NHS Eating Disorder Services

Baroness Wheatcroft Excerpts

Thursday 29th June 2023 Lords Chamber

[Baroness Wheatcroft (CB)]

My Lords, I thank the noble Baroness, Lady Parminter, for securing this important debate. I welcome the Minister to his position and hope that he finds this a congenial setting in which to make his maiden speech.

I start on a positive note. My daughter, like Rose, suffered from anorexia for a long time. She was in a secure unit for nearly a year, and I shall be for ever indebted to Professor Janet Treasure, who ran the unit and who recognised that Lucy was not going to recover unless she was really taken in hand—she is a strong personality—and she was absolutely right about my daughter. However, the good news is that, at the end of September, Lucy will produce her third child. So recovery is possible, but it is not easy.

Anorexia nervosa is the most pernicious of diseases. It is the psychiatric illness that produces the highest number of deaths. At the moment, the number of cases is growing, but support is not. That is why this is such an important debate. We are all now encouraged to talk about mental health issues, but the problem is that not very much is being done about them, and the two need to be equated. It is no good being open about the problems unless we can be competent in dealing with them.

The charity Beat, which does a fantastic job, tells us that around 1.25 million people are suffering from eating disorders. A growing trend is that some of them are men. Beat reckons that around a quarter of that number are men. Money is short—we all know that—but it could be spent better on dealing with mental disease generally and eating disorders in particular.

The ombudsman report that the noble Baroness referred to is a frightening document, not least because it was produced in 2017 after a death that occurred in 2012. The fact that nothing very much has occurred even since then to put things right shows just how slow progress is in this area. The coroner’s report that was produced three years after the ombudsman report said that concerns raised in that report had simply not been addressed. That largely remains the case.

In the meantime, the waiting lists for treatment have got longer. The Lancet tells us that during the time of Covid the number of people identifying with eating disorders rose almost 50% above the levels that had been predicted. It was slightly lower than that in the older age group, but there was a huge leap in eating disorders among teenage girls aged 13 to 16—and that does not appear to have reduced.

The Government have promised more money, but a survey by Stem4, another charity dealing with teenage mental disorders, found that some youngsters were having to wait more than a year for treatment. That is after diagnosis, and we all know that getting a GP appointment is not an easy matter. Getting a GP appointment in person is even harder and, for somebody who is potentially suffering from an eating disorder but refusing—as many children do—to admit it, that GP in-person appointment is crucial for any diagnosis to be made. So the waiting time is now really dangerous, to the extent that sufferers are ending up in A&E because they are just too ill and have no option but to seek treatment.

I had hoped that by the time we met today we would be able to discuss the NHS workforce plan. On Sunday, the Prime Minister said that it would arrive this week, so time is getting short. Without that, it is hard to know exactly what plans the Government are making to deal with psychiatric illnesses. It is worth remembering that it takes 15 years to train a psychiatric consultant. It is a great shame we did not have that workforce plan a little earlier: there might have been more psychiatric consultants coming on stream rather sooner. Let us hope that tomorrow is the day the plan arrives, at long last. I look forward to the Minister enlightening us on that front—it was indeed promised.

The subject of online pornography came up in the previous debate. It is impossible to discuss eating disorders without acknowledging the pernicious effect of online sites, which definitely encourage youngsters to see it as an ideal to get thinner and thinner. I have talked to the Googles of this world and they know that those sites are there and that they are doing damage, but they are highly reluctant to take them down. Their answer is that on the top of these really dangerous pages they refer to Beat and suggest that the people who have gone out of their way to visit these sites because they want to get thin contact the charity, which will stop them doing what they want to do. The operators of those sites know that will not work, but they continue to do it. I like to think that some of the legislation that we are working on in this House at the moment will put paid to that sort of activity, because it encourages people, particularly children, into completely crazy body images.

There are other factors that impinge on them. Some noble Lords may have visited a shop called Brandy Melville, but I doubt that many will have purchased what it sells: teenage clothing that is very popular among a certain age group. The brand prides itself on providing that clothing in only one size: small. The message is clear: if you want to have this wonderful, fashionable clothing, you have to fit into it. Brandy Melville will not change its model; it has had plenty of criticism. That is the sort of message that continues to pervade. It affects our young people and we need to do something about it. We cannot shut down a clothing chain, but we can certainly tell it what we think, and I think it is despicable that that sort of message is sent to our youngsters. Small is not good enough.

The messages are everywhere, so it is really important that we get treatment out quickly. We should not forget—I speak from experience, as does the noble Baroness, Lady Parminter—that it is not just the sufferer who is affected by an eating disorder; it is the entire family. Some wonderful work goes on. There are support groups that help, but it is extremely difficult for people with late-teenage children who are suffering from anorexia. I believe that may well have impinged on the Hart case, in which the victim, in the end, was 19 when she died.

We have to respect, of course, that adulthood brings a degree of privacy. Doctors are often very reluctant to talk to parents of 18 or 19 year-olds about the medical problems that their youngsters may be suffering from, even though we know that that 18 or 19 year-old is simply not functioning like an adult because they are ill. But the doctors are worried about personal privacy and, in many cases, will not talk to the parents. The department could and should address that. I would very much appreciate it if the Minister could take that away and see whether there is a way of finessing it, because I know it has caused agony in some families. We were very lucky; others, not so much.

One of the things that came up in the coroner’s report and was first flagged up by the ombudsman was the need for co-ordination between the various bodies that help to address these issues. That is another issue which I would be grateful if the Minister could address, because organisations need to talk to each other if people are going to be healed.