Covid-19 Response

Jeremy Corbyn Excerpts

Wednesday 22nd April 2020 Commons Chamber

[Matt Hancock]

The target was set at 100,000 because that is what we estimated was needed—scientific advice was provided into that target—and it is what is practically achievable. As I said, we are ahead of our trajectory on capacity, but we need to make sure that demand increases. Increasing demand is about widening access to this testing. We did take scientific advice. I am not sure whether that came directly through the SAGE route or directly from Public Health England, but of course these decisions are based on the science.

[Jeremy Corbyn (Islington North) (Lab)]

First, I want to pay tribute briefly to all those health workers, care workers, delivery workers, street cleaners and cleaners, and so many other groups all over the country, who are doing such an incredible job, together with all the volunteers, to deal with this crisis. It is an amazing moment in this country’s history. However, Parliament’s job is to hold the Government to account, so I have a simple question. The World Health Organisation indicated that there was a danger of an epidemic from coronavirus in January—it later declared this to be a pandemic. The WHO’s director general said, in terms, that the way to deal with it is by “test, test , test”, in order to ascertain the levels of infection across our society, but we did not do that. The Secretary of State came to the House in January to say that he was going to increase the amount of testing. This issue was raised with the Prime Minister on 24 February and again in a meeting we had in March, at which the Secretary of State was present. He told us then that the level of testing would increase, but it is still nowhere near the level that is necessary. Can he assure us that there is going to be a really rapid increase in the level and availability of testing, in order to get on top of this dreadful virus?

[Matt Hancock]

The development of testing has been at pace throughout this crisis, entirely contrary to the story told by the right hon. Gentleman. We were one of the first countries in the world to develop a test. We rapidly increased the number of tests, from 2,000 at the start of March to 10,000 during March—a fivefold increase—and it is now going up further. This is an area where we had our foot on the gas all the way through, because it is incredibly important.

HIV and World AIDS Day

Jeremy Corbyn Excerpts

Thursday 29th November 2018 Commons Chamber

[Lloyd Russell-Moyle]

That is quite right.

We are making progress on treatment, but when it comes to stigma we still have so much further to go. Last week, I was in Kenya with the International Development Committee and met a HIV-positive mother of eight children from the Democratic Republic of the Congo. Although she was on medication, she had suffered such abuse that she was forced to flee the DRC and now lives in a refugee camp. Because of the prejudice and violence that she faced as a result of her status, she was forced to leave without her children, and she knows not of their future.

[Jeremy Corbyn (Islington North) (Lab)]

I thank my hon. Friend for giving way. He is making an absolutely brilliant and historic speech. I am very grateful that he mentioned my good friend, Chris Smith, who very bravely told the world in 1984 that he was gay and proud of it, and we are proud of Chris for doing that. I am also pleased that my hon. Friend has brought up the international context, where there are appalling levels of prejudice and abuse against HIV-positive people and against the LGBT community of many countries around the world. We just need to send out a message from this House of Commons that this country has changed its attitudes. We have done a great deal medically to help people. We need to ensure that the rest of the world understands that we can do the same in every other country. We have to close our minds to prejudice and open up our minds to human rights and justice for people all across the globe.

[Lloyd Russell-Moyle]

I thank my right hon. Friend for his intervention, and I totally agree with him. There are some countries in the world I may now struggle to travel to because of this announcement. It is important that we continue to make international efforts. I do not have time to talk about all the international aspects here. I commend the work of the HIV/AIDS Alliance and plan to come back to this House in future months to talk about its ENDAIDS 2030 Festival, which is really important.

Turning back to the UK, it is the case not just that HIV is treatable, but that it is preventable with one tablet a day. A person can prevent themselves from contracting HIV with pre-exposure prophylaxis. PrEP is revolutionising the fight against HIV transmissions. It has an almost 100% success rate, a higher rate than condoms, in the prevention of HIV, and it is just one pill. We expect this pill to be soon available as a generic drug and, according to the NHS’s own analysis, it could save the health service £1 billion in preventing HIV transmissions for future generations. Astoundingly, however, the only way to access PrEP in England is through a limited trial. This is not a medical trial—those have been done and approved. This is not about financing—we know the cost. This trial, as far as I can see, is about delaying the roll-out of PrEP in England because someone meddling in the Ministry thinks that they know better than doctors when it comes to people’s health. It seems to me that this trial is more concerned about what a person does between the sheets than the health of the nation. Despite being just one year into this three-year trial, 3,000 additional places have already had to be added, and it looks like the 13,000 places will run out early next year. England now lags behind all the other nations in the UK as the only country with capped PrEP access on the NHS. There are two years to go until this trial ends, yet people cannot get immediate access to PrEP, with many clinics now having long waiting lists, and some completely full.

We know that there are cases of young men who have sought out this prevention pill and have been turned away because the clinics cannot accommodate them, and they have subsequently become HIV-positive. Those men now have to live with HIV and everything associated with it because of the misguided morality of this decision. Let us make no mistake: these are not isolated cases. The longer this Government wait to roll out PrEP properly, the more people will be diagnosed.

Will the Minister intervene to ensure that PrEP is made routinely available on the NHS in England—just like his Government have already done with Northern Ireland with direct rule, just like the Scottish Government have done, and just like a Labour Government have done in Wales? Failing that, will he at least uncap the trial to ensure that those trying to access the drug can do so? Will he reverse public health cuts, including those in sexual health, so that the Government meet demand, including that of people affected by HIV, otherwise we seriously risk undoing the really good progress that we have all made?

Just today, the latest Public Health England statistics show that the UK has met its UN AIDS target of 90-90-90, ahead of 2020, which was the date. This is amazing progress, with 92% of people living with HIV diagnosed, 98% on treatment and 97% with undetectable viral load, meaning that they cannot pass it on.

At the Terrence Higgins Trust World AIDS Day reception earlier this week, I am told that the Minister hinted that the Government were considering bolstering their ambition on HIV to committing to reaching zero new HIV transmissions by 2030. In the light of today’s statistics, now is the time to seize that opportunity of reaching zero new HIV infections and be a true global leader. Can the Minister provide details of how the UK Government plan to end HIV infections and what timescale they will commit to?

At present, one young person every day is still diagnosed with HIV and young people continue to suffer some of the worst sexual health outcomes. We cannot be complicit on this. Will the Minister agree to work with the Department for Education to ensure that relationship and sex education guidance has a strong focus on not only HIV prevention, but anti-HIV stigma? Will the Minister also liaise with Department for International Development colleagues to ensure that research funding is increased so that we can make huge gains in scientific breakthroughs to eradicate this disease globally?

In two days’ time, on World AIDS Day, I will stand with my community to mourn the losses of those who have died of AIDS. I will do so at the Brighton AIDS memorial—the only such dedicated public memorial in the country. I will stand there in the knowledge that I will live a life that so many could not. I am able to do that because of the people who have come before me: the people who have fought and lost their lives, and the people who stood up and had their lives changed. We owe it to these people to beat the disease—something we have the power to do. I hope that future generations will look at HIV in the same way that we look at smallpox and polio, as diseases that were once killers but can now be eradicated.

LGBT people often talk about coming out as something that you constantly have to do to new neighbours, friends and work colleagues. You could say the same about your HIV status. I have spent many nervous moments deciding whether to tell new friends and acquaintances about my status. The lump forms in your throat and your heart flutters, and you finally kind of blurt it out and hopefully move on. Well, Mr Deputy Speaker, I would like to thank you for giving me this platform to do just that. I thank my friends, family and colleagues for supporting me. I also thank the Terrence Higgins Trust for all its work and the support it has given me in preparing for this debate.

We have the ability to end new HIV transmissions, as well as to end stigma and discrimination—not only here, but globally. I hope we can all make that our mission. [Applause.]

Organ Donation (Deemed Consent) Bill

Jeremy Corbyn Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Mr Robinson]

I am grateful to my hon. Friend and my honourable colleague from our shared city—we are both immigrants to it, but we hold it very dear to our heart—and his support along those lines is most welcome. I notice that my right hon. Friend the Leader of the Opposition has come in. I repeat my warm tribute to his leadership on the issue and to the tremendous help that I have received from his office in backing up the Bill. I am deeply grateful. I also took the opportunity to express a sincere thank you to the Prime Minister, who has taken a personal interest and lent her support. I know that he will welcome that, too.

[Jeremy Corbyn (Islington North) (Lab)]

I apologise for having just arrived, Mr Speaker. I thank my hon. Friend for what he said. It is wonderful that he has got this Bill introduced, and I hope that today the House can pass it and thus save an awful lot of people’s lives in future.

[Mr Robinson]

That is indeed our aim. However, I shall sound certain notes of caution about what we need to do to ensure that we get and successfully utilise that increase in organ donation. We have to watch out for certain things, and I will mention those as part of the serious approach that my right hon. Friend would expect from me and that, in due course, he would want to see his Government adopt and perhaps have to implement. I hope that that is the case, too.

We have a proud history of innovation in the field of transplantation. I think that time prevents me from going into any detail on that—indeed, I am getting the message from you, Mr Speaker, that time is of no essence, so let me mention a few things that have been achieved. In our proud history, Britain’s first living donor transplant took place on 30 October 1960 at the Royal Infirmary of Edinburgh. The operation was between identical twins, because at the time, the problems of rejection were still a long way from any sort of reliable solution. In November 1965, the first transplant in the UK from a “non-heart beating” donor was carried out, again at the Royal Infirmary of Edinburgh. In 1968, there were the first successful heart and liver transplants. There is a proud tradition, and I am sure that the whole House will join me in congratulating the NHS and all the staff concerned in this department on their magnificent work.

Mental Health and Well-being of Londoners

Jeremy Corbyn Excerpts

Thursday 12th February 2015 Commons Chamber

[Ms Abbott]

I am grateful to you, Madam Deputy Speaker. As ever, you are punctilious about matters of order.

London boroughs spend about £550 million a year on just the social care costs of treating mental disorders. Another £960 million is spent each year on benefits to support people with mental ill health. Across the population, the net effect of those wider impacts substantially affects London’s economy, infrastructure and population. Mental health is not simply an issue for health and social care; it is an issue for everyone. Mental health conditions debilitate London businesses each year by limiting employee productivity and reducing the potential work force. Every year £920 million is lost owing to sickness absences, and a further £1.9 billion is lost in reduced productivity. Moreover, the costs extend more widely: the staggering sum of £10.4 billion is lost each year to London business and industry as a result of mental health issues.

The London criminal justice system spends approximately £220 million a year on services related to mental ill health, and other losses such as property damage, loss of stolen goods and the lost output of victims cost London a further £870 million. Those costs are already too high, but treatment costs are expected to grow over the next two decades. Mental health issues also prevent physical health conditions from being addressed properly. However, mental ill health remains one of the least understood of all health problems. The problem is exacerbated by the existence of an obstinate and persistent stigma that prevents people from talking about mental health or paying attention to the debate about it, and therefore prevents us as a society from addressing it properly.

I want to say a little about the issue of parity of esteem between mental and physical health. The continuing lack of parity of esteem, in terms of both funding and attitudes, underlies some of the mental health problems not just in London, but throughout the country. As the daughter of a mental health nurse, I am very clear about the fact that there is no parity of esteem between mental and physical health. My mother came here as a pupil nurse in the 1960s, and was part of the generation of West Indian women who helped to build our NHS. She took time off work to bring up a family, but she returned to nursing in the 1980s, and her subsequent career in mental health exemplified the issues involved in the lack of parity of esteem.

