The Secretary of State for Health and Social Care (Steve Barclay)
With permission, Mr Speaker, I would like to make a statement on
improving safety in mental health in-patient services across
England. Before doing so, I want to thank all the right hon. and
hon. Members from across the country who have campaigned tirelessly
on behalf of their constituents to improve mental health care. Too
many people have experienced care in mental health in-patient
settings that has been...Request free
trial
The Secretary of State for Health and Social Care ()
With permission, Mr Speaker, I would like to make a statement on
improving safety in mental health in-patient services across
England. Before doing so, I want to thank all the right hon. and
hon. Members from across the country who have campaigned
tirelessly on behalf of their constituents to improve mental
health care. Too many people have experienced care in mental
health in-patient settings that has been well below the high
standard that we all deserve when we are at our most vulnerable.
I would also like to put on record my sincere condolences to the
families and friends of those who have lost their lives.
First, I will update the House on the independent inquiry into
mental health in-patient care across NHS trusts in Essex between
2000 and 2020. I thank my right hon. Friend the Member for
Chelmsford () for tabling a Westminster Hall
debate on the Essex mental health inquiry earlier this year. She
and colleagues, including our hon. Friend the Member for Rochford
and Southend East (Sir ) and our right hon. Friends
the Members for Witham () and for Maldon (Sir ), all spoke passionately
about the need to get justice for patients and their families. I
know that my hon. Friend the Member for South Suffolk () also tabled an
Adjournment debate on mental health in-patient care in Essex
before the independent inquiry was launched in 2021.
I also pay tribute to my right hon. Friend the Member for Saffron
Walden () and my hon. Friends the
Members for Clacton (), for Brentwood and Ongar
(), for Castle Point (), and for Southend West
() for their determined
campaigning on behalf of their constituents. Of course, we should
all remember the important contribution of the former Member for
Southend West, and a great friend to many across this house, the
late . He tabled a Westminster Hall
debate on mental health services in Essex back in 2014, and he
was a passionate campaigner for improving mental health care. I
know he is very much in our thoughts.
In 2021 we launched the independent inquiry to investigate the
deaths of mental health in-patients across NHS trusts in Essex
between 2000 and 2020. The Government appointed Dr Geraldine
Strathdee, a former national clinical director for mental health
for NHS England, to chair the inquiry. I want to place on the
record my thanks to Dr Strathdee and her team, because a lot of
good work has been done. I applaud the bravery of all the victims
and their families who have come forward to tell their
stories.
I also recognise the work that the Essex Partnership University
NHS Foundation Trust—EPUT—has done to assist with the inquiry.
The trust has been in the spotlight, and progress has already
been made to learn lessons and improve in-patient mental health
care. EPUT’s chief executive, Paul Scott, joined in 2020, and
since then the trust has invested £20 million in its mental
health in-patient wards and a further £20 million in community
services. Compared with 2019, patients absconding from care has
decreased by more than 60%, and the use of inappropriate
restraint has fallen by 88%.
However, in January Dr Strathdee raised concerns with me about a
lack of engagement with the inquiry by current and former EPUT
staff. I know that many right hon. and hon. Members share her
concerns. Since then, the inquiry and the trust have worked
together in a concerted effort to increase staff engagement. None
the less, I have listened to Dr Strathdee’s concerns that the
inquiry still needs further staff engagement to get victims’
families the answers they deserve. In a letter to me in March,
she said that
“30 percent of named staff, those essential witnesses involved in
deaths we are investigating, have agreed to attend evidence
sessions. In my assessment, I cannot properly investigate matters
with this level of engagement.”
She has also raised with me concerns about ongoing safety issues
at the trust. To quote from her letter once again, she said:
“I am very concerned that there are serious, ongoing risks to
patient safety. Due to the nature of these issues, I am confident
that these cannot be properly investigated by the Inquiry without
statutory powers.”
The Government take both concerns extremely seriously, and I
agree with Dr Strathdee that we have now reached the point where
the only appropriate course of action is to give the inquiry
statutory powers.
Statutory inquiries do take longer, but this does not mean that
work will start from scratch. Dr Strathdee’s existing findings
will inform the next phase of the inquiry. She has informed me
that, owing to personal reasons, she will not be continuing as
the inquiry’s chair, so I want to thank her once again for all
her commitment and hard work. I am sure the House will agree that
she is a true public servant. Our work to find her successor is
proceeding at pace, and I will update the House on the progress
of setting up the inquiry in due course.
