Health Committee

Debate between Baroness Keeley and Sarah Wollaston

Thursday 16th March 2017 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

(Select Committee Statement): The scale of the avoidable loss of life from suicide is unacceptable. In 2015, 4,820 people in England took their own lives, and across the UK 6,122 people did so in 2014. But those official figures underestimate the true scale of the devastating loss from suicide, which remains the leading cause of death in young people between the ages of 15 and 24, and it is the leading cause of death in men under 50. It is strongly linked to deprivation and is a major contributor to health inequality. However, the key message our Committee heard throughout its inquiry is that suicide is preventable, and we can and should be doing far more to make sure we reduce it. That was the key focus of our suicide prevention inquiry.

First, let me thank all those who contributed to the inquiry, particularly families bereaved by suicide, and those who had experienced suicidal ideation and been users of mental health services. Their evidence was courageous and compelling. I also thank all the voluntary groups and volunteers who are working to provide support for people in crisis, and all our front-line staff. Finally, I thank my fellow Committee members and our Committee staff, particularly Laura Daniels, Katya Cassidy and Huw Yardley.

I shall now move on to what we found in our inquiry. First, let me say to the Government that we welcome their suicide prevention strategy, but as with any strategy the key is implementation. We therefore call on them to go far further in implementing and resourcing it, and to give greater attention to the workforce in order to make the important improvements come forward. We also make further recommendations and we are disappointed that the Government have not gone further in a number of areas. We know that we can take actions to reduce suicide and we highlight a number of these in our report. For example, we know that half of those who take their own lives have previously self-harmed, and we feel it is really disappointing that the experience of so many of those who have self-harmed when they go to casualty departments is that they are made to feel that they are wasting people’s time. We know that liaison psychiatry makes an enormous difference, but there are resourcing issues on that.



We also know that those who have been in-patients in mental health settings should receive a visit within three days of leaving in-patient services, but there simply are not the resources available for that to be put in place. We call on the Government to go further in looking at the workforce and resourcing needed for that to happen. We know of other serious issues, for example, the fact that about a third of people who take their own lives are not in contact with either primary care or specialist health services in the year before their death. We feel that suicide is everyone’s business and we all have a responsibility to reduce the stigma attached to mental health so that it is easier for people to seek help. Again, I pay tribute to all those who are working in this field, reaching out to people in non-health settings and making a real difference. However, many of those voluntary groups are coming under great financial pressure. It is welcome that the Government have announced that there will be £5 million for suicide prevention, although that does not come in until next year, with £10 million in each of the subsequent two years. However, we feel that that is too little, too late, particularly given the cuts to public health grants and across local authorities to those services that can reach out to people who are vulnerable to suicide.

We would like the Government to put a greater focus on adequately resourcing the measures they set out in their suicide prevention strategy. We would particularly like them to look at how those plans are being implemented. It is very welcome that 95% of local authorities have a suicide prevention plan either in place or in development, but there does not seem to be sufficient quality assurance for those plans. We would therefore like a national implementation board to look at how we can move those plans forward, because any strategy, however good, cannot be effective if it is sitting on the shelf and not being implemented. That was one of the key messages we heard from our witnesses, and I know that the Minister will have heard it from the National Suicide Prevention Strategy Advisory Group loud and clear.

We also know that there are things that need to happen when people are in contact with services. It is disappointing that greater focus has not been put on the consensus statement for information sharing. On too many occasions, when someone hears that a loved one has taken their life it is the first time they have heard that their loved one had been in contact with services—nobody had let them know. Understandably, health professionals are concerned about issues of confidentiality and consent, but what the consensus statement makes clear is that if we ask people in the right way, they are much more likely to give that consent to information sharing. We would like to have seen the Government put a greater focus on how we can increase awareness of how health professionals go about sharing information with people’s loved ones, because we believe that will save lives.

We think that measures can be taken across the board both out in the community and within health care settings and specialist settings, but the Minister will know that our inquiry also examines the role of the media. Irresponsible reporting of suicide increases suicide rates, as we know, and far more can be done within the broadcast media, the mainstream media, on social media and on the internet to make sure that we save lives. I was very pleased that during today’s Culture, Media and Sport questions the Culture Secretary agreed to a meeting with me, but I hope that the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), will assure me that she will be liaising with colleagues in the Government to make sure we can save lives in that way.

Finally, I wish to touch on the issue of data. We know that there is an issue relating to the increasing use of narrative verdicts which are hard to code. That results in the official data we have on suicide under-representing the true scale of the avoidable loss of life, and with the huge variation we have around the country this makes it much more difficult to understand what works best in preventing suicide. We would like the Minister to revisit the recommendations in our report on how to provide better training to coroners and how we review the evidential standard and move from using “beyond reasonable doubt” to the “balance of probability” in recording suicide. Only in that way can we ensure that we are doing absolutely everything possible to protect families and individuals in future. I commend the report on suicide prevention to the House and call on the Government to go further in implementation.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Labour welcomes the recommendations in the report, and I join the hon. Lady in thanking Select Committee members and staff for their work.

The Committee visited the award-winning Salford mental health liaison team, which offers 24/7 mental health support at Salford Royal hospital and has been able to halve the admission rates for people with mental health problems. The Royal College of Psychiatrists reminds us that only 7% of emergency departments provide 24/7 liaison psychiatry services, and said it would be difficult to recruit enough psychiatrists and other staff to provide such a service in every hospital—the hon. Lady touched on that in her statement. What does she think the Government must do to ensure that there are enough trained staff to establish and sustain liaison psychiatry services in every acute hospital to help to deliver the suicide prevention strategy?

