person told me that, as a 17-year-old, they were restrained
for feeding via a nasogastric tube three or four times a day by
five people; that went on for about 10 months. Another person
told me that they were restrained for daily NG feeds by five to
six staff at a time for six months. Sometimes, they were held for
an hour after the feed and would come out with bruises, despite
their screams during the restraint. I have heard stories of
15-year-olds being restrained at 11 o’clock at night for NG
feeding. To be clear, it is not just the people I have described
who are suffering because they must wait for access to the care
they need; it is also causing tension between psychiatric staff
and medical staff on wards because these people are getting
inappropriate care.
It is shameful that in such settings the use of restraint does
not need to be recorded. Its use is heavily regulated in mental
health settings for a reason. The use of restraint and
restrictive practice is really consequential to the conditions
that people go on to develop and their ability to recover. I am
disappointed that in a letter and in response to me following a
debate, the Minister refused to act and close the loophole. I ask
her to think again about closing that loophole so that, no matter
where a person is in the system, they have the same rights around
restraint and that it gets recorded.
2.56pm
Mrs (Birmingham, Erdington)
(Lab)
I refer the House to my entry in the Register of Members’
Financial Interests because I am an independent lay manager.
Everywhere we look in Britain at the moment, public services are
crumbling. Chronic neglect by the Conservative Government means
that people across the UK can no longer trust that they will be
able to access mental health services when they need them.
As a lay manager in Birmingham and Solihull Mental Health NHS
Foundation Trust, I often see the impact that dwindling services
and limited resources have on residents across our city. In our
local ICB area in December, nearly 3,000 children and almost
50,000 adults were on the mental health waiting list. In my
constituency, parents have told me that their children are
waiting a number of years for urgent mental health support.
Birmingham and Erdington are not unique cases. Since 2010, the
Conservative Government have cut one in four mental health beds
across the country as waiting times for treatment have soared.
Currently, 400,000 children are waiting for mental health
treatment across the UK. They are being denied the help that they
need.
I am a mum and a grandmother. Like all parents, I want the next
generation to have better opportunities than I did. That is why
Labour’s plan to recruit thousands more mental health staff,
guarantee treatment within a month and provide access to a mental
health professional in every school is so important. It is
inconceivable that the Government have failed to put forward
their own plan to recruit mental health staff or even reduce the
shocking waiting times that our constituents are having to put up
with.
I worked in the NHS for 25 years and, like many of my colleagues,
I despair at how it has been treated by the Government. This year
will mark 75 years of our incredible NHS, but, over the last 13
years, the Conservatives have done all they can to wreck it.
People suffering with their mental health cannot afford to wait
any longer for the support that they need. We need serious
government. We need a Labour Government to tackle the crisis
now.
2.59pm
(Halifax) (Lab)
The Metropolitan police recently announced that it would stop
attending mental health calls unless there was a risk to life.
That has rightly generated much debate about the role of
policing. However, it has not generated much debate so far on
how, if we all believe in the right care, right person
principles, we got into the position where the police are playing
such a primary role, and where our mental health services are in
that conversation. We know that the police are stretched. For all
the Home Secretary’s talk of increased police numbers, the
Government are only restoring the officers they have been cutting
since 2010. Alongside those cuts, years of austerity have
hammered other public services. West Yorkshire police tell me
that mental health-related demand increased by 60% between 2012
and 2022. We have allowed policing to become the one-stop-shop
that we ask to pick up the pieces when everything else falls
apart. Mental health practitioners are also undeniably stretched,
but mental health specialists are the right people to provide
mental health support, especially when somebody is in crisis.
I am in no doubt that the police will have tried various other
ways of encouraging their colleagues in mental health trusts to
recognise the leadership role they are required to play in the
response to a mental health issue. I know that because I also
spend a great deal of time locally in Halifax trying to do the
same, and secure specialist support for people who need serious
and urgent help. When someone is in real distress with their
mental health or approaching a crisis, too often West Yorkshire
police, Calderdale Council, charities and other partners—even the
hospital trust—work together with my team and I to do what we
can. Yet I am afraid that too often it has proved incredibly
difficult to bring qualified mental health specialists into the
team to even be a part of the conversation. That results in the
wrong care for people at their most vulnerable.
