Health: Mental Health

Lord Bradley Excerpts

Tuesday 28th October 2014 Lords Chamber

[Earl Howe]

My noble friend makes an extremely important point. NHS England is currently reviewing the never events framework. My honourable friend the Minister of State for Care and Support will shortly be meeting NHS England officials to discuss the possibility of including suicide following in-patient care as a never event and how the new never events framework will support parity of esteem.

[Lord Bradley (Lab)]

My Lords, NHS England made it clear last week that mental illness costs the economy an estimated £100 billion annually, which is roughly the cost of the entire NHS budget. How do the Government justify only 5.5% of the UK’s health research budget being allocated to mental health and, according to MIND today, a paltry 1.4% of Public Health England’s budget being spent on mental health? Is this what the Government mean by parity of esteem?

[Earl Howe]

My Lords, investment in mental health research by the National Institute for Health Research has nearly doubled over the past four years from £40 million in 2009-10 to £72 million in 2013-14. I hope that the noble Lord will take from that that we put a priority on this. Of course, it is very important that local authorities do not downplay the significance of mental health. We have made it very clear that disinvestment is not an option for them. We are discussing with local authorities this very issue.

NHS: Five Year Forward View

Lord Bradley Excerpts

Thursday 23rd October 2014 Lords Chamber

[Lord Bradley (Lab)]

My Lords, noting my health interests, I am grateful to the Minister for repeating the Statement. We warmly welcome the report, Five Year Forward View, particularly as it endorses key elements of Labour’s plans for the National Health Service. However, there are many questions still to be answered, which will unfold over the coming weeks and months and will form the basis of that measured and intelligent debate in this House. The report endorses Labour’s visions for new models of integrated care, including hospitals evolving into integrated and accountable care organisations, with more salaried GPs. Does the Minister accept these proposals, and does he agree that there should be a greater role for health and well-being boards in helping to deliver this strategy? On public health, does the Minister agree with the report that the time has come for radical action on obesity, and does he accept that the voluntary responsibility deal is clearly inadequate? On GP services, does he agree with the report that primary care has been under-resourced and that people are struggling to get appointments? Will he accept the need to stabilise funding of GP budgets and match our plans to recruit 8,000 more GPs? Finally, does he accept that much more urgent action is needed to deliver the commitment on parity of esteem between mental and physical health and that proper integration of those services is particularly important and will ensure better outcomes for all patients?

Mental Health: Beds

Lord Bradley Excerpts

Tuesday 29th July 2014 Lords Chamber

Asked by

[Lord Bradley]

To ask Her Majesty’s Government what action they are taking to stop patients being unnecessarily sectioned because of shortages of mental health beds.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, we are not aware of any incidents of patients being unnecessarily sectioned. In June 2013, the Care Quality Commission asked for notification of such cases. It is for local clinical commissioning groups to commission the right number of in-patient beds to meet the mental health needs of their local population.

[Lord Bradley (Lab)]

I am grateful to the Minister for that reply, although I am slightly surprised. Does the Minister agree that it is wholly unacceptable that, according to the Royal College of Psychiatrists, doctors are still being forced to section patients to get them their in-patient care? That follows a warning by the Health Select Committee last July on the need to investigate urgently whether patients are being sectioned for them to access psychiatric units, and report to Parliament on the prevalence of that practice. What action have the Government taken on that committee report? Will the Government, if they look carefully at those findings, consider making emergency funding available, similar to that which they made available to A&E departments in the winter, to immediately ease the mental health crisis in beds for adults and children?

[Earl Howe]

My Lords, I am certainly aware that a number of concerns have been raised about the lack of mental health beds and that there are occasions when patients do not receive care quickly enough because approved mental health professionals cannot locate an appropriate bed. As I said in my original Answer, that is essentially a failing of local clinical commissioning. However, AMHPs—approved mental health professionals—should not be put in that position. We are consulting at the moment on a revised code of practice for the Mental Health Act. That consultation includes a specific question which asks what additional guidance should be included to ensure that AMHPs are not put in that position.

