Mental Capacity (Amendment) Bill [Lords]

Helen Whately Excerpts

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a pleasure to follow the right hon. Member for North Norfolk (Norman Lamb), who has such expertise in this area and brought such valuable content to this debate as well as a valuable tone, which was very good to hear. I want to say a few things, first, in support of the Bill. As the right hon. Gentleman said, it is very important that we take a moment to reflect on the significance of getting this right.

Depriving someone of their liberty is a very significant act. Liberty is a fundamental right and freedom. We must take it seriously, and we must get this right. It is clear that the current system is not working. The fact that between 100,000 and 200,000 people are waiting because of an applications backlog is clearly unacceptable and cannot continue, given the consequences for individuals who have been deprived of the safeguards to which they are entitled, and the impact on their families and on care homes in which they may be residing.

[Jim Shannon (Strangford) (DUP)]

Earlier today I had a chance to speak about this matter to the Minister and some of her officials. Is it the hon. Lady’s understanding that the issue of human rights has been included in legislation that has been endorsed by Age UK, the Law Commission and Simon Wessely? If that is the case, the action that the Minister and the Government are taking this year is right, because it brings everyone together and ensures that there is legislation that everyone in the House can support.

[Helen Whately]

The hon. Gentleman has made a good point about the support for the Bill. Some Opposition Members have suggested that there is not much support for it, but it is, in fact, widely supported. Yes, there are concerns, with which I shall deal shortly, but, as the hon. Gentleman has said, there is widespread support for improvements in the current system. Those improvements include simplification—less bureaucracy and fewer administrative burdens—and the critically important representation of individuals through the independent mental capacity advocates, which will give them a voice. The frequency of assessments will become more appropriate; as my hon. Friend the Member for Berwick-upon-Tweed (Anne-Marie Trevelyan) said earlier, timings can be inappropriate and excessively burdensome. There is a better choice of language: the Bill removes the term “unsound mind”, which is very stigmatising and completely unnecessary. I am also pleased that the Government have listened to the concerns expressed by some of my constituents about, for instance, potential conflicts of interests for care home owners when a financial interest may be involved.

However, I have three outstanding concerns. First, there is the question of how the amended Act will work for people with severe mental illnesses. The Bill clearly focuses on those who lack capacity because of, for instance, dementia, learning difficulties, autism or brain injuries, but, if I understand it correctly, it could be applied to people with severe mental illnesses. Figures suggest that the current Act is applied to a significant number of people in such circumstances. We know that such illnesses—bipolar disorders, for example—are likely to fluctuate, and that as a result people’s capacity may also fluctuate. That could cause them to be detained and deprived of their liberty when, in fact, they have regained capacity. The Minister in the Lords, Lord O’ Shaughnessy, gave a commitment that that would be addressed in the code of practice, but may I press this Minister to ensure that there are sufficient safeguards in the Bill?

[Norman Lamb]

Does the hon. Lady agree that, given the cohort that could be covered by both pieces of legislation, it is particularly important that the approach be consistent?

[Helen Whately]

I completely agree, and that relates to my second concern, which others have mentioned and which relates to the interaction between the Bill and the 2005 Act. In his review, Sir Simon Wessely suggested that there should be a new dividing line between the two. I hope the Minister will explain how that will work.

My third concern is whether the Bill will address a situation that I suspect many of us have encountered, when elderly people are locked into their homes. When I have been knocking on doors, I have sometimes been told, “Do not knock on that door, because the lady there has been locked in by her family, and she becomes very distressed and upset if someone rings the doorbell because she cannot answer the door and she does not understand why.” This is clearly a completely inhumane way to treat people, but it is happening. People are being detained at home without appropriate safeguards for their safety as much as anything, so I ask the Minister to say whether the Bill can address this problem, or are there any other steps we might take to deal with the issue of people being inappropriately locked in at home and deprived of their liberty?

I appreciate the spirit in which this Bill has been presented to the House, and the willingness of the Government to listen, as they have already shown as the Bill has been going through the Lords. I have listened to Opposition Members, but think there is widespread support for the Bill among interest groups and experts. I look forward to the Government continuing to listen and improve the Bill so that we have a better system sooner rather than later.

