Eating Disorders Awareness Week

Debate between Adrian Bailey and Rachael Maskell

Wednesday 27th February 2019 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

rose—

[Mr Adrian Bailey (in the Chair)]

I call Louise Haigh.

[Rachael Maskell]

The hon. Lady is making an excellent speech. I am troubled by the fact that, a year on, services in York are still completely inadequate. On Friday, I spoke to GPs who are trying to manage individuals with eating disorders. They have been instructed to take patients’ blood, to monitor the electrolytes, and to weigh them frequently, without the psychological support and clinical competencies that are necessary. Is it not absolutely essential that GPs receive the training that they need, so that we can put in place the holistic services that patients need?

[Kirstene Hair]

The hon. Lady is absolutely correct. I will come on to speak about that in detail. I hope the Minister will give further detail on how she is approaching that with other Departments.

In any five-year medical degree at UK medical schools the average amount of training in eating disorders was 1.8 hours, and one in five gave no training at all. The concern is not confined to one part of the United Kingdom; it is a widespread issue across all nations. That seems absolutely extraordinary, given that this is one of the most fatal mental health disorders, affecting 1.25 million people. GPs must be able to tell the difference between a healthy exercise routine and a compulsive one, low body-mass index and lack of nutrition, and going through a diet phase and the beginning of an eating disorder. They must recognise the clear indicators and how eating disorders manifest in order to deliver the right treatment plan, but to do that they need training.

I would like to see further encouragement of self-referrals and more work with schools, where many members of staff may be able to identify unusual behaviour. I warmly welcome the approach taken by my secondary school, Brechin High School, which has appointed a member of staff to lead on mental health who has a support base within the school and is linked up with the local primary schools, so that at the end of primary school, when an eating disorder—or any mental health disorder—may begin to develop, that support is monitored and continued as pupils enter secondary school and progress their education. I am keen to hear from the Minister how the training aspect can be addressed. I would like to hear from the Scottish National party spokesperson how the Scottish Government could do more to include training within university tuition, and how they will address the role that schools can play in early intervention.

When help is needed, how long do we have to wait? Waiting time targets have been a focal part of the campaigns run by many charities for years. In England and Wales, by 2021, 95% of eating disorder referrals for those under-19 are due to reach a specialist within four weeks, and within one week for urgent cases. Will the Minister confirm that the Government are on track to deliver that target, which is already making a huge impact? Along with the charities, I warmly welcome the ambition shown by this Government.

This is not a political debate and I do not wish to make it one. However, once again, when I wrote to the Scottish Government asking why they refused to equalise that target for young people, no substantive reason was given. I have also asked the Scottish Minister for Mental Health about that, and I look forward to her response. The UK Government have stepped up to treat under-19s. I encourage work so that those targets continue to be ambitious. We know that the sooner patients are seen, the higher the chance of recovery and the lower the long-term cost to the NHS. The current 18-week target in Scotland simply has to be addressed. When sufferers determine they need help, their illness is more likely to be treatable, but by the time they may be seen, the likely outcome is much more negative and potentially fatal. I want my constituents to have the same opportunity for early intervention as people south of the border. I want the Scottish Government urgently to address this needless inequality.

As we know, those with an eating disorder often take up to three years to identify that they have such a disorder. Sufferers must do two things: realise something is wrong and wish to make themselves better. When a sufferer comes forward, given their scepticism about all those trying to help them, we have a moral responsibility to grasp their ask for help and support them as a matter of urgency. That requires step-by-step help, to nurture these fragile but wonderful people and not let any of them fall out of the system.

I want to conclude with a point about social media, which is a force for good in many ways, but a stain on the life of many families, which recognise it as the tool that tore them apart. All age groups regularly browse online to determine what everyone else is up to or to catch up on the news, but they normally see only positive news. I have not seen one Instagram image of anyone in this room getting up in the morning, doing mundane things, such as washing the dishes, or having a bad day at work, because we submit only positive images. However, if we also put out negative images, things might feel slightly more normal.

Social media is a platform for showcasing the positive aspect of our lives, with no balance of the negative aspect that we encounter every day. For someone with an eating disorder, or any mental health disorder, that only accentuates their problems. Recent cases have made us all stop and think. There is so much pro-ana and pro-mia material promoting a harmful mindset, which forms or heightens an eating disorder. We must not forget that this material is often put up by sufferers themselves, so we must push supportive materials towards those who promote such images and material.

I do not believe that that is above any of the social media companies. The Secretary of State for Digital, Culture, Media and Sport made a hugely positive step forward in that respect earlier this month. Will the Minister explain the conversations that her Department has had with the Department for Digital, Culture, Media and Sport? Social media platforms cannot take all the positives of social media, but refuse to take responsibility for some of the damage it causes.

In summary, I would like to thank all hon. Members for supporting this debate. I know that it is close to the hearts of many in this place. I hope that the Minister will show those who have suffered, those who are suffering and those who do not yet know that they will suffer that this Government are on their side. I hope the Minister will show that we will never rest on our laurels, but will continue to address the flaws and increase our ambition, reduce waiting times, develop support and facilities for all who need it, wherever they live in the country, intervene early and offer the right support throughout the whole process, expel the postcode lottery of support, encourage our world-class universities to improve teaching programmes, so that they are in line with the impact this disease has on so many, and ensure that social media companies play their part in bucking this trend. We have to help those who are, through no fault of their own, helpless about their own aid. For many it will be the first time in their lives, because that is what Government is here to do: help you when you cannot help yourself.