The first thing that I want to say about parity of esteem is that those who might be described as the high fliers in health do not necessarily go into mental health. That has always tended to be the case. I shall never forget something that happened in 1987, when I was a brand-new MP. The then chief nurse at City and Hackney told me that I must visit the hospitals in the area. She said that I should meet her at 10 pm, and she would take me to the three major hospitals in hospital: Bart’s, Homerton, and Hackney mental hospital. I met her, and we went around Bart’s. She did not think it in any way remarkable that in Bart’s, even at the dead of night, we did not see a single black nurse. Then we went to Homerton, where there were quite a few black nurses doing the night shift. The chief nurse said to me innocently, “You know, they”—meaning nurses of colour, I assume—“seem to prefer the night shift; our day shift is quite different.”

Then I went to Hackney mental hospital. Although this happened in 1987, I have never forgotten it. The mental hospital was, literally, an old workhouse. It was as grim as anyone could possibly imagine—and, of course, all the nurses there, day and night, were BME. I am afraid that that pointed to a lack of parity of esteem, in the context of the way in which nurses were allocated and the direction in which their careers were leading. I am not in any way detracting from the specialists in mental health, but in respect of nurses there has long been a stratification when it comes to who should work in mental as opposed to physical health.

My mother was a devoted mental health nurse who dealt with geriatric patients with dementia. When my brother and I were older and she went back to nursing, she worked in a hospital outside Huddersfield called Storthes Hall. Thankfully, it has now been closed. It was another former Victorian workhouse, and it looked exactly like a Victorian workhouse. One had only to visit that hospital, see the conditions there and then visit the new Huddersfield royal infirmary in the centre of Huddersfield to see physically demonstrated the complete inequality in services offered to people with physical illness as opposed to people with mental illness.

For a number of years, there has been more focus on mental health in all parties, which is to be welcomed, and more focus on the importance of parity of esteem. However, the financial issues are a challenge. For many years, mental health has been chronically underfunded and it has the reputation of being a Cinderella service. At national level, mental health accounts for 28% of the pressure in the NHS, yet on average clinical commissioning groups spent just 10% of their budget on mental health in 2013. Separate investigations by Community Care and the BBC showed that mental health trusts had their budgets cut by 2.3% in real terms between 2011-12 and 2013-14. The effects of some of those cuts have been felt throughout the system. There have been difficulties in accessing talking therapies. Service provision is creaking at the seams. Over 2,000 mental health beds have been closed since 2011, leading to several trusts with sky-high bed occupancy rates.

There is no question—perhaps Ministers will query this—but that austerity and issues with welfare, access to housing and unemployment have put some of London’s most deprived communities under pressure. Welfare cuts, the lack of stable tenancies and improperly enforced employment regulations must have an effect on the incidence of mental health-related illness. Therefore, on the one hand we have cuts to funding and on the other a rise in the conditions that affect people’s well-being and ultimately their mental health. That is a double-edged sword that spells disaster for the well-being of Londoners.

The specific mental health needs of LGBT Londoners are not discussed often. For a long time, London has been a city where young people come to find themselves. It is an inclusive environment where LGBT people are welcome. London boasts a dynamic gay scene and has successfully hosted World Pride. LGBT Londoners are now able to get married, to raise families and are equal before the law. We must safeguard those achievements by ensuring that they have access to appropriate health care and mental health provision.

It is time to change the stereotype that LGBT people are busy partying and having a good time. Unfortunately, it is not a wholly accurate depiction of the community. There are various estimates about the incidence of mental health problems in LGBT groups, but research I have seen says that sexual minorities are two or three times more likely to report having a long-standing psychological or emotional problem than their heterosexual counterparts; and that two out of five LGBT people will experience a mental health problem at some point in their lives, which is quite a high proportion. In 2014, Stonewall said:

“Compared to the general population, lesbian, gay and bisexual people have higher rates of mental ill health as well as alcohol and drug consumption. Lesbians are also more likely to have never had a cervical smear test, while gay and bisexual men are more likely to experience domestic violence.”

Particularly among young LGBT people, we see rising levels of self-harm. Homophobic behaviour is going unchallenged in the workplace and on London’s public transport system, and hate crimes against LGBT people remain stubbornly high. There are also issues about access to mental health services for LGBT groups.

The situation is even worse for black and minority Londoners who identify as lesbian, gay or bisexual, among whom rates of suicide and self-harm are higher than among than the population generally. Some 5% of black and minority ethnic lesbian and bisexual women have attempted to take their own life in the last year, compared with just 0.4% of men over the same period, and one in 12 have harmed themselves in the last year compared with one in 33 in the general population. What are the Government doing to improve the training of NHS staff on the specific health needs of LGBT people and black and minority ethnic LGBT people, because at present they are both challenged with higher levels of mental health issues but have difficulties accessing services?

There are particular challenges in London associated with the recent reorganisation of the NHS, moving responsibility for public health to local authorities. In principle that move makes it much easier to address the social determinants of ill health, including mental health, but the concern is that because of pressures on local authorities funding for mental health will drop and the ability to provide London-wide services for groups, such as the LGBT community, will weaken.

The House will know that my party is not proposing to put the NHS through a further reorganisation when we return to office in a few months’ time. However, it would make sense for existing structures in London to monitor outcomes for LGBT people throughout the capital, and given the complexity and size of London we cannot simply take a one-size-fits-all approach to LGBT issues.

Young people today are living in a time of unprecedented pressures, with smartphones, the internet, a world of 24-hour communication, new avenues for bullying, new fears and new concerns. The issues are plain to see in the growing demand for services for young people across London, with London hospital admissions for self-harm rising from 1,715 in 2011-12 to 2,046 in the last year. At least one in 10 children in the UK is thought to have a clinically significant mental health problem, which amounts to 111,000 young people in London. The impact of childhood psychiatric disorders costs London’s education system approximately £200 million a year, and in 2013 the Children and Young People’s Mental Health Coalition found that 28% of joint health and wellbeing strategies in London did not prioritise children and young people’s mental health.

What are the Government doing to ensure that joint strategic needs assessments look at, and include information about, the size, impact and cost of local children’s mental health needs, to ensure that sufficient services are being commissioned? Will the Minister ensure that data about BME young people and children will be comprehensively included in the new national prevalence survey of child and adolescent mental health being commissioned by the Department of Health? Concerns have been raised in this House previously about the funding of services for children and adolescents, but it is clear in London in particular that there is an unravelling crisis in relation to young people and mental health.

As I said at the outset, London’s youth, and youth nationally, live in an era of unprecedented pressure. Data obtained from a freedom of information request of top-tier local authorities in England by the mental health charity Young Minds revealed that in 2010-13 local authorities in London cut their children and adolescent mental health service budgets by 5%, at a time of increasing pressure on young people. The latest data show that Southwark cut its budget by 50%, as did Lambeth and Hounslow. Tower Hamlets cut its budget by 30%, and Haringey cut its budget by 10%. Those are some of the most deprived boroughs in London, and if they are really cutting their expenditure on young people’s mental health care to that extent, it is very serious.

[Jeremy Corbyn (Islington North) (Lab)]

I thank my hon. Friend for giving way and congratulate her on securing the debate. She must be aware that the cuts in mental health budgets are, basically, arbitrary because no one knows what the long-term demand will be. No one knows what levels of demand are not being met within communities because people are afraid to come forward even to discuss their need for some kind of help. This is a huge problem and it needs to be given much greater attention by the Department of Health.

[Ms Abbott]

My hon. Friend is right to say that the cuts are arbitrary, and they certainly do not account for unmet need. In my time as a Member of Parliament—my hon. Friend must have had similar experiences—I have met many mothers and other people who are unable to access the mental health care that they need, particularly talking therapies. Cutting provision at a time when we do not even know the size of unmet need is very dangerous.

I want to turn now to mental health care provision for the black and minority ethnic community. I have looked at this issue over many years, and I believe that the manner in which the mental health system fails people of colour is a tragedy that has been consigned to the shadows for too long. As well as talking about parity of esteem between mental health and physical health, we need to talk about a parity of care between all sections of the community, and at this point that is not happening. I hope to set out briefly some of the findings of the research that has been carried out over the decades on black people and mental health, but my central point is that black and minority ethnic people are not getting parity of care and service. This is a long-standing issue that goes back decades, and I call on the Government to do what they can. I shall also call on the incoming Labour Government to pay attention to this issue in a way that has not happened in the past. Governments genuinely need to understand and address these needs.

Black and minority ethnic mental health is a particular issue for London because half Britain’s black and ethnic minority community is inside the M25. Sometimes it is hard to get the data we need, but we know, for instance, that in Lambeth—less than a mile from this Chamber—more than half the people admitted to acute psychiatric wards, and more than 65% of the people in secure wards, are from the Caribbean and African communities. I know from regularly visiting Hackney’s psychiatric wards, and the Hackney forensic unit, that the proportion in Hackney is as at least as high, if not higher, than that. We have accurate statistics for Lambeth, but we only have to walk into psychiatric wards across London to see that the majority of beds in the big mental health institutions such as the Maudsley are occupied by people of colour.

I remember, as a new MP in 1988, raising the disproportionate number of black people on wards with the head of psychiatric services in City and Hackney. I asked, “Why are so many people on your wards black and minority ethnic? It’s way out of proportion even with the population of City and Hackney.” City and Hackney produced three very senior psychiatric doctors to talk to me about this. They turned to each other, paused, muttered, and one suggested that it might have something to do with “ganja psychosis”. Another then ventured the opinion that perhaps more mad people were migrating from the Caribbean. I had to say to him, “It’s hard enough to get into this country if you’re sane; it is to the highest degree unlikely that the authorities are allowing all these mad people to come into the country.” But the striking thing about that conversation was that it was not some casual conversation on a ward; the head of psychiatric services had marshalled the three most senior psychiatric doctors in City and Hackney, and the only explanation they could offer for their wards being full of black people was “ganja psychosis”. I was struck by how low the level of knowledge was and how low the level of interest was.

I also know from my years as a Member of Parliament how many black families are struggling with the consequences of the mental health system’s failure to offer the right support at the right time, and the help and services to which they are entitled. One of the saddest things I see in my work as a Member of Parliament is black mothers, single heads of household, struggling with black males in their household who clearly have chronic mental health problems. I have had women come to see me who have been assaulted by their own son. When they are told that they should go to a GP and that perhaps their son needs to be sectioned, they say,” No, no, no.” That is because there is a terrible fear in the black community of the mental health system. Some women would rather risk assault by their own son and live in fear than consign their son to the mental health system, because their understanding is that once that system gets their child, the child is pumped full of drugs and never comes out again or, if they do, they are not the same. So it is time this Government and any incoming Government give more attention to issues relating to black people and mental health.

Those issues have not altered in decades: there are disproportionate numbers of black people, particularly men, in the system; we are more likely to be labelled “schizophrenic”; we present later to the system, which makes matters worse; we are more likely to come to the mental health system through the criminal justice system, particularly by being picked up by the police on the street and finding ourselves sectioned; and we are less likely to be offered talking therapy. I remember going in the ’90s to a mental health therapy centre in west London that specialised in talking therapy and did excellent work. I noticed that there were no black and minority ethnic people there and when I asked about this I was told, “Oh, we find that black and minority ethnic people don’t benefit from talking therapy.” That is an extraordinary attitude. We need to do more to make talking therapy available across communities, including BME communities. Black people are also statistically more likely to be offered electroconvulsive therapy—in other words, they are more likely to be plugged into the mains. There is also a terrible history of deaths in mental health custody, which are often to do with the type of restraint used and a fear of a violent black male. There is a whole string of such cases, of which Sean Rigg’s is one of the most recent.

--- Later in debate ---

[Dr Offord]

I am grateful for that clarification and I thank the hon. Lady for it.

[Jeremy Corbyn]

I am interested in what the hon. Gentleman was saying about his experience with the police in his borough of Barnet. I have similar discussions with the police in my borough and although many of them are well aware of the vulnerability of people with mental health issues, it seems that there is a lack of consistency in the Metropolitan police training and a lack of continual awareness-raising for police officers, before they attend the scene, on the need to look for a mental health condition when they find somebody behaving in an odd or strange manner on the street.

