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Sir Nicholas Winterton (Macclesfield) (Con): Will my hon. Friend give way?

Mr. Lansley: No, because I have to finish. I beg my hon. Friend's pardon, but I have to conclude my speech.

We need to be vigilant about mental health service cuts because there is a major risk. Not only has there been less of a priority for mental health services than for other services, but with PCTs having to pay acute hospitals dramatically increased costs and having no choice but to pay for the GP contract, it is mental health services such as community hospitals that are bearing the brunt of the reductions in services.
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We must look for a positive change in the future, in terms of priority and of the mental health legislation, which I hope we will have an opportunity to debate in substance when the new Bill is published. However, it must be a Bill that has neither a broad-ranging definition of mental disorder nor a broad-ranging definition of medical treatment, while giving an opportunity for community treatment orders to be imposed on a widespread basis. There are many people—particularly from the black and minority ethnic communities—who know that they are far more likely to be the subject of detention and who fear that the extension of such orders in the Bill will lead to widespread assumptions that they can have community treatment orders imposed upon them.

There is a major risk with the legislation that instead of achieving greater safety for the community, it will undermine compliance and support for patients in the community. Patients will not wish to present to mental health services and we will end up with patients untreated and the community less safe. That is the risk with the Government's legislation.

What do we need for the future of mental health services? We need the Bill to be published in a way that is geared to the positive treatment of patients, encourages compliance with treatment and supports clinicians in what they have to do, rather than taking the Home Office approach of coercion. Mental health services need greater priority and I want the Minister to tell the House that the increase in mental health resources will match the increase in NHS resources as a whole. We need to bring mental health more into the mainstream, so that GPs have greater access to mental health budgets for their patients and more responsibility for seeing the whole of the mental health patient pathway, rather than their being, as at present, more or less forced to abdicate responsibility and hand it over to mental health trusts.

Patients need more choice. At the moment there is no "choose and book" for mental health patients. Indeed, the Government have also virtually given up on direct payments for mental health patients. Mental health patients do not have control when, sometimes, their exercising greater control over the management of their care can in itself make a major contribution to the way in which they can make progress.

We must have dignity through the Bill, we must have no discrimination and we must have support for carers. At the moment, many carers who are supposed to have annual appraisals very often do not have an appraisal of their needs. We need them to be supported. We need all of that, and we need more. However, what we need most of all is to understand that the stigma of mental illness is completely misplaced. All of us are at some risk of mental illness at some time in our lives and we would not want that stigma to be applied to us. We would wish those services to be available for us if we needed them, so we should do no less for our constituents.

4.3 pm

The Minister of State, Department of Health (Ms Rosie Winterton): I beg to move, To leave out from 'House' to the end of the Question, and to add instead thereof:

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The Secretary of State for Health has been taken ill and apologises to the House for being unable to move the amendment.

As the hon. Member for South Cambridgeshire (Mr. Lansley) said, one person in four will suffer from mental ill health during their lives. Mental ill health can have a devastating effect, not just on individuals but on their families and society as a whole. Social exclusion, discrimination and stigma add to the suffering. Less than a quarter of adults with long-term mental health problems are in work. They are nearly three times more likely to be in debt, and can struggle with basic requirements such as transport or decent housing.

More than 1 million of the 2.7 million people claiming incapacity benefit list mental or behavioural conditions as their main disability. It has been estimated that mental illness costs the country up to £25 billion a year—in other words, 2 per cent. of gross domestic product. That is why this Government have recognised the importance of mental health to the well-being of the whole nation, not just of individuals. Along with cancer and coronary heart disease, mental health is one of our top three health priorities.

By 1999, within two years of taking office, we had published the national service framework for mental health—a ground-breaking and ambitious 10-year programme of reform and investment for mental health care in England.

Miss Julie Kirkbride (Bromsgrove) (Con): I recognise that the Government have spent more money on mental health services. The Worcestershire Mental Health Partnership NHS Trust invested money in providing a home care service and we are very grateful for that, but the downside is that the Government are now saying that we must live within our original budget. The result is that mental health care in-patient beds are being cut to make the figures add up. Can the Minister explain why that is happening?

Ms Winterton: If the hon. Lady will allow me to make a little progress, I will come to some of the points that have been made about the financial situation in mental health and the effect on trusts themselves.
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Mr. Devine: My hon. Friend will be aware that I worked as part of a primary care psychiatric team when the Conservatives were in power. They introduced a policy called care in the community, which was in a fact a con in the community, and led to many psychiatric patients wandering around city centres throughout the United Kingdom. Since then, have we not introduced a co-ordinated strategy consisting of investment not just from the health service, but from local government and the voluntary sector?

Ms Winterton: My hon. Friend describes very well the direction in which we are travelling, and it is important that we have such support in the community; we need input not just from the health service but from local government and the voluntary sector. I have seen some very good examples of the three working together to make an incredible difference not just to people with mental health problems, but, crucially, to those who support them—their carers, families and friends. Such support in the community is vital.

Sir Nicholas Winterton: I am grateful to my namesake for giving way. Will the Minister not express some concern about the over-rapid closure of mental hospital beds, which has caused huge problems not only for the mentally ill who really should be accommodated in hospital, but for their families and the community? Community care has an important role to play, but have not too many hospital beds been closed? Will she consider that issue, and in particular the proposed closure of acute mental hospital beds in east Cheshire by the Cheshire and Wirral Partnership NHS Trust?

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