NHS Funding Bill
Preet Kaur Gill ExcerptsTuesday 4th February 2020
(6Â years, 8Â months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Legislative Grand Committee (England) Amendments as at 4 February 2020 - (4 Feb 2020)
Anne Marie Morris
The hon. Lady is absolutely right. The challenge, as she recognises, is how we change the language in a way that is accepted and becomes the norm. Part of this is having a much greater focus, as I hope the Secretary of State and his team ultimately will, on wellness, because that is absolutely as important as dealing with the illness when it happens.
We need to remember that in terms of stages of intervention, the whole lifecycle is not just about birth, education and the workplace; it is also about the elderly and veterans, for whom there is often not as much done to identify need and provide support. An older person in a rural area will often have the need but because they are simply out of scope—under the radar—they will, for a very long time, suffer in silence to a point beyond which they cannot be helped. The challenge of mental wellness/illness for older people needs to be a specific focus.
For all that we say, and rightly, about the importance of ensuring that our veterans are properly diagnosed and properly supported, I am certainly conscious of veterans in my constituency who are struggling to get help and support, or even an initial diagnosis. Sometimes the support they need is so complex that they can only get it in London. For somebody who does not have good mental health, the journey from Devon right the way up to London is something they simply cannot conceive of and make a reality.
I am extremely grateful to the Minister for sitting and listening to my thoughts, and for understanding my approach in terms of looking at this in a much more holistic way and seeing how we might measure and report on it so that we can demonstrate to people that we are making progress on parity of esteem. We should look at inputs as well as outputs. I look forward with a great deal of interest to his reply on the points that have been made, particularly on outputs in mental health.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
I rise to speak to the amendments in my name and the names of my colleagues.
As we have all heard, our NHS needs to be properly resourced in both physical and mental health, but far too often patients are losing out under this Government, with longer waiting times, a huge increase in cancelled operations, and crumbling hospitals. Colleagues have already raised these important issues. I urge the Government to accept the amendments in the name of the Leader of the Opposition as a real signal of their intent to reverse the damage that their party has done to our national health service over the past 10 years.
My amendments focus specifically on mental health. The Government have made much of the need to ensure parity of esteem. This would mean us valuing mental health equally with physical health and adopting an approach that tackles it using the same standards that we expect for physical health patient treatment as a template for treatment that we provide for mental health patients.
I have heard warm words from the Prime Minister, the Secretary of State and Ministers about the importance of mental health and the growing need to tackle mental ill health as an urgent priority, but I have not yet seen that wholehearted commitment manifest itself in actions to tackle the situation we are in. The British Medical Association found that the mental health workforce has had little growth over the last 10 years. The Royal College of Psychiatrists found that the rate of unfilled NHS consultant psychiatrist posts in England has doubled in the last six years. The first briefing paper from the Centre for Mental Health’s Commission for Equality in Mental Health found that mental health inequalities are closely linked to wider injustices in society. Far too many patients with a mental illness are still being sent hundreds of miles away from home.
By accepting the amendments in my name, the Government would show that they are willing to be transparent about the way they go about achieving their long-stated aim of parity of esteem. The Government have already shown, with the presentation of this Bill, that they think it is a good idea to commit, in law, to a minimum allotment that the Secretary of State will make to the health service in England in each financial year for the next four years. That is designed to show that their promise is legally binding and can be scrutinised by Parliament and the public if they do not reach those targets.
To ensure that our mental health services are properly resourced and truly responsive to the various complex conditions that people present with, the public need to know how much is being spent, including how much is being proposed, and what happens in practice. That is all my amendments seek to do—they would provide Parliament and the public with the opportunity to compare the proposed allotment with the final allotment across different years.