[Dr Offord]

I thank the hon. Gentleman for that point, which is certainly something that I would be willing to take up with the Metropolitan Police Commissioner. That was not my experience, but as it has been the hon. Gentleman’s, I think it is a useful footnote for me to take back to show that the approach is not the same all over London. I am grateful for that.

I realise that the Minister is a public health Minister and not a Minister in the Home Office, but I am keen that police officers should not be delayed for up to eight hours of their shift by taking people to hospital to seek an assessment under section 136 of the Mental Health Act 1983 only to find that a doctor is not available and no assessment can be made. I have spoken to several custody sergeants who have made the point that I will make again: a police cell is not a substitute for a place of safety in the form of a hospital. I am keen to take that up with the Home Office myself.

The Mayor’s report said that of every £8 spent on long-term health care, perhaps £1 is spent on people with mental health issues. I spent two hours this morning at the Whittington’s wonderful ambulatory care centre opened by the Government, and I congratulate them on that. It is easy to see people who clearly have long-term medical health problems, and one suspects that their mental health might be in the same fragile state as their physical health. If we include the £1 in every £8 spent on long-term health care, that adds another £2.6 billion to the £26 billion that we are spending on health care in London cited by hon. Lady. We certainly need to address that.

I am aware that in west London there has been an initiative as part of the London growth deal to help people to get into employment. Indeed, the local enterprise partnership has secured money from the Government’s transformation challenge award, and I congratulate the Government on that. I want to see more work going ahead.

It is not only people with long-term health conditions who are likely to suffer from mental health issues, but the long-term unemployed as well. I understand that approximately 46% of the people claiming employment and support allowance for more than two years have mental health issues. I speak not as someone judging those people but as someone who has experienced mental health issues in my family and have seen the consequences of that. Indeed, the Daily Mirror was kind enough to publish an article on me and the consequences of mental health issues in my family. Although most of it was wrong, I will put that to one side. I will not use the Chamber as a confessional, but the media have an obligation and a responsibility to report issues to do with mental health in a more positive and indeed less derogatory fashion than they have.

Finally, I pay tribute to colleagues who have worked hard on this issue. My hon. Friend the Member for Halesowen and Rowley Regis (James Morris) was instrumental not only in securing a debate in this House to which I was able to contribute but in promoting mental health issues through some of us writing an article for a pamphlet he published. I am grateful to him for that. I also congratulate my Whip, my hon. Friend the Member for Croydon Central (Gavin Barwell), who introduced a Bill to allow people with mental health disorders to stand in this place.

Although I am proud of this Parliament’s record, I would like Government action on the employment of people with mental health issues, and more Government action to provide people with a place of safety that is not a police cell. I would like the health service to ensure that its mental health professionals are always available, so that police officers do not spend their time waiting in accident and emergency departments for a professional to see a person who has been sectioned under section 136 of the Mental Health Act. I look forward to the Minister’s response.

[Jeremy Corbyn (Islington North) (Lab)]

I congratulate my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) on obtaining the debate. It is a pleasure to follow the hon. Member for Hendon (Dr Offord) and I am delighted that he had such a profitable morning at the Whittington hospital in my constituency. The ambulatory care centre is indeed excellent. It was a product of a community and all-party campaign to defend the A and E department some years ago. We won that campaign, and as a result we have a thriving A and E department and a new and very efficient ambulatory care centre. I attended its opening with colleagues. It is a great place and I am glad that the hon. Gentleman was well treated there. I hope he will write and tell the hospital so.

The point that the hon. Gentleman raised on policing, on which I intervened, is serious. I make no general criticism of the police force as a whole, but I do think that when the police are called to an incident in a shopping centre, or in the street or elsewhere, they need to be well aware that some of the people there may be suffering from a mental crisis, may be mental health patients, and need to be treated with some degree of care and understanding. Many police officers are very understanding and very careful about that; I am not trying to make any general criticism. I just think we need to send a gentle message to the Metropolitan police that within training, there should be as much awareness as possible of the mental health conditions that exist within the community.

We have moved on a long way in debates on mental health in this House during the time that I have been here. When I was first elected, a person with a mental health condition was not allowed to stand for Parliament. The Speaker had the power to section Members of Parliament under the Mental Health Act—may still do, for all I know. Mental illness was generally the butt of humour—of universal jokes—so that people going through a crisis, perhaps depression, felt unable to talk about it and felt it would blight their career prospects in any walk of life if they did talk about it. Consequently, only if they had the money did they seek private help and private counselling; if they did not have the money, they suffered, and might lose their job and end up with a blighted career.

All of us can go through depression; all of us can go through those experiences. Every single one of us in this Chamber knows people who have gone through it, and has visited people who have been in institutions and have fully recovered and gone back to work and continued their normal life. I dream of the day when this country becomes as accepting of these problems as some Scandinavian countries are, where one Prime Minister was given six months off in order to recover from depression, rather than being hounded out of office as would have happened on so many other occasions.

The issues that I shall raise are much the same as those raised by my hon. Friend the Member for Hackney North and Stoke Newington in opening the debate—on the disproportionate extent to which the people one finds in mental health institutions come from the black and minority ethnic communities, and the socio-economic imbalance on mental health issues. People who lead stressful lives, without housing security, without job security, without financial security, frightened about the consequences of what their children are up to or whether their children can get a job and so on, are sometimes affected by levels of stress that the rest of us would not even want to think about.

The access point to mental health services is usually the GP. That is the great thing about the national health service, although sometimes it is the problem of the national health service. A GP surgery at its best is brilliant, recognises the holistic needs of the patient and does its best to accommodate those holistic needs. The GP system at its worst is a single-handed GP who may have been there a very long time, become rather set in their ways, is not very interested in people coming to them with stress or other psychiatric-related problems, and does not refer them for any kind of therapy or counselling.

I am concerned about the length of time people wait for counselling or support. A report commissioned by the British Psychoanalytic Council and the UK Council for Psychotherapy, based on over 2,000 psychotherapists working across the NHS, the third sector and in private practice shows that in the NHS and the third sector

“57% of practitioners said client waiting times have increased over the last year, 52% report fewer psychotherapy services being commissioned in the last year, 77% report an increase in the number of complex cases they are expected to deal with.”

The report continues:

“The strain on publicly funded therapy services means that the private psychotherapy sector is increasingly ‘picking up the pieces’ with individuals who have been failed by the NHS. The vast majority of private therapists (94%) report they regularly see clients who feel let down by the NHS”.

I am absolutely not attacking the national health service. That is the last thing I want to do. I want the national health service to be there and available for all. I do not want it to so ration its services that those with fairly desperate needs are forced to suffer, seek voluntary help if they can get it or, if they can afford it, get private support.

There are excellent local organisations in my area, including iCope—Camden and Islington Psychological Therapies Service, and the Women’s Therapy Centre, which do a great deal to improve the local service and put a lot of pressure on the local health authority. An excellent report was produced by Louise Hamill and Monika Schwartz, who both work in my area and have done a great deal of work on the subject. I urge the Minister to have a look at that report and at the very serious proposals that they put forward.

The network for mental health did a survey which identified the 10 most important issues relating to mental health treatment. I will not list them all, but the most important seems to me to be access to timely and appropriate treatment. If someone going through a mental health crisis or depression cannot get seen by somebody, they become more and more agitated and stressful. If we have target times for cancer treatment, we ought to have target times for being seen and getting the necessary support at times of mental stress. Likewise, reducing stigma and discrimination is important, as is looking at the effects of benefit and welfare system reforms.

I have had far too many anecdotal reports from constituents and others who go for a Department for Work and Pensions availability for work test. If they have a physical disability, it is usually fairly obvious and it can be quantified and, we hope, taken into account in how the interview and test are conducted. If somebody has a mental health condition, it is not so obvious and cannot be so easily quantified. There are far too many cases where the stress levels are unbelievable for people who have been forced into these tests. Their condition has not been taken into account, they have been declared fit for work, and they then go into a crisis of stress because they feel they simply cannot cope. It is place where we could all be, and we should have some respect for people in that situation and do our best as a society to help them get through it.

That leads me on to education and publicity and how these issues are dealt with. The media have got somewhat better. It is now not routine for TV and radio comedians always to make jokes about people being stressed out, mad, depressed and so on. Things have moved on a bit and I pay tribute to colleagues in all parts of the House who have stood up in the Chamber during the annual mental health debate and said exactly that about ending discrimination.

[Ms Abbott]

Does my hon. Friend agree that one of the worst examples of the way in which the media treat mental illness was The Sun which, when the well known boxer, Frank Bruno, had mental health issues, had a front page headline, “Bonkers Bruno”, for which it eventually had to apologise?

--- Later in debate ---

[Jeremy Corbyn]

The Sun has had to apologise for many things, not least that. We need a process whereby we change the mood music still further on the treatment of people with mental health problems.

There is a local project in my constituency called IBUG—Islington borough user group—where people attend meetings to talk about the kinds of stress they go through and the support they get. It is very interesting to talk to those people, who are incredibly well informed and intelligent.

I say to the Minister that I understand all the demands and financial pressures that are placed on mental health trusts across London. I am pleased that the trust in my area, Camden and Islington Mental Health and Social Care Trust, is much smaller than most. That is partly, I suspect, because my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) and I stressed strongly that we wanted to keep the service fairly small rather than go into a huge segment of London, as trusts in other areas have.

We have a number of very good walk-in places that those with a mental health problem can go to. Lunch is provided, or they can cook their own. Art therapy and various other forms of support are available. That is all good. However, if we turn those places into something over-formal where appointments and references are required, and people can go there only if they have been sent, that takes away the feeling of an oasis. I have met people who have recovered well from whatever they have been through, and are working, but sometimes they feel the need to unburden themselves with others who have been in the same situation. It is important to have that kind of walk-in facility. I hope that the Minister will take account of that in the planning of these issues in London.

A couple of days ago, INQUEST launched a report called, “Deaths in Mental Health Detention: An investigation framework fit for purpose?” I have a copy here. INQUEST is a national organisation that is based in my area. It deals with the issue of deaths in custody. It has been around for a long time, is very effective, and does very good work. The report states:

“The number of deaths in mental health detention is high in comparison with other forms of custody. The most recent IAP figures show that out of 7,630 custody deaths recorded between 2000-2013, 4,573 deaths were of detained patients—making up 60% of the total numbers of all deaths in custody.”

It then draws attention to the need for a genuinely independent investigation into these deaths. We have the Independent Police Complaints Commission, although it could perhaps be stronger, and the prison and probation ombudsman to deal with those two areas where deaths in custody take place, but, the report says,

“no such equivalent investigative mechanism exists to scrutinise deaths in mental health settings.”

We should look at that.

In 2003—quite a long time ago—INQUEST submitted evidence to the Joint Committee on Human Rights inquiry into deaths in custody in which it noted:

“Of particular concern is the failure of government or any of its arms length bodies to even collate and publish annual statistical information about deaths of detained patients…we believe”

that as a result

“some contentious deaths could escape any public scrutiny”.

I urge the Minister to look at the report, which is very serious, well prepared and well researched.

The report also expressed concern about the use of restraint methods in mental health institutions and the wholly

“disproportionate number of people from BAME”—

black and minority ethnic—

“communities and/or those with mental health problems”

who

“have died following the use of force, raising questions about discriminatory treatment and…attitudes”.

Very serious questions have been raised.

My hon. Friend the Member for Hackney North and Stoke Newington has done the House a service by securing this debate. We need greater and more effective assessment of the needs of mental health services across London, because there is still a stigma in some areas. Some communities and families are more able to come forward than others. We need to create an atmosphere in which people understand that we can all experience stress and that we all need help at some time in our lives, and the NHS must and should be there to provide that help when it is needed.