I recognise that Members’ concerns about mental health in-patient
facilities are not confined to Essex. The Government are
committed to improving mental health care across England, which
is why we are boosting mental health funding by at least £2.3
billion this year compared with four years ago, why we are making
urgent mental health support available through 111, and why we
are delivering three new mental health hospitals to provide
specialist care and cut waiting lists.
In January, we commissioned a rapid review of how data is used in
in-patient mental health settings in England. More effective use
of data has the potential to reduce duplication, ensuring that
healthcare professionals can spend more of their valuable time
with patients. The review team—well led again by Dr
Strathdee—heard from more than 300 people representing every part
of the in-patient mental health sector, including former patients
and frontline staff. Dr Strathdee has made recommendations for
how data and evidence can be used to identify risks to patient
safety and failures in care more quickly and effectively. The
findings and recommendations of the rapid review will be
published today, and I will deposit a copy in the Libraries of
both Houses. The Government will consider its findings carefully
and respond in due course.
We recognise, however, that patients and families want to know
how their concerns will be taken forward as soon as possible, and
I also recognise that a wide-ranging statutory inquiry relating
to other settings, or covering multiple patient safety issues,
would not deliver those answers quickly. My Department has
therefore agreed to work alongside the Healthcare Safety
Investigation Branch to prepare for the launch of a national
investigation of mental health in-patient services, which will
commence in October, when the HSIB receives new powers under the
Health and Care Act 2022.
The new Health Services Safety Investigations Body will
investigate the following themes: how providers learn from deaths
in their care and use that learning to improve services,
including post-discharge services; how young people are cared for
in mental health in-patient services and how that care can be
improved; how out-of-area placements are handled; and how to
develop a safe staffing model for all mental health in-patient
services. Across all those areas, it will explore the way in
which providers use data. I want to reassure the House that the
new body will have teeth and will work at speed, that it will
have the power to fine those who refuse to give evidence when
they are required to do so, and that its predecessor’s
investigations were typically concluded within a year.
I hope that today’s announcements will be of some comfort to the
bereaved families who have done so much to raise awareness of the
failings of mental health care in Essex and elsewhere. I want
them to know that the Government are committed to obtaining for
them the answers that they deserve, and to improving mental
health across the country. I commend this statement to the
House.
Mr Speaker
I call the shadow Minister.
1.23pm
(Tooting) (Lab)
I thank the Secretary of State for advance sight of the
statement. However, it beggars belief that it has taken the
Government so long to address the House on this matter. It seems
that every month there are new scandals regarding needless loss
of life and dehumanising behaviour in in-patient mental health
settings. That must be stamped out now—these are people’s
lives.
That brings me to the subject of Essex Partnership University NHS
Foundation Trust. I welcome the announcement today that the
inquiry will be given vital statutory powers, because for several
years families who have lost loved ones at the trust have been
calling for the inquiry to be given those powers. The grieving
families I have spoken to have told me about the pain and anguish
they have felt during their fight for answers, and that has only
been compounded by an inquiry that lacked the necessary powers to
seek the truth.
I must pay tribute to those families for their tireless
campaigning and effort. In particular, I thank Melanie Leahy, who
has fought for too long to achieve the announcement that has
finally come today. I hope that Melanie, and every other family,
will now start learning the truth.
Dr Strathdee has been a powerful advocate for the Essex inquiry,
and we want to express our thanks to her for the work that she
has already put in. The next inquiry chair must continue her
work, and hold the confidence of the families who have been
impacted in Essex.
I have repeatedly called on the Secretary of State to give the
Essex inquiry statutory powers, and I am pleased to see that he
has finally listened to our calls, but why were families left in
the lurch for so long? Following months of scandals in in-patient
mental health hospitals, public confidence is falling. More than
one in three people say that they do not have faith that a loved
one would be safe if they needed hospital mental health care, but
every patient must be treated with dignity. I have repeatedly
asked Ministers whether they have visited failing trusts. The
Minister refused to answer, so will the Secretary of State commit
himself to greater transparency? The Secretary of State has
announced that urgent mental health support will be made
available through 111, but 1.6 million people have been left
languishing on waiting lists for mental health treatment, their
condition deteriorating and reaching crisis point.