[Dr Wollaston]

We need to start right back at medical school recruitment and what happens in medical schools and beyond, to encourage more health professionals—not just doctors, but nurses as well—to consider psychiatry and mental health services as a career. One of the key issues is the lack of a workforce. I know the Government are working with Health Education England to improve the situation, but we would like to see them go further. Also, we need to ensure that resources get to the frontline.

NHS and Social Care Funding

Debate between Baroness Keeley and Sarah Wollaston

Wednesday 11th January 2017 Commons Chamber

[Dr Wollaston]

Absolutely. It was extraordinarily encouraging to hear the Prime Minister say that she was prepared to consider that and to meet Members from across the House. I urge colleagues who feel that this is a better way forward to sign up to it, speak to their party Whips and make it clear that it has widespread support.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I wonder, on this vital issue, whether the hon. Lady wants to say something about what her own party did on the two previous times we tried to get important cross-party working on health and social care: it made it an election issue, producing posters about a “death tax”; and on the second occasion the Secretary of State just walked away from the talks.

[Dr Wollaston]

I am afraid that that intervention is exactly not the kind of debate we want to be having. Let us look to the future. We are in a different part of the electoral cycle. I accept the hon. Lady’s comments—I was still an NHS clinician when that happened and, like many of those working in health or social care, I looked at the yah-boo debate in this place and thought that surely there had to be a better way—but I ask her to put them aside and to look to the future rather than backwards, otherwise we will not get anywhere. I think our constituents want us, as politicians, to recognise the scale of the challenge and to get to grips with it.

Social Care

Debate between Baroness Keeley and Sarah Wollaston

Wednesday 16th November 2016 Commons Chamber

[Barbara Keeley]

I agree, and our motion talks about the need for

“a longer-term settlement to ensure that the social care system is sustainable going forward”.

We absolutely do need that.

On quality of care, I was talking about Susan finding a care home and it giving inadequate care. There are too many such care homes. In its 2016 “State of Care” report, the Care Quality Commission said that when it makes a return visit to a service originally rated as “inadequate”, one quarter of those services were not able to improve their ratings. Susan found poor-quality home care, and last week the ombudsman reported that the number of complaints about homecare is rising and that the number of complaints upheld by the ombudsman is also rising.

[Dr Sarah Wollaston (Totnes) (Con)]

I agree with the right hon. Member for North Norfolk (Norman Lamb) on the need for cross-party working to achieve sustainable funding for both health and social care. As the hon. Lady will know, I have set out my concerns about the underfunding of social care in a letter to the Chancellor. Does she agree that it is not just about funding, however, but also about how we support and train our social care staff? Would she like to see further progress made on the recommendations of Camilla Cavendish about how we train and support our care staff to help to retain them as well as recruit them?

Sugary Drinks Tax

Debate between Baroness Keeley and Sarah Wollaston

Monday 30th November 2015 Westminster Hall

[Barbara Keeley]

That type of initiative is wonderful, but fewer and fewer children are walking to school, and an awful lot more are being taken there by bus or by their parents. The Health Committee report reminds us that the latest figures show a fall in physical activity. In 2012, only 21% of boys and 16% of girls did enough exercise to meet the Government’s physical activity guidelines. That is a fall from four years earlier, when the figures were 28% for boys and 19% for girls. We are therefore going in the wrong direction, and we are all becoming couch potatoes. We might worry about this for ourselves, but it is a great concern when children are involved.

I am a former member of the Health Committee, and it is a pity that little emerges from the report, which simply reiterates and endorses the findings of its predecessor Committee’s inquiry, in which I was involved.

[Dr Wollaston]

I absolutely recognise that physical activity is important and that it should be for everyone, irrespective of their weight or age. Like me, the hon. Lady will remember Julie Creffield, who spoke so powerfully before our Committee in the last Parliament. However, the current Committee felt that it did not want to be distracted by something we had already produced some work on. We therefore wanted to endorse everything that was said by our predecessor Committee, rather than to go over that ground again.

[Barbara Keeley]

I thank the hon. Lady for that intervention, but I think it is a bit too easy to lose sight of physical activity, and that is why I have raised the issue. I hope we can be brave and bold about these issues too—it is good to be brave and bold about children’s health, but let us cover all the issues.

It has been said that treating obesity and its consequences alone costs the NHS more than £5 billion a year. It is great that we are having this debate, because we are past the point where we can just let things trundle along. Let me come to the crucial point in the debate. Public figures such as Jamie Oliver have come out in support of a tax on sugar, and he has added stardust to the debate. However, this is a complex issue, and the solutions must deal with that complexity. We know that something must be done, but what is that something?

The problem goes deeper than the demand side. The food and drink industry has not been dealing with the real problems. A number of hon. Members have talked about the Government’s responsibility deal, which has not worked. Firms have made promises and then failed to carry out their pledges. We have talked about labelling, which I will come on to. Many of the suggested interventions involve better labelling of products, but research by a team at the London School of Hygiene and Tropical Medicine suggests that interventions that improve information about and awareness of the risks do not necessarily translate into positive behavioural change.

As has been touched on, the responsibility deal focused mostly on salt, which was perhaps welcome. There have been real moves in that area, although every time I have a bowl of tomato soup these days, I regret that it does not taste like it used to. It is clear that salt is being taken out of our diets, but not sugar, which is the focus of our debate. The research team also found that although responsibility deal partners claim there has been “considerable sugar reduction” under their calorie reduction pledge,

“the current progress reports do not substantiate these claims.”

In fact, responsibility deal partners say they have reduced sugar levels under the calorie reduction pledge, but they have not.