[Several hon. Members rose—]

Department of Health and Social Care and Ministry of Housing, Communities and Local Government

Helen Whately Excerpts

Monday 2nd July 2018 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a great pleasure to follow the thoughtful speech of the hon. Member for Sheffield South East (Mr Betts). I really enjoyed listening to it.

Everybody has an NHS story, whether a child born, a disease cured or a life saved. I have seen the NHS at its best—when my five-year-old son got appendicitis on Christmas day and three days later was home and happy, without his appendix. I have also seen it at its worst, however—when my fiercely independent grandmother tripped over and bruised herself. What followed included misdiagnosis, mis-medication, a morphine overdose, a six-month stay in hospital and enormous frustration trying to access social care. She returned home only to die. I suspect that my experiences reflect a national picture, of many, many lives saved against the odds and huge public support, rightly, for the NHS, but also of the tragedy of lives lost through omissions and errors.

I would like to take a step back in this the NHS’s 70th birthday year to say there is much to celebrate in our national health service: 44 million babies born, millions more treated, cancers cured, thousands of people alive who would not have been without its help, and long-term conditions such as diabetes much better managed, with much improved quality of life as well as life expectancy. Our health service is renowned around the world for providing the most equitable access to healthcare, and for this it is the envy of the world.

But we must not be misty-eyed about the NHS. Even on access, in my area of Kent there are some terrible A&E waits, while 1,500 children are waiting for mental health treatment, over 100 of them for more than a year. In some areas, NHS outcomes are not what they should or could be. There is still far to go to join up parts of the health and social care systems, as others have said this evening, and too little emphasis on public health and ever rising demand. I welcome the recently announced £20.5 billion of funding for the NHS, and also the forthcoming social care settlement, which is really important, because funding the NHS will not work if we do not also give social care the funding it needs.

The NHS has a huge opportunity to make the funding go further, and I do not mean through salami-slicing, penny-pinching and cost-cutting, through saving on biscuits and paper clips—I actually think a little more should be spent on enabling staff to eat together. I just want to touch on three areas of better spending. One is technology. There is a huge opportunity here. It has been said many times, but should be said again, that there is much further to go to improve the use of technology in the NHS, whether that is just updating systems so they work—so that doctors do not spend time cutting and pasting patients’ information or waiting for a system to turn on after it has turned itself off; having a fully functional single patient record that brings together mental and physical health, dental records and end-of-life instructions; or giving patients far more opportunity to use technology. In that regard, I welcome the recently announced app for booking appointments online. There are many other tools for better self-management. We must drive forward the potential for big data, artificial intelligence and personalised medicine, which could make such a difference to what we get from our NHS.

Secondly, on the workforce, it is fantastic that we are training and recruiting more doctors, including 100 more in a medical school in Kent, but with vacancy rates too high, particularly in mental health, and high staff turnover, we know that for parts of the workforce things are just not working. Junior doctors have told me they feel like cogs in a machine, and so too often do nurses, therapists, healthcare assistants, porters—you name it. So often I have heard them say things like, “Nobody ever listens”. In some parts of the health service, command and control has unfortunately dehumanised the experience of working in the NHS—a job that should be so full of satisfaction. The NHS has much to learn from itself, and from other systems and other sectors, about how to be a better place to work and to make the most of its fantastic workforce in order to provide the care we aspire to.

Thirdly, it is time to end the divide between physical and mental health. We need to give a greater share of the funding pie to mental health, as the Government have recognised, and knit together mental and physical health. When the two are joined together, it improves outcomes for patients and provides better value for the NHS—better outcomes at lower cost, which is exactly what we need and want.

We need to talk about the funding of the NHS and social care, as many Members have done so eloquently this evening. We need to talk about how much money is needed, and about the big question of where we are to find that money. Those are not difficult conversations, and they do not involve difficult decisions. However, we also need to talk about how to make the best use of the money, so that we can have the health and care system that we want for years to come.

Gosport Independent Panel: Publication of Report

Helen Whately Excerpts

Wednesday 20th June 2018 Commons Chamber

[Mr Hunt]

The right hon. Gentleman is absolutely right: we have a regulatory landscape that is very complex, does not achieve the results we want, and forces regulators to spend time doing things they do not want to do and does not give them enough time for things they do want to do. Obviously, because of the parliamentary arithmetic, if we are able to get parliamentary consensus on such a change, that would speed forward the legislation.