As my hon. Friend the Member for Manchester, Withington () said, that is a false economy,
because it falls to all the other services and partners to try to
provide a degree of care that they are not qualified to provide.
We should not criminalise people who are unwell out of necessity.
The police are right to take a step back. The question is what
will it take for mental health trusts and professionals to be
able to step forward?
As our motion sets out, patients suffering with mental health
issues waited more than 5.4 million hours in accident and
emergency last year and we have nearly 400,000 children currently
waiting for treatment. If we are proactive about mental health,
it will, as has been outlined, be cost-effective in the long term
and we can prevent more people from being in a crisis situation.
A Labour Government would recruit thousands of mental health
staff to expand access to treatment, provide access to specialist
mental health support in every school, establish open access
mental health hubs for children and young people, and bring in
the first ever long-term, whole-Government plan to improve
outcomes for people with mental health needs.
I read the Government’s amendment to our motion. Does any MP who
does their casework properly and is truly grounded in their
constituency really recognise the picture it paints? The
Government pat themselves on the back for hitting the target for
interventions in psychosis. I checked what the target was. The
standard is that 60% of people experiencing their first episode
of psychosis will have access to a NICE-approved care package
within two weeks of referral. We have all experienced supporting
people in a psychotic episode. How long does it take to even get
an assessment for that person to then hope that they are in the
60% of people who should get care within two weeks? It is not
good enough. We need a Labour plan to deliver much more.
3.03pm
(Kingston upon Hull West and
Hessle) (Lab)
There has been a narrative about whether it is increasing numbers
of people becoming more aware of mental health that has led to
more cases being reported, or whether there are actually more
people suffering from mental health problems. I spoke to Michele
Moran, the head on this issue for the Humber Teaching NHS
Foundation Trust. She told me, indisputably, that we have more
people suffering from mental health conditions. We only need look
at the examples coming into each and every one of our surgeries
to see how desperate the situation has become. Like other hon.
Members, I would like to thank my staff for the work they do in
supporting people with mental health problems. I will give two
examples.
One example is a 13-year-old boy who has not been in school for
two years. The school funded three counsellor sessions for him,
but it cannot continue to give the boy the level of support he
needs. This is a crucial point. Schools are very willing to help,
but teachers are not mental health professionals. We need the
professionals in the system, which is why Labour’s pledge to have
professionals in schools matters so much. We all know how
desperate the waiting list for CAMHS is and how difficult it is
to get the level of support that is needed. We are left with
families who are desperately struggling, having to rely on other
family members and finding life incredibly difficult.
It is the same for another constituent with a 17-year-old
daughter. She did not get the help she needed at the time she
needed it. She could not access that primary care. What ended up
happening was that she took an overdose, which she survived, but
it was clear that her mental health was in such difficulties that
she was sectioned. Her parents now find that only one of them is
able to work, because the other parent has to be with their
daughter at all times because of the difficulties she is facing.
That is having a huge impact on their income and their standard
of living.
In our area we have tried to do something different with the
police. Right Care, Right Person is a joined-up approach from
Humberside police, the clinical commissioning group—as it was at
the time—local councils, mental health providers and hospitals to
decide who is the right person to attend to someone in crisis,
and then look at developments. It is not perfect, but it tries to
address the difficulties we are having. Many of the cases the
police have been sent to are still people actually struggling
with their mental health, and the police, like teachers, are not
the professionals always best placed to deal with someone in a
mental health crisis. We are evaluating that as it goes along,
but the demand for services is indisputable.
We need to take a step back a little and think about what is
going on. We are talking about citizens advice bureaux providing
counselling and support for people with mental health problems.
The people that the citizens advice bureaux are supporting are
not those who generally have mental health problems; they are
people who do not have enough money to live, and their level of
debt is causing them to have mental health problems. They are in
a situation called negative budgeting, where, quite simply, the
amount of money they have coming in is less than the amount of
money going out. That is what is driving some mental health
problems.
