Defending Public Services

Helen Hayes Excerpts

Monday 23rd May 2016 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

It is a pleasure to follow the hon. Member for Dudley South (Mike Wood), who spoke with passion about the NHS, a theme to which I will return. There can be no denying that the legislative programme outlined in the Gracious Speech is thin and aimed at preserving Tory party unity in the run-up to the EU referendum rather than at tackling head on the issues that the country faces, which is a great pity. This evening, I will concentrate on an issue affecting many of my constituents that was almost entirely absent from the Gracious Speech: the appalling state of mental health provision, and emergency provision in particular, across the country.

Our NHS currently faces an unprecedented financial crisis. Under Labour in 2009-10, the NHS reported a surplus of £2 billion. In the last financial year, the NHS in England reported a record deficit of £2.45 billion. It was the worst ever performance in the history of the NHS and worse than that predicted by NHS England. The deficit is kept from being significantly higher only by a series of creative accounting steps taken in a vain attempt to reduce the number of negative press reports about such disastrous performance.

This week, my family has again been profoundly grateful for the NHS. My mother, who spent many years working in the NHS, was admitted a week last Sunday after attending A&E. She was admitted at the weekend, but there was no absence of either diagnostic tests or expert healthcare at any level of the NHS. I am grateful to the dedicated staff who cared for her, and I am glad to say that she was discharged today. Over the past week, my family have seen NHS staff stretched to the limit, including nurses working 12-hour shifts without time for a break. My mother was not in the correct ward for the condition from which she was suffering, but an overspill patient on another ward, because no beds were available. She was admitted with a physical illness, but of all the pressures caused by the financial crisis facing our NHS it is mental health provision that is one of the biggest casualties.

Since May 2010, clinical commissioning groups across the country have reduced the amount spent on mental health, and we are seeing the consequences. In my constituency, for example, funding for first episode psychosis treatment has seen huge cuts and the number of mental health in-patient beds has been reduced, meaning that people in need of mental health care are in many cases left waiting for extended periods, either at home unable to cope or all too often in A&E. My constituency is served by King’s College hospital, a leading teaching hospital, and the Maudsley, a world-leading psychiatric hospital. Yet despite that combination of exceptional skills, expertise and facilities, the provision for mental health patients in A&E is simply not good enough. Despite the previous Labour Government setting aside funds for a dedicated waiting and assessment area for patients with mental health needs in A&E, it is yet to be delivered. On far too many occasions, patients attending A&E and requiring admission are unable to access a bed, because patients on the wards have yet to be discharged due to a lack of social care provision when they leave hospital.

I welcome the additional spending, although it is limited, on mental health that was announced in the Budget for tackling eating disorders, improving perinatal mental health services and providing mental health liaison services in every A&E, and the Government’s stated ambition of parity of esteem for mental and physical health. But much of the funding has previously been announced, and the overall budget assumes, incorrectly, that NHS trusts, including mental health trusts, will be able to attain unachievable levels of efficiency savings—the failure to do so being one of the main causes of the £2.45 billion deficit the NHS in England currently faces.

The commissioning of in-patient beds for child and adolescent mental health services within England is a national disgrace. Young people in urgent need are shuttled from one end of the country to another as a matter of routine. On the same day as a young person from Liverpool was placed on a ward in London, a young person from my constituency in London was admitted to a ward in Liverpool. No one would think it acceptable for a patient in cardiac arrest to be sent from London to Liverpool, and we should not accept a young person in mental health crisis being moved around the country in this way. Too many young people find themselves in hospitals dozens of miles from home, thus increasing their vulnerability, inhibiting the support that family and friends are able to provide to aid their recovery, and complicating their discharge planning.

The shortage of tier 4 CAMHS beds also means that young people frequently find themselves waiting in A&E for unacceptably long periods—often days at a time. We must see this for the scandal it is; we would not regard it as acceptable for a young person with a broken leg to spend days in A&E with only the most basic triage care, and it is just as unacceptable for someone with a mental health crisis to have to do that. The first step in achieving parity of esteem for mental health is to acknowledge these failures for the scandal that they are.

In my constituency, as across too many parts of the country, there is also an unacceptable shortage of places of safety for people who are detained under section 136 of the Mental Health Act 1983. That shortage delays the help that people who are desperately unwell urgently need. It is clear that there is too little co-ordination of the planning of the provision of places of safety, with police services, A&E departments and mental health services failing to work together to address the need. In London, the Metropolitan police have taken welcome steps to work towards eliminating the use of police cells as a place of safety for people in a mental health crisis who have committed no crime, but, without adequate multi-agency planning, this unilateral decision has exacerbated the pressure on A&E, resulting in situations where NHS staff are responsible for detaining patients and keeping them safe without having the required resources or an appropriate environment in which to do so.

One of the most shocking illustrations of the lack of parity of esteem between mental health and physical health is life expectancy: people suffering from serious mental illnesses such as schizophrenia or bipolar disorder can have a life expectancy 10 to 15 years lower than the UK average. Many mental health patients are dying early from heart attack, stroke and cancer rather than any cause linked directly to their mental health. Suicide is now the leading cause of death for men aged 18 to 49, with close to 5,000 people tragically taking their own lives in 2014. The recent Mental Health Taskforce report recommended the creation of local, area-based, multi-agency prevention plans, with a particular focus on high-risk locations and supporting high-risk groups. I urge the Government to implement the recommendations in full.

Our mental health services are failing too many people. One in four of us will suffer from mental ill health at some time each year, and all of us will know someone close to us who suffers from mental ill health. We are falling very far short of achieving parity of esteem for mental health. I find it astonishing that the Government do not seem to recognise this for the urgent priority that it is, and have failed to include any measures to address it in the Gracious Speech. The absence of significant measures in the Queen’s Speech to tackle these important issues speaks volumes about the priorities of this Government and how out of touch they are with the day-to-day needs and concerns of so many of the people I represent.