[Helen Whately (Faversham and Mid Kent) (Con)]

There are many “if onlys”, but one of them is: if only the junior doctors and others who spoke up had been listened to. I know my right hon. Friend is committed to making sure that people and whistleblowers are listened to and that he is committed to transparency. Will he say a bit more about what he is doing to make sure that everyone involved in patient care—from consultants to healthcare assistants, porters, patients and families—are listened to and that their concerns are acted on?

[Mr Hunt]

I think we have made progress when it comes to whistleblowing because every trust now has a “freedom to speak up” guardian—an independent person inside the trust whom clinicians can contact if they have patient safety concerns. That is a big step forward, which was recommended by Robert Francis. Where I am less clear that we have solved the problem is in relation to having someone for families to go to if they think that everyone is closing ranks, and we now need to reflect on that.

NHS Outsourcing and Privatisation

Helen Whately Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

My hon. Friend, who is extremely experienced, shows with great eloquence the dangers of this relentless outsourcing of services. It damages patient care and is not in the interests of the taxpayer.

[Helen Whately (Faversham and Mid Kent) (Con)]

I thank the hon. Gentleman for giving way. I remember well when I worked in the NHS under a Labour Government, before I was a Member of Parliament. All around me was talk of independent sector treatment centres, offering more choice through bringing in more private sector provision to the NHS, and PFI contracts. That was under the previous Labour Government, who I believe were trying to make the NHS give better patient care, but Labour has changed its tune. I am concerned that this seems to be all about ideology. I care—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order. Members cannot make speeches in interventions.

--- Later in debate ---

[Rosie Duffield]

Absolutely. I was just about to speak about Unison, which is my union.

Leading unions have called the move in my local NHS trust—the East Kent Hospitals University NHS Foundation Trust—a “wolf in sheep’s clothing” and fear, with good reason, that workers’ conditions, including pay, will be eroded. I know many of those workers personally and they include some of my friends. The unions are right: workers’ conditions will be eroded, and it is already happening in other public services across Kent.

The Conservative-run Kent County Council, for instance, has introduced another ALMO called the Education People. Educational psychologists currently working directly for the council are being transferred to be employed by the Education People. The terms and conditions being offered by the ALMO to new educational psychologists are significantly worse than existing terms and conditions for those employed by the county, so no new educational psychologists have been recruited for Kent. We already have a serious shortage.

Of course, Kent County Council is doing that because central Government have starved it of funds and, perhaps because it is the same shade of blue, it is too timid to make that big a noise about things, so I will do it instead: Conservative central Government cuts are reducing our ability to care for people properly. In my constituency, the local NHS is potentially doing the same by setting up an ALMO to make yet more cuts by stealth. More money, less responsibility.

My union, Unison, represents nearly half a million healthcare staff employed in the NHS. That is one in every 60 or so working adults in one sector in the UK represented by one union standing up with one voice against injustice.

In Canterbury, rooms at the once thriving city hospital can now be found stacked with old equipment, and staff tell me that whole wings of old, neglected hospitals, such as the Buckland in Dover, lie abandoned, underused and under-occupied while waiting rooms in our not-so-local accident and emergency departments remain rammed. In Canterbury, services that were removed “temporarily” in 2017 look likely never to return to those old buildings. Proposals are afoot for a new hospital, but it simply will not be built if the central Government funding is not there to fill it. I am the only Labour MP in Kent and, as such, I am proud to make a loud noise about and stand up against the Conservative cuts that have caused vital hospital services to disappear in my county in recent years.

Things need to change drastically, and the new university medical school in Canterbury will be part of that much-needed change. If someone in my constituency is sick, they currently have to travel a long way to Ashford or Margate to get the emergency care they need.

Combine an underfunded NHS with a South East Coast Ambulance Service in special measures, and we have the ingredients for chaos. Chaos and a lot of sadness are apparent in all the letters I receive from constituents about the NHS week in, week out. Members will get the idea. The funding is not there, so the services have gone.