If we are to solve the mental health crisis, we must look at
poverty, debt and the cost of living crisis. That is why I am so
delighted that my hon. Friend the Member for Tooting (Dr
Allin-Khan) said that a future Labour Government’s approach to
mental health would be focused not just on health, but across the
whole of Government. Until we have that joined-up approach, we
will never really tackle the crisis our country faces.
3.07pm
(Wakefield)
(Lab/Co-op)
West Yorkshire has among the highest rates of mental health
issues in the country, with 28,630 children and 63,755 adults on
waiting lists alone. The statistics show that Wakefield,
specifically, is above average, with one in three people
suffering from mental illness. As we all know, some of the
primary causes are poverty, debt, poor housing and long-term
physical health problems. Indeed, Eastmoor in my constituency has
the highest prevalence of mental health illness, as well as those
cause factors, too.
I know from my casework that the number of mental health cases
coming into my office has been rising steadily over the past
year. With mental health provision at breaking point, that is no
surprise: more than 5.4 million hours waiting in A&E in
2021-22 for mental health patients; 1.6 million people stuck on
long waiting lists for mental health treatment; and nearly
400,000 children currently waiting for treatment. On that last
point about children, I am deeply concerned that Wakefield has
the seventh-highest rate of under-18s under mental health care,
with over 6,000 having contact with mental health services in the
past year alone. Parents are left feeling helpless, watching
their children’s mental health deteriorating as they linger on
waiting lists for months, if not years, to access treatment.
Much of the problem is caused by the number of mental health
nurses in the NHS now being lower than when Labour left office.
It is unacceptable that people are left turning to A&E
because of staff shortages in mental health. I have had cases
where patients have been advised that they will have to wait a
year for their treatment to start and such delays are becoming
more common. Nearly 10,000 people in West Yorkshire had treatment
closed without even receiving an appointment. After 13 years of
the Tories running down our health services, we need a Labour
Government that will guarantee mental health treatment within a
month for all who need it, recruit thousands of new mental health
staff and ensure that mental health specialists are in every
school. The scrapping by the Conservatives of the 10-year mental
health plan shows a total lack of long-term focus on those with
mental health needs. That is why Labour would bring in the first
ever long-term, whole-Government plan to improve outcomes for
people with mental health needs.
With mental health services on their knees, I will be voting for
Labour’s motion, and I hope the Government will finally give this
area the attention it so sorely needs.
3.10pm
(Luton South) (Lab)
The Conservative cost of living crisis is causing a mental health
crisis. People living in poverty or, as we are increasingly
seeing, under financial stress and in personal debt are more
likely to develop mental illness, as so many hon. Friends have
already said. Sadly, children from the poorest 20% of households
are four times more likely to have serious mental health
difficulties by age 11 than the wealthiest 20%, and after 13
years of Conservative Government our mental health services are
at breaking point and patients are being failed. It is important
that we talk about mental health in this place because it is a
key issue. Like many other Members, I have constituents who are
struggling to get the support they and their children need; that
is their lived experience and it is right that we hold the
Government to account on it.
For children, recent research shows the average CAMHS waiting
list in February rocketed by two thirds, and the 400,000 children
on mental health waiting lists are waiting an average of 21 weeks
for a first appointment. Data from December 2022 shows that
children in a mental health crisis spent 7,034 hours in A&E
in my Bedfordshire Hospitals NHS Foundation Trust area. That is
in the context of our Bedfordshire, Luton and Milton Keynes
Integrated Care Board area having over 15,000 children on mental
health waiting lists. This is distressing for both the children
and their families.
Turning to adults, Royal College of Psychiatrists research from
last October found that 43% of adults with mental illness said
that long waiting times had worsened their mental health: 23% had
to wait more than 12 weeks to start treatment and many end up
turning to A&E departments. Indeed, data from December 2022
shows that adults in the Bedfordshire Hospitals NHS Foundation
Trust area, including the Luton and Dunstable NHS Hospital, spent
over 11,000 hours in A&E.
It is right that I mention the many volunteers who operate in the
mental health sphere. It is the end of Volunteers’ Week 2023 so I
want to make that shout out, particularly to the brilliant
volunteers with the Luton, South Beds and Harpenden Samaritans,
who are committed to supporting people struggling to cope or
struggling with their mental health through the listening service
the Samaritans offers 24 hours a day. If anyone listening to this
debate needs support, they should call 116 123 for free from any
phone 24 hours a day.