Of course, that is not enough, and it is clear that additional resources for mental health services are only one part of the answer to tackling the mental health problems in this country. We know that education and training services are essential to bring about the necessary increase in the workforce. We know that local government provides significant elements of mental health support through public health, youth services, housing and social care, and two thirds of schools fund their own mental health support. We also know that the Government’s roll-out of universal credit will exacerbate mental health inequalities, which all too often relate to people’s economic and social circumstances. This is not the time to go into those in detail, but I urge the Government to remember the need for those essential services to have a long-term funding settlement and, in the case of social care, an agreed basis for future financing. With ambitious targets to meet in the long-term plan, there is a risk that resources will be diverted from other areas of mental health support to achieve compliance.
I would like to invite colleagues across the House to join me on Thursday for my adjournment debate on Children’s Mental Health Week, which is this week, to discuss these issues further. I know what a commitment to transparency on mental health spending would mean for all those suffering mental ill health and those fighting for them. I hope that the Secretary of State will accept amendment 1 and new clause 1, to ensure that mental health services get a fair deal from the legislation and that pledges made by the Government and NHS England are realised in practice.
Bim Afolami (Hitchin and Harpenden) (Con)
It is a pleasure to speak in this debate, because it is a rare one in so far as there is quite a lot of agreement across the Committee on the substance of it. There appears to be agreement—I await an intervention if anybody disagrees with this—that increasing funding for the NHS is a good thing, that it is good that mental health is a Government priority and that it is very important to establish what parity of esteem means in practical terms.
I would like to take this opportunity to describe what I have seen in my constituency in terms of the importance of mental health and how the increased funding will make a practical difference. One way in which the funding will make a difference is with mental health support teams. There are mental health support teams in 25 areas in the country. Hertfordshire was picked as one of those 25 areas, and we have two teams—one in my constituency, and one just outside it—that effectively piloted a hub-and-spoke model. As the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) said, it is Children’s Mental Health Week, and the aim of that model is to ensure that young people get better mental health support in and around their school, working in conjunction with the NHS.
As I have seen in my constituency and everywhere I go, when I speak to young people, one of the first things they ask me is, “How can we improve mental health?” Whenever I have spoken to young people, their teachers or local NHS staff, they say this model has the potential, as it is rolled out and developed over the coming months and years, to make a real, fundamental difference. If people are looking for the practical impact of our increased funding for mental health, these teams are one way in which we are already starting to make a difference, not just in my constituency but across the country.
I would like to mention a couple of charities I am involved with that are starting to work in an integrated way with the NHS in improving young people’s mental health. There is a charity called GRIT—a word in politics that we should all remember—or Growing Resilience in Teens. It was set up by a fantastic doctor in Hitchin called Dr Louise Chapman, and it does what it says on the tin: it is about growing resilience in mental health.
As politicians, when it comes to legislation or speaking to each other in the Chamber or outside, we think often about pounds and pence and talk about structures such as hospitals and stuff that can be measured in a very easy way, or at least what we think is an easy way. However, growing resilience is one of the things we need to ensure the NHS does more effectively. Not just in mental health, but particularly in mental health, growing resilience in our young people is an integral part of prevention. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), talked about that in his speech, saying that half of mental health problems are established before a young person is 14.
We need to grow resilience among young people to future-proof each and every one of us, and our communities and our society, against serious mental health problems in the future, at the same time as investing in mental health services such as CAMHS, which has already been mentioned several times in this debate. However, we need to do both: to grow resilience and to improve the institutional frameworks. Again, that is what the money this Bill is providing will go towards.
Another charity is called Tilehouse Counselling, which again is based in Hitchin. I do not mean to say that Hitchin has all the charities in my constituency, but in this area Hitchin is a real regional leader and, indeed, a national leader. Tilehouse Counselling provides counselling services to young people, and young people often find themselves at Tilehouse when CAMHS does not have the capacity.
I urge the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is on the Treasury Bench—she knows this because everybody knows how much she cares about the NHS, how much she knows about it and her own personal experience in it as a professional—to use the money provided by this Bill to increase the workforce and to improve the state of CAMHS so that it can treat more people. Again, that means helping the mental health hubs to work with young people and the education system to improve prevention and, when mental health intervention is needed later on if things have got more serious, making sure that CAMHS has more capacity. Again, the money in this Bill will help to provide that.