It is welcome that we will finally see the publication of the
rapid review today—better late than never—but Labour has been
calling for in-patient mental health settings to be reviewed in
the light of these serious failings, and any rapid review should
have had patient voices at its centre rather than being simply
the data exercise that the Government commissioned. When we look
at the planned national investigation into in-patient services
that they will conduct alongside the Health Services Safety
Investigations Body, we see that, yet again, there is no mention
of working with patients and their families. Where is the
learning? Where is the focus on what staff need in these
settings? Are the Government looking at additional training
needs, given that mental health care relies on staff and not
simply on shiny equipment?
Let me turn briefly to the planned consultants’ strike, about
which the Health Secretary has said absolutely nothing. Yet again
he has been missing in action. For my consultant colleagues to
have voted to strike is extraordinary, and the risk to patients
of seven days of strike action is intolerable. Next week marks
the 75th anniversary of the NHS, and it has never been in a worse
state. The country is clear about who is to blame. It is not
nurses, it is not junior doctors, it is not consultants, and it
is not paramedics; it is this Conservative Government. They have
lost control of the NHS, they have lost the confidence of NHS
staff, and they have lost the support of the British people. The
only ballot that we need now is a general election.
It is a shame that the hon. Lady chose to conclude her remarks in
such a way. Let me address that head-on. It is bizarre to accuse
a Minister who is literally at the Dispatch Box of being missing,
particularly when the shadow Health Secretary, having managed to
turn up for Prime Minister’s Question Time, has failed to turn up
for this statement. It is even more bizarre that, although we are
constantly told that the Labour party sees parity between mental
health and physical health as a key priority, when it actually
comes to debating the issue, the contrary is clearly on show.
This debate is not about the issues normally raised during Prime
Minister’s questions about the politics of the day; it is about
the families who have tragically lost loved ones, about how we
can learn the lessons from that, and about how we can ensure that
we get the data right, get the support for staff right, and get
the procedures right so that other families do not suffer loss.
We have responded to the excellent points made by Dr Strathdee
through her rapid review about data. There are two elements to
that: there is data that is collected that does not add value, is
often duplicative and takes staff away from giving care—that is
somewhere that we can free up staff—but there is other data that
is needed to better identify issues early, and we need to look at
how we improve that data. Specific issues arose in respect of
engagement by staff, and we have actively listened and responded
to the concerns raised by families and by many Members of the
House, particularly about the Essex inquiry. I will come on to
those as I go through the wider issues.
The shadow Minister mentioned speed. Of course, there is a
balance to be struck between the completeness of a statutory
inquiry and the greater speed that is often offered by other
independent inquiries. Indeed, the Paterson inquiry was a
non-statutory inquiry commissioned through the Department, and
that is another vehicle that is often successfully used. There
are also inquiries commissioned through NHS England, such as the
Donna Ockenden review. There is often a balance to be struck
between those inquiries, given the speed at which they can
proceed, and a statutory inquiry, which has wider powers but
often takes longer.
It was because of our desire to move at pace to get answers to
families that we initially commissioned a non-statutory inquiry,
in common with Bill Kirkup’s inquiry into Morecambe Bay and
inquiries into many other instances in the NHS. However, we have
listened to families and to right hon. and hon. Members who have
raised concerns about the process and, in particular, the
engagement by staff, and decided to make it a statutory
inquiry.
The shadow Minister asked about our commitment to transparency.
The very reason that we set up the rapid review in January was to
bring greater transparency to the data. That is why I will be
placing in the Libraries of both Houses the outcome of the rapid
review. That speaks to the importance of transparency as we learn
the lessons of what went wrong in Essex and in other mental
health in-patient facilities.
The shadow Minister made a fair point about waiting times. We are
committed to cutting waiting times, including in mental health.
That is why we are spending £2.3 billion more on mental health
this year than four years ago, we have commissioned 100 mental
health ambulances, we have 160 different schemes looking at
things such as crisis cafés to support people in A&E, and we
have schemes such as the review through 111 and the funding the
Chancellor announced in the Budget for mental health digital apps
to give people early support. Of course, that sits alongside
other mental health interventions, such as our programme to train
more people to give mental health support in schools.
The shadow Minister made an important point about working with
families. I agree with her about that. HSIB will be meeting
families—indeed, Ministers have been doing likewise—and we are
keen that that should feed into the terms of reference, both for
the statutory inquiry and for the HSIB review.
We have touched on consultants, but let me make a final point on
that. As far as I am aware, the Opposition do not support a 35%
pay rise, whether for junior doctors or for consultants, but if
that is their position, perhaps they will tell us whether this is
yet another area that the stretchable non-dom contribution will
reach to. Exactly how will it be funded?
This is a serious issue. The measures that we are taking address
the concerns of families who have suffered the most tragic loss.
