(8 years, 7 months ago)
Commons ChamberI thank the Minister for his answer on Kashmir, where I was born. He says that it is up to India and Pakistan to come forward on the matter, but to get a long-term, lasting solution, the people of Kashmir must be given the right to self-determination in accordance with the 1948 UN Security Council resolution. The Prime Minister has said that she supports the rights of the United Nations—[Interruption.]
Order. I indulged the hon. Gentleman and the least he could do was to be brief.
(9 years ago)
Commons ChamberOrder. Just before I call Mr Chishti, the Prime Minister did not say this, but I am going to say it: Members should not shriek at the Prime Minister, or indeed at the Opposition, for that matter. If Members want to try to intervene, they should do so with civility. I call Mr Rehman Chishti.
Thank you, Mr Speaker, and I thank the Prime Minister for giving way. On extremism, Government efforts to tackle hate preachers who poison individual minds and destroy our communities have to be welcomed, and I applaud what the Prime Minister is doing in tackling non-violent extremism. Will he clarify how the Bill will define when an individual has crossed the threshold of what is and what is not acceptable, so that our enforcement agencies and communities know when to take action?
(9 years, 1 month ago)
Commons ChamberCan the Minister confirm that the United Kingdom works very closely with countries such as Pakistan on defence procurement? Will he join me in welcoming the Foreign Minister of Pakistan, who is sitting at the top of the Public Gallery?
Order. First, one should not refer to the place to which the hon. Gentleman referred. After six years in the House, frankly, he ought to know that. Secondly, that was pretty wide of the question.
I call Stephen Phillips. Not—
(9 years, 3 months ago)
Commons ChamberOrder. I will try to accommodate remaining colleagues, but short questions are now required. We are having pithy answers but we need short questions.
As someone who has an open mind and can see competing arguments on both sides, may I ask that we ensure that the information used in the campaign is factually correct? A few weeks ago, a letter criticising the Prime Minister appeared in The Daily Telegraph and the Daily Mail, apparently signed by a local Conservative activist from my constituency, linking the association to the letter, yet no one had ever heard of that person. May I ask that information put forward by both sides is fair, accurate and factually correct so that the British public can decide on the basis of fair evidence?
(9 years, 4 months ago)
Commons ChamberOrder. There is excessive chuntering from a sedentary position from a number of Scottish National party Members, who wanted an orderly hearing for their leader. The hon. Member for Gillingham and Rainham (Rehman Chishti) is entitled to be heard, and I appeal to him to start his question again. Let’s hear it.
Thank you, Mr Speaker. The Prime Minister will be alarmed to hear that a shop in Gillingham selling illicit tobacco was making £25,000 a week, destroying the local economy and damaging people’s health. Nationally, this trade is costing the economy £2 billion a year. Will the Government look at increasing the statutory maximum penalty for this offence to bring it in line with that of supplying class C drugs?
(9 years, 7 months ago)
Commons ChamberI beg to move,
That leave be given to bring in a Bill to make provision about the appropriate level of access to NHS services and accommodation for mothers with perinatal mental illness; and for connected purposes.
The Bill is in addition to my other Bill on the need for accountability and transparency in the commissioning of mental health services. I thank the Minister for Community and Social Care for meeting me and the team from the Royal College of Psychiatrists, led by the president, Professor Simon Wessely. The royal college fully supports the Bills.
We have come a long way in improving attitudes to mental illness over the past few years and I pay tribute to the work of the current Government and the coalition Government for their efforts to improve the quality and provision of care for people with mental ill health. Nowhere is improvement needed more than for women with perinatal mental illness. Perinatal mental illnesses are those that start or are already present during pregnancy and the initial year after birth, which is a time when the risk of mental illness is heightened. Approximately 10% to 20% of women will experience a mental illness in the year after childbirth. In fact, a woman is 33 times more likely to be admitted to a psychiatric ward after giving birth than at any other time in her life. That means tens of thousands of women in England every year.
The consequences of not intervening adequately can be severe. These women might be catatonic or delusional, experiencing hallucinations or suicidal thoughts, and they might be unable to recognise their family or even their baby. Not only is this a traumatic experience for them, but, unsurprisingly, the child’s development can be severely impaired. Tragically, suicide is a leading cause of maternal death associated with approximately 15% of overall deaths in the perinatal period. Although such cases are rarer, some women will kill the child as a result of their illness. Recently, we will all have seen in the media the coroner’s report on the tragic case of Charlotte Bevan, who committed suicide along with her baby. Her parents call for extra perinatal units, and the coroner has called for better services.
Aside from the tremendous human cost, there is an economic cost that far outweighs the cost of providing adequate treatment. A comprehensive economic evaluation conducted last year by the London School of Economics and the Centre for Mental Health calculated that the annual cost of perinatal mental illness to the NHS is £1.2 billion and that the total cost to society is £8.1 billion. Although many cases of perinatal mental illness can be managed by services based in the community, specialised care is required in thousands of cases each year and the mother will have to be admitted to hospital. In such circumstances, typical adult psychiatric wards are inadequate as they are not equipped to allow the baby and mother to remain together and bond. Specialised mother and baby units, which are the subject of the Bill, are designed with that in mind, and research shows that women with serious perinatal mental illness will have better outcomes and better relationships with their infants if cared for in these specialised units.