[Helen Whately]

I have a question about what the hon. Lady said regarding the loss of services at Canterbury Hospital. She and I both oppose that. Does she acknowledge that services were lost under a Labour Government?

[Rosie Duffield]

I agree that services started to be cut under a Labour Government, but they have got so much worse that our hospital is now underused, unusable and unrecognisable.

Madam Deputy Speaker, you will hear the same thing repeatedly from my concerned Labour colleagues this afternoon. The impact of austerity on our health service has been truly dreadful. Trusts are beginning to look to PFIs to keep walls from crumbling, and the desire for a short-term fix has meant that private companies, such as Virgin, Serco and Spire, have stepped in, especially near me in Kent, to profit from sickness, which is fundamentally abhorrent.

So much must change. The privatisation of the NHS and supporting services must be stopped and funding must be fully restored to the levels it was at under the last Labour Government. If Conservative Members continue to erode our health service and encourage private companies to step in to fill in the gaps, there will be little left when they finally realise what they have done. With so many pieces given away, the NHS jigsaw will certainly never look the same again.

Labour Members are constantly accused of running down, criticising and putting down our health service. The fact is that we are telling the truth about the urgent state of our broken NHS, which is staffed by amazing, dedicated and selfless people who deserve so much better from this Government.

--- Later in debate ---

[Alex Chalk (Cheltenham) (Con)]

The allegation of privatisation of the NHS is wholly misconceived. It is a reheated and debunked myth that irresponsible elements have been trotting out for decades, and repeating it does not make it any more true. NHS outsourcing to private providers is being weaponised in a way that involves dressing it up as a threat to the NHS’s guiding principle that treatment should be provided free at the point of use and regardless of ability to pay. That is what people understand when the expression “privatisation” is used, but the reality is that nothing could be further from the truth.

That principle is fundamental, inviolable and enduring. It is all those things because it reflects so much about the kind of country we are and want to continue to be. It is the principle that says that when a member of the public is rushed into hospital needing emergency care, we take pride in the fact that the ability to pay is irrelevant. NHS staff are interested in vital signs, not pound signs. There is no appetite in this country for the Americanisation of British healthcare. Even if there were, I could never support it, my colleagues could never support it and the Government could never support it. That is why it is so important that we make that position crystal clear.

On the issue of outsourcing, we must not rewrite history. As moderate members of the Opposition concede, certain services have been provided independently since the NHS’s inception 70 years ago. Most GP practices are private partnerships; the GPs are not NHS employees. The same goes for dentists and pharmacists. Equally, the NHS has long-established partnerships for the delivery of clinical services such as radiology and pathology, and for non-clinical services such as car parking and the management of buildings and the estate. To give an everyday example, the NHS sources some of its bandages from Elastoplast. That is common sense; it would be daft if public money was diverted from frontline patient care in order to research and reinvent something that was already widely available.

That is why certain members of the Labour party have slammed this kind of argument as scaremongering. Lord Darzi, a former Health Minister, has been highly critical. In 2017, the shadow Secretary of State said on the “Today” programme that there may well be examples

“where in order to increase capacity you need to use the private sector”,

so this argument is completely misconceived. In 2009, Andy Burnham admitted that the private sector could benefit the NHS. As Labour’s Health Secretary, he said:

“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 250WH.]

[Helen Whately]

My hon. Friend is making the point extremely well that there is complete inconsistency in Labour’s argument on this point. Which of the various parts of NHS services that are provided by independent sector providers is Labour against?

[Alex Chalk]

My hon. Friend is absolutely right. I shall give three brief examples from my own constituency. First, Cobalt is a Cheltenham-based medical charity that is leading the way in diagnostic imaging. It provides funding for research, assists with training for healthcare professionals and provided the UK’s first high-field open MRI scanner. Is the Labour party now suggesting that that should be ditched—that we should axe that fantastic facility in my constituency?

Secondly, the Sue Ryder hospice at Leckhampton Court is part-funded by the NHS and part-funded by charitable donations; again, is that for the axe under Labour? Thirdly, what about Macmillan and its nurses? It is a fantastic organisation, yet we have the extraordinary situation in which the Labour party says, “Macmillan is all right, but another provider is not.” What is the logic of the Labour position? What about Mencap? The list goes on and on.

