Childhood Obesity Strategy: Chapter 2

Wera Hobhouse Excerpts

Monday 25th June 2018 Commons Chamber

[Steve Brine]

It was a pleasure to visit my right hon. Friend’s constituency to see how Bexley Council is using its power, money and public health grant—the council made it very clear to me that it would like more, and my right hon. Friend is a very good advocate on the council’s behalf—to bring forward a whole community response like the one I saw in Amsterdam. I would like to see much more of that in England.

[Wera Hobhouse (Bath) (LD)]

We have heard that obesity is caused not only by the wrong food but by a lack of exercise. Far too few children walk or cycle to school. Will the Minister engage with all our schools to make sure we have proper, realistic travel plans in place so that many more children walk or cycle to school?

[Steve Brine]

Yes. The Daily Mile happens when children are in school, but getting to school is important. I work with Sustrans, a charity, quite a lot in my constituency, as I am sure many Members do. It works to help children to cycle and scoot to school. That is very important, and the hon. Lady is right to raise it.

Oral Answers to Questions

Wera Hobhouse Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Hunt]

I sincerely hope so, because Scottish NHS patients are currently 30% more likely to wait too long for their elective care.

[Wera Hobhouse (Bath) (LD)]

What comparison has the Minister made of the cost of preventing children and young people’s mental health issues by tackling adverse childhood experience in the first few years of life, rather than letting them develop into much costlier issues for school-age children?

[Jackie Doyle-Price]

The hon. Lady will be aware that there is much work going on in this area. We are clear that we need to tackle these issues in schools, which is in the Green Paper, but more support also needs to be given in the early years. We are looking at how we can do that.

Oral Answers to Questions

Wera Hobhouse Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Speaker]

Some young people are mothers and do have mental health problems, upon which important matter the hon. Member for Faversham and Mid Kent (Helen Whately) has Question 19, which, sadly, will not be reached. If she wishes to give the House the benefit of her thoughts now, she is most welcome to do so, but it is not obligatory. [Interruption.] We will get her in later.

[Wera Hobhouse (Bath) (LD)]

Given that children of mothers with perinatal health problems are at much higher risk of developing mental health problems themselves, why does the Government’s Green Paper on mental health not address prevention in respect of perinatal health?

[Jackie Doyle-Price]

As I have said before, the proposals in the Green Paper on children and young people’s mental health were very much focused on what we were going to be delivering through schools. Alongside that, we have a very ambitious programme on perinatal mental health, where we are spending an extra £365 million on delivering both acute care and more support in the community. Today, I have just announced the second wave of that funding.

Mental Health Act: CQC Report

Wera Hobhouse Excerpts

Tuesday 27th February 2018 Commons Chamber

[Jackie Doyle-Price]

Clearly, if we can determine the causes of the increase in mental health detention, that will become part of the toolkit that we use to tackle the issue. This is one of the things that we are asking Sir Simon Wessely to look at. There are anecdotal examples of why this might be happening, but the fact that we are seeing higher rates of detention among the black community and among women raises some interesting questions that will bear further examination. I recognise my hon. Friend’s point completely. Good medical practitioners will use detention under the Mental Health Act only as a last resort, and we must ensure that that good practice is spread as far as possible.

[Wera Hobhouse (Bath) (LD)]

An acute mental health facility in my constituency has been forced to close because refurbishment would be too expensive, and patients are forced to travel a long way outside Bath. Is not a local facility much better suited to treating mental health problems than a facility that is many miles away, particularly because carers are a long way away as well?

[Jackie Doyle-Price]

Generally, I would say that local facilities were better, but there is also a tension between a local facility and a good facility. It is better that patients should get the best possible support rather than the closest possible support to them. That is a balancing act, and it is something that needs to be determined by local commissioners.

NHS Continuing Care

Wera Hobhouse Excerpts

Monday 27th November 2017 Commons Chamber

[Norman Lamb]

I am aware of that. Often there is no change in such people’s condition, but sometimes their condition deteriorates. Sometimes the cost is pushed on to the local authority, but sometimes it is pushed on to the family, which is another very serious concern.

There are also a great many complaints about the process that is used. There are complaints about evidence being ignored, which can result in a judgment that someone is ineligible for NHS continuing care, and about professionals lacking an understanding of the condition that they are supposed to be considering. A survey conducted by the Continuing Healthcare Alliance found that 66% of people felt that professionals knew little about the condition that was under consideration. More seriously, there were allegations that medical opinions were being ignored. The BBC heard from three health workers who revealed, effectively as whistleblowers, that medical opinions were actively ignored as part of the process.

[Wera Hobhouse (Bath) (LD)]

It took one of my constituents several months and many phone calls even to receive an assessment for her relative. When she finally managed to receive it, the nurse on the day said that it was unlikely that continuing healthcare would be provided. Does my right hon. Friend agree that treating relatives in such a way when they are already going through a very difficult emotional time is unacceptable, and that staff should be given training before undertaking such assessments?

[Norman Lamb]

I do agree. The problem is compounded by the long delays that people have to face, often at very stressful times when they are wondering whether they will have to sell a home to pay for care and have no idea what the outcome of the process will be.