It is important that we learn the lessons, both in Essex and more
widely. We have actively listened to the points raised by Dr
Strathdee, who has done a fantastic job. It is right that the
work moves on to a statutory footing, but it is also right that
we look more widely at the lessons from other mental health
in-patient facilities. That is exactly what we intend to do.
(Witham) (Con)
First, let me put on the record my personal thanks to the
Secretary of State and Ministers for their honest and frank
engagement with colleagues and with bereaved families, whose
concerns they have listened to. It was my constituent Melanie
Leahy, who was at one stage a constituent of my right hon. Friend
the Member for Maldon (Sir ), who brought the issue
to our attention and to the attention of the Secretary of State.
She deserves a lot of support for the way she has conducted
herself. None of us would want to go through the sheer anguish
and personal trauma that she has experienced. We owe a lot to her
and to others who have come forward.
There are still 80-plus families who did not engage with the
inquiry led by Dr Strathdee, to whom I pay tribute. The statutory
inquiry will give them the confidence and courage to come
forward, speak up and share what will be—we should be frank about
this—deeply harrowing evidence. Will the Secretary of State
expand on how evidence received by Dr Strathdee’s inquiry will be
treated? I know that he said he will come back to the House on
the processes. We are interested, in particular, in the inquiry’s
terms of reference. Importantly for bereaved families, what
measures will be in place to support people to come forward and
give evidence? There have been too many barriers in that regard
for families and, if I may say so, those who have been employed
by EPUT. What involvement will the families have in drawing up
the terms of reference? They are the ones that need confidence in
the process. Again, I thank Dr Strathdee, and I thank the
Secretary of State and Ministers for their engagement.
In my discussions with my right hon. Friend and colleagues, I
found the compassion that they showed and the way they championed
the family voice compelling. I absolutely agree that it is
important that families take confidence from the decision to move
the inquiry on to a statutory footing and come forward with their
evidence. I know that she plays an active part in that. Of
course, we want families to be part of the discussion on the
terms of reference. I know that, with her significant experience,
my right hon. Friend is keen to be part of that too, and we are
keen to engage with her on it.
My right hon. Friend is right to highlight the evidence that has
already been gathered through the excellent work of Dr Strathdee.
I had a meeting with her yesterday to ensure that we capture that
as part of the work that is moving forward. I hope—I reinforce my
right hon. Friend’s point—that families will take confidence from
today’s announcement and that those families who have not come
forward to date will be able to do so. I know that in my right
hon. Friend they will have a resolute champion supporting them to
do so.
(York Central)
(Lab/Co-op)
I, too, welcome the Secretary of State’s statement, but I am
disappointed that he did not say more about the serious risks
that we have raised in the House—not least about timely access to
services and the significant risk that many of my constituents
have faced out in the community—in respect of Tees, Esk and Wear
Valleys NHS Foundation Trust, which serves York. I wonder whether
he can expand on that, and on his proposals for taking things
forward at the trust. I am meeting one of his Ministers next
month, but I would like to hear his position on addressing the
serious concerns that have been raised.
The hon. Lady raises a very valid point. There are real concerns
about Tees. We considered that when considering the scope of the
statutory inquiry. Given that significant work had been done in
Essex, we decided to strike the balance by putting that on a
statutory footing but enabling work to proceed at pace through
HSIB on Tees and some other areas. The hon. Lady will know that
the Care Quality Commission prosecuted the trust in May for a
regulation 12 breach, and that significant work has already gone
in; the report of the system-wide independent investigation was
published last March. They are very serious issues on which I
think there is concern across the House, and we stand ready to
work with her and other elected representatives from that area as
part of the wider work.
(Chelmsford) (Con)
It is a deep, deep tragedy that, over the 20-year period, around
2,000 people lost their life under the care of mental health
services in Essex. Families and survivors are right to want
transparency and accountability. Given the slow progress of the
independent inquiry, it is right that it now moves to a statutory
basis.
When I spoke in Westminster Hall, I shared the testimony of a
constituent who had been an in-patient in the early 2000s. She
described being raped by another patient and being laughed at by
staff when she asked for support. She described being able to
make many suicide attempts, absconding from the ward and
overdosing. She described how staff refused to treat her
self-harm injuries and how she was repeatedly restrained and
forcibly injected. I put on record my incredible respect for the
people who are coming forward to relive their horrors and share
their testimony. They are doing this because families and
survivors want to know that change is embedded so that lives are
safeguarded now and in the future. Will my right hon. Friend give
assurance to my Essex constituents that mental health services in
Essex will now be given the support they need to keep vulnerable
people safe?