Let me deal briefly with the second part of Labour’s motion, whereby it wants to ensure that all communications between Ministers and their officials are revealed. The reason why that is so bogus was explained clearly by the former senior Labour Secretary of State Jack Straw in a statement that was quoted with approval in the Chilcot committee’s report. He said that meetings in Cabinet

“must be fearless. Ministers must have the confidence to challenge each other in private. They must ensure that decisions have been properly thought through, sounding out all possibilities before committing themselves to a course of action…They must not be deflected from expressing dissent”.

What about advice given by officials in the form of memorandums and so on? What would Labour Members say to those officials about a motion that might result in the making public of the advice of professional civil servants—people who, of course, can never answer back themselves—that they thought was given to Ministers in confidence? As I have already indicated, it would also be completely inconsistent with the Freedom of Information Act 2000, which was introduced by a Labour Government. On both bases, the motion is misconceived, and I shall have no hesitation in voting against it.

--- Later in debate ---

[Helen Whately (Faversham and Mid Kent) (Con)]

A constituent wrote to me last year to say that, against the backdrop of negativity around healthcare in this country, he personally had had a really good experience of treatment on the NHS at his nearest hospital. It happened to be KIMS Hospital, an independent sector provider, but it had given him what he really wanted: timely, high-quality and caring treatment free at the point he needed it.

The shadow Secretary of State recognised earlier that there was a place for private providers in the NHS. As in the example I have just given, that place might be enabling somebody to get timely treatment at a time of huge pressure on NHS resources, but, from what we have seen, it seems Labour considers the place for private treatment to be whenever Labour is in power. As we heard, in the years running up to 2010, when Labour was in power, there was an increase in the use of private sector providers in the NHS, as I saw when I worked with the NHS, and there was an increase in their use last year in Wales, where Labour is in power.

I do not want to make an ideological argument—I do not particularly want to talk about who provides the care, because what matters to me and my constituents is that they get good care when they need it—but, as Labour is picking this fight, it is only fair to put some truths on the table, and as far as I can see, the place for private providers, from Labour’s point of view, is whenever it is in government.

What matters to me is great care, and I have observed some ways of getting it. In some parts of healthcare, one way is by offering choice. Giving mothers-to-be the choice of where to have their baby makes maternity teams say, “Hold on. We want to be the best place in the area to have a baby.” Choice works, so long as it is accompanied by transparency, and the Government have done much to improve transparency in healthcare, meaning that people can know where to get good treatment and where there are problems, which has driven up quality.

Innovation and new technology can also transform healthcare. Whether the introduction of keyhole surgery, which has hugely shortened stays in hospital, or the exciting things happening with genomics and personalised medicine, innovation is making a huge difference, and it should not matter where that innovation comes from. If it comes from the private sector, we should welcome it. The workforce also matter. We have skilled, capable and committed people providing great care day after day, but I would argue the Government need to place an even greater emphasis on the workforce to make sure that those who work in the NHS or train to be doctors, nurses or other healthcare professionals are valued and nurtured and have rewarding careers that make the most of their talents.

I will conclude with some facts, given the many myths peddled this afternoon: it is clear the NHS is not being privatised—there has been a zero increase in the last year in the use of the independent sector; the NHS is getting more money—£8 billion more this Parliament; and the NHS is treating thousands more people. Times are difficult, but the NHS is rising to the challenge. We should get away from these ideological arguments and put our energies into making sure we have the best possible NHS.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 8th May 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I will be very happy to meet the hon. Gentleman to look at his local issue.

[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the Green Paper on mental health in schools, which was published earlier this year, but it does prompt a question about the mental health of students in further and higher education. Does my right hon. Friend have any plans to look into that issue? If he does not, may I urge him to do so?

[Jackie Doyle-Price]

I thank my hon. Friend for her question and her continued industry on these matters. As she mentioned, the Green Paper outlined plans to set up a new national strategic partnership focused on improving the mental health of 16 to 25-year-olds. That partnership is likely to support and build on sector-led initiatives in higher education, such as Universities UK’s #stepchange project, whose launch I attended in September. The strategy calls on higher education leaders to adopt mental health as a strategic priority, to take a whole-university approach to mental health and to embed it across policies, courses and practices. [Interruption.]

