Amendment 5

Part of Health and Care Bill - Committee (Day 1) – in the House of Lords at 5:45 pm on 11th January 2022.

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Photo of Lord Patel Lord Patel Chair, Science and Technology Committee (Lords), Chair, Science and Technology Committee (Lords) 5:45 pm, 11th January 2022

My Lords, I will speak to the amendments in the name of my noble friend Lady Hollins. I have put my name to several of her amendments and I will speak to them all but, before I do so, I pay a very special tribute to her. For decades now, she has fought hard to improve the care of people with mental health and learning disabilities. Any progress that has been made has been to her credit, and any progress that we may help to make will not be ours but hers. We should try to help her.

On 8 February 2012, this House voted to put into legislation that mental health should be given parity of esteem with physical health. It was the only amendment of the 2012 Act that was carried, by a very narrow margin, as the then coalition Government had a big enough majority in both Houses. I remember apologising to the noble Earl, Lord Howe, who was the Minister taking the Bill through the House, for moving the amendment—I do not know why. He looked pretty confident, as he should have been because I was not confident; but I had moved the amendment on behalf of my noble friend Lady Hollins because it was her amendment. It just so happened that she was not able to be here; she was advising the Vatican at the time. Despite that, and to give credit to initiatives by NHS England and other NHS bodies, progress has been made—but it has been slow.

I declare an interest. I hold an honorary fellowship of the Royal College of Psychiatrists, which I am very proud of. In my time as a high-risk obstetrician, unfortunately, I had to look after women who suffered from severe puerperal depression and I can testify to how serious a mental condition it is.

The mental health sector faces many challenges, from growing demand and staff recruitment and retention to meeting investment standards set by commissioners that it cannot meet. Many of the challenges are rooted in the historical disadvantage suffered by the mental health sector compared with physical health provision, and the stigma attached to it. Although support is growing, the sector still operates in the context of a care deficit, which means it is accepted that not all those needing help and treatment will be able to access it. We as a society accept that. We would not accept it if it were cancer, heart disease, hypertension or anything else, but we accept that people with mental health conditions may not get the care.

The way mental health is funded, commissioned and paid for leads to the sector’s structural disadvantage. Unless this is addressed, mental health will not have parity of esteem with physical health. There is an important point to make in terms of aspirations around meeting the needs of those with mental health problems which do not apply to physical health, and the Government accept that. For example, the aspiration is to increase access for only 35% of children and young people with a diagnosable mental health condition by 2021. That time has come and gone and we have not met even the 35%. To say that we as a society accept that only 35% of children and young people with a diagnosable condition will be able to be cared for is like saying to cancer patients, “Yes, we know you have cancer, but I am sorry, you do not fit the 35% that we are going to treat.” How can that be right?

The Government’s own figures suggest that, a decade after the scheme was launched, only 15% of children will be able to access these services. Apart from lack of access to care services, mental health trusts are also in need of capital investment. Mental health trust hospitals are in a pretty poor condition. Many have reported serious patient safety issues, with poor infrastructure, yet government plans to fund new-build hospitals do not include any in the mental health sector. The Covid-19 pandemic has further added to the pressure on mental health services, with the full impact still to come. It is a worry that more children and young people are presenting with mental health problems directly related to the pandemic, or so paediatricians are reporting.

The need for reinstating parity of esteem for mental health is even more important now than ever before, with increasing levels of complex mental health needs, growing unmet needs and a pandemic that has affected the young and healthcare workers—and we do not yet know what the mental health effects will be on those who have recovered and are suffering from long Covid health effects. It is therefore right that the Bill reinforces the need for NHS England, ICBs, trusts and foundation trusts to all have a statutory duty upon them to work towards achieving parity of esteem between mental and physical health. In my view, the issue is far too important to miss the opportunity to have it on the face of the Bill. I hope the noble Earl, Lord Howe, will not rely on a vote this time, but will accept the amendment in the name of my noble friend Lady Hollins, to which I have added my name. If the Minister is minded not to, I hope that, at the appropriate time, my noble friend will seek the view of the House. I will support her.