Another new organisation in my constituency is called GoVox. It has already been in discussions with NHS Digital, and NHSX, about online ways of improving mental health for young people. Increasing funding matters, and it is always worth stating and restating in the Bill that these are minimum numbers, not maximum numbers. This money is hugely needed, and it should make a big practical difference.
On the pleas from Opposition Members—in relation to new clauses 1, 2 and 9, and a few others, which say that the Government must report on this or must do that—I urge the Minister for Health to commit in his response to showing how he and the Government will improve the existing reporting procedures and mechanisms so that the House can be kept fully informed. My right hon. Friend the Member for Wokingham (John Redwood) spoke about how Members of Parliament often feel distant, not from information about funding, but from outcomes. Will the Minister explain how the Government could improve that delivery mechanism, as that would allay some concerns across the Committee?
Health and Social Care
Preet Kaur Gill Excerpts(6Â years, 8Â months ago)
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Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
It is an honour to follow the hon. Member for North West Norfolk (James Wild) who, along with many hon. Members this afternoon, made an excellent maiden speech. I wish him well and look forward to working with him and all new Members.
Two months ago, I stood in this Chamber and spoke of my disappointment that the Queen’s Speech included only one reference to mental health, and even that was a reference to the Mental Health Act 1983, rather than a systematic programme to tackle mental health across all demographics. According to research by the Children’s Society, of the 22,365 children in Birmingham, Edgbaston, an estimated 2,733 five to 19-year-olds are struggling with mental ill-health. That is more than 10%. At the same time, the money available for local services for children and young people has fallen by 38%. Is it any wonder that just last week, research by the Education Policy Institute revealed that more than a quarter of child referrals for children and young people’s mental health services in England last year were rejected? Even when a referral was accepted, many children had to wait for an average of two months to begin treatment in 2019—double the Government’s four-week target. Birmingham Women’s and Children’s Hospital has a median wait time of 112 days. That is almost four months.
A decade of neglect in early intervention care, and an under-resourced mental health services sector, has meant that many more young people are turning up to A&E. I had hoped that the Government would have listened when I raised the issue in the debate on the previous Queen’s Speech, but given a second chance, the Prime Minister has failed once again to show that he is serious about tackling mental ill health. Yes, reform of the Mental Health Act 1983 is important and desperately needed, but the Government also need properly to fund vital preventive services.
For the many new Members of Parliament, I will repeat the shocking statistic that failed to elicit any action last time: for the whole of Birmingham there is only one early intervention counselling service for young people. The most recent waiting list has 400 young people and their families who are waiting desperately for treatment and support. The only conclusion I can draw is that the Conservative Government are knowingly and willingly failing our children and young people.
We know what we need. We need genuine parity of esteem. We must use the standards that we expect for physical health treatment as a template, and apply them to mental health patients. We need mental health services that are truly responsive to the complex conditions with which our young people frequently present. We must listen to young people when making decisions about the mental health services they use. I will ask the Minister once again: will he listen to those of us who are calling for the Government to do more for young people with mental ill-health, and deliver on the promises that his party has been making—promises that it has so far been breaking?
As a former social worker, I was surprised that the Queen’s Speech failed to commit to a review of children’s social care—the vital system that is designed to protect some of the most vulnerable in our society. That total and utter dereliction of duty follows cuts of almost a third in services for children and young people since the Conservatives came to power. Children’s social care is coming apart, despite the best efforts of hardworking councils around the country.
It should not be just about this; it should not just be firefighting. Social care should be about providing a system to support every child. We must give children the opportunity for the best start in life, whether that is in the form of late intervention such as safeguarding teams that step in in instances of abuse or neglect, or whether it is early intervention such as children’s centres and programmes that support parents and youth services. Children’s services are not only about looking after children in care; they provide effective family support services that help more children to stay in their homes if it is safe to do so. The Conservative party manifesto recognises the underfunding of children’s social care. Does the Minister agree that local authorities still do not have sufficient resources to address rising demand, even if his Government deliver on their manifesto commitment?