Having discussed that harrowing evidence with my right hon.
Friend, I do not think any Minister could either forget it or not
be moved. I found it an extremely moving experience to hear her
talk about the experiences of a number of her constituents. She
is right to praise those who come forward, and to recognise that
it is often a difficult ask to relive the most awful
circumstances, but it is important that families come forward so
that we learn lessons and ensure this is not repeated.
My right hon. Friend is also right to highlight the two broad
elements of learning the lessons of what happened in the past and
maintaining services for the future. I am therefore happy to give
her an assurance that we will work closely with her on support
for Essex as lessons are learned through the statutory inquiry
and as services continue to be delivered. We are working closely
on that with the chief executive.
(St Albans) (LD)
My thoughts are, first and foremost, with the bereaved families
and all those involved, because this process must be utter agony
for them. It is right that the inquiry is put on a statutory
footing.
In his statement, the Secretary of State quoted from a letter he
received from Dr Strathdee, in which she said:
“I am very concerned that there are serious, ongoing risks to
patient safety.”
The Secretary of State did not expand on that, and I do not know
whether he is able to do so. If I may extrapolate, we know that,
more broadly, there are risks to patient safety when there is not
enough workforce and when there are not enough beds.
Hertfordshire is the most under-bedded area of the country. When
we see the workforce plan, potentially this week, will it include
estimates of the number of qualified mental health staff we need
in in-patient settings, NHS community settings and schools? Will
he meet me and my local mental health trust to discuss the number
of beds we have in the county and our plan to expand them?
Dr Strathdee did not particularly focus on staffing numbers, as
far as I recall; she focused on some of the issues with care from
staff. That was the nature of the concerns. On the ongoing risk,
part of the reason why we commissioned the rapid review was to
look, in particular, at the quality of data. There was a quantity
of data that was not effective, and that often distracted staff
from spending time with patients. There were also gaps in the
quality of data that needed to be filled, and the document that
will be placed in the Libraries of both Houses speaks to that
point. That is why we are so keen to move at pace on learning
lessons.
(Runnymede and Weybridge)
(Con)
I welcome that sentence and the seriousness and speed with which
this is being taken forward.
As a now non-practising consultant psychiatrist, I have a variety
of declarations in this area, which are best summarised in the
pre-legislative scrutiny report on the draft Mental Health Bill.
My constituents are waiting for the rebuild of the Abraham Cowley
unit in my constituency, but the framework under which patients
are looked after is very important. People in in-patient settings
are, by definition, some of the most vulnerable people looked
after by the NHS, and a fair proportion are a detained
population. Could the Secretary of State update the House on how
soon we will see the Government’s response to the pre-legislative
scrutiny Committee report on the draft Mental Health Bill and
when we expect the proper Bill to be brought forward?
My hon. Friend is right to highlight the importance of
pre-legislative scrutiny, into which he had a personal input. I
am hugely grateful for his work and the work of and others. I met some months ago to
discuss the outcome of that pre-legislative scrutiny. I do not
have a date to share today, but I am happy to write to my hon.
Friend with a further update.
(Vauxhall)
(Lab/Co-op)
Many of my constituents depend on mental health services provided
by the South London and Maudsley NHS Foundation Trust, which
provides a range of services for very vulnerable people across a
large part of south London. The in-patient service includes
cleaning and catering facilities, and it is vital that those
services are run well so that well-trained professional staff are
able to treat mental health patients. Some of the trust’s staff
are contracted to a company called ISS, and they have been on
strike. Does the Secretary of State agree that ISS should come to
the table and discuss the issues of the pay dispute so that staff
can provide the cleaning services for mental health professionals
to continue with their vital jobs?
We are investing more in mental health services as a whole, and
that includes the important area of cleaning and catering
services. Obviously, it would be inappropriate for me to comment
on that specific contractual dispute, but industrial action, in
its wider sense, is clearly disruptive and I am very keen for it
to be resolved as quickly as possible, whether in the context of
consultants or cleaning and catering services.
(South Basildon and East
Thurrock) (Con)
I welcome my right hon. Friend’s statement and the move to put
the EPUT inquiry on a statutory footing. He mentioned that
putting it on a statutory footing means it will take longer. On
behalf of constituents and those who are keen to get closure on
these important issues, can he give any kind of indication of
when the findings might be available?