NHS Staff Pay

Helen Whately Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

The hon. Lady speaks eloquently and my right hon. Friend the Secretary of State for Northern Ireland was listening to her comments. It is a matter of great sadness that nurses’ pay has fallen behind in Northern Ireland, not because the money was not available, but simply because the Administration were not in place to implement changes. I know that my right hon. Friend will do everything she can.

[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the proposed pay rise, especially the increase for the lowest paid in the NHS. Nurses at my local hospitals tell me that as well as a pay rise, what they really want is flexibility in relation to things that happen in their lives, so I particularly welcome that aspect of the proposal. Does my right hon. Friend agree that flexibility and investment in training will enable NHS employers to show their appreciation for the valuable contribution that each individual member of staff makes to the care of patients?

[Mr Hunt]

My hon. Friend is absolutely right and speaks with a great deal of knowledge. Let me give an example of something we are doing that is not part of this deal, but that backs up what she says. We are prioritising the use in every hospital of an effective e-rostering system that enables people to book the shifts that they want on their phones and to change them very easily through a modern IT system. That makes an enormous difference to the control that they have over the hours they work, and I think that, in combination with the new deal, that will make a big difference.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 20th March 2018 Commons Chamber

[Steve Brine]

As I have said, we are concerned about child obesity, which is probably the big public health challenge, not least in the impact that it can have on diabetes, heart disease and cancer. That is why I so welcome Cancer Research UK moving into this space. We have one of the most ambitious plans in the world. We have already said that it is the start of a conversation, not the end, and if we need to go further, we will.

[Helen Whately (Faversham and Mid Kent) (Con)]

May I welcome today’s announcement on a new medical school for Kent? In an area that struggles to attract doctors, this will make a huge difference: it is genuinely a game changer. Will my right hon. Friend congratulate the University of Kent and Canterbury Christ Church University on their successful bid?

[Mr Hunt]

I absolutely congratulate them, but I also congratulate my hon. Friend, because I know that she worked incredibly hard on this bid. Thanks to that, I am sure, they are among the successful bidders today.

Psychosis: Early Intervention

Helen Whately Excerpts

Thursday 15th March 2018 Westminster Hall

[Helen Whately (Faversham and Mid Kent) (Con)]

I have been trying to think about how to put the experience of psychosis into words. Having observed it rather than experienced it personally, I suspect that I will not do it justice. From my observation, however, it is a devastating thing to experience: it is debilitating, frightening, bewildering and enormously destructive to someone’s life, aims and prospects. Its impact on people’s lives is severe, as other hon. Members have described.

In the past, a diagnosis of psychosis was essentially a life sentence, but now early intervention and treatment can lead to recovery. People can get their lives back on track—we are not in the dark old days when if someone had a mental illness, that was it. People can and should recover, but getting early treatment is crucial.

I will be brief, not only because you said that the winding-up speeches would begin at half-past 2, Mrs Moon, but because the issue has been covered comprehensively by the right hon. Member for North Norfolk (Norman Lamb), who has such huge knowledge and has clearly done an enormous amount of groundwork; by the hon. Member for Stockton South (Dr Williams), who brings to the debate his expertise as a doctor; and by the hon. Member for Liverpool, Wavertree (Luciana Berger), who does a huge amount of work in the area. I will therefore make only three points.

First, I express my appreciation to the Government, and to the Minister, for their enormous commitment to mental health and their huge focus on improving mental healthcare, achieving parity of esteem and ensuring that far more people have access to treatment, starting from a really low base. They set out that commitment in the “Five Year Forward View”, the most comprehensive strategy for mental health, and have demonstrated it with an increase in mental healthcare funding and with greater transparency. The fact that we can even have this debate, and that there are targets for waiting times and access to mental health, represents great progress from the time described by the right hon. Member for North Norfolk, when targets and transparency were making a huge difference to the quality of physical healthcare but there was no information about the quality of mental healthcare or access to it. We now have a developing, albeit early, set of data about access to mental healthcare. There is a long way to go, and that includes getting much more data about progress through treatment and outcomes, but the access data has at least given us a start. I welcome the fact that we are in a better place with mental healthcare, and that there is a great commitment to improvement.