Health: Dementia

Lord Bradley Excerpts

Monday 14th July 2014 Lords Chamber

[Earl Howe]

It is generally recognised—although some GPs disagree—that early diagnosis of dementia is vital. It is vital for ensuring that a person with dementia can access the relevant advice, information and care and support that can help them live well with the condition. My noble friend is right that there is currently no cure for dementia, but there are drugs that can help with some of the symptoms and people with dementia have the right to know that they have the condition so that they can better plan for the future.

[Lord Bradley (Lab)]

My Lords, I declare my health interests. The Alzheimer’s Society says that one person in five who suffer from dementia gets no support or information after diagnosis. Will the Minister say what specific actions the Government are taking now to try to improve the situation?

[Earl Howe]

My Lords, NHS England is investing £90 million in diagnosing two-thirds of people with dementia by March next year. We have amended the GP contract so that everyone over 75 has a named, accountable GP and the most vulnerable 2% in each practice will receive an enhanced service. The NHS Choices website has been enhanced. NHS England has provided CCGs with tools and guidance to help them set a local ambition to improve dementia diagnosis. The post-diagnostic support that the noble Lord mentions is absolutely central. There is a post-diagnosis working group to identify what good looks like in this area and roll out best practice.

Health: Patient Safety

Lord Bradley Excerpts

Tuesday 24th June 2014 Lords Chamber

[Lord Bradley (Lab)]

My Lords, I thank the Minister for repeating the Statement on patient safety.

As we said in the other place, an open learning culture across all parts of the NHS is an ambition shared across the House and builds on the work of the previous Government following care scandals in the 1990s. It is right to call for openness, transparency and accountability, but I ask the Minister how he will guard against the risk, as pointed out by Martin Bromiley, of creating a naming, shaming and blaming culture.

Secondly, the Minister has told the House that one-fifth of hospitals are failing to report properly. How does he plan to address this? Will he extend full transparency to all providers of NHS services, including the private sector?

Thirdly, the Commonwealth Fund found cause for concern on infection compared to 2010, with the NHS now ranked worst in the world for patients reporting infection in hospitals or shortly after. What is he doing to turn around this very worrying trend?

Lastly, the Secretary of State for Health talks about his new target to save 6,000 lives over three years, which we all clearly welcome. I welcome the appointment of Sir David Dalton, a person I know well, to the position of leading this initiative. However, will the Minister explain further today how this will actually be achieved with the current pressures on NHS budgets?

Mental Health: Social Work

Lord Bradley Excerpts

Monday 23rd June 2014 Lords Chamber

[Earl Howe]

My noble friend makes some excellent points, and I acknowledge her role as a member of the programme board for the Think Ahead programme, which is designed to attract, in particular, new graduates into social work, and specifically into mental health social work. Good-quality social work can transform the lives of people with mental health conditions. It is an essential part of multidisciplinary and multiagency working. As we move forward into new ways of working, particularly in the context of integrating care, my noble friend’s point about other professionals understanding and appreciating the value that mental health social workers can give will be key, not just in terms of earlier intervention but by building resilience, reducing and delaying dependency and ensuring that people have all the information and enabling support that they need to look after themselves better.

[Lord Bradley (Lab)]

My Lords, I note my health interests. What is the Government’s assessment of the scale of shortages of mental health social workers? In particular, what assessment has been made of the capacity to respond to requirements under the Mental Health Act, particularly Section 135, for approved social workers?

[Earl Howe]

My Lords, we need more social workers, particularly in mental health. The Think Ahead programme is certainly one way in which we hope to improve the numbers. Social work is not always seen as an attractive career option. We know that there is a growing appetite among graduates to work in mental health; unfortunately that enthusiasm has not filtered through to the social work profession. We need to focus on that. Much will depend also on finding a greater number of placements in social work, particularly relevant to mental health, so that there is on-the-job training for those trainees.