NHS: Mental Health Funding — Question

– in the House of Lords at 3:15 pm on 2nd April 2014.

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Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Shadow Spokesperson (Health), Shadow Deputy Leader of the House of Lords 3:15 pm, 2nd April 2014

To ask Her Majesty’s Government what action they are taking to ensure that NHS England funds mental health in line with the requirement for parity of esteem.

Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Shadow Spokesperson (Health), Shadow Deputy Leader of the House of Lords

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and refer noble Lords to my health interests.

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

My Lords, our aim is to ensure that mental health has equal priority with physical health. We have made this an objective of NHS England. The mandate of NHS England makes it clear that everyone who needs it should have timely access to the best available treatment, including in mental health services. We enshrined in law the equal status of mental and physical health in the Health and Social Care Act 2012.

Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Shadow Spokesperson (Health), Shadow Deputy Leader of the House of Lords

My Lords, that is all well and good, but the noble Earl knows that NHS England has not carried out the instructions in the mandate, and in the tariff for this year it has discriminated in the funding of mental health services. In our most recent debate on this, the noble Earl said that we should not worry about it because clinical commissioning groups will be heavily monitored. But the Government have no power to instruct clinical commissioning groups to make up for this rather perverse decision by NHS England. So I ask the noble Earl: will he not intervene and tell NHS England to reverse this funding policy?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

My Lords, as the noble Lord will know, the tariff for mental health services is determined locally. Having said that, we are clear that it is important that these tariffs and the priority given to mental health are scrutinised very carefully indeed, which is why my honourable friend the Minister of State for Care and Support has said he will do just that in the case of every single clinical commissioning group. If he determines that the plans are unsatisfactory, we as Ministers will work with NHS England, which we do regularly, to ensure that there is indeed that progress to parity of esteem that we all want to see throughout the country.

Photo of Baroness Hussein-Ece Baroness Hussein-Ece Liberal Democrat

My Lords, is my noble friend aware that there is significant evidence that two-thirds of local authorities have reduced their child and adolescent mental health service budgets since 2010, draining money from early intervention services, which, I think he will agree, is short-sighted and stores up problems for the future? Will he ensure that NHS commissioners and councils provide comprehensive services to address the deepening damage caused by further cuts to children and young people’s mental health services?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

My Lords, I share my noble friend’s concern. I am aware that some local authorities are not giving the necessary priority to this very important area of service. It is an area that local health and well-being boards should focus on. Our aim must be to support children and young people with mental health problems, wherever possible, in the community where they live rather than seeing them go into acute settings. Admission to hospital should be a last resort. While we have no direct leverage over local authorities, we shall endeavour through NHS England and joint working with area teams to ensure that this message is not lost.

Photo of Baroness Uddin Baroness Uddin Non-affiliated

My Lords, on this seventh World Autism Awareness Day, will the Minister join me in paying tribute to the parents and campaigning organisations? I ask him, on behalf of the one in 100 autistic individuals in this country who are disproportionately affected by mental illness: given the actual reduction in cash investment in mental health services, do the Government agree that funding for mental health must encompass funding for the prevention of illnesses among those most at risk rather than responding to crises that can be prevented by early intervention?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

I agree with the point made by the noble Baroness. Prevention is much better than having to cure. I pay tribute to those organisations that champion the cause of those with autism. It is a tribute to the previous Government that they published the Autism Act, part of which involves collecting evidence at local level about the population affected by autism and, in that way, focusing minds at local level—principally the health and well-being boards—to direct services appropriately.

Photo of The Bishop of St Albans The Bishop of St Albans Bishop

Given the significant disparity in mental health diagnosis, treatment and outcomes between minority ethnic groups and the general population, what steps are being taken not only to uphold parity of esteem between mental and physical health but to reflect that in the provision of accessible and effective mental health services for all people?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

The right reverend Prelate raises an important dimension of this whole issue. We have been looking at ways to overcome inequalities in access to services, which includes better access for black and minority ethnic communities to mental health services. For example, we know that people from BME communities have been less likely to use psychological therapies. To tackle that, the department is working with the Race Equality Foundation and other stakeholders to understand why that is so and to understand inequalities around access to other mental health services and what can be done to improve that. NHS England is also working with BME community leaders to encourage more people to use psychological therapies.

Photo of Lord Patel Lord Patel Crossbench

Has the Minister any comment on the fact that Monitor and NHS England have recommended, pro rata, 20% greater cuts in funding for mental health services than for acute services?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

I can only repeat what I already said to the noble Lord, Lord Hunt. We have expressed our dismay at ministerial level about that decision and will therefore scrutinise local commissioning plans to ensure that, if cuts are implemented and there is freedom not to do so, outcomes and access to services are not damaged.

Photo of Baroness Pitkeathley Baroness Pitkeathley Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, there are three times as many deaths from suicide as from road accidents. The prescription of antidepressants went up by 10% last year and still only one-quarter of people with a mental illness are in treatment. Are the Government satisfied with the level of funding for preventive and psychological support services?

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

This is the very reason that we have placed such emphasis on the IAPT programme, into which £400 million is going over the course of this Parliament. I am pleased to say that we are broadly on track to deliver a step change in access to those services.