There are a number of cases around the country in which the costs of packages have been capped, with top-ups required from relatives. A growing number of clinical commissioning groups are applying a cap to what they will pay for home support packages above the cheapest care home alternative. That is really insidious. At the extremes, it is reasonable to recognise the pressures on public finances but, as the BBC reported on “You and Yours”, 19 CCGs refused to pay for home care packages if the costs were 10% higher than the costs of a care home. There are many cases in which couples who may have been married for decades are suddenly forcibly separated. What are we doing? That is inhuman, and, as I have said, it breaches a human right—the right to a family life.

Mental Health Units (Use of Force) Bill

Wera Hobhouse Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Mr Reed]

I completely agree, and I am delighted that the National Autism Society fully supports the Bill and its provisions.

I was talking about the number of patients who have died following the use of restraint, and the many more who have been seriously injured. Government guidelines say that face-down restraint is so dangerous it should not be used at all, but it was used over 9,000 times in the last year alone, including 2,500 times against children as young as seven. People who have been restrained talk about the experience with horror. They say that it is frightening, painful and humiliating, and they feel stripped of their dignity. In the words of one woman:

“It made me feel like a criminal, like I had done something wrong, not that I was ill and needed to get better.”

Statistics from the campaign group Agenda show that women are more likely to be restrained face down on the floor than men. Up to half of all women in mental health hospitals have been physically or sexually abused by men. Subjecting these women to face-down restraint by groups of men adds to the trauma that in many cases led to their mental illness in the first place.

It is difficult to understand clearly from the existing data what exactly is going on. There is no standardised way of recording why, when or how restraint is used. However, from their own data, there appear to be wide discrepancies between mental health providers. Some restrain as few as 5% of patients, while others restrain over 50%. There is no good reason for that variation.

[Wera Hobhouse (Bath) (LD)]

Does the hon. Gentleman agree that it is now time for each provider to publish, correctly and robustly, the data available, and should not the Minister make a commitment to the publication of the data?

[Mr Reed]

I agree, and I very much hope that the Minister will make such a commitment today.

There are fears about unconscious bias in the mental health services. The Angiolini review, a very important review published earlier this week, notes how a disproportionate number of people from black, Asian and minority ethnic communities have died after the use of force in custody more generally. Black people are four times more likely to be sectioned than white people. If we look at the faces of the people who have died after severe restraint in a mental health hospital, we see many more young black faces than in the population as a whole. We need to understand the extent to which assumptions based on stereotypes are causing that, but to do so we need standardised data recording.

What the Bill proposes is simple, but it will make a big difference. It will standardise the way in which the data on every instance of the use of force are recorded, so that we can better understand where force is being used unnecessarily, and the extent of any bias and disproportionality in the system. It will improve arrangements between the police and mental health services, and require the police to wear body cameras when carrying out restraint, unless there are good operational reasons not to do so.

--- Later in debate ---

[Victoria Prentis (Banbury) (Con)]

I am most grateful to have been called first, Mr Speaker, out of the smorgasbord of choice available to you.

It gives me genuine pleasure to rise to support the Bill and to be the first to congratulate the hon. Member for Croydon North (Mr Reed) on his hard work. The Bill stems from great tragedy, but it is always good to see a piece of constituency casework come to fruition and get as far as the Floor of the House. I have enormous respect for the hon. Gentleman, and the all the work he has done with people across the House and outside to get this far. I wish him all the best.

[Wera Hobhouse]

Is it not also time to pay tribute to my right hon. Friend the Member for North Norfolk (Norman Lamb), who as Health Minister introduced the “Positive and Safe” guidelines, a two-year programme with funding to end the deliberate use of face-down restraint in all health and care settings? Unfortunately, those guidelines have not always been followed.

[Victoria Prentis]

I thank the hon. Lady for her intervention. It is very important in these cases to congratulate Members from across the House and to work together on cross-party lines to achieve the consensus needed, so we support those in our communities who need laws like this to keep them safe.

--- Later in debate ---

[James Heappey]

I very much agree. It is interesting to reflect on conversations I have had with police and community support officers in my constituency. The nature of their job means that they understand or know more intimately the community they serve. Very often they have an insight into the mental health of people they routinely see around town who are on the edges of antisocial behaviour or even breaking the law. They can often deal with them very differently because they understand who they are dealing with. The PCSO job description is such that PCSOs naturally seek to de-escalate and deter, rather than enforce the law. My hon. Friend makes an interesting observation, and I certainly agree that it is possible to avoid these circumstances arising as often as they do.

[Wera Hobhouse]

The hon. Gentleman has pointed out the importance of PCSOs, but many police authorities are having to cut those services. Does he not agree that it is regrettable that police services have been cut and that important PCSO services have been taken away from the community?

[James Heappey]

My near neighbour, with whom I share probably the most beautiful diocese in the country, makes an interesting point, which she and I might jointly take up with the police and crime commissioner for Avon and Somerset. The decisions on how PCSOs are allocated are hers. It is not my experience in my constituency that PCSO numbers have been cut. In fact, I have been impressed by the service that we have received from PCSOs in Somerset during my time as MP for Wells. The Bill is not exclusively about the police—it is about the way in which we deal with people with mental health challenges.