Pubs Code 2016

Debate between Adrian Bailey and Rachael Maskell

Wednesday 24th January 2018 Westminster Hall

[Mr Bailey]

I thank the right hon. Gentleman for that intervention. To a certain extent, I was going to cover that, but his precise point is a welcome addition, because transparency is the key. That would give guidance to tenants who were looking for the market rent only option. It would enable them to see how viable their application is and on what grounds they could challenge the pub company, if the pub company refused or obstructed it.

[Rachael Maskell (York Central) (Lab/Co-op)]

I will be writing to the Minister about my constituents’ experience of the Pubs Code Adjudicator following Paul Newby’s visit to York, at my invitation. Despite his commitments about expediency and communications, pubs such as the Golden Ball in York are still waiting 13 months later to hear what is happening about their case. How can that be fair, and how can it be right?

[Mr Bailey]

My hon. Friend raises an important point. I know that many tenants feel that this procrastination over resolution is playing into the hands of the pub companies, and that it is, in some cases, deliberately designed to drive up expenses and deter anybody from making such applications.

[Mr Bailey]

My hon. Friend makes an important point. That is one of the complaints, and I will be discussing some of them in a few moments.

Prior to the implementation of the legislation, subsequent Committees sought the industry’s agreement on a voluntary code, but subsequent inquiries demonstrated that the pub companies, despite paying lip service to a voluntary code, were actually not conforming to it and not making any progress on it. It was then in exasperation—almost desperation—that the Select Committee decided that enough was enough, and that it was time to implement legislation. Subsequently, the legislation materialised.

The key issue, above all else, is tied tenancies and the market rent only option. The argument is that tied tenants have to pay a disproportionate amount of money for their stock and other services, and that, as a result, the pub company gets a disproportionate share of the income arising from the premises. If a tenant seeks to go free of tie, the pub company will implement conditions in the negotiations that remove any financial advantage from that course of action. The legislation, by giving tenants the option of applying for a market rent only option, is designed to overcome that handicap. The way in which the process is being implemented is a matter of huge concern, and it needs further consideration by the Pubs Code Adjudicator and the Government.

The Pubs Code Adjudicator report in July 2017—bearing in mind that the legislation came in one year earlier, in July 2016—said that there were two overarching principles in the code. The first was “fair and lawful” dealings in relation to tied tenants. The second, which I have touched on, was the “no worse off” principle, which sets out

“that individual tied tenants should not be worse off than they would be if they were free of the tie”.

Eighteen months after the introduction of the pubs code and the Pubs Code Adjudicator, it is time to take stock and assess whether the objectives set out in the pubs code—I just defined them—are being met, and, if not, what needs to be done.

Before I do that, I have to touch on the controversy that raged over the appointment of Paul Newby as the Pubs Code Adjudicator. I will not dwell on the whole catalogue of concerns, but it is well known that there are accusations of conflicts of interests arising from his past employment with the valuers and surveyors Fleurets, because it had extensive interests with the pub companies, and from his personal investment in it. I said in the debate last January that unless he divested himself of that particular investment, then in no way should he be the Pubs Code Adjudicator because he had an obvious and transparent conflict of interest. He has not done so. Given that confidence in his commitment and impartiality is crucial to earning the trust of pub tenants, that must be of huge concern. I will come back to this issue in a moment.

He has had opportunities over the past 18 months to demonstrate his effectiveness; however, looking at his performance, we see that it is possibly a slight understatement to say that the implementation and the progress made under his supervision fall short of the level needed to achieve the legislative objectives. The first concern is the slowness of the adjudication process. Between July 2016 and March 2017, arbitration awards were made in only 15 of the 119 cases accepted for arbitration. In the cases specifically relating to the market rent only option, the figure was 12 out of 104. Later in the year, in August, the adjudicator published a market rent only verification exercise report, which demonstrates that of the total of 497 market rent only notices, only 11 were actually converted into agreed market rent only tenancies. Of the 130 arbitration cases listed on 31 July 2017, 79 had been delayed for more than three months, and 12 for more than six months.

Now I will come back to the point that I was making earlier. The slowness of arbitration is not the only issue; impartiality is also a problem. The Chartered Institute of Arbitrators has upheld four of the 12 challenges made by pub tenants to the adjudicator’s decisions. That demonstrates the lack of confidence of tenants in the industry in the robustness and impartiality of the way in which he is exercising the code. To have a one-third failure rate in such a key, sensitive position is absolutely unacceptable.

[Rachael Maskell]

My hon. Friend is making a very solid case. A further conflict of interest in dragging out these cases is that doing so is economically disadvantaging tenants. Has he discovered the same fact?

[Mr Bailey]

Again, my hon. Friend makes an important point. The more we drill into this subject, the more comes out of it. Unfortunately, I am too constrained by time to go into every single issue that arises.