Children’s Health
Debate between Caroline Johnson and Nusrat Ghani(2 days ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Before I start, I should declare my interest as a consultant paediatrician and a member of the Royal College of Paediatrics and Child Health, which the hon. Member for Stroud (Dr Opher) mentioned earlier. I congratulate him on securing this important debate.
Getting the right start in life is one of the most important factors in adult health and wellbeing. We must ensure that the NHS is providing the best treatments and preventive care available for children, while prioritising safety and convenience for patients and cost-effectiveness for taxpayers. I have seen significant improvements in paediatric care in my career. We must look broadly at the social and environmental factors that affect children’s health and ask what more we can do to help protect and prevent illness in children. Prevention is better than cure, which is one of the Government’s three shifts, with which I agree and on which I wish to focus today.
Often children brought to hospital to see consultant paediatricians have conditions that have been caused, or further complicated, by social and environmental factors. These are things that medics cannot treat on their own, and, as every professional knows, we must work with parents, families and children to achieve the very best outcomes. One very clear example is the childhood obesity crisis, which many right hon. and hon. Members have mentioned already this afternoon. Research shows that 36% of children in year 6—these are 10 and 11-year-olds—are now overweight or obese. I have seen some extreme cases in my practice—for example, a nine-year-old who weighed over 80 kg—of young patients who have suffered serious illness because of their weight. These are the tip of the iceberg, but they are undoubtedly part of a much broader shift.
We know what causes obesity: lack of exercise and a diet too high in calories. But this is more complicated than that. There are complex problems with roots in broader issues such as poverty and family work patterns. The Government cannot determine what each child eats, but there are things that they can and should do to help support parents and their children. What is the Minister doing to encourage exercise, participation in sport and active travel to school? What is she doing to improve the quality and availability of food for parents and families? What is she doing to improve the quality of school food, to build nutrition education into the curriculum and to help children learn about managing their own health and how to cook healthy food?
I know the 10-year plan includes reference to the reformulation of some products, but there is a risk that manufacturers encouraged to remove sugar from products will simply replace it with sweeteners and other chemicals. What is the Minister doing to ensure that they do not solve one problem and then walk unwittingly into another?
The hon. Member for Lowestoft (Jess Asato) mentioned tooth brushing. We often hear that tooth extractions are the leading cause of hospital admissions among young children. Can the Minister provide details on the steps that she is taking to improve youth dental outcomes, such as broadening access to NHS dentists, pursuing fluoridisation schemes and encouraging the use of fluoride varnish?
Parents have a responsibility here too. According to the chief dental officer, who I spoke to the other day, children who brush their teeth twice a day with a fluoride toothpaste, reduce the amount of high-sugar drinks they consume and reduce the sugar in their diet can significantly reduce the risk of needing fillings and having dental decay.
Another area raised today is mental health. Young people face mental health pressures from home and school worries, friendship concerns and many other factors. In particular, we know that the covid lockdown had a serious impact on children’s development and socialisation. We also know that social media is causing increasing harm to children—whether by contributing to anxiety about body image or personal achievements, or by exposing children to harmful material and ideas. The previous Government’s Online Safety Act 2023 was a welcome step in addressing some of these issues, but the Government rejected a Conservative amendment to the Children’s Wellbeing and Schools Bill to help reduce the use of phones in schools. What more does the Minister plan to do to encourage children away from their screens and back towards a healthier existence with their friends and families?
I also want to discuss neglect. A total of 25,350 children are currently on a child protection plan for reasons of neglect—a marked increase from 20,970 in 2014. Organisations such as the National Society for the Prevention of Cruelty to Children have highlighted the fact that numbers are typically underestimated in neglect cases, but we should not underestimate the harm caused to health and development by neglect. What steps are the Department and the Government in general taking to get a more accurate picture of neglect and to intervene on behalf of the children who are suffering?
One area of improvement is the balance of acute and community care, and, again, the Government have talked about this in their three shifts. We know the Government are keen to move acute care into the community, but does the Minister agree that we should ensure that core community care is available more widely and more quickly in the community first before giving them extra work to do? Too often in my practice I see children with paediatric problems who have been referred to hospitals because of long waits and capacity problems in the community. What steps is the Minister taking to ensure that there is enough supply in the community sector to deal with the problems that children face?