--- Later in debate ---

[Jeremy Corbyn]

Would my hon. Friend support an investigation, on the basis of the INQUEST report, with a view to changing the regime of inspection, inquiry and appeal where there are tragic deaths in custody? She must be aware, as must the rest of the House, that many people in mental health institutions are completely alone, never get any visitors or support and are at the mercy of what we, the state, are prepared to provide and do for them.

[Luciana Berger]

I thank my hon. Friend for his important intervention, and for raising the point earlier. It is right to look at this issue. It is very clear from the report that INQUEST has outlined and provided that many serious challenges have not been addressed. Part of the challenge is that people find themselves isolated because they are placed in care and treatment, which can be hundreds of miles away from their homes, families and support structures. This means they are less likely to have visitors. Seeing the footage of one family’s experience—of their child’s in-patient care and the quality of her surroundings—was frightening. I hope that the Minister will address this specific report and share with us what the Government intend to do to look at the issue a lot more closely.

We have heard today that mental health is one of the most unaddressed health challenges of our age. Mental health services across our country are increasingly facing significant challenges, and as we have heard today these pressures are being acutely felt in London. Meeting the mental health needs of London’s population is critical to ensuring the future health and economic sustainability of the capital. In order fully to tackle these pressures, we must end the false economies and the stripping back of preventive and early intervention services that we have seen under this Government, and achieve a new focus on prevention and early intervention. I look forward to the Minister’s response.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

We have, unsurprisingly, had a very thoughtful debate, and this has been a welcome opportunity to discuss such an important topic. I hope that the hon. Member for Liverpool, Wavertree (Luciana Berger) will forgive me if I focus my response on Back-Bench contributions, given that this is a Backbench Business Committee debate. She regularly debates these issues with the Minister of State who leads on care issues.

I congratulate the hon. Member for Hackney North and Stoke Newington (Ms Abbott) on securing this debate on an issue that is important to her and her constituents, and to me as a London MP and my constituents. It is good to see a broad cross-section of London colleagues in the Chamber.

The fact has been well established that at least one in four people will experience a mental health problem at some point in their life. As others have said, that means an estimated 2 million Londoners, and we know that London has the highest rates of mental ill health in the country. Some Members spoke about the reasons for that—those things that we know are responsible—and others suggested alternative reasons. I would slightly guard against the over-use of the word “crisis” and exaggerating to make a political point. To prepare for this debate, as the House would expect, I met some of the leading mental health clinicians in London and put some searching questions to them. I did not gain a sense of crisis, although we all gain the sense that this area has not been given sufficient attention in the past and needs to be given far more attention in the future. We all agree on that, and I hope to outline some of the areas that the Government are paying attention to and working on.

The Government’s commitment to prioritising mental health is encapsulated in the principle of “parity of esteem”, which others have mentioned. This means equal priority for mental, as for physical, health. This commitment was set out in our mental health strategy, “No health without mental health”, in February 2011, and was made explicit in the Health and Social Care Act 2012. Planned NHS spending on mental health is expected to grow by over £300 million in 2014-15, and in our five-year plan for mental health, “Achieving Better Access to Mental Health Services by 2020”, we identified £40 million of additional spending for this year, and freed up a further £80 million for 2015-16. This will for the first time ever enable the setting of access and waiting time standards in mental health services, to which the hon. Member for Islington North (Jeremy Corbyn) alluded.

Looking at the constituency of the hon. Member for Hackney North and Stoke Newington, I am sure she would welcome the fact that the City and Hackney clinical commissioning group has increased spending on mental health services by almost 4% this year, and is investing almost £2 million in a range of new service alliances intended to reduce service variation, reduce inequalities, and improve access and recovery outcomes.

I was glad to hear my hon. Friend the Member for Hendon (Dr Offord) refer to the Mayor’s London Health Commission and the work done by the Mayor’s office. The hon. Lady also referred to the work of the Greater London authority. The commission, led by the Mayor, has identified the mental health and well-being of Londoners as a key priority for the Mayor’s office. Indeed, the Mayor has said:

“Mental ill health is an issue that affects millions of Londoners, yet we are too often frightened to discuss it, worried about what people might think, or unaware of who to turn to.”

That very much captures what was said by my right hon. Friend the Member for Uxbridge and South Ruislip (Sir John Randall).

In a report on London mental health which was published in January last year, the Mayor made clear that mental health is an issue for everyone who lives and works in the capital. The report attempted to quantify, as far as possible, the impact of mental ill health on Londoners in order to gauge the scale of the problem. I shall not repeat the statistics, but they show that there is a considerable impact not only on individuals and their families, but on the economy of our city and everything that flows from it, and on the costs of care. However, despite those substantial costs, diagnosis and treatment rates for mental disorders have remained poorer than those for most physical health conditions. NHS England has worked with partner organisations to establish a strategic clinical network for London chaired by Matthew Patrick. The network’s members include MIND, Rethink and the National Survivor User Network.

Let me now deal with the important issue of race equality in mental health care, to which the hon. Lady devoted much of her speech. The issue is obviously of great concern to her, but it is of concern to all of us, because we all acknowledge London’s incredible diversity, although the degree of diversity in our constituencies varies. Our commitment to tackling inequalities in access to mental health services is set out in our mental health action plan “Closing the Gap”, which was also published in January last year. That plan recognises that people from black and minority ethnic communities are less likely to access psychological therapies. We are working with the sector to find out exactly why that is, and what can be done to change it. NHS England is also working with BME community leaders to encourage more people to use psychological therapies, and to establish the reason for those barriers. In 2012-13, as part of the Time to Change programme, the Department of Health funded a mental health anti-stigma and anti-discrimination project. It ring-fenced 25% of a fund amounting to up to £4 million for work with African and Caribbean communities, which involved building partnerships with trusted BME organisations in BME communities. I think that, to some extent, addresses the point made by the hon. Member for Islington North, who is no longer in the Chamber.

NHS England has worked with Black Mental Health UK, and has established a leadership programme for GP mental health leads for London. A BME taskforce is undertaking a root-and-branch review of mental health services in London, to ensure that they are equitable and free of ethnic bias. I am not sure whether the hon. Lady is in touch with the taskforce, but I am sure that she would want to be. I shall ensure that she is given details of who is leading it, and I should be happy to put other Members in touch with it if they want to know more.

I must put on record that the hon. Member for Islington North is now present. He may not be in the place where he was before, but he is here.

The mental health trust in east London is strengthening families, with a focus on support for BME groups, by helping the families of patients with serious mental health issues, using an approach that treats the condition as being similar to any other long-term chronic illness and providing positive support and advice. That, I think, addresses a question raised by a number of Members: why, in many instances, are such different approaches taken to physical and mental illness?

Members rightly expressed concerns about child and adolescent mental health services. It is estimated that 50% of mental illness in adult life begins before the age of 15 and that 75% of mental illness in adults starts before the age of 18, so—as others have pointed out—early intervention is key. Over the next five years, we will invest £30 million a year in improving services for young people with mental health problems, with a particular emphasis on eating disorders, which were also mentioned. We are investing £54 million between 2011 and 2015-16 in the children and young people’s IAPT—improving access to psychological therapies—programme to transform child and adolescent mental health services. I am glad that my hon. Friend the Member for Hendon mentioned that. Let me also draw attention to his distinguished record in respect of looked-after children; I was very aware of his work when we were both on Barnet council.

Public Health England also plays a role in addressing the mental health needs of Londoners and is engaging with schools, teachers and pupils to promote and build resilience among young people through the London grid for learning. As a partnership, City and Hackney, about which I was briefed in anticipation of the debate, has one of the highest spends in London and England on CAMHS—close to £5 million.

I want to pick up a point that the hon. Member for Hackney North and Stoke Newington mentioned with regard to BME children being recorded in prevalence data. I want to give her some assurance on that. The commissioning of a new prevalence survey on children and young people and mental health is a priority for the Department. Our chief medical officer has identified the need for prevalence data on the mental health of BME children and young people. Therefore, we anticipate that the new survey will look at the prevalence of issues in those groups and we hope to announce the procurement process in the near future.

More than £400 million is being invested over the spending review period to make a choice of psychological therapies available in all parts of England for those who need them. We all acknowledge that we are not there yet, but it is important that as part of the “Five Year Forward View”, NHS England has committed that, by April 2016, 75% of people referred to the IAPT programme will be treated within six weeks of referral and 95% will be treated within 18 weeks of referral; and that more than 50% of people experiencing a first episode of psychosis will be treated with a National Institute for Health and Care Excellence-approved care package within two weeks of referral. Those are important and ambitious targets to secure improvement in this area.

Data on mental health bed occupancy has not been routinely collected across the NHS London region, but NHS London has initiated a process to do that to allow year-on-year comparisons to be made. The first year of the initiative was 2014. The results of that suggested that across the different types of mental health in-patient facilities occupancy rates ranged from 78% to 100% during the period the audit was undertaken, which was September to November 2014.

London’s CCGs are committed to delivering the IAPT access and recovery targets for 2014-15. Additionally, the hon. Lady’s CCG, City and Hackney, is using a range of alliances—I was interested to hear about this—across CAMHS, psychological therapies, dementia, primary care and crisis services to improve the integration of service partners, with a clear focus on involving voluntary sector and social enterprise groups. I am sure that that is mirrored in other parts of London.

The hon. Lady raised the challenges facing LGBT people. The National Institute for Mental Health in England carried out a review that showed that LGB people are at greater risk of suicidal behaviour and self-harm, as others have said, and that the risk of suicide is four times more likely in gay and bisexual men, while the risk of depression and anxiety is one and half times higher in LGB people. I was interested to hear what she said—it mirrors my experience—highlighting the concerns of young gay people from BME communities. I have experienced that too as a constituency MP. Interestingly, some of those people said that the worst prejudice they experienced was from within their community. In that regard, London’s diversity also poses us a challenge sometimes. We as constituency MPs, and in other roles we have in our communities, must try as much as possible to stand up to and challenge that when we acknowledge London’s diversity.

West London mental health trust has a specialised gender dysphoria service, the largest in the country, which is accessed following GP referral to general mental health services with a question as to whether the patient has gender dysphoria. The total annual value of that service is £9.9 million. The London Lesbian and Gay Switchboard provides national information and a listening service over the phone and by e-mail and instant messaging. The helpline operates from 10 am to 11 pm, seven days a week, 52 weeks a year. It is based in London but takes calls from the whole of the UK. I thank all local LGBT support groups. They do such a great job. I look forward to spending this evening with the Wandsworth LGBT forum at one of its film nights. We will watch a new film that addresses issues of particular concern. That organisation provides a great service in my community. I am sure other people have the same experience.

As we have heard, mental health crisis care is crucial. The first national crisis care concordat was published in February last year to improve service responses to people in mental health crisis, and in particular to keep people in mental distress, who have committed no crime, out of police cells. NHS England has signed up to the mental health crisis concordat and is in active partnership in London with the police, the ambulance service, the mental health trusts, CCGs, local government and the voluntary sector, as we would expect. Huge progress has been made in London in reducing the number of people taken to police cells for assessment after they have been detained under section 136 of the Mental Health Act. I am pleased to tell the House that this number has reduced from several hundred a year to less than 20. That is a very welcome process.

Interesting contributions were made by Members on both sides of the House about the conversations we have had with our local police agencies. I, too, had an interesting experience when I went out with two very impressive young officers as part of my rapid response unit locally. They showed great understanding of the challenges they met. It was nice that that was acknowledged in all parts of the House, while also recognising the very considerable concern that the hon. Member for Islington North raised about deaths in custody.