Guidance from the National Institute for Health and Care Excellence accordingly recommends that mothers who require in-patient treatment for any mental health problem in the perinatal period should be admitted to such a unit with their child. Last month, I had the pleasure of seeing the fantastic work that the specialist units do first hand when I visited the Margaret Oates mother and baby unit in east London. The Scottish NHS is some years ahead of ours when it comes to providing such vital services. Since 2003, the Mental Health (Care and Treatment) (Scotland) Act, which was the inspiration for this Bill, has stipulated that commissioners must provide enough mother and baby unit services so that women with depression who require in-patient admission and their infants can be accommodated together.
There is no similar provision in English law and both NHS England and NICE have acknowledged that there is a significant national shortfall in the provision and distribution of mother and baby units of approximately 60 to 80 beds. As a result, women with serious mental illness are forced either to be admitted without their babies to general adult psychiatric wards or to travel hundreds of miles out of their area to a specialist mother and baby unit. Both have damaging consequences for the mother and baby. Dr Liz McDonald, one of the country’s leading perinatal psychiatrists, calls this
“the bleakest of all postcode lotteries”.
I agree, and the Bill seeks to correct that.
It is important to note that the number of beds needed is not the only consideration. Thought must also be given to where they are located. I recently met Dr Giles Berrisford, a senior perinatal psychiatrist who runs an excellent mother and baby unit in Birmingham. He told me that he has received patients from as far away as Cornwall and that new motherhood, the onset of mental illness and having to travel huge distances for care, being separated from families, friends and communities, are a toxic combination. That is why the Bill will make it a requirement that 95% of the women who need such services should be able to access them within 75 miles. Those figures were recommended to me by experts at the Royal College of Psychiatrists, who strongly support the Bill.
The distance element is innovative. I appreciate it might raise an eyebrow or two in the Chamber, but it is just a different way of conceptualising the rights that already exist. For years, patients have had the legal right to access NHS treatment for physical illnesses within a maximum period of 18 weeks. Unfortunately, this 18-week target would not be relevant to acute perinatal mental illnesses, whereas, as I have explained, the problem is with both the shortage and the location of these services. That is why the Bill thinks slightly differently and uses distance, rather than time, as a basis. This is novel for the NHS, but innovation is not a bad thing.
If we can enshrine a time-based right in law, with no ill effects, why not a distance-based one? It is not unheard of. In the United States, Kentucky, Illinois and Minnesota have laws about the maximum distance patients have to travel for care. Moreover, the financial implications of the Bill are actually positive. An evaluation by the London School of Economics and the Centre for Mental Health estimates the cost of providing the 60 to 80 beds that NHS England and NICE say are needed to be approximately £7 million. I am pleased that the Government have already earmarked extra funding for perinatal mental services more generally. In the March 2015 Budget, a pledge was made to spend £75 million over five years on improving perinatal mental illness services, but no detail has been forthcoming about what it means in practice.
The Bill complements existing Government spending plans, but importantly would serve to compel NHS England to act and focus its attention on these much-needed mother and baby units. When I have spoken to colleagues about the Bill, some have cautioned that it might lead to legal action being taken if these services are meant to be available but are not. I am pleased to say that these concerns are unfounded. The Royal College of Psychiatrists informs me that it is not aware of the similar Scottish law having led to any such cases.
I have also been asked why these services are a special case, deserving of their own Bill. There is a particularly strong argument for action in this case. As we know, the Government have set the laudable objective of giving mental health parity of esteem with physical health, reflecting the fact that unfortunately mental healthcare has lagged behind physical healthcare for so long, and perinatal mental healthcare has lagged behind other areas of mental healthcare and so has been doubly disadvantaged in many ways. This and the consequences of not getting this care right for mothers and babies justify the Bill and the novel approach it takes. As for whether the Bill will set a precedent, that, as right hon. and hon. colleagues will know, is ultimately within Parliament’s control.
In summary, the Bill reflects current NICE guidance and will result in better outcomes for the mothers and infants concerned—
We have a moral duty to make sure the Bill is fully considered and taken on board by the Government.
Order. We have got the thrust of it. I am afraid that people will have to rediscover the habit of staying to time. The hon. Gentleman did so in the last Parliament, but he will need to brush up a little bit. None the less, we are grateful to him.
Question put and agreed to.
Ordered,
That Rehman Chishti, Norman Lamb, Frank Field, Tim Loughton, Fiona Bruce, Tom Brake, Jim Shannon, Valerie Vaz, James Berry, Jeremy Lefroy and Kelly Tolhurst present the Bill.
Mr Rehman Chishti accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 20 November 2015, and to be printed (Bill 78).
I am genuinely sorry that the Chamber is marginally less packed than it previously was, but that is no reflection on the hon. Gentleman or the quality of his petition.
I am very grateful, Mr Speaker. I wish to present a petition about the protection of green spaces at Capstone Valley and areas around Otterham Quay Lane in Gillingham and Rainham.
The petition states:
The Petition of residents of Gillingham and Rainham,
Declares that the Petitioners believe that the importance of Capstone Valley and the green lungs east of Rainham around Otterham Quay Lane should be protected from development.
The Petitioners therefore request that the House of Commons urges the Government to protect these much valued important green areas.
And the Petitioners remain, etc.
[P001527]