In summary, children’s health is a large and complex policy area. We know that we can make good progress when we treat these complex conditions with new research and novel treatments. We know that most children will get better—in fact, one reason that I enjoy paediatrics is that almost all the patients get better, because they are robust, resilient and great fun. We must help parents do things that help protect children’s health today and prepare those children to manage their own health tomorrow.
Madam Deputy Speaker (Ms Nusrat Ghani)
I now call the Minister, who has up to 5 pm, although we do need a few minutes at the end for the lead Member to wind up.
Oral Answers to Questions
Debate between Caroline Johnson and Nusrat Ghani(3 months, 1 week ago)
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Dr Johnson
I would be delighted to pay tribute to Dawn and the Rugby Street Pastors for their excellent work. Many street pastors around the country do really important work in keeping people safe and secure on nights out.
Mental Health Support: Educational Settings
Debate between Caroline Johnson and Nusrat Ghani(3 months, 4 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I congratulate the hon. Member for Redditch (Chris Bloore) on securing this important debate in the Chamber. I should also declare an interest: I am a consultant paediatrician and have worked throughout my career with children usually at the point of severe crisis when they have been admitted through A&E to hospital following episodes of deliberate self-harm, such as cutting themselves or taking overdoses, and I have clearly seen the heartbreak for families as they have struggled to understand what they can do to best help their young person get better.
Over recent years there has been a decline in the mental health and wellbeing of children and young people and an increasing demand for mental health services. This is perhaps one of the big challenges of our era. Currently around one fifth of children aged eight to 16 are said to have a probable mental health disorder, up from 12.5% in 2017. This figure is even higher, at 22%, for people aged 17 to 24. The consequences of mental health issues for students range from poor academic performance and dropping out of university or college to self-harm and suicide, and we must do all we can to help.
I want briefly to talk about university students because university is supposed to be one of the most enjoyable and formative periods of a person’s life, but for many it is also when they leave home for the first time and when they are separated for the first time from their family and friends and their support networks. Data from the Office for National Statistics shows that during the covid-19 pandemic students reported higher levels of anxiety and lower levels of happiness than the general population. The number of students saying they have a mental health condition has increased sevenfold in the last decade. Even before the pandemic students consistently reported worse mental health than the rest of the adult population, but these trends were greatly exacerbated by the impact of lockdown. Will the Minister update the House on what steps he is taking to support young people with mental health problems as they go to university or who develop mental health problems at university?
Despite the unprecedented challenges the previous Government faced, not least the pandemic, we made important strides in improving mental health services, in increasing the recognition and discussion of mental health problems, in increasing investment and in reducing stigma. Between 2018-19 and 2023-24, spending on mental health services increased by £4.7 billion which gave an additional 345,000 young people access to the mental health support they needed, and the number of mental health nurses increased by 30% since 2010, yet still we see that demand is outstripping supply.
Prevention is better than cure and we need to understand why we have such high levels of mental health problems in children. Can the Minister update the House on how the Government are working to identify risk factors for poor mental health and how they will support children and families to prevent it?
The last Government tried to detect mental health problems early and stop them escalating, expanding mental health support teams in schools, committing almost £8 million of funding for 24 early support hubs in ’24/25. These offered earlier open access mental health intervention without the need for a referral by a doctor or school. The drop-in centres offer vital advice to young people going through the trauma of stress and anxiety, giving them a space to go to when their problems first emerge. Can the Minister update us on what the Government are doing in terms of expanding the availability of these centres?
The Online Safety Act 2023 made very good progress in protecting children from harmful online content but there is much more to do on the topic of screen time, as has been mentioned by hon. Members this afternoon. Does the Minister agree that the mounting evidence we are hearing especially from health professionals about the impact of smartphones in particular on children’s mental health is very concerning? If so, will he support the Conservative amendment to the Children’s Wellbeing and Schools Bill to ban smartphone use in schools?
However, there have been some concerns that in the desire to support and enable individuals to have positive mental wellbeing, there is a danger that the pendulum has swung a little far and the boundaries between distress and disorder have become blurred. That means that there is a risk that those who are most unwell may miss out on the treatment they deserve and need because of the volume of referrals, as well as a risk of burdening others with unhelpful labels and prescriptions that could hold them back, without addressing the root cause of their very real need.