The chair is to be appointed, and given that statutory basis and
the independence of the chair, it would be wrong for me to
pre-empt the terms of reference. People can look to other
statutory inquiries and come to a conclusion. The inquiry is not
starting from scratch, and part of the reason we originally went
with a non-statutory inquiry was because of the desire for speed.
Of course, Dr Strathdee has done a huge amount of work and it
will be available to the new chair of the statutory inquiry. One
can look to other inquiries and draw conclusions, but I would
expect it to move more quickly in this instance because a
significant amount of work has already been done.
(Plymouth, Sutton and
Devonport) (Lab/Co-op)
I welcome the statutory inquiry, which is a step in the right
direction. I also welcome the Secretary of State’s focus on
families. Ensuring family involvement in the care of mental
health in-patients not only improves patient outcomes but enables
proper scrutiny and questioning of care. In regions such as the
south-west, many patients facing the most serious mental health
crises receive care outside the region, which is often a long way
for families to travel. Is he considering the increased
commissioning of local provision so that families can know their
loved ones are being well cared for? Many families will be
concerned about the statement and the experiences of patients in
Essex. The right care and the best care for many patients is
closer to home.
The hon. Gentleman raises an extremely important point, and he is
right that a particular downside of out-of-area placements is
often the distance from families. Indeed, one can see in the data
that there is often a corresponding uptick in issues of harm. The
crux of his point is very valid. That is why we are committed to
building new facilities, with three new hospitals for mental
health announced in the statement I gave on the new hospitals
programme; that included three new mental health ambulances. This
is also about preventing people from needing in-patient care
through our crisis cafés, our earlier intervention in community
services and the interplay with 111. More fundamentally, it is
about giving greater power to commissioners on a place-based
basis. The reforms through integrating health and social care,
having fewer targets from the centre and allowing more devolved
decision making mean that those areas that want to put more money
into in-patient mental health, for example, have greater
flexibility to do so. The point the hon. Gentleman raises is
extremely important and it is exactly what we are
facilitating.
(Thurrock) (Con)
As my right hon. Friend observed, a non-statutory inquiry is
generally more fleet of foot than a statutory one. It is so
disappointing that the failure of staff to engage in that process
has brought us to where we are now. That would indicate a very
poor culture and sets the tone for how this inquiry will be taken
forward. Let me remind him that one reason we are so anxious to
get the Mental Health Act reformed is that kind of behaviour
towards patients. Too many in-patient settings see patients as an
inconvenience to be managed, rather than having their real
welfare at heart. Will he therefore redouble his efforts to make
progress on this, because many people who have been through the
other side want to see that progress?
First, I do not want to wait for legislation before we make
changes. Indeed, under the leadership of Paul Scott, who joined
EPUT in 2020, investment has been made, with an extra £20 million
being put into the in-patient wards and a further £20 million
into community services. We are keen to make further progress on
that. On the wider issue of legislation, I know that my hon.
Friend, as a former Government Whip, is particularly acquainted
with how the legislative process works, but the Government take
her comments, and those of the House, on engaging staff in this
process seriously, and we are working very actively on that.
(Warrington North)
(Lab)
It is vital that the Government work with sector experts and
those with lived experience of in-patient mental health services
in getting this vital area of policy right. As someone who spent
almost a month as a psychiatric in-patient back in 2021, I know
at first hand how difficult, disorientating and dehumanising
these settings are, at a time when you are at your most
vulnerable, and how easily things that are well-intentioned can
and do go wrong. Will the Secretary of State therefore commit to
working with Mind and other organisations giving patients and
their families a voice to shape these improvements, to ensure
that any changes happen with patients and their families, and not
to them?
I very much agree on that. The hon. Lady speaks powerfully of the
importance of engaging with those with experience—the charity
sector, the families and those directly impacted by the decisions
taken in in-patient mental health facilities. She makes an
extremely pertinent point and it is very much part of the
approach we are taking.
(Rayleigh and Wickford)
(Con)
I thank the Secretary of State for mentioning our great friend
. I am sure that, if he were
still with us today, he would welcome this statement, as do I, as
does his successor and, as is clear, as do all other Essex MPs.
The Secretary of State has done the right thing and should be
commended. EPUT has been a troubled organisation for some time,
although I believe that its chief executive, Mr Paul Scott, is
genuinely trying to turn it around. As we look back to find out
what went wrong—some things clearly went very badly wrong—will
the Secretary of State work with the chief executive, providing
support and resources, not just to make sure this does not happen
again, but to try to help EPUT improve in the future as well as
examine the past?
