Mental Health

Rehman Chishti Excerpts

Wednesday 9th December 2015 Commons Chamber

[Norman Lamb]

I was so pleased that the hon. Gentleman made that point in his speech, and I pay tribute to him for the work he has done. The answer is not simply to have more beds; we should also be reducing the length of stay, which often is not therapeutic for the individual. Getting them into secure housing is central to their health and wellbeing.

[Rehman Chishti (Gillingham and Rainham) (Con)]

Will the right hon. Gentleman give way?

[Norman Lamb]

I am afraid that I cannot give way, as I have very limited time.

At the heart of that inequality is the stigma that still attaches to mental health. We have made real progress in combating that stigma, but we have a way to go. My message to the Government is that the inequality of access is morally wrong. We cannot begin to justify one person not getting access in the way that somebody else does in our publicly funded NHS. I am pleased that the Secretary of State has acknowledged that that is a scandal, but the Government now have to deliver that equality of access. We have to deliver by 2020 the vision that he and I set out last October.

That inequality of access is not only morally wrong, but economically stupid, as many Members have mentioned. The Centre for Mental Health reckons that neglecting mental ill health costs us about £105 billion a year, so continuing to neglect it is stupid and completely counterproductive. If we make the investment up front, we will achieve savings further down the track. I therefore welcome the £600 million that the Chancellor indicated in the spending review would be made available over this Parliament for mental health. That is real progress, but it is not enough. We have to keep arguing the case for genuine equality.

We need to do two things. First, we need to spend the money differently. Many hon. Members have made the point that we need to shift resources away from containing people, often in long-stay, secure settings, to early intervention, recovery and ensuring that there is proper crisis support in the community to stop hospital admissions, which can be so damaging to someone’s wellbeing.

Secondly, up-front investment is needed to fund a programme for comprehensive maximum waiting time standards, including for children and young people, so that there is a complete equilibrium, with equal rights of access to treatment. We published that vision last year, and I hope that the Secretary of State will deliver it. If we give up on the right of equal access, if we give up on ending that discrimination at the heart of our NHS, and if we do not end this historic injustice, we will let down countless families across the country, and that would be an utter disgrace.

[Johnny Mercer (Plymouth, Moor View) (Con)]

I thank the hon. Member for Liverpool, Wavertree (Luciana Berger) for bringing forward this debate. I truly believe that mental health is the social challenge of our generation. Suicide is now the biggest killer of young men under 50 in Britain. Today, 17 of our fellow men and women in this country will take their own lives. This year, thus far, has seen the greatest number of male suicides ever. Suicide kills more young people than any physical illness.

I am currently trying to visit every school in my constituency before the end of the academic year, and the teachers I speak with have been genuinely struck by the dramatic increase in mental health problems in our young people, even since I left school some 15 years ago. With all those statistics, there is also the classic issue of underreporting of mental health conditions, given the stigma surrounding the whole issue, so the real extent may, if anything, be worse.

I believe that how we deal with this challenge will define the future of communities such as mine in Plymouth. I genuinely believe that our approach to mental health is that important. I am determined to win that battle for those in Plymouth who do not have the strength to fight for it themselves. What do we do? It requires a genuine shift in our attitudes—that most difficult of changes to achieve—and a cultural change in how we view and consequently deal with mental ill health.

As the Secretary of State suggested, interventions in mental health can produce the most brilliant results, whether it is the inspirational staff at Marine Academy Plymouth making talking about mental health a part of the school day; South West Trains employing staff specifically to look out for people on the network who are in that 10 to 15-second trance before they throw themselves in front of an oncoming train; or the Royal Marines in Plymouth taking responsibility to talk about mental health away from the medical chain and putting it with the main chain of command in order to totally de-stigmatise talking about post-traumatic stress and other prevalent mental health conditions in young men.

In any of those examples, early intervention and talking about mental health can have dramatic effects, but even that is not enough on its own, and that is the nub of the problem. The interventions that really work are early interventions, so last weekend I started an executive mental health group in Plymouth to determine a way of producing a project similar to one running in Trieste in Italy. Now, city council chiefs, commissioning group heads, police chiefs and healthcare providers will get together every month in the local police station until we have a 24/7 mental health capability in Plymouth to match our 24/7 capability for dealing with physical healthcare.

[Rehman Chishti]

My hon. Friend is making a brilliant speech. Does he agree that local commissioning group spending should reflect commitments made at a national level on parity of esteem for mental and physical health?

[Johnny Mercer]

I completely agree, and I draw my hon. Friend’s attention to the comment made by our right hon. Friend the Member for North Somerset (Dr Fox) on how important it is to ensure that CCGs ring-fence the funding so that we get the parity of esteem that I am trying to establish in Plymouth, and which I know the Government are committed to establishing across the country. It might take five months or five years in Plymouth, but I and the others will keep going until we get there, because this problem is actually too big to fail at.

We must be the Government who turn the corner on this. If we are to be so—rightly—fixated on a healthy economy to deliver our manifesto pledges, we must be equally as committed to our less high-profile commitments to those who will not make as much noise if we fail but whose need is of equal, if not greater, importance.

[Jeff Smith (Manchester, Withington) (Lab)]

I want to make some brief remarks in support of the motion and, just as importantly, to welcome the opportunity to talk about this issue. I do so as someone who, like many Members of this House, and many millions of people across the country, has had my life affected by mental ill health. I grew up in a home where a very close family member suffered from severe depression and had a number of breakdowns. I experienced how it affected the whole family over many years, and not just individual suffering, but the effect on everyday family life of regular hospitalisation and the need for other family members to be home carers. Like most of us probably, I have a number of friends who have been affected by mental ill health, and some years ago a close friend committed suicide as a result of her depression.

