That is a fair challenge. We certainly will. One of the difficulties when there is a financial challenge arrangement is that people retreat into their silos and say, “This bill is your problem.” That is not good enough. We have to be better at challenging them when that happens.
I am very clear that commissioners need to be much more imaginative. There is often a tendency to over-medicalise some of these issues. We have heard today that wrap-around services can be delivered much better by the voluntary sector, with better value for money and in a less intimidating way. That can often be more reliable than relying on in-NHS services.
There are two aspects to homelessness. It can often be symptomatic of a mental health issue or addiction; it is symptomatic of the fact that the person needs help. Equally, it exacerbates the issues that those people have. We have made resource available to tackle the holistic needs of rough sleepers, but again we are treating the problem at the crisis end. People struggling with their housing situation will be more likely to need help, so we need to look at what else we can do to support people at that stage.
I was challenged on when we will end the use of police cells to detain people under the Mental Health Act. I want that to be written on the face of the Act, so that there is a clear binding commitment to do that. We have reduced it by 95% so far with places of safety, so I am confident in saying that detention in a police cell is a rarity these days; nevertheless, we need to guarantee that.
On in-patient care and out-of-area placements, it is clear that people recover more quickly if they are closer to their family and friends. As the hon. Member for Bristol East said, there is sometimes a need for specialist support. We need to look at how that interaction happens with NHS England. Specialised commissioning and delivering a very narrow service will inevitably lead to out-of-area placements, but are we doing more harm than good? Should the best be the enemy of the good? NHS England commissions a quantum; it does not scrutinise individual commissioning decisions. That is more likely to happen if it takes place locally. That is still work in progress.