Finally, I want to state my support for Labour’s
community-focused preventive plan for mental health so that
people will be guaranteed to be seen within one month, there will
be 8,500 new mental health staff, with open access mental health
hubs in each community and a mental health professional in every
school. We need this bold plan; we need it now, and we need a
Labour Government to deliver it.
3.13pm
(Oxford West and Abingdon)
(LD)
There is no doubt that our mental health system is broken. Like
many other Members, I receive hundreds of emails from my
constituents about the dire state of mental health services, and
there is a story for every age and every system failure, but
today I want to focus on young people, particularly students.
It will come as no surprise that the Mental Health Foundation
found that 40% of students are not coping well with their
anxiety. In Oxfordshire, a survey by The Tab in 2022 found a
staggering 82% of students at Oxford Brookes University had
self-medicated with drugs or alcohol to cope with mental health
issues. Where students know that they cannot rely on the NHS, an
added burden is put on university staff. Tutors increasingly find
themselves acting as therapists or counsellors for their
overburdened, ill or anxious students.
Oxford University is working hard to improve services. It has
come up with a joint mental health committee and a more common
approach across the colleges and departments. It deserves praise
for that, but the students I have spoken to have made it clear
that
“University wellbeing services are not and cannot be a substitute
for adequate mental health care”
and those gaps have dire consequences when severe mental health
issues are left untreated. My constituents Jacquie and Mark faced
every parent’s worst nightmare when their son Rory reached crisis
point. Rory was suffering from anxiety and depression and found
no support after a year of absence. He tragically committed
suicide at university at just 22. His parents told me that
“we can’t bring Rory back, but we can help other young people
preparing to go to uni.”
They are calling for a statutory duty of care for universities,
which would force them to take proactive steps and intervene
where a student is clearly at risk of harm. It is just common
sense. It already exists between employers and employees. All we
are asking is for the same duty of care to apply to students.
But, as we all know, the problems in young people’s mental health
services are not restricted to those at university. So many
people tell me the system is broken: parents, teachers,
educational psychologists and clinical psychologists all identify
the same failings. One parent wrote to me:
“I am breaking my heart listening to my son saying horrible
things about himself, threatening to take his life, and
struggling with his mental health in general. Next year we would
have been on the waiting list for four years and nothing will
probably happen.”
That story is not unique.
So it is left to voluntary organisations and local authorities to
step in where this Government are clearly failing. Oxfordshire
Mind and Restore do incredible work. Last year, I visited The
Abingdon Bridge, a fantastic charity that provides specialist
support for 13 to 25-year-olds. When I visited, it had 50 young
people on its waiting list, who had to wait up to 24 weeks for an
assessment and a further 10 weeks for counselling. Shockingly,
that is still much shorter than CAMHS, where the waiting list is
between two and four years.
We know how to fix this; it is about more funding. A senior
healthcare professional in Oxfordshire told me that
“every pound spent on a child’s mental health saves thousands in
the future.”
It is this Government who are failing our young people and their
parents. The Government are dragging their feet. Young people and
their parents deserve so much better than this.
3.17pm
(St Helens South and Whiston)
(Lab)
Suicide is a tragedy: it is a tragedy for the person, their loved
ones and their community. As we have heard in the debate, suicide
affects people of all ages. However, I am going to focus on one
group: men. For men under 50, suicide is the biggest killer—not
cancer, not other physical illnesses, but suicide. Mental health
matters so much and it should be on a par with physical health.
The NHS is there to look after and care for us all. That is the
basic principle it was founded on. With suicide being such a big
killer, it is only right that more effort and resources go into
treating poor mental health.
Each suicide cracks an irreparable hole in the lives of loved
ones. They often ask themselves, “Could I have done more? How did
I not spot any signs?” or even, “Did I contribute towards it?”
This would not be the case for physical illness; instead they
would rely on professional healthcare. That is why the same
resources need to be in place to treat poor mental health. Yet
instead this Government have scrapped their 10-year mental health
plan, displaying yet again that they are not interested in
long-term planning. If it does not give them an instant headline,
it seems the Government lose interest.