My second point, however, is about the worrying trend in the treatment of people with psychosis. The direction of travel seems to be towards a decline in early access to treatment—not just in percentage terms, which could be explained by rising demand, but as an absolute number. The data cited by the right hon. Member for North Norfolk shows the gap between the treatment that some patients receive and the full recommended amount. A large number receive only some treatment, so we cannot hope for the recovery and outcomes that the full NICE-recommended package would offer.

My third point is that we need to know the reason for this worrying trend, which goes against our ambition to treat more people and help them to recover, and against the Government’s commitment to mental health. What is going on? Why do we appear to be going in the wrong direction? We have heard some possible reasons this afternoon, including lack of governance and accountability; lack of focus in many parts of the country, although there is clearly huge variation; underfunding of treatment packages, despite the overall backdrop of more money going into mental health; and shortage of workforce. Under the “Five Year Forward View”, there were meant to be 60 extra psychiatrists to provide early intervention in psychosis, but it is not clear—perhaps the Minister will tell us—whether those posts have been filled. It is clear to all hon. Members who work on mental health issues that the workforce is facing a huge challenge in recruitment and retention.

Is there a lack of ambition to provide early access to treatment for psychosis? Even achieving the 2020-21 target of 60% would leave 40% of people without much-needed treatment; we could argue that that is too low an ambition, especially as we know how effective treatment can be. I welcome the Government’s commitment, but it is worrying that the direction of travel seems not to be positive, so it would be extremely helpful if the Minister gave us some insight into what is going on and what steps are being taken to ensure that people get treatment that works.

Mental Health Act: CQC Report

Helen Whately Excerpts

Tuesday 27th February 2018 Commons Chamber

[Jackie Doyle-Price]

I would say to the hon. Lady that this report represents sunlight, not clouds. It is very transparent, and these are exactly the things that I will be holding myself and NHS England to deliver to address these points.

[Helen Whately (Faversham and Mid Kent) (Con)]

It is very worrying to hear the CQC’s judgment that there has been limited or no improvement, especially relating to the failure to involve patients in planning their care. The Government’s review of the Mental Health Act is therefore timely, and it rightly considers evidence from people who have experienced being sectioned. The report mentions significant variation in performance. Will my hon. Friend be looking into the performance of specific organisations? Can we have more transparency about the failures, down to specific organisation level? What steps are being taken to intervene earlier and to care for people better in order to avert crises and reduce the need for sectioning in the first place?

[Jackie Doyle-Price]

My hon. Friend will be aware that, in addition to this annual review of how the Act operates, the CQC is also involved in inspections at individual provider level. Those institutions that are not performing to the standards that we expect are under close scrutiny by the CQC. In fact, I have had exchanges on the Floor of the House about some of them. I repeat my point about the spirit in which we embrace the challenges offered in the report. We have asked the CQC to undertake this annual report precisely so that we can ensure that the Mental Health Act is operating properly, and I actually welcome its frankness. I do not run away from the criticisms in the report, because it highlights exactly where we need to take action.

Medicines and Medical Devices Safety Review

Helen Whately Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I can give the hon. Gentleman an absolute assurance that she will do so. In the case of valproate it is very clear what the next steps should be, because there is no dispute over the science. When there is controversy over the science—and I appreciate how distressing that is for the families involved—the first thing we must do is establish the truth of the situation, and that is why we have given Baroness Cumberlege a free hand to look at the whole issue.

[Helen Whately (Faversham and Mid Kent) (Con)]

I welcome the statement, which is consistent with my right hon. Friend’s track record of driving the NHS to stop causing harm to patients. May I ask him to continue to focus on encouraging, requiring and supporting all healthcare professionals to make the shift from a defensive to a learning mindset, so that they listen and learn not just from NHS experience, but from patients as well?

[Mr Hunt]

My hon. Friend, who has huge experience in healthcare, is right to say that at the heart of dealing with these very complex issues is the need for us to be careful not to inadvertently encourage a culture of defensive medicine. If doctors feel unable to be open about mistakes that may have happened because they are worried about legal consequences, we will not benefit from the learning that is so incredibly important, and one of the purposes of the review is to ensure that we support that open learning culture.