Some 84% of GPs are now said to believe that society’s approach to mental health has led to medicalising the normal ups and downs of life. The terms “wellbeing”, “mental health” and “mental illness” are often used interchangeably, so what steps is the Minister taking to distinguish between those terms in educational contexts, and to deliver public services to ensure that we can get the best outcomes for those affected, so people get the treatment they clinically require?
I pay tribute to the work that many charities do to support our young people with mental health problems. Will the Minister talk to the Chancellor about funding for those services? Dr Sarah Hughes, the chief executive of Mind, said that
“the implications of the NIC rise is eye-watering, at a time when we are trying to direct every penny towards delivering the best support.”
Such charities do immense work to create a mentally healthy society, putting everything they have into it, and the Government should recognise that huge investment, not destabilise it by introducing mounting costs that charities simply cannot subsidise.
It is important to recognise the connection between physical and mental health, and that those with long-term physical conditions are considerably more likely to have poor mental health. What are the Government doing to support children who have chronic illness to help improve their mental health?
In 2023, the now Education Secretary said that Labour wanted a trained mental health counsellor available in every secondary school. What steps have the Government taken towards achieving that aim? More specifically, why have they focused on secondary schools? In April 2024, Dr Patrick Roach, the general secretary of NASUWT, said:
"We also need to see improved support for pupils in primary schools to secure wraparound care for pupils at all stages of their education.”
What are the Government doing to support children in primary schools with their mental health?
Ahead of the last general election, the Labour party promised to establish Young Futures hubs, recruit 8,500 mental health staff and provide mental health support in schools. Why has so little progress been made on delivering those promises? When the Minister stood on a manifesto to establish the Young Futures hubs, which were said to have a cost of £95 million, and to provide mental health support in all schools, at a cost of £175 million, the Government said that they would fund that through revenue raised from applying VAT and business rates to private schools. Will the Minister confirm whether the revenue obtained from applying the VAT to private schools looks like it will be sufficient to expand the mental health support as described? If not, how do the Government intend to fund the measures they said they would implement?
In a speech to the Confederation of School Trusts on 7 November last year, the Education Secretary claimed that the Government would give
“every single child the very best life chances”
in
“a new era of child-centred government.”
How does she justify the impact on the wellbeing of those children who are forced to move schools due to the imposition of VAT on the private sector? Numerous think-tanks and mental health charities have noted that being forced to move school at a non-standard time can have a significant and long-lasting impact on children’s friendships, support networks and emotional development. What support is the Minister offering to those children?
Mental health issues among our young people are one of the defining issues of our time. As with so many other policy areas, the Government have promised a panacea, but so far they have delivered a sticking plaster.
Point of Order
Debate between Caroline Johnson and Nusrat Ghani
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
On a point of order, Madam Deputy Speaker. On Second Reading of the Data (Use and Access) Bill on 12 February, I raised concerns over the accuracy and reliability of data with the Minister for Data Protection and Telecoms, the hon. Member for Rhondda and Ogmore (Chris Bryant), particularly in relation to verification of sex. He undertook to write to me, which indeed he has:
�Digital verification services can be used to prove sex or gender in the same way that individuals can already prove their sex using their passport for example.�
That is a direct quote from the letter.
In fact, a passport does no such thing; it says what sex someone likely is. For example, if it says someone is female, it means they are likely female, but they could be male with a gender recognition certificate, or a male person who has a letter from their doctor saying that they are likely to continue living as though a female for the rest of their lives. This has been the case for many years.
I am worried that this letter, which has been put in both Libraries, may mislead the House, or indeed any constituent who may need to read it. How can I correct the record in this regard?
Madam Deputy Speaker (Ms Nusrat Ghani)
I am grateful to the hon. Lady for giving notice of her point of order. I understand that she has notified the hon. Member for Rhondda and Ogmore that she intended to raise the matter in the Chamber. The Chair is not responsible for the accuracy of ministerial correspondence. However, the hon. Lady has put her point on the record, and I am sure that those on the Treasury Bench will indeed take note.
SUPPLY AND APPROPRIATION (ANTICIPATION AND ADJUSTMENTS) BILL
Motion made, and Question put forthwith (Standing Order No. 56), That the Bill be now read a Second time.
Question agreed to.
Bill accordingly read a Second time.
Question put forthwith, That the Bill be now read the Third time.
Question agreed to.
Bill accordingly read the Third time and passed.