Of course, society has a role to play. For too long, men
struggling or even displaying emotion are told to “man up,” “stop
being a wimp,” or even, more cruelly, to “grow a pair.” Those
words may seem harmless at the time, but in reality they are
dangerous and cause tremendous harm. No one knows what is going
on in somebody else’s head. That again reinforces why a national
strategy is so important, not only to offer better and more
accessible mental health care but to help to shift societal
attitudes. We all have a role to play. How we conduct ourselves
towards others is very important. In everyday life, we have an
impact on every person we come into contact with. Pre-emptive
mental health care is a must. That is why Labour’s plan to
prioritise mental health care in an open access hub is so
important.
Businesses and employers also have a role to play. They have a
duty to their employees’ mental health. Modern workplaces should
have accessible mental first aid in the way that they have
physical first aid. For any strategy to combat suicide to be
successful, it needs to be a priority of national Government. We
need professional mental health support requirements for
employers and a plan to change attitudes in society, not just a
plan to swat the flies with. We need a plan that is resourced and
put into practice.
We should make it easier for men to talk at work, in the pub and,
most importantly, with professionals. Labour’s plan to recruit
thousands of mental health staff would put us on the right path
of caring for our men. The Government need to and should do more
to solve that crisis, and our Labour Government will resolve
it.
3.21pm
(Salford and Eccles)
(Lab)
In Greater Manchester, the number of children on waiting lists
under the NHS Greater Manchester Integrated Care Board is 23,510.
The number of adults on waiting lists is 89,250, and the number
of patients whose treatment was closed without receiving an
appointment at all was 31,405. Those statistics represent people
facing crisis, who desperately need help.
Like other Members of this House, I have heard many stories from
constituents, including those waiting over a year for assessment
and treatment for obsessive compulsive disorder, attention
deficit hyperactivity disorder, autism or potential learning
disabilities. Many have been forced, through desperation, to take
out personal loans to pay for private assessments. Then, they
have tried to privately fund their own treatment and medication.
I have heard from constituents suffering with severe depression,
waiting months for therapy and simply being told to ring 999 if
it gets serious.
I have heard traumatic cases of teenagers battling serious mental
health conditions who needed urgent help, with no bed available
for them for hundreds of miles unless they chose to go on an
adult ward, which I am sure for most children and young people
would be an extremely frightening experience. I also hear the
stories of our hard-working NHS mental health staff, who are
overworked, overstretched, underpaid and at breaking point. So
there is not a mere crisis in mental health; the service has
effectively collapsed. Sadly, I fear for what is to come if the
Government do not urgently act today.
Salford City Council estimated in 2021 that there would be
between 36,537 and 40,902 additional diagnoses of anxiety and
depression in Salford alone, equating to a point prevalence of
between 14% and 15.8%. That was before the cost of living crisis
hit. For those who reach crisis point, the outlook is equally
frightening. An overstretched, underfunded ambulance service
means that, often, the police are diverted to emergency mental
health calls. That is why there was huge concern expressed
recently in response to plans by the Metropolitan police to stop
attending emergency mental health incidents.
More broadly, in addition to the chronic understaffing of mental
health services, funding remains a huge issue. The Centre of
Mental Health estimates that mental health conditions make up 28%
of all referrals, but services receive only 13% of NHS funding.
The Health Foundation found that the lack of funding meant that
just four in 10 people seeking help would be able to receive it.
The sad fact is that it makes no economic sense not to increase
investment in the NHS and funding of NHS mental health services.
As the Mental Health Foundation states:
“Poor mental health costs the UK a staggering £118 billion per
year, but much of this is preventable.”
I welcome wholeheartedly the motion of my hon. Friend the Member
for Tooting (Dr Allin-Khan) and I will support it. The Government
must recognise this crisis, properly fund our NHS mental health
services, and properly recruit those staff and pay them the wages
that they deserve.
3.25pm
(Blaydon) (Lab)
The Minister spoke earlier about what the Government have done
for the mental health service, but we have all known for far too
long that people in mental health crisis are not getting the
support that they need urgently. They need swift, accessible and
effective support and treatment. I am glad that we in Labour have
a clear and thought-through plan to address this issue and
suicide prevention.