I know that my right hon. Friend was particularly close to Sir
David and is uniquely qualified to speak of his interest and
involvement in these issues. I am happy to give him the
reassurance that he seeks on working closely with the chief
executive and the leadership team there. I know from my
engagement with colleagues across the House that they will be
closely involved in this in the weeks and months ahead.
(Bermondsey and Old Southwark)
(Lab)
South London and Maudsley is the mental health trust that covers
my constituency. This year, as a direct result of the Secretary
of State’s wider policies, SLaM is cutting £45 million from
services. He has said today that he wants to improve mental
health care and that he takes safety concerns seriously, but when
will those words be meaningful for mental health care for
patients and their families in Southwark?
The meaningfulness of those comments can be seen in the fact that
we are putting this inquiry on a statutory basis; the £2.3
billion additional investment compared with what we had four
years ago; the crisis cafés and the other schemes we have, as
part of the 160 schemes we are bringing forward; and our
willingness to innovate in mental health through the use of
mental health digital apps. There is a whole range of initiatives
because that is the right approach. Across the House, it has been
recognised that in the past mental health did not get as much
focus as physical health, which is why we are investing more.
Again, the House recognises that covid has brought more focus to
these issues, which is why this is a priority for the Government.
Today’s statement is a further continuum in that effort.
Sir (Rochford and Southend
East) (Con)
I thank the Secretary of State for his attitude to this issue and
the time he has put in. I fully support the points he has made
about non-statutory and statutory inquiries. It was right to
start off non-statutory and to change when the situation changed
and we were not getting what we wanted.
I reflect on the comments of my right hon. Friend the Member for
Rayleigh and Wickford (Mr Francois) about, “Where did this go
wrong?” Since I first visited Rochford Hospital, part of what is
now EPUT, in my constituency, I believe we have had three
Secretaries of State visit, as well as at least five Ministers
responsible for these areas. What was the South Essex Mental
Health Partnership grew to take in more of Essex, and it then
reached across the border into Hertfordshire and, if I recall
correctly, went further. It perhaps just got too big. Early on,
the constituents I spoke to were concerned about getting in; they
wanted their children to get in, but there were delays and this
was about overall capacity. Now the issue is about the quality of
what goes on. The hon. Member for St Albans () mentioned beds and I can tell
her that this is not a problem of beds, certainly in Rochford
Hospital, where there are plenty of beds; it is about having the
clinical psychiatrists specialised in children’s services and the
supporting nurses to deliver. We should also pay attention to the
fact that things are much better where people have simple mental
health problems, but very few people have those. When these
problems are combined with drug use or autism, particular
challenges are presented while people are in these places and
during discharge. I urge the Secretary of State to encourage the
inquiry to look into all those issues.
My hon. Friend makes extremely important points, and I absolutely
agree with him. Indeed, I will draw the inquiry’s attention to
the points he raises. He is right about the trade-off between
non-statutory inquiries giving speed and statutory inquiries
having a wider range of powers. We have followed the evidence on
that, which Dr Strathdee has shared. There is also a balance
between the size of a facility and the quality of the care. Data
is a key component within that and the rapid review was focused
particularly on it. All of us are focused on, “How do we get the
best patient outcomes? Where those have fallen short, how do we
ensure the lessons of that?” That is what the statutory inquiry
is absolutely focused on and it is important that families then
engage with it.
(Bristol East) (Lab)
The Care Quality Commission report at the end of last year said
that workforce issues and staffing shortages are the greatest
challenge facing the mental health sector. I am sure that that
would not have come as a surprise to the Health Secretary. The
Glenside campus, part of the University of the West of England,
is in my constituency, and it runs mental health training courses
for nurses. What conversations is he having with the sector about
how we can ensure we get enough mental health nurses trained, so
that we get the right people coming through and they are
encouraged to stay the course?
The hon. Lady’s point is important, given that in the wake of the
pandemic we have seen significant increases in demand,
particularly for children’s and young people’s services. For
example, in a year, the demand increased by 41%, so there is
significant demand, which places pressure on the workforce. That
is why the Prime Minister and the Chancellor have committed to
the long-term workforce plan, which we will be bringing forward
very shortly. We have been engaging with the sector, including
the mental health sector, as part of that plan. NHS England has
been doing significant work on that in recent months.