[Jeremy Corbyn]

I am sorry that I was out for a couple of minutes during the Minister’s concluding remarks. The point about deaths in custody is essentially about the powers of investigation—the powers of inquiry. In my experience, too often it is left to the randomness of whether there is a family and community support network or not. If there is not one, absolutely nothing happens; if there is one, something might happen. I am sure the Minister is aware of this, and I would be grateful if she would have a good look at the INQUEST report on this subject. Perhaps her Department might like to study it and come up with some proposals in relation to its very sensible suggestions.

[Jane Ellison]

I will of course bring that report to the attention of the right Minister in our Department, and the hon. Gentleman is correct to highlight it.

I want to give a note of assurance on street triage, which was mentioned by my hon. Friend the Member for Hendon. The DOH has funded nine street triage pilots, with police and mental health professionals working together to support people in crisis. In the areas where the pilots are operating, the number of people being detained under section 136 has dropped by an average of 20%. There are some encouraging results.

On the points made only by the hon. Member for Islington North, we are obviously concerned about the reports of high levels of physical restraint. Restraint should only ever be used as a last resort, and we think that the transfer of police custody health to the NHS and commissioning to a standard specification, together with liaison and diversion services being available in every police station, will help to improve that situation and the care and advice available to people in police custody.

I am proud of the Government’s record on mental health, but we have always acknowledged that there is more to be done, and I would not want to suggest any complacency on the part of Government on this vital issue. I will certainly draw to the attention of my DOH colleague the Minister of State who has responsibility for care, all the issues raised by Members on both sides of the House in this very thoughtful debate. I end by thanking all the people in our constituencies—whether within the NHS, the voluntary sector or all the community groups that Members have acknowledged—who provide care to those experiencing mental ill health. We are grateful to them all for what they do to keep Londoners well.

Ebola

Jeremy Corbyn Excerpts

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

We have not yet made a decision on Birmingham and Manchester, and we will continue to review the risk advice from the chief medical officer and PHE on whether such action would be appropriate. It is important to say that the measures we take must be proportionate, but they must also look forward to potential changes in the risk, so that we can react very quickly were that risk to increase dramatically, and that is exactly what we are doing at other UK airports.

[Jeremy Corbyn (Islington North) (Lab)]

I thank the Secretary of State for his statement and for the support given to health services in west Africa, but does he not agree that this terrible time shows the massive health inequalities that exist all around the world and that, although there will be a big international effort to deal with Ebola, it calls into question the effectiveness of the millennium goals on preventive health measures, not just in west Africa, but in a much wider sense? Do we not need to redouble our efforts to reduce health inequalities around the world for the protection of everyone?

[Mr Hunt]

The hon. Gentleman is right, although the millennium development goals have been successful in making a start on the process of reducing health inequalities. We can see that in other areas, such as the provision of antiretroviral drugs to HIV-positive patients in Africa, and that has been completely transformed in the past decade. But he is right: while some countries have very underdeveloped health care systems, the risk of such public health emergencies is much higher and therefore the risk to the UK is higher.

Changes to Health Services in London

Jeremy Corbyn Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. When the dust settles on these decisions—there is rightly so much local passion, concern and uncertainty relating to hospitals, such as Charing Cross, which has a great tradition—what people will notice is whether their local NHS services are getting better. I am afraid that one of the legacies from the previous Government was the abolition of named GPs in 2004 and a sense that it has become more difficult to access one’s local GP. The proposals mean that her constituents will be some of the first in the country to have seven-day GP services, a big step forward that her constituents will welcome.

[Jeremy Corbyn (Islington North) (Lab)]

Will the Secretary of State give me an assurance, following the huge debate that took place over the future of the A and E department of the Whittington hospital—and, by extension, the neighbouring Royal Free hospital—that its future is secure and that he will not try to reconfigure services once again in north London? Does he recognise that during that debate, my right hon. Friend the Member for Leigh (Andy Burnham), who was then Secretary of State, intervened to assure the future of the Whittington A and E department? I would like the same assurance from the Secretary of State, if that is possible.

Mental Health

Jeremy Corbyn Excerpts

Thursday 16th May 2013 Commons Chamber

[Paul Burstow]

I am grateful to the hon. Gentleman for that question. He is absolutely right that access to talking therapies—begun as a result of Lord Layard’s initiatives before the general election, which the coalition Government continued to support and which is being rolled out—is very important in enabling people to recover socially, get back into work and get on with their life. At the best performance rates, as many as half the people that go through talking therapy services recover, and that can make a huge difference to them, their families and the figures I was talking about earlier. I shall return to the subject of talking therapies in a moment.

Last year I took part in the debate from a slightly different position—I spoke from the Dispatch Box. I was able to report some important progress. We had a new mental health strategy. We had the continued roll-out of talking therapies, which the hon. Member for Harrow West (Mr Thomas) just asked about. Groundbreaking work was being done to reinvent child and adolescent mental health services from the inside out, to offer access to talking therapies for children and young people. We had the flowering of a new movement to establish social recovery as a goal for mental health, with the establishment of recovery colleges channelling the lived experience of mental illness into practical learning and skills, and resilience to enable people to get on with their lives.

There was the good news that the Government had backed financially the task of Time to Change, the charity sponsored by Rethink and Mind, really motoring to tackle issues of social stigma in our country. Reports since then show that the first phase of that programme has materially altered public views about mental health in this country, but the programme needs to be sustained.

[Jeremy Corbyn (Islington North) (Lab)]

The right hon. Gentleman makes a good case for supporting Mind and other mental health charities, which do a very good job in changing attitudes to mental health. Is he not concerned, however, that many health authorities throughout the country are cutting funding to non-governmental organisations—voluntary organisations that do very good mental health therapy work, often on a contract basis? They are being cut, and therefore the opportunities for support for people going through crisis are reducing, not increasing.

[Paul Burstow]

Yes, I am concerned. The picture is complex. The figures show that spending on adult mental health services over the past couple of years overall has reduced by about 1%, which is not good, but deeper analysis of those figures shows that about half of commissioners have increased their investment and the other half have reduced their investment, so the picture is more complex than it first appears. None the less, it is concerning that services are being withdrawn where they involve providing peer support or reaching into harder-to-reach communities, particularly black and minority ethnic communities, which often get left behind and often are most prone to being subject to the most coercive parts of our mental health system. So I agree with what the hon. Gentleman said.

In the debate last year I was delighted to be able to signal the Government’s support for the Mental Health (Discrimination) (No. 2) Bill, which was introduced by my hon. Friend the Member for Croydon Central (Gavin Barwell). It is a rare thing—as we heard earlier in the business statement, only about 10 Bills last year which were introduced as private Members’ Bills made it on to the statute book. It was great that that Bill made it on to the statute book, and I congratulate my hon. Friend and all those involved in taking it forward.

I have referred to the mental health strategy for which I had some responsibility. At its heart is the radical—I might even say revolutionary—idea that there should be parity of esteem between physical and mental health. That idea is gathering momentum. We have seen the Government place that notion in the mandate for NHS England as a driving force for the way the Commissioning Board takes its responsibilities forward. It is increasingly on the lips of policy makers and service commissioners. But the recognition that there are critical interdependencies between physical and mental health still has a long way to go.

There are more than 4.6 million people in this country living with long-term physical and mental health problems, and far too often their experience of the NHS is that they are broken down into their constituent diseases, rather than being treated as a whole person. As a result, their physical health needs are treated in one place—in many cases, in many places—and their mental health needs, if they are identified at all, are dealt with in another.

--- Later in debate ---

[Mrs Madeleine Moon (Bridgend) (Lab)]

It is a privilege to follow the right hon. Member for Sutton and Cheam (Paul Burstow). The House will recognise the work that he has done in bringing this issue not just to our attention, but to that of the wider public. I also pay tribute to the hon. Member for Broxbourne (Mr Walker), who has done fantastic work in this area, and to my hon. Friend the Member for North Durham (Mr Jones). [Interruption.] My hon. Friend moves away from me just as I am commending him.

I want to consider mental health issues in the armed forces, because there is an urgent need to address some myths and problems. The armed forces also have wonderful examples of best practice that are not generally appreciated and have not been dispersed throughout wider mental health services.

Looking back in time, there were 80,000 cases of shell shock or battle fatigue during the first world war. The British Government, realising that they had to do something because of problems in getting troops to the front line, started looking at mental health. Changes in mental health treatment started because the military needed to deal with mental health problems.

[Jeremy Corbyn]

My hon. Friend is making an important point about the experience of the first world war. Does she recognise that there was a great deal of discrimination against and abuse of ordinary soldiers who suffered mental health trauma as a result of the first world war, whereas some of the officers who suffered it got therapeutic treatment in special homes around the country? There was an enormous difference between the approach taken to soldiers and to officers.

[Mrs Moon]

My hon. Friend is correct. Craiglockhart hospital and the work of Dr Rivers are a prime example of the excellent treatment that was given to some officers. Many people continued to cope with post-traumatic stress disorder, which we now recognise. It was not identified as a condition at the time, although it is detailed in some post-war journals. We have, however, moved forward.

To return to my original point, the military is often at the cutting edge—it needs to be—of looking at mental health problems. Post-traumatic stress disorder has risen up the mental health agenda in the armed forces, mainly because of statistics from the United States. The US Department of Veterans Affairs estimates that post-traumatic stress disorder affects 11% of veterans of the war in Afghanistan and 20% of Iraq war veterans. By contrast, the figure for the UK—these statistics are taken from a 2010 edition of The Lancet—is 4%, while 19.7% reported more common mental health disorders and 13% reported alcohol abuse.

I want to consider the issue of alcohol abuse in the armed forces and its impact on mental health problems. The Ministry of Defence has spent a lot of time providing services, raising awareness and developing programmes such as TRiM—trauma risk management—which I will look at later, and there is far greater understanding of mental health problems among the military. Much of that is thanks to the excellent work of and collaboration between the MOD and King’s college London. I draw Members’ attention to “King’s Centre for Military Health Research: A fifteen year report”, which was published in 2010 and sets out the stunning work that has been carried out. It talks about the roll-out of TRiM. The unit has helped to raise the awareness of most common mental health problems among military personnel, including depression, alcohol misuse and post-traumatic stress disorder, although that is not the most prevalent. The unit found that pre-deployment screening was not effective in picking up problems and that mental health problems did not necessarily apply only to those whose problems had been indentified before they were deployed. Who will be affected by deployment cannot be predicted.

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[Mr Walker]

I know that the hon. Lady is an expert on these matters. I was going to say in response to the hon. Member for Bridgend that there are experts in this place. I did not want to identify the hon. Member for Ashfield (Gloria De Piero), but, to her enormous credit, she has identified herself. She is a fantastic representative of her constituents, and it is a delight to have her here today.

We have to make progress on drug therapies. Lord Stevenson of Coddenham, who is known to me and the hon. Member for North Durham (Mr Jones) very well, is doing enormously good things in this area. He has established a charity with a significant budget to look into new treatments, pathways and the brain. The charity is called MQ, its chief executive is Cynthia Joyce and I commend its work to the Minister. I would also like to thank my hon. Friend the Member for Loughborough (Nicky Morgan), who cannot speak today because, according to some bizarre convention, Whips cannot speak in the Chamber, which is a great sadness, because I wish she could. I also thank my hon. Friend the Member for Halesowen and Rowley Regis (James Morris), who has done much in this area, and of course the hon. Member for North Durham, who has become a great friend over the past year and is a fellow musketeer in these areas.

I said that I would touch on suicide. We need to build mental health resilience in our schools. That should start at a very young age. It is a great tragedy that many young men and girls decide to end their lives in their teens and early 20s. It is a public health issue, and we need to address it.

[Jeremy Corbyn]

I compliment the hon. Gentleman on his speech and on his work on this subject. I am glad that he has raised the issue of suicide. Like me, he must be shocked by the number of suicides and attempted suicides within our prison service and by the number of prisoners clearly suffering mental health problems but not receiving the care and support they need. Does he agree that we need a much better regime of training and support on mental health issues for all prisoners?