I want to start with some figures. The shadow mental health
Minister, my hon. Friend the Member for Tooting (Dr Allin-Khan),
has already touched on the national figures. The figures from my
local trust in the north-east are also worrying. Just in the
2021-22 financial year, adults in mental health crisis spent more
than 1,134 hours in A&E at Gateshead Health NHS Foundation
Trust, while children in crisis spent 180 hours there. The North
East Ambulance Service received 3,622 emergency 999 calls from
people in mental health crisis. NHS Digital figures for 2022
showed that, in the north-east and north Cumbria ICB alone,
31,345 children and 70,770 adults were on waiting lists, and
12,845 patients had treatments closed without even receiving an
appointment. Those staggering figures have been reflected
nationally.
This morning, I met representatives from the charity YoungMinds,
who told me that urgent referrals to CAMHS are the highest on
record. Let us make no mistake: many of our young people are in
acute crisis. Research by the charity shows that 43% of the young
people turned down by CAMHS had experienced suicidal thoughts,
psychosis or self-harm. As a result of having to wait so long,
26% had tried to take their own life.
In an intervention, I raised the concerns of mental health
charities about the subsuming of the mental health strategy into
the major conditions strategy. There is real concern that the
voices heard in the mental health consultation will be lost and
that a five-year major conditions strategy is too short to bring
about the changes needed and to emphasise the cross-governmental
work envisaged in the original plan.
As the Mental Health Foundation highlighted,
“public mental health has traditionally received extremely
minimal funding”,
of an average of about 2% of the public health budget of local
authorities. That has been accompanied by a cut of 26% in public
health grants in real terms. The Mental Health Foundation notes
that we cannot simply “treat our way” out of mental health
problems. We know that they are formed by hard socioeconomic
factors that the Government need to address, and that the poorest
regions, such as mine in the north-east, see the highest number
of suicides. The Government need to work on that.
As the chair of the all-party parliamentary group on suicide and
self-harm prevention, I have the pleasure of talking with many
local organisations that have been formed by people who have
personal experience of suicide. To name just one, James’ Place is
a charity that offers professional support to men in acute
suicidal crisis. It currently has centres in London and
Liverpool, but I am delighted to say it will be opening a centre
in the north-east, where, sadly, we have the worst suicide
figures in the UK. There is so much more I could say, but I wish
to emphasise my wholehearted support.
3.29pm
(City of Durham) (Lab)
As we have heard today, England is in the midst of a mental
health crisis, and that is certainly true in the north-east. I
join my hon. Friends the Members for Middlesbrough () and for Darlington () in calling for an
independent inquiry into the Tees, Esk and Wear Valley NHS Trust.
The testimonies I have heard have shocked me. I know that I can
speak only in broad terms, but they include serious cases of
improper care and misdiagnosis, and of putting people on waiting
lists despite their feeling suicidal.
The Care Quality Commission reports that we have seen raise
concerns about risk assessments, communications and record
keeping, and a lack of observation. There have also been concerns
raised about the lack of beds for children, as well as poor
staffing levels, high staff turnover and a lack of neurodiversity
training. Horrifically, young people have even taken their lives
while in the care of the trust. We owe it to them, and all those
who have been harmed, to investigate what is going on within the
trust. Will the Minister commit to an independent, judge-led
inquiry into the trust? She can either respond to me now or I can
wait for her response in her closing speech. One thing is clear:
this cannot go on.
I want to highlight the crisis in children’s mental health. In my
region, children spent over 1,000 hours in A&E because they
were in a mental health crisis. There are over 30,000 children on
waiting lists. Across England, one in six children aged five to
16 are likely to have a mental health issue. Children’s happiness
and sense of wellbeing continues to decline. With mental health
trusts raising the threshold of how ill under-18s must be, we
have seen a quarter of a million children being denied help for
their mental health. Poor mental health compounds. Left
untreated, it can spiral out of control, as we have heard many
times today. No one should be in a mental health crisis, let
alone children. The Government must invest in children’s mental
health today—no more delays and no more referrals. The Minister
must allow children the happiness that they deserve.