I have my own personal experience of mental ill health. Like other Members of the House—I think that there are probably a number of us—I have suffered from depression. As a result of these depressive episodes, I know how it feels to be unable to function normally, or to perform even the most basic everyday tasks, because the weight of the depression is so overwhelming. I know how debilitating depression and other mental ill health can be. It is quite difficult to explain to people who have not experienced that just how debilitating it can be.

I am really heartened that mental health is increasingly being not only recognised, but acknowledged and spoken about. People increasingly accept that it is an illness that should be without stigma or taboo. The more that mental health is discussed, the clearer it becomes that it is something that affects people in huge numbers from all walks of life, all backgrounds and all ages. More and more I think my experience is not unusual.

As a councillor for many years before coming to this House in May, I noticed an increase over the years in the number of people coming to advice surgeries with serious mental health problems. Most of us will have stories about how constituents with mental health problems have been failed by the system. We need to treat those people with more sensitivity and understanding. It is the right thing to do not only for the individual, but for society and the economy.

[Rehman Chishti]

With regard to addressing constituents’ needs, the hon. Gentleman might have seen that I have a private Member’s Bill on perinatal mental healthcare. The aim is that mothers should be able to get that healthcare at that most vulnerable time within a reasonable distance from home—75 miles—because at the moment we have a postcode lottery on where they can get it.

[Jeff Smith]

That is a very important issue, and I thank the hon. Gentleman for bringing forward his private Member’s Bill.

A person recently came to my surgery who had some very difficult personal circumstances that left them unable to work due to mental health issues. They were told by an official at the jobcentre that in order to maintain their benefits they were required to take part in telephone counselling, without reference to their GP. That turned out to be an extremely detrimental experience. It brought up episodes from the past that meant that my constituent was set back in their recovery and is now even further away from the ability to regain confidence and rejoin the workforce.

Because of my personal experience, I understand how depressive illness can blight the life of an individual, but it blights our society too. It is difficult to measure the cost of mental ill health to society, but it clearly runs into several billion pounds each year. That is why cuts to mental health services, particularly preventive services, are a false economy, as the Secretary of State acknowledged in his very good words earlier. We are all seeing the effects of the cuts to social care budgets, to wider council support budgets, and to mental health trust budgets. That is a bad thing at a time when demand is growing and we can finally acknowledge the need for concerted action to tackle this issue, and that is why I am supporting this motion.

I have experienced how medication and physical treatment can make a difference—medication worked for me—but I know that psychological therapy can also make a big difference. It is illogical that the right to one of those can be enshrined in the NHS constitution but not the other. We are making progress on parity of esteem, as I think we can all acknowledge across the House. We now need to go beyond that ambition and that rhetoric and match it with action.

--- Later in debate ---

[Chloe Smith (Norwich North) (Con)]

People deserve better service. For too long some constituents have battled to get the care they need. Many do get excellent care, and I pay tribute to the staff of the Norfolk and Suffolk mental health foundation trust, who dedicate their lives to caring for thousands of patients successfully. I am pleased to see the hon. Member for Norwich South (Clive Lewis) and the right hon. Member for North Norfolk (Norman Lamb) here. I hope they will work with me and meet the trust here next week.

What we should be debating today is how to complete the job of bringing mental health into the light, into equality with physical health and into an era where the norm is of a better service, with every patient getting the treatment they need. I am currently helping constituents who have lived with seeing someone they love go down in a spiral—fast, sudden, out of control and finding it too hard to know what to do. I am concerned about continuity of care, the role of GPs and out-of-county beds. Poor provision of services is not acceptable or just: people deserve a better service.

I want to say three things: first, funding matters; secondly, equality matters; and thirdly, good management matters. On funding, I welcome the steps that the Government are taking to increase investment. The Norfolk and Suffolk mental health foundation trust has been open about the funding shortfall it can see in its books compared, for example, with the Norfolk and Norwich hospital down the road. The chief executive has called for the same system of funding for mental health compared with physical health.

Of the seven CCGs in the region, Norwich devotes the highest proportion of its budget to mental health. Although the overall budget for this year rose by just over 6%, spend on mental health increased by just over 4%.

[Rehman Chishti]

Will my hon. Friend give way?

[Chloe Smith]

I am afraid that I cannot take an intervention.

Norwich CCG notes that its

“spend on mental health has increased significantly in real terms, by almost £2m.”

It believes that

“access to mental health care is consistent across the county in line with demand.”

I welcome the announcement today of transparency measures, which will help us to understand such a statement.

On equality, we need proper parity of esteem between mental and physical health to be made a reality through funding. It is welcome that, in the planning requirements, commissioners are required to invest additionally in mental health.

Finally, good management is also needed, as the Minister for Community and Social Care recently argued in the Eastern Daily Press. By the way, I pay tribute to its campaign on mental health. My trust is in special measures and subject to an improvement plan. We must work with the trust to help it to get better. The staff have made very clear the pressures that they perceive; I also pay tribute to them. The CCG found that the trust was good at caring, but inadequately led. Monitor found that its financial management was lacking. Patients deserve better and other trusts are doing better: Norwich deserves better.