[Mr Walker]

I absolutely agree with the hon. Gentleman. It is a great sadness that we shut down and cleared out the asylums only to put too many of those people in our prisons. They go in ill and they come out even more ill and more addicted. It is a disgrace and something we need to address.

I thank colleagues for being here today. I know that the call of their constituencies is hard to resist, but they will be congratulated by their constituents for taking part in this debate. I commend the work of the all-party group on mental health. We have done a lot of work on mental health, schizophrenia and ethnic minority mental health. I see that my hon. Friend for Taunton is here—no, it is not Taunton, but? [Hon. Members: “Totnes.”] Well, it begins with a T for crying out loud. What’s a T among friends? I thank my hon. Friend the Member for Totnes (Dr Wollaston) for her great work. I thank you, Madam Deputy Speaker, and the Backbench Business Committee for allowing the debate to take place, and I thank the Minister and his predecessor, the right hon. Member for Sutton and Cheam (Paul Burstow), who was also a fabulous Minister, for giving the matter such attention and focus. They are to be lauded and applauded.

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[Mr Jones]

I have spoken at a few events with the Minister, and I want to thank him for his interest in, and understanding of, this subject. Getting Government Departments signed up to Time to Change would be a very good move, and he should please ask if he requires any assistance from me.

I want to talk about an issue that affects many of our constituents—namely, the work capability test and the ongoing issue with the company Atos. Is work good for people’s mental health? Yes, it is. Should people be in work if they can work? Yes, they should, with the right support. The problem with the work capability test, however, is that it is still not looking at people with mental illness with any sympathy or understanding.

I believe that individuals with long-term mental illnesses should be taken out of the current work stream, and that there should be a dedicated system for dealing with such people. I am not saying that we should write them all off and leave them at home without making any assessment, but we cannot continue with the present ludicrous system in which they are assessed by the same people who assess claimants with bad backs and other injuries. There are assessors with no expertise at all in mental illness. The assessment process is leading to some people’s conditions being made worse, and, in some cases, to people taking their own lives. One of my constituents has taken an overdose because of the trauma of being asked to attend an interview.

[Jeremy Corbyn]

My hon. Friend is making an excellent point. Does he think it would be better if, instead of calling people with mental health conditions in for an interview, Atos simply sought medical reports on them and then considered setting up an interview with a suitably qualified examiner? Would that not be better than the production line that Atos operates at the moment?

[Mr Jones]

My hon. Friend makes a good point. The starting point should be the medical history of those individuals. Someone at the Department for Work and Pensions has said that it is not possible to identify such individuals, but that is complete nonsense. The process my hon. Friend has just suggested should be the starting point.

Professor Harrington’s review of the process put forward the idea of mental function champions. The Government spun that idea out a bit, as though it was the big answer to the problem, and I actually fell for it at the beginning, thinking that those people would be the ones who would carry out the assessments. That was not the case, however; they are there to give advice to the Atos assessors. We still have assessors with no mental health qualifications.

Representatives of the charity Mental Health Matters, a good advocacy charity in the north-east, have just met Atos to ask about the champions, and a number of questions have been raised. Atos would not tell them how the champions were recruited, and there is no indication that they need any formal qualifications. I understand that they are given a two-day Atos in-service training course, but they do not interact with any of the royal colleges or other outside bodies. Remarkably, they are also not accountable to the DWP. I put it to the Minister that he needs to tell the DWP that this must be looked at again. The process is not only causing a lot of heartache and difficulty for many of our constituents; it is actually not a good use of public money. People are failing the tests and going to appeal. At least one of my constituents has been affected in that way. They sometimes go through the process and end up in a residential hospital for a month, which must cost more than the amount of benefit that might have been saved.

We also need tailor-made programmes for people with mental illness. We should consider a separate work stream that could include voluntary work, given that many people with mental illness find the transition back into work through voluntary work easier than being thrown straight back in. We also need a pool of employers who understand and are sympathetic towards people with mental illness. There is an idea that such people can just join the normal job market and that employers will just accept that they might not turn up for work for a day or a week because they are not feeling well, but that is not the case. Those people will not keep their jobs for very long.

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[Jeremy Corbyn (Islington North) (Lab)]

Like all the other Members who have spoken, I welcome the debate. It is important for us to have it, and I hope that it will become an annual event. It is a way of reducing the stigma that is attached to mental illness, increasing understanding of it, and also, quite correctly, holding the Government to account on how their policies develop.

There is still an enormous amount of discrimination against people who have suffered from some kind of mental illness or breakdown, or have spent time in a long-stay institution. Like all discrimination, it is incredibly wasteful of resources, because it means that those people cannot contribute to society in the way that we want, and as a result we all lose out.

I want to raise two points. The first relates to local experiences, and the second to national policies. My borough has an image as being relatively wealthy and high-achieving, and there are certainly some wealthy and high-achieving people in it. Islington council, however, undertook an interesting exercise: it set up a fairness commission to examine the quality of the delivery of public services to everyone in the borough, with the aim of ensuring that the purpose of the council’s policies, including health policies, was to reduce inequality.

According to a briefing that the council gave me before the debate, it is estimated that in my borough

“30,000 adults experience depression or anxiety disorders in any one week…. Mental ill health among 5 to 17 year olds is estimated to be 36% higher…than the national average”.

The briefing states that more than one in eight children are

“experiencing mental health problems at any one time.”

It also states:

“The suicide rate is… 8 per 100,000…second highest in London”,

and broadly

“similar to the national average”.

Physical ill health is often related to mental health problems. According to the briefing,

“Poor mental health was found in 43% of all Islington patients who died of cardiovascular disease before the age of 75. As people live longer, there are an increasing number of people with dementia, although Islington has a relatively smaller number of older people”—

only 9% of the population. Islington has a 70%—higher than average—rate of diagnosis of dementia. Increasingly, as others have pointed out, people who care for adults with mental health problems are much older people who find it extremely difficult to cope. Those carers need more support, so that they are better able to look after people who are becoming more and more dependent.

Both my local council, in its study, and the Mental Health Trust draw attention to the enormous over-representation of people from black and minority ethnic communities in the context of diagnosis and, in particular, the context of long-stay institutions. We should ask whether there is, in fact, a higher level of prevalence, or whether there is a perception that it is somehow OK to put black and minority ethnic people into long-stay institutions, whereas it would not be OK in the case of other people.

Indeed, I urge Members to visit long-stay institutions and talk to people resident in them. I get the impression some of them have had very difficult lives and very little support, and that they have led very isolated existences. I also get the impression that many of them have very few friends and very little representation, and whereas those who come from a fairly stable family background with a series of understanding relatives are able to get representation and often win their cases where there has been a section order, others do not get the same quality of representation and consequently do not win any tribunal cases.

In an earlier speech, I made an intervention about the role of the voluntary sector in dealing with mental health conditions. As I have pointed out, my borough has considerable problems in dealing with mental health, but we have a number of very good local organisations that often deal with mental health issues in an innovative and supportive way, and are often very successful. Nafsiyat, an intercultural therapy centre based in Finsbury Park which was founded by the late Jafar Kareem, was groundbreaking in its ideas of looking at the cultural background and ensuring culturally appropriate treatment of people with mental illness, for example by making sure there are people who speak the necessary languages and understand something of the specific cultural background. The Maya Centre, which particularly relates to women, does much of the same work, as does ICAP or Immigrant Counselling and Psychotherapy, a counselling and psychotherapy centre originally founded by people in the Irish community that now deals with a much wider community.

We also have a considerable refugee population. A very good group called Room to Heal deals with people who have achieved asylum status in this country. They have often been through the most dreadful experiences of torture, which are frequently dealt with in a community way. People meet regularly and do things together, such as gardening and taking trips. Many of them improve a great deal and get through the terrible traumas they have suffered. I find it very interesting talking to people from different countries all around the world who have all experienced torture in one form or another and who have benefited from these activities. We also have the Refugee Therapy Centre and the Women’s Therapy Centre, which also provide therapy on a culturally sensitive basis. Finally, we have the Holloway Neighbourhood Group stress project.

These are all valuable groups, and they all depend on contracts obtained either from the local health authority or neighbouring health authorities. All of them spend a great deal of time filling in forms in order to gain what are often relatively small sums of money for relatively short-term contracts. Health authorities must value these organisations and look to use them. We should give out the message that we recognise that the voluntary sector has a very important complementary role to play in supporting statutory services in the treatment of mental illness. I do not see them as competitors or rivals; I see them as complementary.

[Mr Kevan Jones]

I agree with what my hon. Friend says about the smaller contracts these organisations get and the bureaucracy they have to deal with. Does he agree that some of them could bid for larger contracts to provide services as well, but the bureaucracy and financial hurdles involved in bids for such contracts make it very difficult for them to do so?

[Jeremy Corbyn]

I agree. The bureaucracy involved and the skewing of the contract culture frequently means voluntary organisations that have a tradition of the voluntary provision of services—often in an effective and innovative way, as I have described—are debarred by the contracting process. Instead, very large private sector medical companies come in to privatise those services and run them in a profit-related way, rather than the voluntary sector, which is motivated not by profit, but by the care of the individuals. I urge Ministers to look very carefully at how services are contracted out to the private sector, which is motivated by profit, as opposed to voluntary sector organisations, which often have a very good record in looking after people who need help and support.

We must also recognise that if we are to deal with mental illness problems in any community, there must be a level of understanding that goes wider than just what GPs, hospital doctors and the statutory services do. There is the question of signposting. I pay tribute to local organisations—voluntary groups, churches, mosques —that understand the situation and help signpost people into getting help and support, because many people in our society with some degree of mental illness get no support whatever. This debate may well help us to understand that that is needed.

We must also recognise that there is a cost involved. The cost to health budgets of dealing with mental health is very high. Unfortunately, the policy of community care for the mentally ill has often resulted in lack of care, and in deep isolation and serious problems for the individuals concerned.

I recall a debate in the House in 1986. The Select Committee on Health was looking in an interesting and critical way at the closing down of large asylums and long-stay institutions, such as Friern Barnet and Napsbury, that existed all around London, and, indeed, all around the country. The Committee warned that community care should not be seen as a cheap option, saying it should instead be seen as an opportunity, but as one requiring comprehensive support, support workers and care.

I am sure all MPs have talked at their surgeries with neighbours of those with mental health problems who have come to complain about noise and inappropriate behaviour. Many of them say to me they are sympathetic to the plight of the individual, and recognise there is a lack of support. We should not see community care as the cheap option. It is an option that can be followed, but a great deal of support is also required to carry it through.

[Mr Kevan Jones]

Does my hon. Friend also agree that under the new NHS structure, local councils will have to do a lot more in terms of understanding the needs of people with mental health conditions?

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[Jeremy Corbyn]

Absolutely, which is why I referred in my opening remarks to the strategy adopted by my local authority. It has taken the issue very seriously, and has developed a strategy that involves signposting, understanding, support for care in the community and a close relationship with the mental health trust locally. I suspect many local authorities are not particularly well geared up for that role, and they need to address that quickly.

We must recognise that children and young people suffer a great deal of diagnosable mental health conditions. The Mental Health Foundation estimates that one in 10 children suffer from them. One in six young adults aged between 16 and 24 are also suffering from them at any one time. It is very hard for young adults and teenagers to admit they have mental health problems. It is very difficult for them to go to a GP and say they have a mental health problem. Peer group rivalry and peer group abuse—abuse in schools and colleges—is nasty, dangerous, damaging and very hurtful, and can ultimately lead to suicide. The old saying “Sticks and stones can break my bones, but names cannot hurt me” is wrong. Names do hurt. Name calling does hurt. It can lead to young people becoming isolated, and in extreme situations it can lead to suicide.