Madam Deputy Speaker ( )
Before I call the shadow Minister, I must say that I am very
disappointed that seven Opposition Members who spoke in the
debate are not back in the Chamber for the wind-ups, as well as
about three Government Members. I must emphasise again that it is
really important for people to get back to hear what the shadow
Minister has to say, as well as the Minister. I hope that message
will be conveyed back to those Members who are not here. I will
say it again in the hope that they are back by the time the
shadow Minister has finished his speech.
3.33pm
(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
() and for Penrith and The
Border (Dr Hudson), from the right hon. Member for Chelmsford
(), and from the hon. Members for
Runnymede and Weybridge (Dr Spencer), for Penistone and
Stockbridge (Miriam Candidates), for Newcastle-under-Lyme (), for Devizes (), for St Albans (), and for Oxford West and
Abingdon ().
We also heard from my hon. Friend the Member for Hemsworth
(), my hon. Friend the Member for Bermondsey and Old
Southwark (), who made an extremely powerful
contribution, and my hon. Friends the Members for Chesterfield
(Mr Perkins), for Batley and Spen (), 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 (), for Leeds North West
(), for Sheffield, Hallam (), for Birmingham, Erdington
(Mrs Hamilton), for Halifax (), for Kingston upon Hull West
and Hessle (), for Wakefield (), for Luton South (), for St Helens South and
Whiston (Ms Rimmer), for Salford and Eccles () and for Blaydon
(). Finally, we heard from my hon.
Friend the Member for City of Durham (); 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—
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.
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.
rose—
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.
Madam Deputy Speaker ( )
I reiterate for those who were not here that it is incredibly
important that people get back in good time to hear the
Opposition wind-up as well as the Government wind-up—that
includes Ministers. I would expect anybody who was not here at
the beginning of the Opposition wind-up, some of whom are still
not here, to write to Mr Speaker to apologise. I take it that
people will do that.
3.45pm
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Thank you, Madam Deputy Speaker.
What a shame it is that the Opposition have chosen to play
politics with mental health, as we heard from my right hon.
Friend the Member for Chelmsford () and my hon. Friends the
Members for Watford (), for Runnymede and Weybridge
(Dr Spencer) and for Penrith and The Border (Dr Hudson), because
these are important issues. All countries are facing challenges
with rising cases of mental ill health and capacity issues, but
we have made progress in the last 10 years. It was in 2016 that
first talked about changing
the stigma on mental health and, as my right hon. Friend the
Member for Chelmsford put it so well, we want more people to come
forward. The problem in the past was that people did not come
forward, instead waiting until they became so acutely unwell that
it was more difficult to support them.
Dr Hudson
A recurrent theme in today’s debate, on both sides of the House,
has been the importance of prevention and breaking down stigma.
Does my hon. Friend agree that the message should go out from
Members on both sides of the House that it is okay not to be
okay, that people should reach out and that more people in all
walks of life should be first aid-trained to help when people do
reach out?
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—
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.
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—
Will the Minister give way?
Unfortunately, given the time I have left, I will not give way
any more.
As for the challenges we face, we are seeing rising numbers, but
we are seeing that in all parts of the country. The shadow
Minister, the hon. Member for Denton and Reddish (), talked about not judging
Labour on its track record on health in Wales, where Labour has
produced smaller funding increases for its health service; its
7.8% increase compares with the 8.6% increase that we have given
in England. Mind Cymru has said that hundreds of people across
Wales are currently waiting more than a year to access
psychological therapies. The target is supposed to be that 80% of
people in Wales access therapies within six months, but that
target has never been met. It gets worse, because since 2020 the
number of people waiting longer than a year in Wales for mental
health support has increased by 17%. Labour talks a good game,
but its actions speak louder than its words. I urge shadow
Ministers to acknowledge that these problems exist in all
countries and that we all face these pressures. A grown-up
conversation would be about sharing best practice and working
together to make that happen.