(Watford) (Con)
The background stories to today’s announcement are truly
heartbreaking, and I welcome the statutory inquiry. The Secretary
of State referred to recent announcements about funding and the
111 helpline. Will he expand on what support can be accessed by
people, especially young people, if they are going through a
crisis right now?
It is extremely important that we get support to young people,
because many mental health cases start at a young age. Indeed,
data suggests that as many as 50% of mental health cases
crystalise by the age of 15, so it is important that intervention
is made early. Our programme in schools, for example, is focused
on that. It is also important for us to have better community
support, which is why we are looking at what mental health
support can be offered when people phone 111 and at how we can
better scale up the use of digital apps that offer support, given
that people often access information through their phones or
digital channels in a way that they did not five or 10 years
ago.
(Strangford) (DUP)
On behalf of my party, I express my sympathy to all the families
who have been bereaved and hurt by what has taken place. I thank
the Secretary of State for his announcement about the statutory
inquiry and the new powers. It is clear to those of us in the
House who listened to his statement that he is committed to
making patients’ lives better; we thank him and I put it on the
record that he deserves credit for that. I know that the
Secretary of State is always keen to share progressive strategies
and policies with the regional Administrations; he is on record
as having said that. It is clear that many lessons can and will
be learned, so does he intend to share them with the regional
Administrations?
I am extremely keen to share our experience, so that we can learn
from each other. As the hon. Gentleman knows, this is a shared
challenge across our United Kingdom. The pandemic shone a
spotlight on the mental health pressures that many people face,
and I am extremely keen to work on a UK-wide basis with
colleagues to ensure that we learn from each other as we take
these measures forward.
(York Outer) (Con)
Given that a recent report into mental health services in York
established that communication is a clear concern that is
affecting mental health outcomes and safety locally, what
specific steps would my right hon. Friend take to ensure better
communication between primary and secondary care services? As we
all know, that is vital in delivering faster and better outcomes
for patients not only in York but across the country.
That is an extremely good point. In fact, a key element of the
primary care recovery plan looks at the handover points between
secondary and primary care, which are often the cause of
significant additional work within primary care. We are keen to
see where we can ease those pressures, which in turn frees up our
experienced GPs to do those tasks that require more time, so that
is part of the primary care recovery plan. Through the rapid
review and the focus on data, we are better able to identify
where there are gaps or areas of duplication that take clinicians
away from spending time with patients. That matters both in
secondary and primary care, and it is something that the rapid
review has been addressing.
(Darlington) (Con)
I welcome my right hon. Friend’s statement and the publication of
the rapid review. While Essex is rightly getting its statutory
inquiry, it appears that the situation in Tees, Esk and Wear
Valleys NHS Foundation Trust will merely be covered by the new
powers of the Healthcare Safety Investigation Branch. Will my
right hon. Friend confirm that TEWV will be covered by the HSIB
review? When can families expect to hear anything from that
review? Will he keep the need for a statutory inquiry into TEWV
under review?
It will be covered by the HSIB review. On how long that will
take, investigations under the predecessor body typically took
around a year, which is one of the advantages of the speed at
which these things can be done. I hope my hon. Friend can see
from the statement today that we will follow the evidence, given
the decision we have taken to put the Essex inquiry on a
statutory footing, but the HSIB approach has the benefit of
speed. I hope that will benefit his constituents, as we learn the
lessons.
It is worth clarifying that the new body will have much greater
teeth, as a result of the reforms that were passed by the House
in 2022. While it is not on a statutory footing, it actually has
more power than was the case in the past. That is why we think it
is the right approach for learning the lessons in his
constituency and more widely.
(Brigg and Goole) (Con)
The Secretary of State has rightly pointed to the £2.3 billion in
extra funding and has reiterated from the Dispatch Box his belief
that early support for children’s mental health is vital. Does he
agree that this is sadly still patchy across the country? Early
access to children’s mental health services needs to be a
priority for all new care systems. I commend to him the approach
being taken in north Lincolnshire, where that is absolutely the
case and where it has been championed by the wellbeing boards and
in all our health partnerships. That should be replicated across
the country.
I commend my hon. Friend for the service he gives as a community
first responder. Through that, I know he takes a huge interest in
these matters. As with the point about data, I am extremely keen
that where there is good practice, we are socialising that across
the country as a whole, rather than having it in pockets. I would
be extremely keen to work with him on the lessons coming out of
north Lincolnshire and on how we scale that across the country,
so that good practice can be adopted more widely. Indeed, the
statement today is about how we will ensure that the lessons from
Essex can be applied more widely, so that best practice is
socialised across the country.
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