[Mike Crockart]

The all-party group on social mobility has looked at that issue, and we found that one of the major things holding children back from realising their full potential was not necessarily access to the right type of education—further education or higher education—or to funding for such education. Instead, it is their having the social and emotional resilience to be able to bounce back from such problems and take their careers forward.

[Jeremy Corbyn]

The hon. Gentleman is absolutely right in what he says. Bouncing back from these things and then getting on in education or any career is very important. I hope that debates such as this one and the remarks made by hon. Members who have been through mental health problems and depression begin to help give a greater understanding in the much wider community.

I wish to make only a couple more points, because I know that other colleagues wish to contribute to this debate. I intervened earlier about the number of suicides that take place in prisons and the number of people in our prisons who are suffering mental illness. Although such people may be there on the basis of a crime, they need mental health support rather than incarceration in a prison. Today’s edition of The Guardian contains a helpful reproduction of a map of suicides in British prisons. Although the number of suicides has reduced, 833 prisoners committed suicide in the decade up to 2011. When a prisoner commits suicide it is traumatic for the prison and for the prison officers concerned, and devastating for the rest of the prison population. We need to look much more seriously at how our prisons operate, the training that is given to prison officers and the mental health issues that need to be assessed much more carefully by the courts and by the prison services. We also need to examine whether it is really necessary or appropriate to put someone who has a mental health condition into a prison, at any level of security, knowing that there is a real danger of their committing suicide. They are not going to become less better because of this approach; they are probably going to get considerably worse.

My hon. Friend the Member for North Durham (Mr Jones) made an important point about people’s availability for work interviews undertaken by Atos on behalf of the Department for Work and Pensions. I am sure that every hon. Member has had people come to their constituency surgery who have been through the misery of an Atos interview when they are suffering from a mental health condition. Whether on a good day or a bad day, nearly all of them get assessed as being capable of work. They therefore start losing benefits and then go through an appeal. Usually, these people eventually win the appeal, but the trauma caused during that process has led to suicides, to deep depression and to deep fear among them.

When I intervened on my hon. Friend, I suggested that instead of automatically calling those with mental health conditions in for an interview, just as every other person with a disability is called in, medical records should be looked at first and a much more sympathetic and appropriate way forward should be taken. Where someone is able to work and an employer is able to take them on, as there is a job, that is clearly good—we want and welcome that—but we should not force them into it. We should not force people to try to hide mental health conditions. Instead, we should be supportive and sympathetic towards them. I hope that the message we can send from the debate is that that is the direction in which we want to go.

This is a valuable and timely debate on an issue that can affect any of us at any time. We all know people who are affected by mental health conditions and as a society we should stop the name calling, stop the abuse and start understanding this as a condition that we can all suffer from and that we can also, generally speaking, always get over.

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[Mr Reed]

I thank the Minister for his intervention. I am grateful for his generous offer, which I will certainly take up.

[Jeremy Corbyn]

I compliment my friend on an excellent speech. Does he agree that the problem of representation of people both in initial assessments and when they are placed in long-stay mental health institutions often means that many poorer young black men never get any representation whatever and end up being completely institutionalised as a result, leading to those ludicrously higher statistics for black and ethnic minority people, who are no more prone to mental health problems than anyone else in society?

[Mr Reed]

I thank my hon. Friend for that contribution. There are a range of concerns about the treatment of black people in the mental health system that need to be tackled to reassure that community.

I believe other Members in the House will agree that this cannot be allowed to go on. I urge Ministers to use their offices to persuade the IPCC, the CPS and the Metropolitan police to work together to obtain a quashing order against the IPCC’s original decision so that a criminal investigation into the Seni Lewis case can go ahead, followed by a full public inquest. Instead of apparently washing their hands of the concerns that this matter raises, Ministers should acknowledge the need for a national strategy on policing within mental health settings.

The organisation Inquest points out that it is an unacceptable anomaly that there is no independent body charged with investigating deaths in the mental health service, as there is for deaths in police custody. As a result of that anomaly, reviews are conducted internally, they may not involve the family affected, and there is no collation or joining up of learning across the service nationally. After this case and other cases like it, the community deserves the reassurance of an independent inquiry into the treatment of black people in the mental health service.

Two years and eight months after their son’s death, the Lewis family still do not know how or why he died. The public hearings scheduled for July 2012 and then March 2013 were both delayed without explanation. Seni Lewis deserves justice. The Lewis family deserve justice and they must not be kept waiting any longer.

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[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I apologise to the House for not being present for the debate’s opening speeches, which was due to circumstances beyond my control. I certainly meant no lack of respect for this debate; I think these Backbench Business Committee debates have been one of the more important and successful innovations of this Parliament, and mental health is a particularly important subject.

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow) on leading the debate in a detailed and informative fashion, and my hon. Friend the Member for Bridgend (Mrs Moon), who raised a number of important points, including alcohol abuse and its impact on mental health—those two issues are inextricably linked. I follow the hon. Member for Totnes (Dr Wollaston) in saying that if we are concerned about addressing alcohol abuse, one issue—although not the only issue—must be to do something about the flood of cheap alcohol that is overwhelming some of our communities, and put in place a minimum price for alcohol. I am glad to say that that is the Labour party’s policy.

I congratulate the hon. Member for Broxbourne (Mr Walker) on his speech. I remember a similar debate last year in which he made a moving speech about his experience, which resonated country-wide. Since then, he has shown great leadership in the mental health all-party group. He made a number of important points, including the fact that although the NHS can be good at managing symptoms, it is not necessarily so good at addressing their underlying causes. I will return to that issue when I mention Atos later in my remarks.

I am sorry to have missed the remarks of my hon. Friend the Member for North Durham (Mr Jones). He is always well worth listening to, and he too received country-wide respect for his contribution to last year’s debate on mental health when he spoke about his personal circumstances for the first time on the Floor of the House. He made a number of important points, including that mental illness and depression are equal opportunity conditions. They do not discriminate; they affect all social classes and backgrounds.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke about a number of issues, including borderline personality disorders and the way that eating disorders affect women and girls. She made the important point that, although we sometimes associate mental disorders with socially marginalised communities and persons, eating disorders can affect the most high-achieving, educationally focused girls. That issue should not be trivialised because it is harming the life chances, health and well-being of many young women up and down the country.

My good Friend the hon. Member for Islington North (Jeremy Corbyn) made an important speech about mentally ill people in prison. When getting caught up with the “prison works” narrative, it is worth remembering how many people in prison are either illiterate or simply mentally ill, and if we want to contain the number of people in the prison estate, we must address the mentally ill. My hon. Friend also mentioned black and minority ethnic communities and mental health, and I will return to that point later.

The hon. Member for Totnes made an important speech and mentioned social exclusion and BME mental health. My hon. Friend the Member for Croydon North (Mr Reed) made an important speech about Olaseni Lewis and the issue of black and minority ethnic persons detained under the Mental Health Act 1983. I am glad that the Minister has agreed to meet my hon. Friend and engage with him and the family on that issue. The hon. Member for Harrogate and Knaresborough (Andrew Jones) also made an important speech.

My hon. Friend the Member for Bolton South East (Yasmin Qureshi) made a speech about—among other things—the importance of a holistic treatment for mental health issues and taking account of people’s different cultural backgrounds, which I thought was important. There was, as always, an interesting and provocative speech from the hon. Member for Southport (John Pugh), and I was interested to listen to the hon. Member for Battersea (Jane Ellison) who spoke about mental health and female genital mutilation—if it had been my choice, her speech could have gone on longer. I thought she raised important issues, and the House should respect the lead that she has shown in addressing the issue, which is difficult for people outside the affected communities to address. If in future some young girls are not subjected to that child abuse because of her work, she will deserve the congratulations of this House. The hon. Member for Finchley and Golders Green (Mike Freer) also made an important contribution.

We have heard figures for the incidence and prevalence of mental health problems, and because it is a Cinderella service and a Cinderella issue it is always worth reminding people that one in six people in Britain is affected by mental illness at any one time. In other words, almost every family will have experience of mental health. It is not something that happens to other people, but something that happens in our own families. One in four of us will suffer from mental illness at some point, and by 2030 depression will be the leading cause of disease around the world, costing the NHS a further £10 billion a year. The criminal justice system will also pick up the bill because 70% of those in our prisons have a mental illness. Mental health problems cost British business almost £26 billion a year.

The subject has been addressed by my right hon. Friend the Member for Doncaster North (Edward Miliband) who made an important speech to the Royal College of Psychiatrists in October last year. The key points he made are worth reporting and concern the importance of breaking down stigma—something that the House dwelt on at length in last year’s debate—and the importance of parity of esteem for mental health within the NHS. My mother was a mental health nurse in Huddersfield, and her hospital was a former Victorian workhouse on the fringes of Huddersfield. Having an old workhouse outside the city for mental health issues, and mainstream health services in the centre, illustrates the lack of parity of esteem for mental health in relation to the services we offer, and also to practitioners at every level within mental health services.

Finally, my right hon. Friend the Member for Doncaster North mentioned the importance of mental health in our society, and argued that good mental health does not start in hospitals but in workplaces, schools and communities. He took the opportunity last October to announce the formation of a taskforce on mental health in society, which will look in particular at employers and the role they play.

[Jeremy Corbyn]

Perhaps my hon. Friend can help me. I hope that the taskforce will also look at issues surrounding the voluntary sector and its excellent work within the mental health service, as well as the dangerous tendency of franchising out mental health services to the private sector by some mental health trusts that do it for profit rather than care.

[Ms Abbott]

My hon. Friend’s points are well made.

Let me consider the future for mental health and set out for the House how important the role of local authorities can be in addressing the social determinants of mental ill health. Public health has become the responsibility of local authorities. They have a ring-fenced public health budget, and despite all their pressures and difficulties—which I do not seek to minimise—there is an opportunity for local authorities to do important and interesting work, bringing together education and housing with health care to address mental health problems and intervene in them early.

I was shocked to hear of a social housing project near King’s Cross that, presumably to make its tenants more manageable, did not want to give tenancies either to people who had a history of rent arrears or to people who had a history of mental health problems. Such things need to be highlighted and addressed. Sitting responsibility for public health with local authorities could address mental health, particularly in respect of early intervention and preventive work with children in schools.

I gave a speech this morning on the crisis in masculinity. We need to focus on the mental health challenges that face men. Whether it is because they are unwilling to come forward or because of stress in society, we know that, during a recession or economic downturn, suicide rates among men increase. Suicide is currently the biggest cause of death among under 35s. In planning services nationally and locally, we need to pay particular attention to that issue among others.

The hon. Member for Totnes made an important point. She said that, in our desire to reduce health tourism—a desire supported by the Opposition—there is a notion that people will need their passport when they turn up to see their GP. That runs the risk of making it harder for the socially excluded to access health care—many simply do not have a passport or such documentation.

I will not speak at this point about the merits or otherwise of the welfare reforms, but there is a lot of anecdotal evidence that they are having an effect on the mental health of some who are caught up in the system. There is a lot of anecdotal evidence that Atos, as it is currently configured and as it currently operates, does not meet the needs or seem to understand the problems of people with mental health challenges.

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[Norman Lamb]

Yes, I completely agree. This is about treating people as individuals, and with dignity and respect. Those things are important to people and they should be treated as such.

[Jeremy Corbyn]

My hon. Friend the Member for North Durham (Mr Jones) and I raised the question of the work capability interviews being undertaken by the Department for Work and Pensions with people with mental health conditions. I do not think that the Minister was in the Chamber at the time, but we suggested that it would be better for the DWP to have access to those people’s medical reports rather than conducting rather bald interviews. Would the Minister be prepared to undertake discussions with the DWP about the treatment during those interviews of people who suffer from mental health conditions?