Many Members talked about preventive and early intervention
therapies. My hon. Friends the Members for Bosworth and for
Devizes () talked about that and about
moving away from the medicalisation of mental health. That is why
we are investing in talking therapies. For anyone who has not
been on the Every Mind Matters website, let me say that it
provides practical support for people who are anxious, distressed
or not sleeping. It also provides for self-referrals to talking
therapies. Since we introduced that, more than 1.2 million
patients have accessed NHS talking therapies in the last year,
helping them to overcome anxiety and depression. More than 90% of
those people have had their treatment completed within six
weeks.
Many Members talked about schools, and we are introducing mental
health support teams in schools. We have almost 400 now, covering
more than 3 million children, and about 35% of schools and
colleges. More than 10,000 schools and colleges have trained a
senior mental health specialist, including more than six in 10
state schools. That work is happening already and it is making a
difference right now. My hon. Friend the Member for
Newcastle-under-Lyme () highlighted how we need to
move that into universities, and I would be happy to talk to him
about how we can do that further.
On in-patient services and the quality of care, we have recently
conducted a rapid review of mental health in-patient settings.
The Secretary of State will announce the results of that soon. We
have also introduced a three-year quality transformation
programme, which seeks to tackle the root cause of unsafe,
poor-quality in-patient care, particularly for those with
learning disabilities and autism.
On suicide prevention, our forthcoming strategy will target
high-risk groups and locations of concern. We will also provide
£10 million of funding for charities that do so much good work in
this space. I say to my hon. Friend the Member for Penrith and
The Border that I would be very happy to meet the 3 Dads Walking,
Andy, Mike and Tim. I know that they have met the Prime
Minister.
Will the Minister give way?
I am just answering a question on suicide. I would be very happy
to meet the 3 Dads Walking to learn the lessons for our suicide
prevention strategy.
Ms Brown
Will the Minister give way now?
I will not give way. I only have a few minutes left.
It is disappointing that Labour Members cannot understand the
progress that has been made and are determined to make political
points, damaging the work that our NHS staff up and down the
country do day in, day out, backed by record levels of investment
that have never been seen before in mental health services.
It is true that we have tabled an amendment this afternoon, in
which the Prime Minister acknowledges how much work we have done
in this space. With a rising number of people accessing mental
health support, which is a good thing and not something to be
criticised, we are investing in those services and in 27,000
extra staff.
Ms Brown
Will the Minister meet me?
Madam Deputy Speaker, I will continue if I may.
Despite the disingenuous motion proposed by the Labour party, it
is my privilege to hear about the valuable contributions being
made up and down the country. It is so easy to talk down our
services, but if Labour Members are serious about improving
mental health services, perhaps they should talk to their Welsh
counterparts. Action speaks louder than words. Mental health
services in England are performing better than those in Wales. We
all know that this is not really about improving mental health
services; it is about using mental health as a political
football, but we on the Government Benches will not play that
game.
Question put (Standing Order No. 31(2)), That the original words
stand part of the Question.
[Division 246
The House divided:
Ayes
185
Noes
280
Question accordingly negatived.
Held on 7 June 2023 at
3.56pm](/Commons/2023-06-07/division/46859608-0CCB-4C9C-BD79-C2C792285D8A/CommonsChamber?outputType=Names)
Question put forthwith (Standing Order No. 31(2)), That the
proposed words be there added.
[Division 247
The House divided:
Ayes
278
Noes
0
Question accordingly agreed to.
Held on 7 June 2023 at
4.11pm](/Commons/2023-06-07/division/54CEA8F7-1635-4B06-B97A-E95F70C03508/CommonsChamber?outputType=Names)
The Deputy Speaker declared the main Question, as amended, to be
agreed to (Standing Order No. 31(2)).
Resolved,
That this House notes the increased burden on mental health
following the pandemic, including on young people and those with
severe mental illness; recognises the historic levels of
investment being delivered by this Government into services, with
an increase of £2.3 billion per year in front-line mental health
funding over the past four years; notes that current NHS targets
around access to talking therapies and intervention in psychosis
are being met due to the efforts of NHS staff; and acknowledges
the investment in mental health teams in schools, as well as the
ongoing investment into open access mental health helplines in
the 111 service and into the estate, including three new mental
health hospitals to be opened in the next two years accompanied
by a further £150 million in investment in new mental health
ambulances and the development of better alternatives to accident
and emergency services, including crisis houses, safe havens and
step-down services.
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