Oral Answers to Questions

Jeremy Corbyn Excerpts

Tuesday 26th February 2013 Commons Chamber

[Anna Soubry]

Is it not remarkable to have criticism of a reorganisation from someone who supported a Government who had nine reorganisations in nine years? The sexual health strategy document is very important, which is why we are working hard to ensure that it is absolutely right. I re-wrote a large section to ensure that it will deliver—[Interruption.] I do not know why the hon. Member for Hackney North and Stoke Newington (Ms Abbott), from a sedentary position, says “Ah.” It is an important document and we want to get it right, and I am sure she will welcome it when it is published. However, let me make it clear: any delay in the document is not preventing rightful commissioning at a local level. I saw that yesterday when I went to Bedford and met the Brook organisation and the Terrence Higgins Trust, which have long been engaged, certainly in that county, in a tendering process from the local authority to continue to deliver excellent services.

[Jeremy Corbyn (Islington North) (Lab)]

5. What recent discussions he has had with the Whittington hospital on the proposed disposal of its assets and reductions in medical and non-medical staff.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

This is a matter for the local NHS, in particular the Whittington Hospital NHS Trust. Neither the Secretary of State nor the ministerial team have met with the trust recently on this subject.

[Jeremy Corbyn]

That is a disappointing reply from the Minister. Is he aware that the Whittington is a successful, popular, local district general hospital, yet, as part of its application to become a foundation trust, it is proposing to: sell off a quarter of its land; make 500 of its staff, including many nurses, redundant; and reduce the number of beds to 177, roughly half the current figure? This is, apparently, to provide a better service to the community, a point totally lost on the thousands of local people who are angry at the reduction in their hospital services. They see it as a prelude to its ultimate closure as a district general hospital with an A and E department. Will the Minister take an interest and perhaps intervene to protect a very good local hospital from this not very sensible plan?

[Dr Poulter]

The hon. Gentleman is right to highlight the fact that the trust has handled this issue badly at a local level, but, as he will know, decisions about local health care reside with local trusts. The point is this: if we look at the plans, the trust is talking about selling off land that is mostly not used for clinical purposes and reinvesting that money in front-line patient care: investing £10 million in improving the maternity department, which has already benefited from £750,000 from the Government only this year; £2.9 million in the same-day treatment centre to support A and E and treat patients faster; and £1.9 million for a new undergraduate education centre and library. Those assets are being sold off to directly influence and improve patient care, which has to be a good thing.

Accident and Emergency Departments

Jeremy Corbyn Excerpts

Thursday 7th February 2013 Commons Chamber

[Mr David Lammy (Tottenham) (Lab)]

Twelve years ago I sat where the Minister is sitting, when I was the Under-Secretary of State for Health. I had responsibility for accident and emergency services in particular, and I want to impress on her that she has power to respond to what is being said in the House today.

All Members will understand that the NHS does not stand still. Reconfigurations are necessary. Changes are necessary. I was born in a constituency that had a wonderful hospital called the Prince of Wales; it no longer exists. In the Roehampton part of London, there was a hospital; it no longer exists. Things change. In London we have seen changes to stroke services. It is possible that someone in an ambulance, having been unfortunate enough to have a stroke, will drive past a hospital to get to another hospital, a centre of excellence. That was a configuration that was carried out with great consensus across London. I pay tribute to Richard Sumray, who was chair of the primary care trust in Haringey and led the consultation on changing stroke services in London.

The Minister has heard deep concerns expressed about the changes proposed in every area of our capital city—deep concerns about King George hospital in the east and about the much loved hospital in Lewisham in the south. No one can understand why Lewisham should pay for problems in an adjoining area, as currently proposed. We raised concerns about the problems in the north. I will refer briefly to the Whittington, although my hon. Friend the Member for Islington North (Jeremy Corbyn) is in his seat and will major on that. We have heard about Chase Farm and about pressures deep in the south, in St Helier and the Croydon area, which were described by my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh). We have also heard about concerns in the west of London around Ealing. That is unprecedented.

[Jeremy Corbyn (Islington North) (Lab)]

Does my right hon. Friend accept that one problem is that London’s population is rising, health inequalities are rising, and health demands are rising among poorer people? Although I understand all the arguments about putting services in the community, if hospitals are closed, many desperately poor and ill people will not be properly served.

[Mr Lammy]

My hon. Friend makes the point beautifully. Let us look at the demographics of London. The Mayor’s London plan estimated London’s population to be 7.8 million. The census later showed us that it was 8.17 million at least. The London plan assumed that the population would break 8.5 million in 2027. We now believe that it will exceed that figure in 2016. By 2031 there will be 9.5 million people living in our capital city. The areas marked for growth are the upper Lea valley—Chase Farm; the Metropolitan line corridor, with nine A and E units now turning into five; and the south-east of London, where Lewisham is based. There will be 9.5 million people using services that the Health Secretary is seeing shut down. There are huge concerns.

I sat in the Minister’s seat. That was after the terrible winter flu epidemics in the late 1990s. At that point the Whittington hospital in north London was at the epicentre of a public storm because of the bed waits and other long waits. My job, set by the former Member for Darlington who was then Secretary of State for Health, was to ensure that that four-hour wait was a reality across our country. I would sit with chief execs and we would go through the so-called sitreps to ensure that those hospitals were meeting the four-hour waiting target. That was the key element of my job.

I decided to look at the sitrep for the past four weeks across London. There is a target, and if hospitals are doing badly they are flagged as red, while if they are doing well and meeting the target, they are marked as green. I was startled. Ealing, Hillingdon, Imperial, North West London Hospitals, West Middlesex, Barnet and Chase, Whittington, Barking, Guy’s and St Thomas’, King’s College, Lewisham, South London, Epsom and St Helier, Kingston, Croydon and St George all currently fail. Yet it is proposed that we can lose many of our A and E departments—eight across London—at this time. It does not make sense.

This is a health service in London that we look to when a helicopter falls out of the sky or when bombs go off in Canary Wharf or on the underground. This is an A and E service that we look to following riots. I remember the A and E serving our police officers on the first night of riots in my constituency. Londoners will be very concerned indeed that this debate is being framed and structured in this way at this time, with the lack of consultation described so well by my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock).

I was staggered when I found out about the proposed changes to Whittington hospital in Camden New Journal. In November, I had a meeting with the chair and the chief executive, with other Members of Parliament, and we found out that a third of the hospital was to be sold off, that it was apparently to be totally reliant on community services, that it was to lose 500 jobs, and that the people of north London would again have to fight to retain the hospital that they loved—a hospital in my constituency in which my two sons and I were born, and which has been served particularly by nurses from the Caribbean.

Londoners are concerned and Londoners will fight. The Minister has the power to act to put an end to the disarray that we are now seeing across London, and I ask her to do so.

--- Later in debate ---

[Jeremy Corbyn (Islington North) (Lab)]

I will try to be as brief as possible so that the debate can be properly concluded.

This debate goes to the heart of what the NHS is about. Many Members of Parliament are deeply frustrated about health plans being hatched in their constituencies, but they have very little power to influence events. The health service is being atomised by a large number of private interests through private finance initiatives, and by a large number of trusts with competing interests. We need a properly planned health service rather than the internal market and competition, which are at the heart of so many of our problems.

If the hon. Member for Enfield North (Nick de Bois) were still in his place, I could tell him something that would make him even more depressed about the future of Chase Farm hospital. As a former member of the late Enfield and Haringey area health authority in the 1970s, I recall debates on whether Chase Farm should be closed. There are agendas—colleagues will recognise such agendas all over the country—that live on beyond past directors, trusts and reconfigurations: somebody always has an aspiration to close something and centralise something else. If hon. Members think politics in the House of Commons is robust, they should try NHS politics, which is far more robust and nastier than anything we experience here.

I congratulate my hon. Friend the Member for Ealing, Southall (Mr Sharma) on opening and securing this debate, and on the campaign he is running on behalf of the people of his constituency. Many Members are involved in that campaign in west London and the one in south London. What is going on in London is outrageous. I ask the House to consider what my right hon. Friend the Member for Tottenham (Mr Lammy) said. London has a fast growing population, great health inequalities and poverty, and a fast growing number of people in the daytime: the population of central London goes up phenomenally during the day because of people commuting to work, going to cultural or sporting events, or simply passing through the capital city. If we start closing A and E departments and saying that everything should go out into the community, and thus that hospitals can be reduced and closed, we are making the future very dangerous for our communities.

As the House is well aware, I represent Islington North. The Whittington hospital is in my constituency. Anything I say about the hospital is not a criticism of it or its wonderful staff—I absolutely support them and their work. Some three years ago, we discovered that the A and E department was due to be closed. As ever, there were denials all over the place. I tell the hon. Member for Morecambe and Lunesdale (David Morris) to be ever so sceptical when told that an A and E department is not closing, because closure is probably in a plan somewhere.

We exposed the plan to close the Whittington A and E and eventually had the most bizarre general election rally ever in 2010, when the right hon. Member for South Cambridgeshire (Mr Lansley), the hon. Members for North Norfolk (Norman Lamb) and for Hornsey and Wood Green (Lynne Featherstone), my right hon. Friends the Members for Holborn and St Pancras (Frank Dobson) and for Tottenham, and my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) and I were on a platform pledging to save the A and E department, which was duly saved. However, time moves on. The hospital wants to become a trust and has begun putting together a financial package, to which my right hon. Friend the Member for Tottenham referred. The package involves the sale of a quarter of the site—apparently, £17 million is to be made from that—the loss of 500 jobs and a reduction in the number of beds in the hospital to 177, which is about half what it was five years ago.

We asked whether an A and E department with a hospital of only 177 beds behind it was viable. Is that not a plan to remove the Whittington as an overall local district general hospital with an A and E department in future? The Camden New Journal and Islington Tribune reported on this with great alacrity last week. I congratulate Tom Foot and all those who put the story together, because I suspect the issue would not otherwise have reached the light of day. At a public meeting next Tuesday, friends, neighbouring MPs and many others from the local community will be questioning the chief executive and others from the hospital, and taking part in a big campaign to protect our hospital.

We all face issues of health care. I think there is a consensus that we all respect and value the principles of the national health service, but if we allow buildings to be sold off and A and E departments to close, we will end up with the health service becoming a service of last resort and with the promotion of private medicine at the expense of the NHS. We will end up with much poorer societies and much greater health inequalities, and that is in nobody’s interest. Let us get control of this in a democratic way, so that we can control what goes on in the health service in our name.

NHS Commissioning Board (Mandate)

Jeremy Corbyn Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

My hon. Friend, as a GP, will recognise from the mandate that a lot of the improvements that we need in the NHS are in primary care. The budget for the NHS is protected, but demand for services is going up, so we need to make these changes. I will give her one example where I think that this is particularly important. The number of hours it will save GPs if the majority of prescriptions are ordered online, which does not happen at the moment, could transform life for more than 8,000 GP surgeries up and down the country.

[Jeremy Corbyn (Islington North) (Lab)]

One of the great problems the NHS has is the millstone of private finance initiative costs that are so damaging to so many hospitals. The other millstone is the huge profit made by the private sector on contracted out and privatised services. Is it not time for the Government to give a clear directive to the NHS to employ its staff to deliver its services and borrow money in the traditional way to build new facilities, so that public money goes into a public service and the public are not lining the pockets of the banks and private health providers instead?

[Mr Hunt]

I hope we can move beyond the debate about public good, private bad and private good, public bad that has dogged the NHS for many years. I believe there is a role for the independent sector and the voluntary sector. Of course, the primary role will be for the traditional NHS. However, when the private and voluntary sectors are used will not be a matter not for politicians or parties; but for local doctors on the ground. I think that in the vast majority of cases, they will want to use and contract with traditional NHS services, but it is important that they have the choice to do what is in the interests of the patients for whom they are responsible.